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The Office of Developmental Programs (ODP) has shared ODPANN 24-044 and the accompanying instructions. The purpose of this announcement is to outline criteria and provide instructions for requesting a SIS-A 2nd Edition reassessment for individuals who receive residential services and whose 2023 SIS-A assessment resulted in a Needs Group (NG) decrease of two or more levels.

Please view the announcement and accompanying instructions for information and details.

OMHSAS Approves RCPA Telehealth Extension Request
Deadline for Consent/Service Verification Compliance Now March 31, 2023

In an effort to assist provider members in their efforts toward consent and service verification compliance, RCPA requested an extension of the December 31, 2022, deadline. RCPA outlined ongoing challenges towards meeting these standards that included integrating new platforms into existing infrastructure, funding, training, and internal process changes.

Yesterday, we met with the Office of Mental Health and Substance Abuse Services (OMHSAS) to outline these concerns and review provider progress towards compliance. In response, OMHSAS has agreed to extend the date for meeting the consent and service verification standards to March 31, 2023. Funding concerns, especially in the middle of a budget year, were also discussed, and OMHSAS will make available funds to aid providers in implementing these practices.

As part of the RCPA Telehealth Work Group meeting at 10:00 am on Tuesday, December 20, 2022, we will be covering this and other telehealth topics on the agenda. These include our hope to conduct online polling on specific telehealth issues. You can register for the meeting here. Additionally, the second half of the meeting will feature OMHSAS Policy Director Jenna Mehnert Baker, who will provide updates, guidance, and a Q&A. We hope you are able to join us for this call, as your participation in the meeting will provide up-to-date information on your efforts and information that will assist RCPA in our collective endeavors.

We are grateful for the collaboration with OMHSAS and their willingness to extend the compliance timeframe. RCPA is committed to working with providers to ensure telehealth services remain a viable part of the service delivery continuum.

Please forward all questions you may have for OMHSAS to RCPA Policy Director Jim Sharp.

Read the OMHSAS response from Dr. Dale Adair below:

The purpose of this communication is to address concerns expressed by RCPA specific to the impact of ending OMHSAS’ bulletin suspensions on 12/31/22. There appears to be a significant amount of concern about providers’ ability to have telehealth platforms in place by 01/01/2023. Just to clarify, at no point has OMHSAS stated that providers must have HIPAA-compliant platforms in place by January 2023? It is important to note that the Pennsylvania General Assembly has defined telebehavioral health to specifically include platforms. Act 76 of 2022 defined: “Telebehavioral health technology. (i) Any of the following:(i)  Real-time interactive audio and video communication using technology that conforms to industry-wide standards and is in compliance with Federal and State privacy and security laws.(ii)  Real-time interactive audio-only telecommunication, provided that the use of audio-only telecommunication technology is consistent with Federal and State laws, guidance and requirements.(2)  The term does not include technology solely using voicemail, electronic mail messages, facsimile transmissions or instant messaging, or a combination thereof.”

OMHSAS Memorandum dated February 18, 2021, that temporarily suspended portions of bulletins and other guidance documents, stated that “verbal consent must be documented at the time of service, and providers are strongly encouraged to obtain electronic signatures when possible.” This language allowed verbal consent without a second witness during the public health emergency. At that time, OMHSAS also stressed the need for providers to acquire platforms capable of securing electronic signatures. Given OMHSAS’ previous recommendation, providers have had nearly two years to secure a platform capable of securing electronic signatures for consent and service verification. DHS is intending to provide a funding opportunity for providers per the approved HCBS spending plan. OMHSAS continues to look for additional ways to support compliance with the expectations of the Pennsylvania Act 69 of 1999 (Electronic Transactions Act).

