Authors Posts by Sarah Eyster

Sarah Eyster

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Ms. Eyster represents the association at state-level meetings and serves as staff liaison to the Mental Health Committee. She is responsible for member communication of, and the analysis of, Department of Human Services and other key policy decisions.

This training, scheduled for Tuesday, September 29, will include general facts and myths regarding suicide as well as warning signs and clues. The importance of assessment and developing a safety plan will also be discussed. The training will have a strong focus on individuals with Autism and Intellectual and Developmental Disabilities. Please register for this free event sponsored by Moving Agencies Toward Excellence (MAX). Send questions to Dconway@maxassociation.org.

The Jana Marie Foundation, Prevent Suicide PA, Pennsylvania Network for Student Assistance Services (PNSAS), and Garrett Lee Smith (GLS) Youth Suicide Prevention Grant are pleased to share a resource guide for communities for National Suicide Prevention Month.

Within the month of September, the week of September 6th-12th is recognized as National Suicide Prevention Week, with Thursday, September 10 marking World Suicide Prevention Day.

The resource guide provides examples of activities that you can implement in your community to raise awareness of the importance of suicide prevention. This includes ideas for training, social media posts, virtual backgrounds, a sample proclamation, and more.

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The Jana Marie Foundation, Prevent Suicide PA, Pennsylvania Network for Student Assistance Services (PNSAS), and Garrett Lee Smith (GLS) Youth Suicide Prevention Grant are pleased to share a resource guide for communities for National Suicide Prevention Month. The week of September 6–12 is recognized as National Suicide Prevention Week, with Thursday, September 10 marking World Suicide Prevention Day.

The resource guide provides examples of activities that you can implement in your community to raise awareness of the importance of suicide prevention. This includes ideas for training, social media posts, virtual backgrounds, a sample proclamation, and more.

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Business Team Concept: FUNDING

Evidence-based mental health services are often not used, or not used effectively, in low-resource settings and in settings with clients from traditionally underserved populations. The National Institute of Mental Health (NIMH) supports a research agenda aimed at understanding and reducing these mental health disparities to achieve greater equity in mental health care. NIMH has released two funding opportunity announcements (FOAs) to support research to evaluate evidence-based mental health practices in these disadvantaged populations, including:


Brain from NIMH AlertImplementing and Sustaining Evidence-Based Mental Health Practices in Low-Resource Settings to Achieve Equity in Outcomes (R34 Clinical Trial Required)
This FOA supports pilot work for subsequent studies testing the effectiveness of strategies to deliver evidence-based mental health services, treatment interventions, and/or preventive interventions in low-resource mental health specialty and non-specialty settings within the United States.
The application deadline is August 25, 2020 by 5:00 PM local time of applicant organization. No late applications will be accepted for this FOA.

Learn More

Effectiveness of Implementing Sustainable Evidence-Based Mental Health Practices in Low-Resource Settings to Achieve Mental Health Equity for Traditionally Underserved Populations (R01 Clinical Trial Optional)
This FOA encourages studies that develop and test the effectiveness of strategies for implementation and sustainable delivery of evidence-based mental health treatments and services to improve mental health outcomes for underserved populations in under-resourced settings in the United States.
This FOA is published in parallel to a companion R34 (RFA-MH-20-401) that supports pilot studies in preparation for the larger-scale studies described here.
The application deadline is August 25, 2020 by 5:00 PM local time of applicant organization. No late applications will be accepted for this FOA.

Learn more

Physician Fee Schedule Proposed Rule would make permanent certain telehealth and workforce flexibilities provided during the COVID-19 Public Health Emergency and improve healthcare for Americans in Rural Areas

The Centers for Medicare & Medicaid Services (CMS) is proposing changes to expand telehealth permanently, consistent with the Executive Order on Improving Rural and Telehealth Access that President Trump signed today. The Executive Order and proposed rule advance our efforts to improve access and convenience of care for Medicare beneficiaries, particularly those living in rural areas. Additionally, the proposed rule implements a multi-year effort to reduce clinician burden under our Patients Over Paperwork initiative and to ensure appropriate reimbursement for time spent with patients. This proposed rule also takes steps to implement President Trump’s Executive Order on Protecting and Improving Medicare for our Nation’s Seniors and continues our commitment to ensure that the Medicare program is sustainable for future generations.

Expanding Beneficiary Access to Care through Telehealth 

Over the last three years, as part of the Fostering Innovation and Rethinking Rural Health strategic initiatives CMS has been working to modernize Medicare by unleashing private sector innovations and improve beneficiary access to services furnished via telecommunications technology. Starting in 2019, Medicare began paying for virtual check-ins, meaning patients across the country can briefly connect with doctors by phone or video chat to see whether they need to come in for a visit. In response to the COVID-19 pandemic, CMS moved swiftly to significantly expand payment for telehealth services and implement other flexibilities so that Medicare beneficiaries living in all areas of the country can get convenient and high-quality care from the comfort of their home while avoiding unnecessary exposure to the virus. Before the public health emergency (PHE), only 14,000 beneficiaries received a Medicare telehealth service in a week while over 10.1 million beneficiaries have received a Medicare telehealth service during the public health emergency from mid-March through early-July. For more information on Medicare’s unprecedented increases in telemedicine and its impact on the health care delivery system, visit the CMS Health Affairs blog here.

