Proposed Restructured Funding Plan for DHS Released
HHS
Federal COVID-Related SUD Grants to Continue While Courts Consider Request for Temporary Restraining Order
The Pennsylvania Department of Drug and Alcohol Programs (DDAP) notified single county authorities (SCA) that it will continue to distribute federal COVID-related grant funding to SCAs while the US District Court considers a 23-state lawsuit seeking an emergency temporary restraining order against US Health and Human Services Secretary Robert F. Kennedy Jr. for abruptly terminating COVID-grant funds that were appropriated for use for states until September 30, 2025. Those grant funds include a supplemental to the Substance Use Disorder Block Grant. The lawsuit was filed on April 1.
Though not confirmed, media reports suggest the termination of grants could cost the Pennsylvania Department of Health $301 million, along with an additional $28 million or more hit against DDAP.
DDAP had been using these grant funds to expand testing and provide resources for COVID; support providers and help meet local needs during the pandemic; and expand the substance use disorder prevention, intervention, treatment, and recovery support services continuum, including various evidence-based services and supports for individuals, families, and communities.
PA Among 23 Plaintiffs Suing US HHS Secretary RFK Jr. Over Termination of COVID Grants
Governor Shapiro and Pennsylvania are listed along with 22 other plaintiffs in a lawsuit filed in US District Court in Rhode Island, requesting an emergency temporary restraining order against US Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. for abruptly terminating COVID-grant funds, including a supplemental to the Substance Use Disorder Block Grant, that were appropriated for use for states until September 30, 2025.
Though not confirmed, media reports suggest the termination of grants could cost the Pennsylvania Department of Health $301 million, along with an additional $28 million or more hit against the Pennsylvania Department of Drug and Alcohol Programs (DDAP).
DDAP had been using these grant funds to expand testing and provide resources for COVID; support providers and help meet local needs during the pandemic; and expand the substance use disorder prevention, intervention, treatment, and recovery support services continuum, including various evidence-based services and supports for individuals, families, and communities.
DDAP is examining its options to maintain the full array of services offered by single county authorities and their providers to ensure Pennsylvanians continue to receive the lifesaving supports they need.
The factual allegations and legal background in the lawsuit state that during the COVID-19 pandemic, Congress appropriated substantial funds to strengthen public health programs that were not tied to the duration of the public health emergency. HHS and Congress continued to make these public health funds available after the end of the pandemic.
On Monday, March 24, with no advance notice, HHS abruptly terminated $11 billion in grants and cooperation agreements funded by appropriations from COVID-related laws. States were notified through letters from the Substance Abuse and Mental Health Administration (SAMHSA). The letters indicated the grants were issued for a limited purpose: to ameliorate the effects of the pandemic. The end of the pandemic provides cause to terminate COVID-related grants. Now that the pandemic is over, the grants are no longer necessary.
The lawsuit goes on to state the terminations have caused and will continue to cause irreparable harm and asks the court to vacate and set aside the termination of the funding and any other further actions taken by US HHS to implement or enforce them, among other requests.
National Council Issues Notice on Rescission of Certain COVID-19 Relief Funds
U.S. HHS Renews Public Health Emergency Declaration to Address National Opioid Crisis
The U.S. Department of Health and Human Services (HHS) announced yesterday that the public health emergency declaration addressing the nation’s opioid crisis has been renewed, allowing sustained federal coordination efforts and preserving key flexibilities that enable HHS to continue leveraging expanded authorities to conduct certain activities in response to the opioid overdose crisis.
The public health emergency, first declared under President Trump in 2017, was set to expire on March 21, 2025. The renewal extends the emergency for 90 days.
More information about the declaration is available on the Substance Abuse and Mental Health Administration’s (SAMHSA) website.
Transforming Health and Human Services Systems to Improve Care for Complex Populations — Social Innovations Journal Vol. 28 Released
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.
