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Policy Areas

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Image by Markus Winkler from Pixabay

Message from the Office of Long-Term Living (OLTL):

The Commonwealth is working collaboratively — Governor Shapiro’s office and the health hub agencies (Health, Human Services, Drug and Alcohol Programs, and Insurance) — to develop a statewide maternal health strategic plan. We need your help to make it a robust, comprehensive, collaborative, living, and most importantly, active plan.

As you are likely aware, Pennsylvania, like the nation, is experiencing a maternal health crisis.

According to the Pennsylvania Maternal Mortality Review Committee report, in 2020, Pennsylvania residents experienced a pregnancy-associated mortality ratio of 83 deaths per 100,000 live births with large disparities identified. In total, 107 individuals lost their lives during pregnancy, delivery, or up to one year postpartum.

Those numbers are far worse for Black women, where the rate was twice as high at 163 deaths per 100,000.

We also know that women and birthing people with disabilities experience unique challenges and needs on their health journey, so we are inviting you to join us for a 90-minute Zoom listening session where members of the Commonwealth’s health agencies and members of the statewide maternal health strategic plan can engage with you to learn what specific needs you have and how you feel the Commonwealth should address those needs.

We want our strategic plan to address all Pennsylvania women and birthing people, and sharing your voice at this listening session will help inform our plan.

The Zoom listening session is scheduled from 10:00 am – 11:30 am, on Friday, December 6, 2024. Please RSVP electronically by December 1 if you plan to attend. We will send the Zoom link by end of day December 4 to those who RSVP.

Thank you for considering spending 90 minutes with the disability community and state health team members to share your thoughts and needs around maternal health.

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Inglis’s Regional Housing Coordinators (RHC) offer a variety of FREE webinars each month on Zoom, focused on understanding and navigating the affordable housing system and resources for people with disabilities in housing.

If the training times listed below do not work for your organization, you can always use their Information and Referral form to request a private training.

  • Navigating Income-based Housing Options: Tuesday, November 5, at 11:00 am
  • Introduction to Housing Concepts: Wednesday, November 6, at 1:00 pm
  • Assistance Animals Explained: Thursday, November 14, at 12:00 pm
  • Home Modifications: Tuesday, November 19, at 10:00 am
  • Eviction Prevention and Processes: Tuesday, November 26, at 11:00 am
You can register at their training calendar here!

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On Friday, November 1, the Centers for Medicare & Medicaid Services (CMS) released an anticipated Final Rule titled “CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-FC),” which includes three new exceptions for the federal “four walls” rule. At present, the “four walls” rule prohibits Medicaid payment for clinic services when both the practitioner and individual receiving service are outside of the “four walls” of the clinic unless the services are being provided to unhoused individuals (such as through street medicine). The new exception for Indian Health Services and Tribal Facilities is required nationally. The exceptions for Behavioral Health Clinics and Rural clinics are optional. States who determine that their Behavioral Health Clinic and/or Rural Health Clinic populations served meet the four criteria established by CMS (see page 1323 of the final rule) must submit a Medicaid State Plan Amendment (SPA) and receive approval from CMS for these exceptions to be in place for their state.

The Office of Mental Health and Substance Abuse Services (OMHSAS) had been working toward a short-term state level solution to the four walls issue for both Outpatient Psychiatric Clinics and Drug and Alcohol Clinics. However, now that a long-term federal option has been made available, the team in OMHSAS will be pivoting to pursue this newly available federal exception for Behavioral Health Clinics. While OMHSAS is still in the process of developing a timeline for the new State Plan Amendment, their team will be working on this as a top priority, with the goal of having a SPA in place in early 2025.

It has been confirmed that OMHSAS will not be shifting their current enforcement policy around the four walls while they work through getting this waiver in place. RCPA will continue its collaboration with OMHSAS on the process as this move forwards. If you have any questions, please contact RCPA COO and Mental Health Policy Director Jim Sharp.

For additional information, please see the following:

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The Office of Developmental Programs (ODP) has announced a new staff member for their fiscal department. Joseph Shala will be working in the ICF/ID Rate Setting Unit. Joe has an excellent accounting background, including a BS in Accounting from Susquehanna University, and has worked in accounting for a number of companies, including working with Cost Reports for a rehabilitation facility.

Contact Info:

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The agenda for the PD&A meeting includes three of the hottest topics for all providers serving older persons and individuals with physical or intellectual disabilities.

  1. Election Recap – including implications of state and federal results
  2. Secretary Jason Kavulich providing an update on the state Strategic Plan and the Older Americans Protective Services Act
  3. Anna Keith, VP of LTSS at Pennsylvania Health & Wellness, will share a presentation she recently made at the National MLTSS Association, about Workforce Development.

Register here to participate. If you have any questions, please contact Fady Sahhar.

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RCPA has been notified about an interesting brain injury project in development that will benefit survivors, care partners, and professionals.

This project is being led by staff from the University of Washington, with a number of individuals from Pennsylvania working with them. The project aims to develop the National Brain Injury Network — a network connected by a website offering resources, research, and a platform for connection among those with lived experience, care partners, and health care providers. Please use this link for more information about this project.

A very quick survey was developed to gather feedback that will play a crucial role in shaping the site to ensure it meets the needs and priorities of the brain injury community. Participation is voluntary and anonymous. RCPA’s brain injury providers are strongly encouraged to complete the survey and also to pass it on to others within your networks (professionals, survivors, and caregivers). If you have questions or comments, please contact the Brain Injury Network core team.

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