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.

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RCPA sent a letter to the leadership and support of the Office of Mental Health and Substance Abuse Services (OMHSAS) and the Department of Drug and Alcohol Programs (DDAP), requesting that a task force be formed to review and change the extremely outdated drug and alcohol medical assistance outpatient regulations, Chapter 1223 Outpatient Drug and Alcohol Clinic Services. OMHSAS did an outstanding job of organizing a task force and developing regulation changes for mental health outpatient services. These much improved regulations are in the last stages of being finalized. The same process needs to be implemented for drug and alcohol outpatient services. As stated many times before, outpatient treatment in Pennsylvania is at risk of collapse.

A number of years ago, RCPA (known as PCPA at the time) developed a white paper, which highlights the value of outpatient services, reviews the current challenges/threats to services, and outlines what needs to happen to assure the viability of these critical services. The paper emphasizes that when utilized appropriately, outpatient treatment can save millions of dollars in inpatient and emergency room costs. The paper also highlights specific clinical, regulatory, and financial challenges, and makes recommendations for changes in both mental health and drug and alcohol services.

As with the mental health outpatient regulation changes, changes in the drug and alcohol outpatient regulations will save money, improve access and services, reduce unnecessary paperwork, update clinical terminology, update treatment trends, and improve outcomes.

RCPA requested that a time limited group of stakeholders be convened to evaluate drug and alcohol outpatient medical assistance regulation issues and make recommendations for much needed changes. Given the current issues that exist, this task force needs to be implemented as soon as possible. Contact Lynn Cooper with questions or for any additional information.

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RCPA received the Collaborative Documentation Guidelines issued by the Office of Mental Health and Substance Abuse Services (OMHSAS) today. RCPA is pleased that OMHSAS has issued these guidelines, which support the recovery process for people receiving services by supporting the therapeutic process. The guidelines are here for your review.

Critical to implementing collaborative documentation in your organization is the creation of policies which utilize the guidelines for defining it. These policies should be developed for each service line which will utilize collaborative documentation and be ready for review at future licensing visits. For further information, please contact Sarah Eyster.

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Secretary Ted Dallas sent a notice out on April 20 highlighting the changes resulting from the Affordable Care Act (ACA). If you enrolled on or before March 25, 2011, you must be revalidated by March 24, 2016; if you enrolled after March 25, 2011, your revalidation must occur on or before five years from the date of initial enrollment. The Pennsylvania Office of Medical Assistance Programs issued a Bulletin on Provider Revalidation on March 7, 2014.

Information is available on the DHS website regarding the requirements and process of revalidation (also called re-enrollment). Also included is a link to the Quick Tip 155 to view each service location revalidation due date.

Access the most current Pennsylvania PROMISe™ Provider Enrollment base application, dated March 2.

Two program offices have issued additional information:

The Office of Long Term Living required all of their providers to re-enroll as Provider Type 59 by December 31, 2014.
*Information provided by Joan Martin, senior associate, S.R. Wojdak & Associates

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The Department of Human Services has prepared training/informational guides to help providers, business and community partners in the transition to the new HealthChoices Expansion Program. These were added to the HealthChoicesPA.com website under the Provider Information tab.

Included are the following:

  • Eligibility Verification System
  • Benefit Package Coverage and Limits
  • Transition Plans
  • Continuity of Care
  • Template for Resources
  • Recipient Benefit Package
  • Copayments
  • Health Screening