Tags Posts tagged with "Independent Regulatory Review Commission"

Independent Regulatory Review Commission

0 620

Governor Wolf has re-submitted his Overtime Rule to the Independent Regulatory Review Commission (IRRC). As you may recall, the Pennsylvania Senate towards the end of the Fall Session voted in favor of SB 79 to gradually increase Pennsylvania’s minimum wage to $9.50/hour over the next 18 months to two years. Prior to the Senate approving SB 79, the State Senate and Governor Wolf agreed to increase the state’s minimum wage by $2.25 from the current rate of $7.25, and in conjunction for raising the minimum wage, the Governor would not submit his proposed rule to expand overtime to low level managers for the next two years, until after the next governor is elected.

Despite the agreement between the State Senate and the Governor, SB 79 is now in the House Labor and Industry Committee, where it appears it will not receive a vote; therefore, the Governor has resubmitted his Overtime to Rule to the IRRC. The IRRC has placed the Governor’s Overtime Rule on its January 31 agenda.

RCPA, along with other statewide business groups and associations, are asking members to IMMEDIATELY contact House Leadership and members of the House Labor and Industry Committee, requesting that SB 79 receive a favorable vote out of committee and have a vote on the House floor.

Talking Points
RCPA supports an increase in the minimum wage for entry level health care workers. With an increase to minimum wage, the General Assembly needs to appropriate supplementary monies to cover the additional costs providers will incur to increase wages for managerial workers.

Most employers are already paying new hires and existing employees more than the proposed increase to the minimum wage in SB 79, due to market demands.

The Governor’s Overtime Rule will have a more detrimental effect on employers than an increase to the minimum wage. Questions, please contact Jack Phillips.

Today, the 55 Pa. Code Chapter 1155, Intensive Behavioral Health Services and the 55 Pa. Code Chapter 5240, Intensive Behavioral Health Services were unanimously approved by the Independent Regulatory Review Commission (IRRC).  These regulations are the result of an OMHSAS and stakeholder partnership that included a 75-person statewide work group that began in May of 2016.

During testimony, Acting Deputy Secretary Val Vicari, provided an overview of the process, as well as addressing the need for revisions to the regulatory reform language around staffing qualifications for individual services, ABA, and group services ensuring fidelity to each specific treatment modality. Additionally, areas of supervision were included in the Deputy Secretary’s comments that adjustments to the operational language will need to be consistent across the regulations.

Several attendees provided testimony on the record, including Jim Sharp, RCPA Children’s Division director. While RCPA supports the broad scope of the IBHS regulations, their noted concerns regarding the preservation of Individual Services delivery standards, operationalizing staff supervision activities, and the creation of a program sustaining fiscal rate infrastructure model were all addressed in the OMHSAS position to advance the approval of the regulations.

RCPA congratulates the Department of Human Services (DHS); OHMSAS Acting Deputy Secretary Val Vicari, as well as Children’s Bureau Director Scott Talley and team. We would also like to express our gratitude to the RCPA IBHS work group and Children’s Division Steering Committee for their dedicated efforts during this process and their integral thoughts in preparing for the IRRC IBHS hearing this week.

The RPCA Children’s Steering Committee will continue to monitor the progress of the IBHS regulations as they move to the Office of the Attorney General.

RCPA will send the final regulations out as soon as they are approved by the Office of the Attorney General and published by DHS.

Contact Jim Sharp, RCPA Children’s Division Director, with questions.

Today, the 55 Pa. Code Chapter 1153, Outpatient Psychiatric Services and 55 Pa. Code Chapter 5200, Psychiatric Outpatient Clinics were approved unanimously by the Independent Regulatory Review Commission (IRRC). This has been a long time coming. These regulations are the result of a work group that began in late 2013 and was adjusted and updated over the course of the last several years. The next stop is the Office of the Attorney General.

The need for revisions to the regulatory reform process was discussed, and IRRC leaders reminded the attendees that the IRRC is a place for re-review three years after promulgation.

While RCPA congratulates the Department of Human Services (DHS) on this latest development, RPCA members continue to work on a redesigned outpatient model to present to DHS and payors.

RCPA will send the final regulations out as soon as they are approved by the Office of the Attorney General and published by DHS. Contact RCPA Mental Health Division Director Sarah Eyster or RCPA Children’s Division Director Jim Sharp with questions.

