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Mental Health

RCPA has been notified by the PA Department of Corrections (DOC) / Bureau of Community Corrections (BCC) of a new referral process for Alcohol and Other Drugs (AOD) or Mental Health (MH) services for reentrants. This initiative is part of a continued effort to reduce and maintain the Department budget, to streamline services, and to offer consistent and needed programming.

Effective immediately, any referrals made to the BCC for AOD or MH services should be made as a last resort. This includes any inpatient placements as well. It is the responsibility of the person making the referral to find placement through other community resources first, when possible. In many cases, reentrants either have or are eligible for medical assistance. Medical assistance will allow a range of services to be funded under their contracts.

If a reentrant is in need of services, reach out to the statewide single county authority (SCA) helpline first. The number to call is 800-662-HELP (4357). A more complete list of every SCA, every county MH office, and their contact person is being formulated and will be forthcoming in the near future. Until those lists are distributed, please use the SCA HELPLINE number that is provided. It can be a starting point for both AOD and MH services, and inpatient beds in the county.

The correspondence from the Department of Corrections / BCC can be found at this link.

For our RCPA members currently providing these services, please contact RCPA Criminal Justice Division Director Jim Sharp and/or RCPA Drug & Alcohol Division Director Kristen Houser to discuss the potential impact on your services.

On December 24, 2019, DHS announced the approval of the Department’s Good Faith Effort (GFE) Exemption application for the Electronic Visit Verification (EVV) implementation. This GFE does not change DHS’ expectations of providers of personal care services to comply with the requirements of the 21st Century Cures Act. The Department will continue with a soft launch period through June 30, 2020. Throughout this time, providers must begin using EVV and complete any integration and certification activities if they have not been completed already. The Department continues to develop a policy bulletin that will outline additional requirements, including compliance benchmarks for manually edited visits. This bulletin will be released as soon as it is finalized.

During claims processing in PROMISeTM, EVV validation against the EVV Aggregator will continue to be performed and EVV Error Service Codes (ESCs) will set without impacting claim payment. During the extended soft launch period, the expectation is that provider/provider agency/Agency with Choice and Vendor Fiscal/Employer Agent billing staff will note when the EVV edit(s) set and actively make corrections either to the data stored in the DHS EVV Aggregator or the claim itself to ensure errors do not repeat. DHS will be monitoring which EVV edits set and how often.

Regular updates to the stakeholder community will be made on the progress of the implementation. Outreach and technical assistance will be performed based on results and as applicable. As of July 1, 2020, any claims without a corresponding EVV visit or any mismatches between what is found on the claim versus what is found in the EVV Aggregator will be denied.

2020 EVV Implementation Timeline:

  • January 1, 2020: All Providers must begin using EVV for Personal Care Services (PCS).
  • January 2020 – March 2020: All Providers must complete system integration activities with the DHS Aggregator for fee-for-service programs. Providers who are experiencing difficulties in integrating and will not be ready by March 2020 are asked to submit an extension request using this form, documenting the difficulties they are experiencing no later than February 1, 2020. The completed form should be emailed to the EVV resource account.
  • Starting July 1, 2020: Claims submitted for Personal Care Services without a matching EVV visit will be denied.

If providers have not yet completed the necessary steps to implement EVV, please contact the appropriate entity to complete the necessary training and system integration activities.

OLTL and ODP Fee-For-Service Providers

  • The DHS Sandata system training is available for providers electing to use the DHS Sandata system. Providers using the DHS system must complete this training in order to begin setting up their agency accounts and security permissions. Providers may register for the independent web-based training offered through Sandata here.
  • The DHS Aggregator will receive information from Alternate EVV systems being used by providers in fee-for-service programs.
  • Providers using Alternate EVV systems should contact Sandata at 855-705-2407 to complete Alternate EVV system integration activities for fee-for-service programs.

Current Community HealthChoices (CHC) Providers and Aging, Attendant Care, and Independence Waiver Providers

  • If providers are electing to use the HHAeXchange EVV system offered by the Managed Care Organizations (MCOs), providers must work with the MCOs to complete training and other onboarding requirements.
  • Providers using Alternate EVV systems in CHC will need to send their EVV data to the CHC-MCOs.
  • Providers should contact HHAeXchange to complete Alternate EVV system integration activities for CHC.

