Mental Health

The National Council Conference will be held Mon–Wed, April 23–25, 2018, at the Gaylord National Resort & Convention Center, Washington, DC. This event is the health care industry’s foremost behavioral health conference. Each year, more than 5,000 leaders like you explore health care’s greatest innovations in practice improvement, financing, integrated health care, technology, policy and advocacy, and professional development at the National Council Conference. Pennsylvania is consistently among the most well represented groups from around the country.

Please register before Friday, December 1, 2017, to take advantage of a special preview rate. RCPA members are offered a more deeply discounted registration; please use the coupon code 18memberPA for an additional $225 in savings. Contact Richard Edley with any additional questions.

(From OMHSAS)

The Department of Human Services is making available for public review and comment the proposed Federal Section 1115 Demonstration waiver application for substance use disorder (SUD) services.

The purpose of this Demonstration is to afford continued access to high quality, medically necessary treatment for opioid use disorder (OUD) and other substance use disorders (SUDs). Pennsylvania recognizes the importance of a full continuum of treatment services, including residential services that are provided in a cost-effective manner and for a length of stay that is governed by appropriate clinical guidelines.  This Demonstration is critical to provide the necessary funding to support the continuation of medically necessary services.

The goals of this Demonstration are to:

  1. Improve the overall population health outcomes for Medicaid beneficiaries diagnosed with a substance use disorder by:
    1. Reducing overdose deaths
    2. Increasing the number of Medicaid beneficiaries who access substance use treatment
    3. Increasing the rate of retention in treatment across all levels of care
  2. Decrease utilization of high-cost emergency department and hospital services by:
    1. Decreasing the number of emergency department visits and inpatient admissions
    2. Decreasing the number of readmissions to the same level of care or higher levels of care for a primary SUD diagnosis
  3. Improve care transition across the continuum of substance use services by:
    1. Enhancing coordination of care with other behavioral and physical health services
    2. Enhancing the process for transitions between levels of care

The 1115 Demonstration waiver application is available here. In addition, copies of the application are available upon written request to the Director, Bureau of Policy, Planning, and Program Development, Office of Mental Health and Substance Abuse Services, 11th Floor Commonwealth Tower, 303 Walnut Street, Harrisburg, PA 17101.

The Department will hold four public hearings throughout the Commonwealth to accept testimony on the proposed 1115 Demonstration waiver application.  The Department will also present updates and solicit comment on the waiver application at the Medical Assistance Advisory Committee meeting on December 14, 2017.

The schedule of dates, times and locations for the public hearings is listed below:

Public Hearing Schedule

December 4, 2017, 10:00 a.m. to 12 noon
OMHSAS NE Field Office Conference Room
100 Lackawanna Avenue
Scranton, PA

December 5, 2017, 10:00 a.m. to 12 noon
Norristown State Hospital Auditorium
1001 Sterigere Street
Norristown, PA

December 8, 2017, 8:00 a.m. to 10:00 am
Child Welfare Resource Center
403 East Winding Hill Road
Mechanicsburg, PA

December 11, 2017 from 1:00 p.m. to 3:00 pm
Shenango Crossing
2520 New Butler Road
New Castle, PA 16101

Public Comment

The Department seeks public input on the proposed 1115 Demonstration waiver application for SUD services.  The 30-day public comment period began on November 18, 2017 and ends on December 18, 2017.  Persons who wish to testify on the proposed 1115 Demonstration waiver application at one of the public hearings should schedule a time by telephoning (717) 772-7900.  Persons from outside the Harrisburg area may send a written request, including telephone number, to Satoko Hariyama, Bureau of Policy, Planning, and Program Development, Office of Mental Health and Substance Abuse Services, 11th Floor, Commonwealth Tower, 303 Walnut Street, Harrisburg, PA 17101.

Individuals also may submit written comments at any of the public hearings or by email or by mail to the address of the contact person identified above.  The Department will consider all comments received by December 18, 2017 in developing the final waiver application.