0 2756

RCPA is pleased to report that the long-awaited Outpatient Regulations have been submitted to the Pennsylvania’s Independent Regulatory Review Commission (IRRC). A copy is available of the final-form annex of the Outpatient Regulations, 55 Pa. Code Chapter 1153, Outpatient Psychiatric Services and 55 Pa. Code Chapter 5200, Psychiatric Outpatient Clinics. Also available is the regulatory summary, which indicates that the final regulations will be published in September 2019.

A few of the highlights include the new requirements for psychiatric time, staffing patterns, and time frame for the development, review, and sign-off of treatment plans. Below is an excerpt from the regulatory summary:

“Previously, a psychiatric outpatient clinic was required to have a psychiatrist at the clinic for at least 16 hours each week and employ four full-time equivalent (FTE) mental health professionals regardless of the number of individuals being served. The regulation amends the requirements for staffing patterns and psychiatric time by allowing 50% of the treatment staff who provide psychotherapy to be mental health professionals and requiring 2 hours of psychiatric time for each FTE mental health professional and mental health worker per week. Additionally, although 50% of the psychiatric time must be provided by the psychiatrist at the psychiatric outpatient clinic, the final-form rulemaking allows the other 50% to be provided by an advanced practice professional or by a psychiatrist offsite through the use of tele-behavioral health, or by a combination of advanced practice professionals and tele-behavioral health, consistent with the OPOA.

The final-form rulemaking allows 30 days for the development, review, and sign-off of the initial treatment plan, and extends the time frame for treatment plan updates to 180 days. In addition to changes to the time frame for the treatment planning process, the rulemaking allows a psychiatrist or an advanced practice professional to review and sign the initial treatment plan. Previously, only a psychiatrist could review and sign an initial treatment plan or update. The final-form rulemaking also allows the treatment plan updates to be reviewed and signed by the primary professional providing services to the individual at the psychiatric outpatient clinic. The primary professional may be the mental health worker under the supervision of a mental health professional or a mental health professional. For individuals receiving medication management services, the primary professional may be a physician, an advanced practice professional, a certified registered nurse practitioner (CRNP), or a physician assistant (PA) prescribing medication within the practitioner’s scope of practice. The rulemaking will improve access to medically necessary behavioral health services, including medication management services, and allow licensed professionals such as advanced practice professionals, CRNPs, PAs, or mental health professionals to provide services within their scope of practice when employed by a psychiatric outpatient clinic.”

RCPA looks forward to attending the IRRC meeting when these regulations are presented for approval. Further updates will be provided. If you have any questions in the meantime, contact Sarah Eyster.

Today the Independent Regulatory Review Commission (IRRC) approved the adoption of the proposed Chapter 6100 regulations and the accompanying changes to Chapter 2380, 2390, 6400, and 6500 (program requirements for licensed residential and day facilities). The revisions made to the four licensing chapters align requirements to provide continuity across all programs, eliminate conflict for providers, and reduce DHS oversight complexity and costs. Areas that are now compatible include individual planning, individual rights, staff training, incident management, medication administration, and restrictive procedures. Chapter 6100 replaces Chapter 51 which previously regulated program and fiscal rules for services provided in facilities and in the home and Chapter 6200 Room and Board Regulations.

Chapter 6100 was developed over a four-year period of time, with much input from stakeholders including a work group made up of 45 individuals, families, advocates, universities, county programs, and providers that met 15 days over the four years. A smaller fiscal work group also met several times in 2015. Much public comment was received and major changes were made from proposed rulemaking to the final regulations as a result.

Now that the IRRC has approved the regulation, the next step is for the package to be sent to the Attorney General for approval and then to the Legislative Reference Bureau for publication in Pennsylvania Bulletin. It is anticipated that publication will occur on December 29, 2018.

The effective dates will be as follows:

  • Date of Publication (target date is December 29, 2018) – Reserved Capacity, Claims, Progress Notes, Payment, Enforcement, AWC, OHCDS, Vendors
  • March 17, 2019 – Size of Service Location
  • 120 Days following publication (target date April 29, 2019) – Licensing and Remaining Sections of Chapter 6100

Any questions, contact Carol Ferenz, RCPA IDD Division Director.