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DHS

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On Friday, February 6, Department of Human Services (DHS) Secretary Val Arkoosh presented an overview of Governor Shapiro’s proposed Fiscal Year (FY) 2026/27 budget and detailed the projected spending across DHS, which totals $21.94 billion in state funding. The Secretary highlighted that all three Medicaid managed care programs, as well as waiver programs for people with intellectual disabilities and autism, are receiving increases, largely driven by patient needs and costs associated with delivering care. The proposed FY 2026/27 budget includes $39.7 billion in federal funding as well as $5.6 billion from augmentations and additional programs, such as lottery and tobacco funds, making the total DHS funding $67.2 billion.

The Secretary expressed how the proposed budget reflects the direct impacts of HR 1, with significant federal funding at risk. The distribution for the 2026/27 budget is based upon the current structure of Medicaid and other federally funded programs, but the Secretary noted that beginning in 2028, changes in Medicaid financing rules will remove $20 billion from Pennsylvania’s Medicaid program over the following decade.

Budget Highlights and Investments

  • Investments in Health:
    • Food is Medicine: $900,000 (federalizes to $2.3 million) in state funds to launch a pilot program that will provide nutritionally appropriate food to improve quality of life and health outcomes while lowering overall health care costs for Medicaid recipients with significant health care needs.
    • Housing Stability: $1 million in state funds (federalizes to $2.5 million) to launch a pilot that will connect people experiencing homelessness to stable housing and services that improve health and care management.
    • Reentry Supports: $900,000 in state funds (federalizes to $2.7 million) to provide pre-release coverage (up to 90 days prior to release from a State Correctional Institution) for substance use care and intensive case management.
  • Continuing ODP Multi-Year Growth Strategy: Building upon Shapiro’s 2024 multi-year strategy to expand access to home and community-based services and effectively end the emergency waiting list of adults with intellectual disabilities with autism, the proposed budget allots $30 million in state funds, which federalizes to $66.2 million. This will allow for 850 more people to be served in the Community Living Waiver and 400 more people to be served in the Consolidated Waiver.
  • Supporting 988 Call Centers and Crisis Services: The proposed budget includes a $10 million investment in the crisis response workforce to help 988 call centers, as well as $5 million in state funds to continue prior year commitments for emergency behavioral walk-in centers.
  • Sustaining Early Intervention Rate Increase: The Secretary stated that the EI line item in the executive budget reflects the changing state cost to run the program and not an anticipated cut in funding. The release of the DHS Blue Book will have more information about the total funding with federal match. DHS intends to keep the new, updated rates from the 2025/26 budget, and revised rates will be released soon.
  • County Base Mental Health Services Funding: RCPA has confirmed that there will be no allocation increase for county base funding. While previous budgets had included $20 million for county base mental health funding, it was not included in the 2025/26 budget or the proposed 2026/27 budget.

Due to technical difficulties, DHS was unable to record the webinar, but the presentation slides and transcript can both be viewed.

Please contact your RCPA Policy Director with any questions or concerns.

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RCPA remains a leading voice for Pennsylvania’s health and human services providers, advocating for policies that support access, sustainability, and quality care. The 2025 Year in Review highlights key accomplishments that reflect our collective advocacy efforts, strengthened alliances, and measurable progress toward shared priorities. These successes help ensure providers can continue delivering critical services to individuals, families, and communities across the Commonwealth.
Read RCPA’s 2025 Year in Review
If you have any questions or comments regarding the Year in Review, please contact your respective RCPA Policy Director.

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The Independent Regulatory Review Commission (IRRC) has released their comments on the proposed rulemaking for the Mental Health Procedures Act. The IRRC summarized the questions and concerns that were submitted by legislators, providers, and stakeholders during the public comment period and made recommendations for clarity. The Department of Human Services (DHS) must consider and respond to the IRRC’s comments and all comments submitted during the comment period as they prepare their final form regulations.

The majority of the comments were in regard to proposed “Section 5100.33. Patient’s access to records and control over release of records,” where commentors voiced concern of potential conflict with existing statutes. The IRRC also responded to the legislative comments from Rep. Doyle Heffley, Republican Chairman of the House Human Services Committee, who emphasized the importance of resolving the questions asked by providers and stakeholders.

Please contact RCPA Policy Associate Emma Sharp with any questions.

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Secretary Val Arkoosh and leadership from the Department of Human Services (DHS) will host a webinar to discuss the proposed 2026/27 budget for the department. The briefing will take place at 10:00 am on Friday, February 6. If you are unable to attend, the briefing will be recorded and available for viewing afterwards on DHS’ YouTube channel.

Visit here to register for the briefing. All who plan to attend must register individually. A link for the webinar will be sent Thursday evening. DHS encourages you to submit questions ahead of the briefing so they can prepare as much information as possible. The Department will follow up on any questions that they are unable to answer during the webinar.