Persons with a disability who require auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

The Wolf Administration has launched the Pennsylvania Link to Community Care website, which connects older Pennsylvanians and individuals with a disability or behavioral health need to services and supports available in their community.

The website provides users with a wide variety of resources, including a home care directory and an information referral tool. It is a collaboration of the departments of Aging (PDA) and Human Services (DHS), and is an extension of PDA’s Aging and Disability Resource call center. By providing assistance online, the initiative further enhances the Commonwealth’s efforts to help Pennsylvanians locate and best utilize services at the local level.

The site features 12 service and support categories: Advocacy, Behavioral Health, Employment, Finance, Health Care, Housing, In-Home Services, Legal, Meals, Protection from Abuse, Support Groups, and Transportation.

Users can find information about organizations, services, and programs within these categories. A major component to the site is the home care directory, which connects individuals to in-home services available in their counties. In-home service providers appearing on the searchable directory may offer personal care, assistance with activities of daily living, companionship services, respite care, and/or habilitation services.

If you are an in-home service provider licensed by the Pennsylvania Department of Health, and would like to appear on the home care directory, you may submit your information by navigating to the footer of the site and selecting “Apply.”

In addition to the home care directory, another major feature of the website is the information referral tool. This tool guides users through a series of questions and then provides a list of resources based on their specific needs.

Moving forward, the departments of Aging and Human Services will continue to enhance the website using data and feedback from users, and expand the resources and information provided through the site. This includes working with your organization and other stakeholders to increase the number of options appearing within each category. Read the press release here.

The Pennsylvania Office of Vocational Rehabilitation (OVR) has announced that individuals who are interested in OVR services can complete a pre-application online through JobGateway. This is considered to be a streamlined approach that should expedite the process of connecting with OVR services. To request services, a person can simply complete and submit the online pre-application using these instructions. Anyone having difficulty completing their pre-application can contact their closest OVR district office for assistance.

It is important to note that completing a pre-application online is not required; rather, it is being made available to streamline the process.

Anyone can refer themselves or someone else to OVR. If not using the online process, then simply call OVR’s toll free number (1-800-442-6351 voice/1-866-830-7327 TTY) or a district office. OVR exists to assist people with disabilities in securing or maintaining employment and independence. Generally, people are eligible for OVR services if they have a “physical or mental impairment that results in a significant impediment to employment.” Additional information about OVR, who can be served, and the services available through OVR can be found here.

The ABFT training originally scheduled for November 15, December 5, and December 6 has been rescheduled.

THE NEW DATES ARE:

We want to thank the providers who expressed an interest. Registration fees will be refunded unless you specify otherwise. For instance, if you wish to retain your registration status and keep your spot reserved, to determine if the newly scheduled dates work for you and/or your clinical staff, we could place the registration fees “ON HOLD” for you.

We have been consulting with the model developers at Drexel University and our partners at OMHSAS Children’s Bureau to update the plan for making this a successful training. We have negotiated reduced fees for the total training package in hopes of attracting more trainees.

The clinical strategies of ABFT can be utilized in various child serving programs to include schools, outpatient clinics, and residential treatment programs. It is designed to treat depression and prevent suicide among adolescents and young adults, ages 14–24.

Download the updated registration brochure here. If you have any questions or concerns, please contact Robena Spangler.

The Substance Abuse and Mental Health Services Administration (SAMHSA) offers 14 self-paced online business courses to behavioral health organizations and providers through BHbusiness. The courses are available at no cost and participants can earn continuing education credits at their own pace.

New courses include Value-Based Purchasing and Bundled Payments. Other course offerings include:

  • Data-Driven Decision Making;
  • New Business Planning;
  • Assessing Your Readiness in Integrating Primary Care;
  • Costing Out Your Services;
  • Effectively Marketing Your Services;
  • Exploring Affiliations and Mergers;
  • Improving Your Third Party Billing System;
  • Planning For the Next Generation of HIT (Health Information Technology);
  • State Assessment on Sustaining SUD Service for Safety Net Populations;
  • Strategic Business Decision Making;
  • Third Party Contract Negotiations; and
  • Eligibility and Enrollment: The ACA, Insurance Eligibility, and Your Business.

