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On behalf of its opioid treatment program (OTP) provider members, RCPA submitted comments to the Independent Regulatory Review Commission (IRRC) in support of a final-omitted regulation that would allow an initial physical examination required for prescribing, administering, and dispensing controlled substances through an OTP to be conducted via telehealth under certain circumstances under Pa. 49 Code § 16.92.

This final-omitted regulation would enable the Pennsylvania Department of Drug and Alcohol Programs (DDAP) to grant a statewide exception to 28 Pa. Code § 715.9(a)(4), which today requires Pennsylvania OTPs (called narcotic treatment programs in DDAP regulations) to conduct a face-to-face determination of whether an individual is currently physiologically dependent on an opioid.

IRRC will consider the final-omitted regulation at a public meeting on December 5.

In its comments, RCPA wrote:

“Enabling OTPs to conduct the initial examination required as part of induction into methadone or buprenorphine treatment through telehealth significantly improves and expedites patient access to the gold standard treatment for OUD without sacrificing quality or safety. In a treatment environment where finding qualified physicians, physician assistants and certified registered nurse practitioners is challenging, telehealth bridges a significant gap. Physicians would no longer need to be physically on site at the OTP where treatment is to take place to examine a patient as part of the induction process. Rather, from anywhere in the commonwealth, a physician can examine more patients, who can then begin treatment with medication faster at a facility near their home. In fact, with this final-omitted regulation, OTPs will have the ability to accommodate same-day or walk-in admissions instead of scheduling intake appointments days later.”

The final-omitted regulation, submitted by the Department of State, Bureau of Professional and Occupational Affairs, State Board of Medicine, along with comments in support from the Department of Drug and Alcohol Programs and RCPA, can be viewed on the IRRC website.

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.

To address Pennsylvania’s high maternal mortality rate, the Commonwealth, through a partnership with Governor Shapiro’s office and the Departments of Health, Human Services, Drug and Alcohol Programs, and Insurance, is developing a statewide Maternal Health Strategic Plan. Interested stakeholders are invited to share their opinion through the Commonwealth of Pennsylvania’s Maternal Health Strategic Plan survey, which will remain open through November 4.

The vision for Pennsylvania’s Maternal Health Strategic Plan is a Pennsylvania where every pregnant and birthing person has easy access to high-quality perinatal, birth, and postpartum care that is person-centered, comprehensive, equitable, and affordable and that results in healthy outcomes and long-term good health and well-being.

The Pennsylvania Department of Drug and Alcohol Programs (DDAP) announced the availability of $9 million in funding to expand or enhance recovery support services for individuals in recovery from opioid use disorder (OUD) and other substance use disorders (SUD).

DDAP will award approximately six grants of up to $1.5 million each. Applicants must have at least two years of experience as of July 1, 2024, in providing recovery support services and be able to demonstrate the capacity to provide those services to individuals in recovery from OUD and other concurrent SUDs.

DDAP is placing a focus on health equity as a part of this grant opportunity. Based on a variety of criteria from the Pennsylvania Department of Health’s 2022 overdose death data, DDAP will select two grantees located in Philadelphia, two grantees located in Allegheny County, and two grantees from the remaining 19 qualifying counties located within Pennsylvania with a crude death rate higher than the state average.

Funding for these grants is provided through the federal Substance Abuse and Mental Health Services Administration’s (SAMHSA) State Opioid Response (SOR) IV grant program. The SOR program aims to help reduce unmet treatment needs and opioid-related overdose deaths nationwide through state-by-state allocations.

Read the full press release.

You can send questions electronically regarding the grants and the application process.

Last Thursday (October 3, 2024), the Pennsylvania Department of State’s Board of Medicine submitted to the Independent Regulatory Review Commission (IRRC) a final-omitted regulation that would allow an initial physical examination required for prescribing, administering, and dispensing controlled substances to be conducted via telehealth under certain circumstances under 49 Pa. Code § 16.92. A final-omitted regulation does not require a public comment period and is in essence an expedited process for proposing a regulation change. IRRC will hold a public meeting on November 21 to approve or disapprove the regulation.