It remains imperative for all entities delivering MA funded behavioral health services to have policies in place to capture consent in a way that creates an auditable trail. There are multiple ways that providers of telebehavioral health can meet this requirement including messages typed into the chat box of an audiovisual platform, email, text messaging, USPS mail and two-person verification of a verbal consent secured over the phone. Given the options available to providers and the fact that since 02/2021 OMHSAS has stressed the importance of developing appropriate systems to capture electronic signatures, OMHSAS asks that providers meet federal and state expectations. Understanding the challenges providers are experiencing, OMHSAS will extend the bulletin suspension specific to consent to treat, service verifications and treatment plans only that is scheduled to end on 12/31/2022 until 3/31/23. Effective on April 1, 2023, providers are expected to capture consent to treat, service verifications and approval of treatment plans in a manner that creates an auditable file and in accordance with the timelines expected within regulation. While we understand the operational challenges, waiving the requirement that consent and service verification are secured in a manner that would withstand an audit any longer than three additional months is simply not possible. We believe the definition created in Act 76 serves to govern the delivery of telebehavioral health in the Commonwealth moving forward.

The 2022 RCPA Conference, Together, will be held October 11–14 at the Hershey Lodge as a premier statewide event. The Conference Committee is seeking workshop proposals in every area for possible inclusion. The deadline for submissions is Monday, March 14 at 5:00 pm. Encouraged presentations are those that assist providers in developing and maintaining high-quality, stable, and effective treatments, services, and agencies in an industry where change is constant. The committee looks for presentations that:

  • Highlight new policy, research, and treatment initiatives, such as telehealth innovations;
  • Provide specific skills and information related to individual and organizational leadership development and enhancement;
  • Address system changes that affect business practices, including value-based purchasing and alternative payment models;
  • Provide guidance on recruiting and developing a committed workforce;
  • Offer concrete skills and tools to operate more efficient, effective agencies; and
  • Inspire ideas for organizations to work Together.

Workshop ideas for 2022 include:

  • Workforce shortage solutions;
  • The changing health care landscape, including telehealth changes;
  • Executive leadership;
  • Integrated care strategies for implementation and reimbursement;
  • Managed care models for people with intellectual/developmental disabilities, including other state experiences;
  • Advanced ethics topics;
  • Acquisitions/mergers and consolidations;
  • Value-based purchasing and alternative payment options; and
  • Employing people with disabilities.

The committee welcomes any proposal that addresses these and other topics essential to rehabilitation, mental health, substance use, children’s, aging, physical disabilities, and intellectual/developmental disabilities & autism. Members are encouraged to consider submitting and to forward this opportunity to those who are exceptionally good speakers and have state-of-the-art information to share.

The Call for Proposals (featuring a complete listing of focus tracks) and accompanying Guidelines for Developing Educational Objectives outline requirements for submissions. Please send RCPA your proposal by Monday, March 14 at 5:00 pm. Proposals must be submitted electronically on the form provided; confirmation of receipt will be sent. Proposals submitted after the deadline will not be considered.

If the proposal is accepted, individuals must be prepared to present on any day of the conference. Workshops are 90 or 180 minutes in length. At the time of acceptance, presenters will be required to confirm the ability to submit workshop handouts electronically four weeks prior to the conference. Individuals unable to meet this expectation should not submit proposals for consideration.

Individuals are welcome to submit multiple proposals, and we encourage members to share this information with speakers and presenters who they believe would be a good fit for the conference. Notification of inclusion will be made via email by May 13, 2022. Questions may be directed to Sarah Eyster or Carol Ferenz, Conference Coordinators.

We look forward to coming together again this October!

The 2022 RCPA Conference, Together, will be held October 11–14 at the Hershey Lodge as a premier statewide event. The Conference Committee is seeking workshop proposals in every area for possible inclusion. The deadline for submissions is Monday, March 14 at 5:00 pm. Encouraged presentations are those that assist providers in developing and maintaining high-quality, stable, and effective treatments, services, and agencies in an industry where change is constant. The committee looks for presentations that:

  • Highlight new policy, research, and treatment initiatives, such as telehealth innovations;
  • Provide specific skills and information related to individual and organizational leadership development and enhancement;
  • Address system changes that affect business practices, including value-based purchasing and alternative payment models;
  • Provide guidance on recruiting and developing a committed workforce;
  • Offer concrete skills and tools to operate more efficient, effective agencies; and
  • Inspire ideas for organizations to work Together.