The link to the registration page can be found here.

“Vulnerability sounds like truth and feels like courage. Truth and courage aren’t always comfortable, but they’re never weakness.” — Brené Brown

Register for NatCon18 – the National Council Conference – to experience the dynamic Brené Brown and her life-affirming message. Dr. Brown challenges us to view vulnerability in a new way – as a source of courage.

More than 30 million people have viewed her life-changing TED talk, The Power of Vulnerability, and she has written four New York Times #1 best-sellers based on her 16 years of research on courage, vulnerability, shame and empathy.

You can expect the most provocative and relevant speakers and educational offerings in behavioral health at NatCon18. More than 5,000 attendees expect the very best – and they get it.

Register today for NatCon18 and remember to take advantage of the RCPA Member Discount!

On November 3, 2017, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2018 Medicare Physician Fee Schedule final rule. The proposed rule updates payment policies, payment rates, and quality provisions for services with an overall payment update of .41 percent.

Some of the key provisions finalized in the rule include:

  • Addition of several codes to the list of telehealth services, eliminating the required reporting of the telehealth modifier GT for professional claims in an effort to reduce administrative burden for practitioners, and separating payment for CPT code 99091, which describes certain remote patient monitoring, for 2018;
  • Adoption of CPT codes for CY 2018 for reporting several care management services currently reported using Medicare G-codes and clarifying a few policies regarding chronic care management;
  • Increase in payment rates for office-based behavioral health services that better recognizes overhead expenses for office-based face-to-face services with a patient;
  • Revision of Part B drug payments for infusion drugs furnished through an item of durable medical equipment (DME) to conform with requirements of the 21st Century Cures Act;
  • Revision of payment for chronic care management in Rural Health Clinics (RHCs) and Federally-Qualified Health Centers (FQHCs), and establishing requirements and payment for RHCs and FQHCs furnishing general behavioral health integration (BHI) services and psychiatric collaborative care model (CoCM) services;
  • Implementation of the Medicare Diabetes Prevention Program (MDPP) expanded model starting in 2018;
  • Change to the current Physician Quality Reporting System (PQRS) program policy that requires reporting of 9 measures across 3 National Quality Strategy domains to only require reporting of 6 measures for the PQRS with no domain requirement; and
  • Revision to the rules for accountable care organizations (ACOs) participating in the Medicare Shared Savings Program to reduce burden and streamline program operations.

In addition, CMS indicated they will continue to consider the following based on comments from stakeholders:

  • Stakeholder input in response to the proposed rule’s comment solicitation on how CMS could expand access to telehealth services, within the current statutory authority;
  • Reviewing and updating “outdated” Evaluation and Management (E/M) visit codes; and
  • Reviewing stakeholders’ comments for potential future rulemaking or publication of sub-regulatory guidance pertaining to the Clinical Laboratory Fee Schedule (CLFS) data collection and reporting periods.

The final rule will be published in the November 15, 2017 Federal Register.

Overdose deaths from heroin and prescription drug abuse pose a public health crisis. In 2016, 4,642 drug-related overdose deaths were reported in Pennsylvania – an increase of 37 percent from 2015 – and every day 13 Pennsylvanians die of a drug overdose.

Yesterday, President Trump officially declared the opioid crisis a public health emergency. This declaration will allow states to redirect federal funds to the opioid crisis. However, it provides no new federal funding. RCPA was pleased to learn that President Trump proposed relaxing the Institutions of Mental Diseases (IMD) exclusion for inpatient substance use disorder treatment. The IMD exclusion, which bars Medicaid payment for services delivered in certain facilities with 16 or more beds, has been a major barrier against patients accessing treatment. Pennsylvania officials have stated on numerous occasions that they clearly understand the severity of the IMD exclusion and are working on numerous ways to resolve the problem. Trump’s announcement will likely make that easier to accomplish. This announcement may also allow for expanded access to telemedicine, including remote prescribing for medication-assisted treatment.

