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Mental Health

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PDE and DHS are offering the following policy clarification on the Head Start/Early Head Start vaccination mandate:

PDE and DHS are cognizant of the staffing challenges that many providers are facing. Providers are thus encouraged to work creatively to ensure that children continue to receive a free and appropriate public education during these trying times. In this regard, providers should examine whether unvaccinated individuals may continue to provide services in accordance with an allowable exemption, and, where appropriate, consider whether parental agreement to alternative delivery of services may be prudent.

OCDEL has clarified that this is to include all individuals working with Head Start enrolled children and families, including early intervention and behavioral health. OCDEL further requests that agencies work with Head Start partners to address this requirement and asks for support considerations, including; encouraging staff and contractors to become fully vaccinated; working to identify fully vaccinated EI personnel to support children in Head Start; when possible, working to provide written assurance to Head Start partners to only send fully vaccinated staff and contractors to go into classrooms; and exploring technological solutions to help support children within their Head Start classroom activities and routines.

The United States Department of Health and Human Services (HHS) has implemented an Interim Final Rule (IFR) requiring all staff who work with Head Start/Early Head Start (Head Start) children and families in any capacity to be vaccinated. According to HHS guidance, this includes those individuals who do not have any contact with children. The IFR also requires contractors whose activities involve contact with or providing direct services to Head Start children and families and volunteers in classrooms or working directly with Head Start children and families be vaccinated. The IFR is now understood to apply to all individuals working with Head Start children and families, including but not limited to services provided by Preschool Early Intervention, 0-3 Early Intervention, and behavioral health specialists in Head Start programs, including those provided pursuant to a memorandum of understanding or other agreement by which Head Start programs provide for or permit the provision of such services.

The Federal Office of Head Start (OHS) is responsible for ensuring compliance with the IFR through their identified monitoring processes. PDE or DHS is not responsible for monitoring programs for compliance with this mandate.

Head Start IFR and guidance do allow for exemptions for individuals who are not vaccinated. In the event individuals meet this exemption, OHS has issued guidance regarding circumstances in which unvaccinated individuals may be able to continue to work with Head Start children and their families.

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Capitolwire: Wolf Budget Proposal Spurs Debate on Mental Health Funding
By Robert Swift

HARRISBURG (Feb. 14) — A budget proposal by Gov. Tom Wolf is spurring a new debate about providing more state mental health services during this time of pandemic-related stress.

The governor proposes spending $36.6 million from the taxpayer-supported General Fund in Fiscal Year 2022-23 to restore much of a decade-old cut in state aid to county-run mental health programs.

He would also direct $75 million in federal American Rescue Plan funds for support payments to help keep and hire new employees for qualifying home and community service providers.

A 21-member Mental Health Safety Net Coalition sent a letter Monday to lawmakers asking them to consider the proposed $36.6 million increase as a starting point in budget negotiations.

“The governor’s proposed increase will help offset the loss in purchasing power due to a decade of level funding,” wrote the coalition that includes service providers, hospitals, treatment centers and professional groups. “This money is critical to help counties get back to the effective level of resources they had 10 years ago, but it does not even begin to address all the gaps in our mental health system or surging demand for mental health services as we enter the third year of the global pandemic.”

Not only has the pandemic increased demand for services, it has also led to significant health staff shortages and increases in suicides and opioid deaths, the coalition said.

Also the County Commissioners Association of Pennsylvania issued a statement Monday calling on lawmakers to support Wolf’s proposal. It would restore two-thirds of a 10 percent cut to the budget line item in 2012 if enacted.

“If the funding continues to be uneven with the growing demand, counties will continue to struggle to in meeting the needs of their residents,” said CCAP President and Bradford County Commissioner Daryl Miller.

A key feature of county mental health programs is they are available to the entire community regardless of income, said Brinda Penyak, CCAP deputy executive director.

CCAP made rebuilding a “crumbling” mental health system its top priority this year. For the past six decades, counties have carried the responsibility to provide and contract for a range of community-based mental health services, including crisis intervention, treatment, education and prevention.

“We would strongly support advance planning and (mental health funding) increases that are practical and sustainable to ensure increased system availability for the long term,” said Dr. Kathy Quick, executive director of the Pennsylvania Mental Health Consumer Association while voicing concern that the proposed funding hikes for this year can’t be sustained in the future.

The issue of pandemic-related mental health challenges facing the general population and students as well has been the subject of several legislative hearings during the past two years.

The Senate Agriculture and Rural Affairs Committee held a hearing last month focusing on mental health issues facing agricultural workers. Pennsylvania has received a $500,000 grant from the U.S. Department of Agriculture to provide more resources to support mental health programs in rural areas by linking to national hotline networks and providing education and training, said state Agriculture Secretary Russell Redding at that hearing.

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The next Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting will be held on March 1, 2022, as a webinar from 10:00 am–1:00 pm.

You can register for the meeting here. After registering, you will receive a confirmation email containing information about joining the webinar. Remote captioning and streaming services will be provided; if you require these services, please visit here. If you require another accommodation, including an alternative method for submitting questions or comments about meeting topics, please send an email no later than February 18, 2022, so other accommodations can be scheduled.

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Photo by Markus Winkler on Unsplash

RCPA staff reviewed the Governor’s proposed budget, and while many details still need to be sorted out, RCPA can provide some high-level facts about the proposed budget from the House Democrat Appropriations Committee 2022/23 Executive Budget Proposal At–A-Glance and the Governor’s 2022/23 Executive Budget Spreadsheet. Of note, please see pages 12–13 for the Department of Human Services line items and page 6 for the Department of Drug and Alcohol Programs.

