Govt. Affairs

The draft of the 2018–2019 Community Mental Health Services Block Grant (CMHSBG) is now available for comment. This application was developed with stakeholder input from the Mental Health Planning Council; view/download the application here.

The application provides a review of the current strengths and needs in the Pennsylvania Mental Health System and plans priority areas for improvement.

Any comments or questions regarding the 2018–2019 CMHSBG may be directed to Wendy Tucker via email or phone at 717-705-8280. The comment period will close August 31.

In the interest of time, please feel free to submit comments to Wendy Tucker directly; however, we would be very interested in your input into the draft. Please copy Sarah Eyster or Robena Spangler with your comments. Thank you for your anticipated response to this opportunity.

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Governor Wolf announced that he has selected Teresa Miller, current Commissioner for the Pennsylvania Insurance Department, to lead the Department of Human Services, effective Monday, August 21. Commissioner Miller’s leadership, advocacy, and dedication to the people of the Commonwealth have been evident during her tenure at Insurance, and the Governor’s Office is confident that she will lead DHS with those same characteristics and commitment. As Commissioner Miller joins DHS, Jessica Altman will begin serving at the helm of the Pennsylvania Insurance Department.

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The Federal Department of Labor (DOL) is seeking comments from the public concerning the Fair Labor Standards Act (FLSA) overtime exemptions regulations. As you may recall, the Obama Administration wanted to increase the overtime threshold from $23,660 to $47,476. At the time, RCPA submitted comments to the Department of Labor objecting to the increase. RCPA also presented testimony in front of the Pennsylvania State Senate regarding the impact that the DOL’s Overtime Exemption Rule would have on health and human service providers in Pennsylvania.

Before the rule took effect, a federal judge issued an injunction halting the FLSA rule. The judge granted the injunction because the FLSA rule “exceeded its delegated authority and ignored Congress’ intent such that it supplants the duties test.” (The duties test refers to one of the conditions that determines which workers are exempt from overtime rules.)

You may submit comments on the Federal Register’s website. Questions, contact Jack Phillips, RCPA Director of Government Affairs.

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Today, the Senate sent a package of five code bills back to the State House for their approval. Highlights of the codes bills are below:

Fiscal Code (House Bill 453)

The fiscal code directs how revenue is to be spent and contains local earmarks.

The fiscal code bill will:

  • Transfer $30.4 million from a settlement with Volkswagen to the General Fund. The Commonwealth will receive $30 million from Volkswagen as part of efforts to settle lawsuits stemming from the automaker’s diesel emissions-cheating scandal;
  • Require slot machine licenses issued this fiscal year be paid in full by June 30, 2018, thus generating an estimated $50 million for the General Fund;
  • Require repayment of an earlier $165 million transfer from the Workers’ Compensation Security Fund by July 1, 2019, thus easing General Fund costs this fiscal year;
  • Provide another $25 million for water and sewer projects awarded by the Commonwealth Financing Authority;
  • Authorize a $10 surcharge collected by the Unified Judicial System to be applied to traffic citations, thus generating $10 million for the system.

Additionally, the fiscal code directs spending for a host of community projects identified only as an unnamed education program or health care institution in a county or city with a specific population classification.

Human Services Code (House Bill 59)

The Senate Rules Committee removed a few of its Republican-crafted provisions, though most were left intact. The provisions removed from HB 59 include:

  • Eliminating a premium on disabled children and their families who receive Medical Assistance and have an annual income that exceeds 1000 percent of the federal poverty level;
  • Removing language that would have limited Medical Assistance recipients’ choices for managed care organizations. The House’s version would have required DHS to have a one-year, annual enrollment for medical assistance for an individual who is Medicaid-eligible, so the individual would stay on the MA/MCO plan for one year;
  • RCPA lobbied the Senate relentlessly to have the above provisions removed from HB 59.