Governor Wolf stated that “President Trump’s decision to declare the opioid epidemic a public health emergency is an important step, but this is only the beginning.” He added that “Without a commitment to fund the crisis in specific ways, it’s difficult to say how much this declaration can do. While an awareness of this critical health emergency is important, an increased availability of grant money would help. Every effort to fund treatment, including medication-assisted treatment options, should be explored.”

Pennsylvania has numerous efforts underway to respond to this crisis. Governor Tom Wolf announced at the end of September that Pennsylvania, through its Department of Drug and Alcohol Programs (DDAP), had been awarded a $5.7 million Medication-Assisted Treatment Prescription Drug and Opioid Addiction (MAT-PDOA) grant from the US Department of Health and Human Services, to help in the state’s ongoing fight against the opioid epidemic. The US Department of Health and Human Services also awarded Pennsylvania a $26.5 million grant, funded by the 21st Century Cures Act, signed into law by President Obama in December 2016. Pennsylvania will soon award four $1 million federal PA Coordinated MAT grants to providers in Pennsylvania, via the 21st Century CURES grant funding. Over the next two years, the grant is intended to help combat the heroin and opioid epidemic. In addition, 45 Centers of Excellence (COE) have been implemented to better initiate people into — and keep them engaged in — treatment. DDAP is also working to expand the “warm handoff” process to get overdose survivors directly into treatment. DDAP has implemented a hotline to direct people needing help with treatment (800-662-HELP).

RCPA members have welcomed these initiatives, but members continue to emphasize the need for more funding for basic services. Many rates provided do not even cover the full cost of treatment; the drug and alcohol program has been chronically underfunded for many years. Increased capacity and improved access must be fully funded and that will take new and additional resources. Persons and families struggling for help with an opioid addiction should not have to wait for beds/placements — it is a matter of life or death.

Contact Lynn Cooper, RCPA Director, Drug & Alcohol Division, with any questions.

The Office of Developmental Programs and the Office of Mental Health and Substance Abuse Services has circulated information on the next two offerings in the Dual Diagnosis Professional Conference Series. There is no registration fee but pre-registration is required.

  1. Title: Drumming & Autism

Description: A four-hour workshop designed to show people how to facilitate rhythmic interventions with people with Autism Spectrum Disorder (ASD). This training is beginner friendly and requires no musical ability to be successful. These clinically proven techniques were developed at Saint Francis University and are designed to meet goals such as:

  • Increased attention to task;
  • Non-verbal expression;
  • Socialization; and
  • Stress reduction for individuals on the autism spectrum and other disabilities.

Audience: People providing clinical or other direct support to individuals with Autism Spectrum Disorder.
Date: Monday, November 20, 2017
Time: 10:00 am – 3:00 pm
Location: Torrance State Hospital (Torrance, PA)
Register here
Additional Information can be found here.

  1. Title: Delving More Deeply into Biographical Timeline Facilitation

Description: Will explore clinical and group dynamic issues that arise during the facilitation as well as approaches to help assure that the awareness developed during a biographical timeline process translate into better supports and clinical interventions. Questions collected in advance via a participants’ survey will be addressed during the training.

Audience: People trained in biographical timeline facilitation or who facilitate and/or attend the process regularly and want to enrich the experience and outcomes.
Date: Friday, December 1, 2017
Time: 9:00 am – 3:00 pm
Location: PA Child Welfare Resource Center (Mechanicsburg, PA)
Register here
Additional information can be found here.

A MyODP account will be required in order to register for these events. If you need technical assistance, please email the MyODP HelpDesk. If you have questions about these programs, please email Carmen Culver.