This final-omitted regulation would enable the Pennsylvania Department of Drug and Alcohol Programs (DDAP) to grant a statewide exception to 28 Pa. Code § 715.9(a)(4), which today requires Pennsylvania OTPs (called narcotic treatment programs in DDAP regulations) to conduct a face-to-face determination of whether an individual is currently physiologically dependent on an opioid.

In its Regulatory Analysis Form, the Department of State’s Board of Medicine wrote:

“This final-omitted rulemaking amends the Board’s regulations at § 16.92 by allowing the initial physical examination required for prescribing, administering, and dispensing controlled substances to be conducted by means of telehealth for those patients being admitted into an Opioid Treatment Program (OTP) for treatment of opioid use disorder with either buprenorphine or methadone, provided that the health care provider determines that an adequate evaluation of the patient can be accomplished via telehealth and a full in-person physical examination is completed within 14 days after admission to the OTP. This standard is the same physical examination standard utilized as a result of the Bureau of Professional and Occupational Affairs regulatory waiver issued during the COVID-19 epidemic, which proved to be safe and effective during and after the COVID-19 epidemic. This final-omitted regulation also conforms the Board’s regulations to the Federal opioid use disorder treatment standards as the Board does not wish to unnecessarily maintain a more stringent standard than required by Federal law for OTPs given the continued opioid crisis in this Commonwealth.”

In February 2024, the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) published a final rule amending the federal regulations for the certification of OTPs in 42 CFR Part 8. The changes to the federal rules were used temporarily to improve access to treatment during the COVID-19 federal public health emergency. SAMHSA has now made those changes permanent, and DDAP intends to implement the updated federal rules and reduce barriers to treatment, as described in its latest Licensing Alert 07-2024. This final-omitted regulation is part of the commonwealth’s process for aligning with the final rule on 42 CFR Part 8.

The Pennsylvania Department of Drug and Alcohol Programs (DDAP) will host its monthly ASAM Technical Assistance webinar at 10:00 am Monday, October 7. Staffers from the Bureaus of Quality Assurance and Administration, County Program Oversight, and Program Licensure will provide updates, including information about changes to 42 CFR Part 8, impacts to licensing, and how those changes align with the ASAM Criteria.

Past webinars and additional ASAM 3rd Edition resources are available on DDAP’s ASAM Transition page.

If you want to receive email notification of upcoming ASAM Technical Assistance webinars, email DDAP’s ASAM Resource Account.

The following information can be used to connect to each month’s webinar, including Monday’s.

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Meeting ID: 225 792 355 092
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The Pennsylvania Department of Drug and Alcohol Programs (DDAP) issued Licensing Alert 07-2024 today to grant statewide exceptions to narcotic treatment programs (NTP) to expand access to medication for the treatment of opioid use disorder in alignment with the federal government’s Final Rule on 42 CFR Part 8.

The statewide exceptions to DDAP regulations that are being granted will enable:

  • People with less than one year of physical dependence on opioids to be treated at an NTP;
  • Verbal consent to treatment;
  • A wider range of dosages based on physician discretion;
  • Eight drug screens per year instead of 12;
  • An increase in take-home medication; and
  • Clinicians to determine counseling requirements unique to each person’s needs instead of mandatory minimums.

DDAP granted the statewide exceptions using 28 Pa. Code § 701.11, which gives it the authority to do so. Through Licensing Alert 07-2024, DDAP is granting these exceptions if the NTPs comply with the rules in 42 CFR Part 8. There is no need for NTPs to submit exception requests or to inform DDAP they are using these exceptions.

DDAP plans to include the changes to the federal rules when it updates its own state rules.

You can email DDAP with questions about this licensing alert.

Image by Werner Moser from Pixabay

The Pennsylvania Department of Drug and Alcohol Programs (DDAP), through RCPA, is seeking input on its plan to license telehealth-only outpatient SUD treatment providers.

