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Regulation

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The Office of Mental Health and Substance Abuse Services (OMHSAS) has submitted to the Pennsylvania Independent Regulatory Review Commission (IRRC) IRRC No. 3417 — Psychiatric Residential Treatment Facilities (14-555) regulations for the first phase of the promulgation process.

At this time, the regulations will be open for the submission of public comments from November 2, 2024, to December 1, 2024. The IRRC will review these comments and work with OMHSAS on developing responses as well as any potential language changes.

This process for regulation development with stakeholders began in 2019, and RCPA and its members have been active partners with the OMHSAS Children’s Bureau in the ongoing process through forums and work group meetings. The RCPA Residential Services Work Group completed a cursory review of a PRFT regulation presentation by OMHSAS in July and will begin working on developing a full response to the regulations.

RCPA will be connecting with these members this week to schedule the PRTF Regulatory Review Team that will support our recommendations to the current draft. If any member is interested in participating in the review group, please contact RCPA COO and MH Director Jim Sharp.

The regulations can be view at the links below.

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The Administration for Community Living (ACL) is seeking input on a proposed rule to establish the first-ever federal regulations for adult protective services (APS) programs. Instructions for submitting comments and registering for an informational webinar can be found on ACL’s website and below.

APS programs across the country support older adults and adults with disabilities who experience, or who are at risk of, abuse, neglect, self-neglect, or financial exploitation. APS programs investigate reports of maltreatment; conduct case planning, monitoring, and evaluation, and provide, or connect people who have experienced maltreatment to, a variety of medical, social service, economic, legal, housing, law enforcement, and other protective, emergency, or support services to help them recover. Over the past decade, ACL has led federal efforts to support the critical work of APS programs through a variety of initiatives.

First-Ever Federal Regulations for APS

The proposed rule aims to improve consistency and quality of APS services across states and support the national network that delivers APS services, with the ultimate goal of better meeting the needs of adults who experience or are at risk of maltreatment. To those ends, the proposed rule:

  • Establishes a set of national standards for the operation of APS programs that all state APS systems must meet. These standards formalize — and build upon — the existing National Voluntary Consensus Guidelines for State APS Systems.
  • Establishes common definitions for the national APS system to improve information sharing, data collection, and standardization between and within states.
  • Requires state APS systems to develop policies and procedures, consistent with state law, for coordination and sharing of information to facilitate investigations with other entities, such as state law enforcement agencies and state Medicaid agencies.
  • Requires state policies and procedures to be person-directed and based on concepts of least restrictive alternatives.
  • Establishes requirements for data collection, retention, and reporting.
  • Establishes requirements for mandatory staff training and ongoing education on core competencies for APS staff and supervisors.

ACL has created a fact sheet with highlights of key provisions of the rule, and the full text of the proposed rule can be found on the Federal Register website.

Input Needed

The proposed rule is the culmination of many years of engagement with stakeholders from APS and long-term care ombudsman programs, as well as disability advocates, from across the country. It also reflects input received through several listening sessions, extensive research, and analysis of data from a 2021 survey of 51 APS systems, ACL’s National Adult Maltreatment Reporting System, and policy profiles from APS programs in all states and territories.

ACL now seeks feedback on the proposed rule from all who are interested in improving implementation of APS programs and services. Input from the aging and disability networks and the people served by APS programs is particularly crucial.

Comments will be accepted for 60 days, beginning when the proposed rule is officially published in the Federal Register (which currently is scheduled for Tuesday, September 12). Instructions for commenting, along with the comment deadline, can be found in the Federal Register notice and on ACL’s website.

An informational webinar will be held on Monday, September 18, at 11:30 am ET. Advance registration is required.

For additional questions, contact Fady Sahhar.

A proposed regulation related to Adult Protective Services is currently posted on the Independent Regulatory Review Commission’s (IRRC) website. This proposed regulation “identifies mandatory reporters and prescribes penalties for their failure to report suspected abuse, neglect, exploitation, or abandonment; requires consistent and timely investigations of allegations; and when necessary, provides for protective services to mitigate risk to individuals.”

The public comment period has started and will end on May 22, 2023. Please take the opportunity to review the proposed regulation and submit any comments that you may have following the processes outlined within the timeframe allotted. Consider sharing your thoughts with Carol Ferenz or your policy division director by May 19, 2023, for inclusion in RCPA’s comments.

RCPA SUD Treatment Services Policy Director Jason Snyder will testify on Thursday, March 9, at the Center for Rural Pennsylvania’s hearing, “New Developments in the Opioid and Substance Use Disorder Crisis in Rural Pennsylvania.”

Snyder will testify on a panel that will examine SUD treatment workforce and regulation. Justin Wolford, Director of Outpatient Services at RCPA member CenClear, also will testify on the panel. Wolford will focus on the workforce crisis, while Snyder will discuss regulations that exacerbate the crisis and should be reformed.

The hearing will be comprised of four total panels:

  • Developments in the Supply of Narcotics;
  • Data Resources;
  • Funding and Programming; and
  • Workforce and Regulations.

The hearing begins at 9:00 am and will take place in the Main Capitol Building, Room 8E-B, in Harrisburg. It also will be livestreamed online.

The Office of Management and Budget (OMB) has released the Unified Regulatory Agenda and Regulatory Plan, which outlines regulatory actions federal agencies are considering in the coming months. Regulations can be searched by specific agency, such as Department of Health and Human Services (HHS), which includes the Centers for Medicare and Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), and the Substance Abuse and Mental Health Services Administration (SAMHSA).

ODP Bulletin 00-22-02, effective June 2, 2022, is to establish the process for requesting a waiver of a regulatory requirement. This bulletin applies to entities seeking to be licensed or are currently licensed under one or more of the following chapters:

  • 55 Pa. Code Chapter 2380 (relating to Adult Training Facilities);
  • 55 Pa. Code Chapter 2390 (relating to Vocational Facilities);
  • 55 Pa. Code Chapter 6400 (relating to Community Homes for Individuals with an Intellectual Disability or Autism);
  • 55 Pa. Code Chapter 6500 (relating to Life Sharing Homes); and
  • Providers of home and community-based services (HCBS) for individuals with an intellectual disability or autism subject to 55 Pa. Code Chapter 6100 (relating to Services for Individuals with an Intellectual Disability or Autism).

Licensees and ODP-enrolled providers are expected to comply with all applicable regulations. However, the Department recognizes that there are occasions where compliance with a regulation impedes the licensee’s or ODP-enrolled provider’s ability to provide services to an individual. As a result, the Department permits licensees and ODP-enrolled providers to request that a section, subsection, paragraph, or subparagraph of a regulation not apply when it is in the best interest of an individual or group of individuals who receive services from the licensee or ODP enrolled provider.

Not all regulations can be waived. Section 6100.43(a) prohibits waivers of the following regulations:

  • Sections 6100.1–6100.3 (relating to General Provisions);
  • Sections 6100.41–6100.56 (relating to General Requirements);
  • Sections 6100.181–6100.186 (relating to Individual Rights); and
  • Sections 6100.341–6100.350 (relating to Restrictive Procedures).

Additionally, section 6500.12(7) prohibits waivers of sections 6500.1–6500.4 (relating to General Provisions). While Chapters 2380, 2390, and 6400 do not address waivers of regulation, waivers for these chapters are at the discretion of the Department and can be requested pursuant to 1 Pa. Code section 35.18.

Providers should utilize the Office of Developmental Programs’ form “Request for Regulatory Waiver.”