Workshop ideas for 2022 include:

  • Workforce shortage solutions;
  • The changing health care landscape, including telehealth changes;
  • Executive leadership;
  • Integrated care strategies for implementation and reimbursement;
  • Managed care models for people with intellectual/developmental disabilities, including other state experiences;
  • Advanced ethics topics;
  • Acquisitions/mergers and consolidations;
  • Value-based purchasing and alternative payment options; and
  • Employing people with disabilities.

The committee welcomes any proposal that addresses these and other topics essential to rehabilitation, mental health, substance use, children’s, aging, physical disabilities, and intellectual/developmental disabilities & autism. Members are encouraged to consider submitting and to forward this opportunity to those who are exceptionally good speakers and have state-of-the-art information to share.

The Call for Proposals (featuring a complete listing of focus tracks) and accompanying Guidelines for Developing Educational Objectives outline requirements for submissions. Please send RCPA your proposal by Monday, March 14 at 5:00 pm. Proposals must be submitted electronically on the form provided; confirmation of receipt will be sent. Proposals submitted after the deadline will not be considered.

If the proposal is accepted, individuals must be prepared to present on any day of the conference. Workshops are 90 or 180 minutes in length. At the time of acceptance, presenters will be required to confirm the ability to submit workshop handouts electronically four weeks prior to the conference. Individuals unable to meet this expectation should not submit proposals for consideration.

Individuals are welcome to submit multiple proposals, and we encourage members to share this information with speakers and presenters who they believe would be a good fit for the conference. Notification of inclusion will be made via email by May 13, 2022. Questions may be directed to Sarah Eyster or Carol Ferenz, Conference Coordinators.

We look forward to coming together again this October!

The 2022 RCPA Conference, Together, will be held October 11–14 at the Hershey Lodge as a premier statewide event. The Conference Committee is seeking workshop proposals in every area for possible inclusion. Encouraged presentations are those that assist providers in developing and maintaining high-quality, stable, and effective treatments, services, and agencies in an industry where change is constant. The committee looks for presentations that:

  • Highlight new policy, research, and treatment initiatives, such as telehealth innovations;
  • Provide specific skills and information related to individual and organizational leadership development and enhancement;
  • Address system changes that affect business practices, including value-based purchasing and alternative payment models;
  • Provide guidance on recruiting and developing a committed workforce;
  • Offer concrete skills and tools to operate more efficient, effective agencies; and
  • Inspire ideas for organizations to work Together.

Workshop ideas for 2022 include:

  • Workforce shortage solutions;
  • The changing health care landscape, including telehealth changes;
  • Executive leadership;
  • Integrated care strategies for implementation and reimbursement;
  • Managed care models for people with intellectual/developmental disabilities, including other state experiences;
  • Advanced ethics topics;
  • Acquisitions/mergers and consolidations;
  • Value-based purchasing and alternative payment options; and
  • Employing people with disabilities.

The committee welcomes any proposal that addresses these and other topics essential to rehabilitation, mental health, substance use, children’s, aging, physical disabilities, and intellectual/developmental disabilities & autism. Members are encouraged to consider submitting and to forward this opportunity to those who are exceptionally good speakers and have state-of-the-art information to share.

The Call for Proposals (featuring a complete listing of focus tracks) and accompanying Guidelines for Developing Educational Objectives outline requirements for submissions. Proposals must be submitted electronically on the form provided; confirmation of receipt will be sent. Proposals submitted after the deadline will not be considered.

If the proposal is accepted, individuals must be prepared to present on any day of the conference. Workshops are 90 or 180 minutes in length. At the time of acceptance, presenters will be required to confirm the ability to submit workshop handouts electronically four weeks prior to the conference. Individuals unable to meet this expectation should not submit proposals for consideration.

Individuals are welcome to submit multiple proposals. Notification of inclusion will be made via email by May 13, 2022. Questions may be directed to Sarah Eyster or Carol Ferenz, Conference Coordinators.

We look forward to coming together again this October!