Tablet on a desk - Questions and Answers

The Office of Mental Health and Substance Abuse Services (OMHSAS) has released an updated version of the Intensive Behavioral Health Services (IBHS) FAQ. Additionally, there will be another FAQ update in early January. Please review the new version as the inquiries include OMHSAS responses on staff training / qualifications, licensing parameters, service delivery, and other key feedback brought forth by stakeholders. The new IBHS FAQ can be found here.

We have been informed that there will be new OMHSAS IBHS bulletins released in December, regarding the prior authorized services in the fee-for-service delivery system and the medical necessity guidelines. All new IBHS information provided will also be reviewed by the RCPA IBHS Work Group.

As the IBHS implementation moves forward, we ask that RCPA Children’s Division Director Jim Sharp be included on questions sent to the IBHS RA account or directly to OMHSAS regional offices. We will continue to maintain our own member inquiry repository. If you have any questions or feedback, please contact Jim Sharp.

As we approach the conclusion of the Governor’s Council on Reform public comment period on December 16, 2019, RCPA would like to ensure that each member has the materials for providing their public comments, feedback, and support. RCPA will be submitting commentary within each policy director’s purview, and we strongly urge your agency to submit your thoughts to the Council, including areas and issues that may not be represented in the current recommendations.

If you would like to send your submissions to your respective policy director for inclusion in the RCPA public comment, please have them submitted by close of business on Wednesday December 11, 2019.

Below you will find the links to important documents relating to the Council on Reform, including the Public Comment Submission Form. If you have further questions, please contact your respective RCPA Policy Director.

  1. Governor’s Executive Order
  2. November 1 Press Release
  3. Recommendation Document
  4. Public Comment Form

Thank you for your efforts and partnership to bring these recommendations to the forefront of your work.

The Office of Mental Health and Substance Abuse Services (OMHSAS) is sponsoring our second annual training series, “Supporting Transgender Clients,” in partnership with the Gender and Sexuality Development Clinic at Children’s Hospital of Philadelphia. Training dates/locations for in-person trainings will be coming soon; once the dates are announced, RCPA will send out an Alert. Dates for the webinar series are available here. Webinar slots are limited; if multiple staff from one location wish to participate, please consider viewing jointly. If you have questions, or would like additional information, please email Jill Stemple or RCPA Children’s Director Jim Sharp.

On Wednesday, November 20, the Office of Mental Health and Substance Abuse Services (OMHSAS) conducted its most recent WebEx, outlining several key areas to the Intensive Behavioral Health Services (IBHS) implementation. The materials for the presentation can be found here.

This presentation provided an overview of the following:

  • Written Orders;
  • Assessment;
  • Training Approval Process;
  • Current Department Approved Trainings;
  • Family Outreach;
  • Medical Necessity Guidelines;
  • Licensing;
  • Enrollment/ Billing; and
  • Rates.

This link will direct you to the IBHS Website on the HealthChoices server. At the bottom of the page is the repository of information on these topics as well as the updated FAQ. The RCPA IBHS Work Group will be reconvening in early December to continue to address implementation issues in conjunction with OMHSAS. If you have any questions or feedback, please contact RCPA Children’s Division Director Jim Sharp.

On October 8, 2019, the Office of Mental Health and Substance Abuse Services (OMHSAS) hosted a statewide webinar to discuss Act 147 of 2004, Mental Health Treatment – Consent to Treatment, Release of Medical Records. The recording of the webinar, along with supporting documentation, can be found here. A frequently asked questions document is also being created and will be available upon completion.

Act 147 has elicited many questions and discussions across our mental health and school-based services committees. We recommend you share this information with your program leadership, perhaps as part of training. We will continue to review Act 147 in our work groups and report out on information and activities as warranted.

If you have any questions or feedback, please submit them to this email and copy RCPA Children’s Division Director Jim Sharp on the correspondence.