As directed by President Trump’s Executive Order on Improving Rural and Telehealth Access, through this rule, CMS is taking steps to extend the availability of certain telemedicine services after the PHE ends, giving Medicare beneficiaries more convenient ways to access healthcare particularly in rural areas where access to healthcare providers may otherwise be limited Improving Rural and Telehealth Access.

“Telemedicine can never fully replace in-person care, but it can complement and enhance in-person care by furnishing one more powerful clinical tool to increase access and choices for Americas seniors,” said CMS Administrator Seema Verma. “The Trump Administration’s unprecedented expansion of telemedicine during the pandemic represents a revolution in healthcare delivery, one to which the healthcare system has adapted quickly and effectively. Never one merely to tinker around the edges when it comes to patient-centered care, President Trump will not let this opportunity slip through our fingers.”

During the public health emergency, CMS added 135 services such as emergency department

visits, initial inpatient and nursing facility visits, and discharge day management services, that could be paid when delivered by telehealth. CMS is proposing to permanently allow some of those services to be done by telehealth including home visits for the evaluation and management of a patient (in the case where the law allows telehealth services in the patient’s home), and certain types of visits for patients with cognitive impairments. CMS is seeking public input on other services to permanently add to the telehealth list beyond the PHE in order to give clinicians and patients time as they get ready to provide in-person care again. CMS is also proposing to temporarily extend payment for other telehealth services such as emergency department visits, for a specific time period, through the calendar year in which the PHE ends. This will also give the community time to consider whether these services should be delivered permanently through telehealth outside of the PHE.

Prioritizing Investment in Preventive Care and Chronic Disease Management

Under our Patients Over Paperwork initiative, the Trump Administration has taken steps to eliminate burdensome billing and coding requirements for Evaluation and Management (E/M) (or office/outpatient visits) that make up 20 percent of the spending under the Physician Fee Schedule. These billing and documentation requirements for E/M codes were established 20 years ago and have been subject to longstanding criticism from clinicians that they do not reflect current care practices and needs. After extensive stakeholder collaboration with the American Medical Association and others, simplified coding and billing requirements for E/M visits will go into effect January 1, 2021, saving clinicians 2.3 million hours per year in burden reduction. As a result of this change, clinicians will be able to make better use of their time and restore the doctor-patient relationship by spending less time on documenting visits and more time on treating their patients.

Additionally, last year, the Trump Administration finalized historic changes to increase payment rates for office/outpatient E/M visits beginning in 2021. The higher payment for E/M visits takes into account the changes in the practice of medicine, recognizing that additional resources are required of clinicians to take care of the Medicare patients, of which two-thirds have multiple chronic conditions. The prevalence of certain chronic conditions in the Medicare population is growing. For example, as of 2018, 68.9% of beneficiaries have 2 or more chronic conditions. In addition, between 2014 and 2018, the percent of beneficiaries with 6 or more chronic conditions has grown from 14.3% to 17.7%.

In this rule, CMS is proposing to similarly increase the value of many services that are comparable to or include office/outpatient E/M visits such as maternity care bundles, emergency department visits, end-stage renal disease capitated payment bundles, physical and occupational therapy evaluation services and others. The proposed adjustments, which implement recommendations from the American Medical Association, help to ensure that CMS is appropriately recognizing the kind of care where clinicians need to spend more face-to-face time with patients, like primary care and complex or chronic disease management.

Bolstering the Healthcare Workforce/Patients Over Paperwork

CMS is also taking steps to ensure that healthcare professionals can practice at the top of their professional training. During the COVID-19 public health emergency, CMS announced several temporary changes to expand workforce capacity and reduce clinician burden so that staffing levels remain high in response to the pandemic. As part of its Patients over Paperwork initiative to reduce regulatory burden for providers, CMS is proposing to make some of these temporary changes permanent following the PHE. Such proposed changes include nurse practitioners, clinical nurse specialists, physician assistants, and certified nurse-midwives (instead of only physicians) to supervise others performing diagnostic tests consistent with state law and licensure, providing that they maintain the required relationships with supervising/collaborating physicians as required by state law; clarifying that pharmacists can provide services as part of the professional services of a practitioner who bills Medicare; allowing physical and occupational therapy assistants (instead of only physical and occupational therapists) to provide maintenance therapy in outpatient settings; and allowing physical or occupational therapists, speech-language pathologists and other clinicians who directly bill Medicare to review and verify (sign and date), rather than re-document, information already entered by other members of the clinical team into a patient’s medical record.

Public comments on the proposed rules are due by October 5, 2020.

For a fact sheet on the CY 2021 Physician Fee Schedule (PFS) proposed rule, please visit: https://www.cms.gov/newsroom/fact-sheets/proposed-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year-4

For a fact sheet on the CY 2021 Quality Payment Program proposed rule, please visit: https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1100/2021%20QPP%20Proposed%20Rule%20Fact%20Sheet.pdf

For a fact sheet Medicare Diabetes Prevention Program- https://www.cms.gov/newsroom/fact-sheets/proposed-policies-medicare-diabetes-prevention-program-expanded-model-mdpp-calendar-year-2021

To view the CY 2021 Physician Fee Schedule and Quality Payment Program proposed rule, please visit: https://www.federalregister.gov/documents/2020/08/17/2020-17127/medicare-program-cy-2021-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other