Transforming Health and Human Services Systems to Improve Care for Complex Populations — Social Innovations Journal Vol. 28 Released
HHS
DDAP Issues Bulletin in Response to Federal Extension of Telemedicine Flexibilities
As RCPA previously communicated, the Drug Enforcement Administration (DEA), jointly with the U.S. Department of Health and Human Services (HHS), has extended the temporary COVID-19 telemedicine flexibilities through December 31, 2025. These flexibilities enable prescribing of controlled medications via telemedicine. As such, the Pennsylvania Department of Drug and Alcohol Programs’ (DDAP) suspension of 28 Pa. Code § 715.9(a)(4), which allows an initial evaluation for a person who will be treated by an opioid treatment program (OTP) with buprenorphine to be completed via telehealth, is also extended.
DDAP’s complete Information Bulletin 03-2024 is available here.
DOS, DDAP Poised to Enable Tele-Induction of Narcotic Medications at OTPs
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.
Wireless Calls to 988 Get a More Localized Response With Geo-routing
The process to route cell phone calls to the 988 Suicide & Crisis Lifeline based on the caller’s approximate location, versus by area code, has started; FCC to vote next month on a final rule that would require all U.S. wireless carriers to implement geo-routing with specific timelines
The 988 Suicide & Crisis Lifeline announced that the process to start routing cellular phone calls to 988 contact centers based on the caller’s approximate location, versus by area code — known as “geo-routing” — began last week with two major U.S. wireless carriers that combined make up about half of all wireless calls to 988. The U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) and the 988 Network Administrator, Vibrant Emotional Health, have been working with all of the major U.S. cell phone carriers for more than a year to improve call routing to 988 so that callers on a cell phone can be connected more locally to centers that are better equipped to provide nearby resources and services.
These new rules, if adopted by a vote from the full commission next month, would require all U.S. wireless carriers to implement geo-routing. In addition, the rules will also establish an implementation timeline for geo-routing calls to the 988 Lifeline of 30 days following the effective date of the rule for nationwide wireless providers and 24 months after the effective date of the rule for smaller, non-nationwide providers.
More than 200 contact centers across the country provide support through the 988 Lifeline network. Geo-routing connects cell phone callers to the closest 988 contact center to the caller’s physical location. Geo-routing differs from geolocation in that it does not provide a precise location of the caller, allowing callers to maintain their location privacy. Studies have shown that after speaking with a trained crisis counselor, most callers feel more hopeful and less depressed, suicidal, and overwhelmed.
If you have additional questions, please contact RCPA COO and Mental Health Director Jim Sharp.
President’s Committee for People With IDD Meeting to Be Held Sept. 26–27
The President’s Committee for People with Intellectual Disabilities (PCPID) will be hosting its next meeting on Thursday, September 26, 2024, from 9:00 am – 4:00 p.m. ET, and Friday, September 27, 2024, from 9:00 am – 3:00 pm ET. Register for the meeting here.
The meeting is open to the public and will be hosted at the U.S. Department of Health and Human Services. The meeting will take place in the Switzer Building Conference Room 1400, located at 330 C Street, SW, Washington, DC 20201. Members of the public can observe the meeting in person or virtually. To observe the meeting in person, seating will be available for the first 25 individuals to reserve seats due to space limitations. In order to observe the proceedings in person or virtually, you must register in advance.
The Committee will discuss the 2024 PCPID Report focused on home and community-based services (HCBS) as it relates to direct support professionals, employment, community living, and federal support programs. The Committee will also discuss emerging issues facing people with intellectual disabilities.
Comments and suggestions, especially from people with intellectual disabilities, are welcomed. If there are comments that you would like to inform the PCPID, please share them using ACL’s comment form. Comments received by Friday, September 13, 2024, will be shared with the PCPID at the meeting.
AHCA Files Lawsuit Against Federal Staffing Mandate
Section 504 of the Rehabilitation Act of 1973 Part 84 Final Rule Fact Sheet Now Available
The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has issued a Final Rule to advance equity and bolster protections for people with disabilities. The final rule, Discrimination on the Basis of Disability in Health and Human Service Programs or Activities, updates, modernizes, clarifies, and strengthens the implementing regulation for Section 504 of the Rehabilitation Act of 1973. Section 504 prohibits discrimination on the basis of disability in programs and activities that receive Federal financial assistance.
The historic rule provides robust civil rights protections for people with disabilities in federally funded health and human services programs, such as hospitals, health care providers participating in CHIP and Medicaid programs, state and local human or social service agencies, and nursing homes. Reflecting on over 50 years of advocacy by the disability community, it advances the promise of the Rehabilitation Act and helps to ensure that people with disabilities are not subjected to discrimination in any program or activity receiving funding from HHS. This final rule is consistent with Section 504 statutory text, congressional intent, legal precedent, and the Biden-Harris Administration’s commitment to advancing equity and civil rights.
ACL to Host Webinar on Section 504 of the Rehab Act on May 28
Overview of HHS’ Final Rule Implementing Section 504 of the Rehab Act
Tuesday, May 28, 2024
2:00 pm ET
Register Here
On May 1, 2024, the US Department of Health and Human Services (HHS) made disability rights history with the release of a long-awaited final rule implementing Section 504 of the Rehabilitation Act of 1973. This comprehensive update — the first since the initial regulation was put into place more than 40 years ago — creates one of the most powerful tools we have ever had to combat discrimination based on disability in health care and human services.
In this webinar, leaders from the HHS Office for Civil Rights (OCR) will provide an overview of the rule’s critical provisions for the disability and aging networks. ASL and CART will be provided. A recording will be available on ACL’s website shortly after the webinar.
ACL was proud to work with their partners in the OCR and the disability community to achieve this top priority, and they are looking forward to working with OCR, the disability and aging networks, and the broader community to ensure that people with disabilities know about the rule’s powerful provisions to uphold their civil rights and guarantee they have equal access to health care and human services.
HHS Finalizes Rule Strengthening Protections Against Disability Discrimination
The US Department of Health and Human Services (HHS) has updated the regulations that prohibit discrimination based on disabilities to clarify obligations in several critical areas. Specifically, the rule:
- Ensures that medical treatment decisions are not based on negative biases or stereotypes about individuals with disabilities, judgments that an individual with a disability will be a burden on others, or dehumanizing beliefs that the life of an individual with a disability has less value than the life of a person without a disability.
- Prohibits the use of any measure, assessment, or tool that discounts the value of a life extension on the basis of disability to deny, limit, or otherwise condition access to an aid, benefit or service.
- Defines what accessibility means for websites and mobile applications and sets forth a specific technical standard to ensure that health care and human service activities delivered through these platforms are readily accessible to and usable by individuals with disabilities.
- Adopts the U.S. Access Board’s standards for accessible medical diagnostic equipment, like exam tables and mammography machines.
- Details requirements to ensure nondiscrimination in the services provided by HHS funded child welfare agencies, including, but not limited to, reasonable efforts to prevent foster care placement, parent-child visitation, reunification services, child placement, parenting skills programs, and in- and out-of-home services.
- Clarifies obligations to provide services in the most integrated setting, like receiving services in one’s own home, appropriate to the needs of individuals with disabilities.
Additionally, the Final Rule updates existing requirements to make them consistent with the American with Disabilities Act (ADA), as many HHS recipients are also covered by the ADA. This consistency will improve and simplify compliance.
View the full press release here. If you have any questions, please contact Fady Sahhar.
ANCOR Shares Analysis of DOL’s Final Overtime Rule