As ANCOR is analyzing the impact of the Centers for Medicare and Medicaid Services (CMS) mandate released this morning, it is clear that ICF employees are included; however, waiver services are not unless the provider employs 100 or more employees. We are trying to get a handle on how many providers this will impact. Please let Carol Ferenz know ASAP if this will impact your organization.

From the CMS Frequently Asked Questions document:

Q. Does this requirement apply to Medicaid home care services, such as Home and Community-Based Services (HCBS), since these providers receive Medicaid funding but are not regulated as certified facilities?

A. No, this regulation only applies to those Medicare and Medicaid-certified provider and supplier types that are subject to CMS health and safety regulations. CMS’s health and safety regulations do not cover providers of Home and Community-Based Services.

As vaccinations and/or testing of employees becomes more of a requirement for many of our members, there will also be a need to develop policies for the implementation of these requirements. Philadelphia providers have already been forced to deal with this situation, and others are preparing, or have already decided to implement, mandatory vaccine protocols for their employees.

We are trying to gather as much information as possible to help all of our members handle this new demand, including determining what testing will be acceptable to meet the mandate in lieu of vaccinations, who the mandates will apply to, and what are acceptable reasons for exemption from a vaccination mandate.

RCPA is requesting that those who have developed polices and who are willing to share those policies send them to RCPA HR Committee staff so that others may learn from your experiences. We will make these available to other members only and will share them in whatever format you choose to send them (with or without your agency name).

Thank you in advance to any members who are willing to share your policies.

OMHSAS has released the following Telehealth Regulatory Waiver Request template in order to streamline regulatory waiver requests for the continued delivery of telehealth services following the 9-30-21 end date of statewide regulatory waivers based on the COVID-19 Emergency Declaration.

The waiver submission process will adhere to the revised OMHSAS Waiver Bulletin 16-13.

The waiver will cover deliverable considerations for the following services

  • Mental Health Intensive Case Management 55 Pa. Code § 5221.33(4)(iii)
  • Outpatient Psychiatric Services 55 Pa. Code § 1153.14(1)
  • Outpatient Drug and Alcohol Clinic Services 55 Pa. Code § 1223.14(2)

Each waiver request will remain in place for a 1-year period and will require providers also have documented policies in place for clinical appropriateness and the delivery of telehealth in emergencies. RCPA recommends agencies carefully review each section of the waiver request as they complete their submission.

The waiver will outline the following service considerations:

  • To ensure continuity of telehealth delivery of services by allowing this agency/facility to use audio-only service delivery for Outpatient Psychiatric Services, Outpatient Drug and Alcohol Clinic Services when the individual served does not have access to video capability or for an urgent medical situation.
  • To ensure continuity of telehealth delivery of services by allowing this agency/facility to accept verbal consent/verification for documentation where a signature cannot be obtained when delivering Mental Health Intensive Case Management Services.

Submission Considerations:

  • For all Mental Health Intensive Case Management and Outpatient Psychiatric Clinic Waivers: Please submit all waiver requests to the appropriate OMHSAS Regional Field Office with an attached letter of support from the County MH/ID Administrator where your primary licensed location is at.
  • For all Outpatient Drug and Alcohol Clinic Services Waivers: Please submit here. No letter of support is required for these waivers.

Providers may utilize the following language in your waiver request letter:

Kristen Houser, Deputy Secretary
OMHSAS
Commonwealth Tower, 11th Floor
303 Walnut Street, Harrisburg 17101

Dear Deputy Secretary Houser:

This letter is a request for a waiver of Department of Human Services regulation(s) to continue the delivery of services through telehealth after September 30, 2021, which is the end date of the Governor’s COVID -19 Emergency Disaster Declaration which authorized certain regulatory suspensions.  The details for this request for waiver are included in the form below.  In addition, a letter of support from the County MH/ID Administrator for this request for waiver is attached. (REMOVE if Outpatient D&A Clinic Waiver) 

Your consideration for approval is appreciated. I look forward to your response. If you have any questions or concerns regarding this regulatory waiver request, please contact me at (Phone and e-mail address.)

Sincerely,
(Signature)
(Name)

Members may contact RCPA Policy Director Jim Sharp or their respective Policy Director with questions or feedback.