The Senate left a provision in HB 59 that could potentially establish employment requirements for certain Medicaid recipients. The bill doesn’t inherently impose a work requirement on able-bodied Medicaid recipients, it would instead instruct the state’s Department of Human Services to seek waivers from the federal government to do so.

Administrative Code (House Bill 118)

The Administrative Code was the place where everyone was expecting the merger of the agencies to appear; however, the Administrative Code bill did not contain such language. Although the mergers are currently missing from the bill, there’s still plenty of time for them to be added.

The bill also:

  • Includes language to transfer $200 million from the Pennsylvania Professional Liability Joint Underwriting Association (PPLJUA) to the General Fund in Fiscal Year 2017-18;
  • Includes a proposal to transfer $200 million is to be transferred from the Pennsylvania Professional Liability Joint Underwriting Association (PPLJUA) to the General Fund. The PPLJUA is a non-profit association created by the state’s MCARE Act to offer medical liability insurance to health care providers.
  • Provides for several hikes in state fees to generate revenue. Some fee hikes include:
    • increasing the fee for a copy of a certified death record;
    • increasing various inspection and permit fees in the department of Labor and Industry;
    • increasing the fee for child welfare background checks from $10 to $13;
    • authorizing the Pennsylvania State Police to increase the fee for criminal background checks; and
    • setting fees on certain higher education institutions when they apply to operate in the state.
  • Extends the sunset date of the Municipal Recycling Fee to Jan. 1 2023 and repeal the transfer to the Solid Waste Abatement Fund;
  • Allows the Office of Attorney General to keep 25 percent of debt, taxes and accounts collected for the state up to $2.5 million per fiscal year;
  • Requires Department of Revenue employees who have access to federal tax information to provide a criminal history record and fingerprints;
  • Allows lawmakers on the Pennsylvania Commission on Crime and Delinquency Board to designate staff to be their alternate on the board;
  • Requires the Department of Health to establish a detoxification program in licensed health care facilities;
  • Requires the Department of Conservation and Natural Resources to study the feasibility of a state park in Wyoming County;
  • Extends the expiration date for permits issued to water treatment facilities that exclusively treat water from conventional oil and gas well operations;
  • Prohibits the closure of a correctional facility without a public hearing;
  • Establishes alternate contracting procedures for construction and renovation of certain county jails;
  • Exempts Living Independence for the Elderly (LIFE) programs from the Older Adults Daily Living Center licensing requirements; and
  • Sets the dispensing fees for the Pennsylvania Pharmaceutical Assistance Contract for the Elderly (PACE) and PACE Needs Enhancement Tier (PACENET) at $10.49.

Public School Code (House Bill 178)

House Bill 178, approved by the Senate Rules Committee on Wednesday night, doesn’t include any reference to additional funding for the EITC, which could be a sticking point for the House Republican Caucus, which strongly favors additional dollars for the program.

Unlike the House’s bill, the Senate’s version also provides schools with the option to conduct security drills in lieu of fire drills and applies a new truancy law implemented last year to nonpublic schools beginning in the 2018-19 school year.

Tax Code Bill (House Bill 542)

 

The Senate approved a Tax Code bill containing $571 million in new or increased taxes, along with borrowing $1.3 billion. Those funds, along with a $200 million transfer of funds and $200 million from a gambling bill that has yet to be resolved, are directed at closing a $2.2 billion deficit projected for Fiscal Year 2017-18, $1.5 billion of which was rolled over from the recently completed 2016-17 fiscal year.

