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COVID

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The Centers for Medicare and Medicaid Services (CMS) has released a new Frequently Asked Question (FAQ) document that addresses how their review contractors (Medicare Administrative Contractors, Recovery Audit Contractors, and the Supplemental Medical Review Contractor) will conduct medical reviews after the COVID-19 public health emergency (PHE). Read the FAQ here.

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Counties Face Uncertainty on State Funding for Mental Health Services
By Robert Swift
Capitolwire Staff Reporter

HARRISBURG (Aug. 2) — County officials face some uncertainty in running their basic mental health programs upon learning they get flat funding under the new state budget.

Getting a level amount of state aid means counties will have difficulty reducing waiting lists for services which are widespread, hiring to address staff shortages, and expanding services to meet various mental health needs, said Lisa Schaefer, executive director of the County Commissioners Association of Pennsylvania, on Tuesday.

“We are certainly disappointed,” she said. “There is certainly a lot of good increased funding could do.”

CCAP learned this week there is no increase in that line item as analysis continues with the Fiscal Year 2022/23 budget enacted early last month.

CCAP is part of a coalition that lobbied this year to end level state funding for basic county mental health services for the past 11 years. Gov. Tom Wolf proposed a $36.6 million increase to restore much of a decade-old cut in state aid to county-run mental health programs, but that didn’t make the final budget enacted last month.

Instead the budget provides an additional $53 million for assorted mental health-related needs, including the county programs and state-run hospitals.

“Counties can continue to get grants for mental health programs from the Department of Human Services under the Community Mental Health Services Block Grant (CMHSBG),” said DHS spokesman Brandon Cwalina.

“This funding supports counties in their planning and implementation of mobile crisis services, as well as crisis receiving and stabilization services, that meet national standards for crisis intervention services,” he said.

“It can also be used to support service expansion efforts that ensure a full continuum of community crisis intervention services for anyone regardless of insurer or ability to pay…” said Cwalina. “Counties have until 2025 to use the funds available through these CMHSBG grant allocations to continue the building of crisis mental health service infrastructures across the commonwealth.”

And the budget directs $100 million in unspent federal COVID relief funds for general mental health programs and an additional $100 million in COVID funds for school mental health grants.

The one-time funding comes after lawmakers of both parties said this year that more needs to be done to address mental health issues among Pennsylvanians.

Counties could get a share of that, but Schaefer said annual funding is needed to rebuild the counties network of mental health programs.

The $100 million for general mental health programs can’t be spent until a new special state commission meets and makes recommendations for to how to spend it the money and the Legislature passes enabling legislation.

Whether that happens during the remainder of Gov. Tom Wolf’s term or after a new governor takes office next January is uncertain.

The 24-member Behavioral Health Commission for Adult Mental Health is charged with considering funding for the following areas: telemedicine services, mental and behavioral payment parity, workforce development and retention, expansion of peer support services, crisis services, integration of behavioral support and substances abuse disorder treatment, cultural issues in providing behavioral health care, impact of health on behavioral health, intersection of behavioral health and the criminal justice system, and timely delivery of psychiatric care.

The commission composed of state officials and legislative appointees, is supposed to hold its first meeting by September and hold at least two meetings, one with rural care providers and law enforcement and one with urban or suburban providers and law enforcement.

Counties will have a representative on the commission who can advocate for funding, said Schaefer.

“The $100 million in ARPA funding and the grants available through the CMHSBG are a start, but further investment will be necessary to support growing behavioral health care needs,” said Cwalina. “The Wolf administration is encouraged by the General Assembly’s recognition of ongoing need through their establishment of the Behavioral Health Commission for Adult Mental Health, and we hope the recommendations adopted by the commission will be considered for future investments outside of ARPA funds.”

RCPA has been asked to be a part of the Behavioral Health Commission process and will continue its collective efforts with the Mental Health Safety Net Coalition to create sustainable pathways for all mental health funding platforms in Pennsylvania.

If you have any questions, please contact your RCPA Policy Director.

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Each day we learn more about COVID and try to better understand the rules and guidelines being promulgated for safety. Just a couple of months ago, RCPA announced that we will continue all events virtually. One month later, we announced the ability to hold hybrid events with the option to attend in person. Clearly, that is what we all want, and what we hear from RCPA members.

So, with the Annual Conference approaching at the end of September, we need to again re-evaluate where we are with our approach to such events. And discussion about COVID was obviously a big part of last week’s virtual RCPA Board meeting.
As of today, here are the RCPA guidelines:

  1. Annual Conference. The plan proceeds with a fully hybrid event. You can attend in-person for part or all of the conference and it will all be available virtually as well. We already have many sponsors and exhibitors — and the program, which is excellent, is near completion. The change, however, is that we are requiring on-site attendees — including speakers, exhibitors, etc. — to be fully vaccinated. It is the most responsible approach at this time, and you will be seeing more about this shortly. If you are not vaccinated, or are just uncomfortable attending in person, the virtual event is available and we hope you actively participate, as many did at our successful virtual conference last year.
  1. Meetings. Similarly, each RCPA division director will be discussing with members whether any upcoming meetings will be in person, hybrid, or virtual. Again, all such meetings will require on-site attendees to be fully vaccinated.
  1. Provider Site Visits. One of the hallmarks of RCPA is that staff historically have spent a great deal of time “on the road” visiting with providers for better understanding programs, services, issues, etc. COVID clearly brought that practice to a halt. Of recent, some of these important visits have been reinstated. Moving forward, this will be based on a case-by-case discussion between the RCPA staff member(s) and the provider organization.

The most current federal and local guidance will be followed regarding mask wearing at all events. Having outlined all of the above, we all know it can change again tomorrow. But given the many questions and comments from members on this issue, we felt it important to document the thinking at this time.

Thank you,

Richard S. Edley, PhD
RCPA President/CEO

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