If the registration link above does not work, please try copying this link directly into your browser: https://forms.office.com/Pages/ResponsePage.aspx?id=QSiOQSgB1U2bbEf8Wpob3tuk6VNEbjZIvvnDA4XOB-dUN1FXNFUzSjBSUEtEUk9GM1A3WEhMSlBSUC4u

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The Department of Human Services (DHS) is making available for public review and comments the Office of Long-Term Living’s (OLTL) proposed amendment for the Community HealthChoices (CHC) waiver and the proposed renewal of the OBRA waiver. The proposed amendment of the CHC waiver and renewal of the OBRA waiver will be effective July 1, 2026.

DHS is proposing the following changes to the CHC waiver:

  • Add a teleservice option to the following waiver services:
    • Behavior therapy.
    • Benefits counseling.
  • Add language to specifically address teleservice delivery of waiver services and the Home and Community- Based Settings (HCBS) rule based on sections added to the waiver application.
  • Remove and modify outdated language throughout waiver.

The proposed CHC waiver amendment and a summary of all revisions are available for review here.

Written comments regarding the proposed renewal to OBRA should be sent to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Keeley Anglin—CHC Waiver Amendment, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments can also be sent via email. Use ”CHC Waiver Amendment” as the subject line. Comments received within 30 days will be considered in subsequent revisions to the proposed amendment.

DHS is proposing the following changes to the OBRA waiver:

  • Add a teleservice option to the following waiver services:
    • Behavior therapy.
    • Benefits counseling.
  • Revise outdated language regarding the OLTL quality improvement strategy and quality monitoring processes.
  • Add language regarding the need for a Service Coordinator to reassess a participant due to a trigger event.
  • Add language to specifically address teleservice delivery of waiver services and the Home and Community-Based Settings (HCBS) rule based on new sections in the waiver application.
  • Add language to comply with the Centers for Medicare and Medicaid Services (CMS) Ensuring Access to Medicaid Services Final Rule (Access Rule) to update the complaint process for the fee-for-service waiver and update the timeframe to resolve a complaint from 45 to 60 days due to the additional requirements of the Access Rule.
  • Update OLTL’s goals for unduplicated number of waiver participants who are expected to elect participant direction.
  • Modify performance measures AA-2 and QP-2 and divide SP-5 into three separate performance measures: SP-5 (amount, frequency and duration), SP-9 (type) and SP-10 (scope).
  • Remove and modify outdated language throughout waiver.

The proposed OBRA waiver renewal and a summary of all revisions are available for review here.

Written comments regarding the proposed renewal to OBRA waiver should be sent to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Keeley Anglin—OBRA Waiver Renewal, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments can also be sent via email. Use ”OBRA Waiver Renewal” as the subject line. Comments received within 30 days will be considered.

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The Department of Human Services (DHS) has launched a new website for the PA Rural Health Transformation Plan, containing information on goals as well as links to the full plan and news updates.

While a formal RFP process has not yet been released, providers can submit the following inquiry form. This brief survey provides each organization with an opportunity to introduce your agency and services you offer, ask questions regarding the Rural Health Transformation Plan, and identify the Rural Care Collaborative region(s) where you and/or your organization is based or provides services (see map below). Once submitted, DHS will review and respond to your inquiry as soon as possible.

Providers and stakeholders may also sign up for updates on the Rural Health Transformation Plan.

If you have any questions, please contact RCPA COO Jim Sharp.

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Message from the Office of Mental Health and Substance Abuse Services (OMHSAS):

The Pennsylvania Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services (OMHSAS) is issuing the bulletin OMHSAS-25-05 “Behavioral Health Clinic Services Provided Outside of the Clinic,” effective November 12, 2025, following changes to Federal Regulation 42 CFR 440.90(d).

OMHSAS 25-05 announces an amendment to Pennsylvania’s Medicaid State Plan which allows all behavioral health clinics that are enrolled in the Medical Assistance (MA) Program, who deliver services through the fee-for-service and managed care systems, to provide clinically appropriate services outside of the clinic. Behavioral health clinics include psychiatric outpatient clinics, outpatient drug and alcohol clinics, and methadone maintenance clinics.

Furthermore, OMHSAS-25-05 also announces the abrogation of 55 Pa Code §§ 1153.14(6) (relating to noncovered services) and 55 Pa. Code 1223.14(11) (relating to noncovered services) by Act 46 of 2025.

The guidance in OMHSAS-25-05 is separate from any “telehealth only” licensure and guidance that may be in place. The changes discussed in this bulletin also do not apply to the existing Mobile Mental Health Telehealth (MMHT) services.

Questions and comments can be directed to OMHSAS via email. RCPA members can also contact RCPA COO and MH Policy Director Jim Sharp with any questions.

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