The proposed taxes include:

  • A severance tax that will be in addition to the state’s existing impact fee paid by unconventional natural gas well drillers, with that fee to remain unchanged. The added severance tax, which is a levy of two-cents-per-thousand-cubic-feet of natural gas (Mcf) extracted for 2017-18, would be applied to the same wells subject to the impact fee and is expected to generate an additional $100 million during the current fiscal year, with that revenue directed into the General Fund;
  • A Gross Receipts Tax (GRT) on natural gas consumers, at 5.7 percent, meaning an additional $5.70 cents for every $100 a household spends on the natural gas they purchase. More than half of the state’s households use natural gas for home heating;
  • Increasing existing GRTs on electricity and telecommunications, from 5.9 percent to 6.5 percent for electricity, and from 5 percent to 6 percent for telecom bills. Combined, the planned GRT changes are estimated to deliver an additional $445.8 million in 2017-18;
  • Attempting to have third-party vendors, who sell items through Internet marketplaces like Amazon and eBay, remit Pennsylvania’s sales tax if they don’t currently do so. That idea could generate another $43.5 million;
  • Another $3 million in additional revenue is to be generated from taxing consumer fireworks (not those used by professional pyro-technicians license by the state) at a new 12 percent rate, which is in addition to the sales tax on such sales;
  • Another $200 million from some type of gaming expansion, but that bill will not be considered this week by the Senate;
  • Borrowing against the state’s expected Tobacco Settlement Fund payments. The planned bond, of up to $1.3 billion with no more than a 30-year repayment period, will have its borrowing costs either deducted from the more than $300 million the state receives each year from tobacco companies as part of the settlement, or from the General Fund; and

The bills above are now headed back to the House for their approval. It is yet to be determined if the House will return prior to their next scheduled Session date of Monday, September 11.

Questions contact Jack Phillips, RCPA Director of Government Affairs.

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A new Request for Information (RFI) has been released by the US Department of Labor. This RFI pertains to the overtime rule that defines those employees exempt from the minimum wage and overtime requirements of the Fair Labor Standards Act. In order to gather information to consider when deciding if and how to revise the regulation, the agency is requesting comments from the public.

RCPA is hosting a free educational webinar on the Federal ORP (order, refer, or prescribe) Requirements on Wednesday, August 16, 2017, 1:00 pm – 3:00 pm. The webinar will be presented by David C. McAdoo, MBA, Executive Director, Southwest Behavioral Health Management, Inc. and Jamie Buchenauer, Director, Bureau of Fee for Services. Registration is required. Please register here to participate.

The Affordable Care Act requires all physicians including psychiatrists, physician assistants, and certified registered nurse practitioners to directly enroll in PA State Medicaid (PROMISe) to order, refer, or prescribe medications, testing, services, or other items billed to Medicaid. Any MD acting as the Medical Director in a licensed substance abuse or mental health facility must meet this requirement for the facility to bill Medicaid. Specifically, each psychologist, MD, CRNP, or PA touching the PA State Medicaid program must have at least one PROMISE ID under the NPI number on their license.

This webinar will address the requirement, the specific services that are covered, documentation that must be collected, the modifications needed in claims to bill Medicaid moving forward, and strategies for maintaining patient safety and uninterrupted access to medication and services during the transition to full compliance with this new requirement.

Outline

  • Introductions
  • Overview of Goals
    1. Understand the purpose of the ORP
    2. Understand which medical licenses are covered under the ORP
    3. Understand which medications, labs, services, and other benefits are covered under the ORP
    4. Understand the impact of the ORP on Medicaid and Medicare access to:
      1. Medications
      2. Lab Testing
  • PH Testing
  1. Behavioral Health Services
    • BHR Services
    • Peer Support and Psych Rehab
    • Family Based
    • BH services with an identified “medical director”
  • Understand the technical requirements for paper and electronic claim submission compliance with the ORP
  • Identify the changes and/or modifications needed in BH services to document ORP compliance
  • Identify the actions that are needed to assure all clients have uninterrupted access to BH and all prescribed medications
  • Review the timelines for ORP implementation in PA

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This weekend, Senator McConnell announced that there would be no vote on the BCRA this week, and the Congressional Budget Office (CBO) announced that there would not be a score of the BCRA, either. Additionally, the State Senate is scheduled to return today in the midst of a possible state budget action. Because of this, Wednesday’s press conference is being postponed.  We will keep you updated on future events.