The highlights of the Governor’s proposed budget include:

Education Funding

  • Spending $43.7 billion in state General Funds;
  • $1.55 billion, a 24% increase, in basic education funding;
  • $1.25 billion to be distributed through the fair funding formula;
  • $300 million in Level Up funding to the 100 most underfunded districts; and
  • $200 million, a 16% increase, in special education funding.

Economy

Proposed increase to state’s minimum wage to $12 per hour effective July 1, 2022, including tipped workers, with 50 cent annual increases up to $15 per hour ($74.6 million direct revenue increase).

Protecting the Most Vulnerable

  • $91.25 million ($190.1 million total funds) to increase MA rates for skilled nursing facilities, effective January 2023, to comply with regulatory changes planned for July 2023;
  • $50 million, or a 44% increase to state supplemental programs for aged, blind, and individuals with disabilities, to increase the personal care home state supplement from $439.30 to $1,351.80 per month;
  • $75 million in federal funds to recruit and retain behavioral health providers;
  • $36.6 million to invest in critical county behavioral health services;
  • $15 million in federal funds to stabilize payments to substance use disorder treatment providers and assist with pandemic related expenses;
  • NEW: $14.3 million to increase the monthly Supplemental Nutrition Assistance Program (SNAP) benefit from $20 to $35 for 75,000 to 95,000 seniors and individuals with disabilities;
  • NEW: $280,000 to implement Agency with Choice, preserving the ability for home and community-based waiver participants to choose their worker while allowing workers to obtain the support of an agency;
  • $18.8 million to serve an additional 832 individuals with intellectual disabilities and autism currently waiting for services;
  • $1 million to provide community placements for individuals residing in intermediate care facilities;
  • $1.25 million to discharge 20 individuals from state hospitals through the Community Hospital Integration Project Program (CHIPP);
  • $2.4 million for Department of Aging and Department of Human Services to strengthen older adult protective services (8 positions), create a child welfare crisis response team (4 positions), and support increased regulatory, licensing, budgetary, and administrative functions (30 positions) through increasing complement;
  • NEW: $8 million to extend postpartum coverage for birthing parents eligible for Medical Assistance to 12 months;
  • $15 million, a 77% increase, to implement additional evidence-based home visiting and family support services to 3,800 additional families;
  • $1.8 million to support court-appointed volunteer advocacy; and
  • NEW: $10 million for State Disaster Assistance, a new initiative to provide disaster assistance to individuals and to improve access to safe, secure, and weathertight homes.

In addition to the above proposed funding, the Governor and Democratic legislative leaders support allocating the unused American Rescue Plan funds from last year’s budget to various programs, which are outlined in the Democrat’s American Rescue Plan Act — State Fiscal Recovery plan, to help Pennsylvanians rather than letting the funds be transferred to the General Fund to sit in reserve.

The above information is a high-level overview of the Governor’s budget proposal. The specific line items contained in the Governor’s 2022/23 Executive Budget Spreadsheet are the overall dollars allocated for health and human services. The Department of Human Services (DHS) has not yet released their Budget Blue Book, which breaks down these line items and provides a detailed dollar amount allocated to specific human service programs. We are being told the DHS Blue Book should be available with this specific information at the end of February or the first week of March. Once RCPA obtains the Blue Book and reviews it, we will provide members with a more detailed summary and analysis.

As a reminder, the Governor’s Proposed Budget is just that: a proposal. The General Assembly will now hold budget hearings; a complete hearing list can be found here. The General Assembly and the Governor will conduct budget negotiations after the House and Senate budget hearings conclude to hopefully finalize the Commonwealth’s 2022/23 budget by June 30. If you have any questions, please contact Jack Phillips.

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As someone on the frontlines, you already know that the workforce crisis affecting Pennsylvania’s human services is worsening. Unless lawmakers act swiftly, vital supports for individuals and families will be in jeopardy. Without additional state funding for human service professionals, providers may have no choice but to cut services or eliminate programs due to this increasing shortage of workers.

State government currently has billions of federal dollars and “rainy day” funds that could increase wages to help retain workers and attract and train a new workforce. Yet, even amid this worsening crisis, the money remains unspent as the needs of our most vulnerable residents go unmet.

That’s why we’re taking action — and we hope you’ll join us.

RCPA is partnering with other associations to urge lawmakers to increase funding and support human services professionals, so individuals and families in need get the assistance and care they deserve. View our official press release.

You can help.

  • Visit the coalition’s website to learn how you can help.
  • Follow us on Facebook and Twitter to stay informed of our progress.
  • Share this message with your own network of providers, professionals, and families and encourage them to do the same, using the hashtag #DirectCarePA.
  • Most importantly, TAKE ACTION TODAY. Tell lawmakers to release funding to address the workforce crisis facing Pennsylvania’s health and human services.

As always, thank you for all you do – for the support and care you provide to our most vulnerable residents. If you have any questions, please do not hesitate to contact us. We appreciate your support.

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The Office of Mental Health and Substance Abuse Services (OMHSAS) has just published an FAQ on the Home & Community-Based Services (HCBS) workforce support payments. Any remaining questions may be sent to the RA Account.

Please note that after receiving anticipated payment amounts on the attestation forms that were sent to providers at the locations of qualifying services, some providers alerted us to apparent irregularities in the payment amounts. OMHSAS is pulling our data and rerunning our formulas to ensure that payments are based on proper calculations and a balanced distribution of funds. Revised attestation forms will be sent to any providers who may have been impacted in their total allocation (positively or negatively) with a new due date in early March.

RCPA continues to work with its members and OMHSAS on the attestation and allocation process. Please contact your RCPA Policy Director for guidance or questions.

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