In an effort to regulate unlicensed, out-of-state telehealth providers marketing themselves as addiction treatment providers as well as expand access, DDAP plans to license telehealth-only outpatient SUD treatment providers. These DDAP-licensed telehealth-only providers may provide intake, evaluation, and referral, as well as outpatient, intensive outpatient, or partial hospitalization services via telehealth only, without a physical plant location in Pennsylvania, to individuals who are located in the Commonwealth as long as the provider complies with all applicable federal, state, and local laws.

DDAP will not require the provider to maintain a physical location in Pennsylvania. DDAP also will grant all telehealth-only providers an exception to §709.11(b) regarding the requirement to conduct an onsite inspection for the renewal of a license as part of licensure.

DDAP has also said licensure is no guarantee of payment. Providers that are considering applying for a telehealth-only license should consult their public and private insurance payers to confirm whether they will meet conditions for network enrollment and payment, as DDAP cannot guarantee a DDAP-licensed telehealth-only provider funding or a contract.

Some providers have raised concerns about:

  • The effectiveness and quality of tele-only treatment without an ability for in-person counseling and how it could harm patients;
  • The siphoning of commercial patients from community-based providers and how it would negatively affect their financial situation;
  • The long-term sustainability of community-based providers who understand their community as large national players enter Pennsylvania; and
  • Maximizing existing outpatient capacity in Pennsylvania.

Comments may be emailed directly to DDAP Deputy Secretary Kelly Primus. Or, by the close of business this Friday, Sept. 20, please submit to RCPA SUD Treatment Services Provider Policy Director Jason Snyder any comments about this plan. RCPA will then share the comments with DDAP. In addition to any concerns you may have about this new license category, please include in your comments any proposed solutions you have about preventing unlicensed telehealth-only outpatient organizations from providing SUD treatment counseling via telehealth in Pennsylvania.

Photo by Copernico on Unsplash

The Pennsylvania Department of Drug and Alcohol Programs (DDAP) 2024 Emerging Drug Trends Symposium is set for 8:00 am – 3:30 pm Tuesday, November 19, at the Penn Harris Hotel, 1150 Camp Hill Bypass, Camp Hill, PA 17011. The symposium is free to attend, but registration is required.

Attendees will gain a better understanding of:

  • The latest trends in drug use in Pennsylvania;
  • Changes in overdose trends; and
  • Best practices and innovative approaches to respond to emerging drug trends.

Continuing education credits and reduced hotel room rates are available.

DDAP is also accepting proposals for breakout sessions that would address the following topics:

  • Emerging New Drugs of Misuse
  • Emerging Drugs in Schools & Communities
  • Social Media & the Connection to Drug Use
  • Specialty Court Drug Trends
  • Cannabis (including Deltas 8 & 10)
  • Cannabis Legislation
  • Vapes & Vaping Trends
  • Cannabis Vapes
  • Narcotics & Opioids
  • Heroin to Methamphetamines
  • Stash Compartments
  • “To go” Alcohol Trends
  • Underage Drinking/Alcohol Trends
  • Drug Accessibility/Legal Drugs
  • Over-the-Counter Drug Misuse

Close-up of Hands holding pens and making notes at the conference

The Pennsylvania Department of Drug and Alcohol Programs (DDAP) is hosting the following clinical supervision skills trainings:

  • October 21–25 at 7th Street Conference Center, 2525 N 7th St., Harrisburg
  • November 4–8 at Gateway Rehabilitation, 311 Rouser Road, Coraopolis

This in-person training will build on the information provided in the online training and provide participants with the opportunity to practice their clinical supervision skills. Participants will also be provided with tools to assist in assessing and working with their supervisees.

Trainings will be from 9:00 am – 4:00 pm each day. Cost of the training is $300. Registration is limited and will be processed in the order they are received. A registration form is available on DDAP’s Training Management System website. You can email questions about the training to the DDAP Training Section inbox.

An additional clinical supervision skills training is being planned for the southeast region for December 9–13. Once a location is confirmed, it will be posted in the Training Management System.