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IRRC

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The Independent Regulatory Review Commission (IRRC) recently posted a proposed regulation from the Pennsylvania Department of State on behalf of the State Board of Physical Therapy (PT) for consideration.

The State Board of Physical Therapy (Board) proposes to amend §§ 40.1, 40.14, 40.15, 40.61, 40.63, 40.67, 40.163, 40.164, and 40.192. The proposed rulemaking will allow physical therapist (PT) students and physical therapist assistant (PTA) students to sit for the requisite examinations up to 90 days prior to graduation from their respective programs, and it will allow PTs and PTAs to receive a limited amount of continuing education credit for providing clinical instruction to student PTs and student PTAs at clinical facilities affiliated with accredited programs. Additionally, the proposed rulemaking will allow applicants to directly register for the national examination with the examination provider, by removing the requirement that the applicant first seek the Board’s permission. Lastly, it will allow applicants to sit for a third or successive examination, after two failures, without first seeking the Board’s permission.

The amendments will be effective upon notice or publication of the final-form rulemaking in the Pennsylvania Bulletin scheduled for January 27, 2024. The proposed regulation will be open for public comment upon publication, and comments will be accepted through February 26, 2024. Written comments, recommendations, or objections regarding this proposed rulemaking should be sent to Thomas M. Davis, Board Counsel, at P.O. Box 69523, Harrisburg, PA 17106-9523 or by email within 30 days of publication of this proposed rulemaking in the Pennsylvania Bulletin. Please reference “Regulation No. 16A-6522 (Early Exam, CE for Clinical Instruction, and AAP)” when submitting comments. IRRC comments on the proposed regulation will be due by March 27, 2024.

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A proposed regulation related to Adult Protective Services is currently posted on the Independent Regulatory Review Commission’s (IRRC) website. This proposed regulation “identifies mandatory reporters and prescribes penalties for their failure to report suspected abuse, neglect, exploitation, or abandonment; requires consistent and timely investigations of allegations; and when necessary, provides for protective services to mitigate risk to individuals.”

The public comment period has started and will end on May 22, 2023. Please take the opportunity to review the proposed regulation and submit any comments that you may have following the processes outlined within the timeframe allotted. Consider sharing your thoughts with Carol Ferenz or your policy division director by May 19, 2023, for inclusion in RCPA’s comments.

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Photo by Markus Winkler on Unsplash

The Pennsylvania Independent Regulatory Review Commission (IRRC) has approved RCPA’s request to review the RCPA IBHS Regulatory Review Recommendations within the context of the current IBHS regulations.

The premise of the recommendations addresses the challenges and barriers IBHS providers have faced in creating the staffing infrastructures and meeting the burdensome operational protocols for regulatory compliance. The overreaching nature of the regulations, coupled with the impact of the pandemic, has caused great strain on an already depleted behavioral health workforce. These system stressors limit the ability to provide vital, quality services to children and families. Due to the prohibition for the use of waiting lists, it is difficult to capture the true number of children and families going without these essential services. We contend there are thousands of children across the Commonwealth with unmet treatment needs and written orders for IBHS services who await care.

The current lack of access to care is a result of the workforce crisis and operational requirements of implementing the regulations. We feel these access issues and children waiting for services are compelling reasons, in the interest of the public, to merit a review of the regulations. We have also provided these recommendations to OMHSAS, the HealthChoices BHMCOs, and leadership in the Pennsylvania General Assembly.

RCPA extends its gratitude to our members and those who have supported this process as well as the IRRC for their review. There is no current timeframe for the review, as there are many other, similar regulatory review requests on the docket. With that said, we remain vigilant in our efforts and seek partnership and collaboration with all stakeholders to address the current crisis.

If you have any questions, please contact RCPA Mental Health Policy Director Jim Sharp.

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On behalf of the RCPA IBHS Providers and the children and families of Pennsylvania, RCPA has requested the Independent Regulatory Review Commission (IRRC) to reopen for review Regulation #14-546: Intensive Behavioral Health Services, based on section 8.1 of the Regulatory Review Act (71 P.S. § 745.8a).

The premise of our recommendations addresses the challenges and barriers IBHS providers have faced in creating the staffing infrastructures and meeting the burdensome operational protocols for regulatory compliance. The overreaching nature of the regulations, coupled with the impact of the pandemic, has caused great strain on an already depleted behavioral health workforce. These system stressors limit the ability to provide vital, quality services to children and families. Due to the prohibition for the use of waiting lists, it is difficult to capture the true number of children and families going without these essential services. We contend there are thousands of children across the Commonwealth with unmet treatment needs and written orders for IBHS services who await care.

The current lack of access to care is a result of the workforce crisis and operational requirements of implementing the regulations. We feel these access issues and children waiting for services are compelling reasons, in the interest of the public, to merit a review of the regulations.

The COVID-19 DHS regulatory flexibilities provided initial relief for providers, and OMHSAS continues to offer waivers to agencies experiencing critical staffing shortages. Providers are grateful for these temporary solutions; however, these waivers do not address the long-term impacts of the current regulatory requirements. Providers continue to struggle to hire qualified staff and contend with burdensome operational requirements, many of which negatively contribute to the efficiency of care delivery.

The expressed purpose of the IBHS regulations was to ensure access to quality care in a consistent and efficient manner. Conversely, the result has been a labyrinth of regulatory and operational interpretations, differentiated reimbursement for the same services, and a human services workforce crisis with no upcoming relief.

RCPA would like to thank the members of the RCPA IBHS Steering Committee for their commitment to conduct the review and the Commission for their willingness to consider this request. We believe these recommendations, if implemented, can address the barriers identified without compromising the original vision for high-quality services and broad access to care.

At last correspondence, the IRRC is in receipt of the recommendations. We will be providing a copy to the Office of Mental Health and Substance Abuse Services (OMHSAS), as requested by the Commission. We will continue to keep members apprised of the review process. If you have further questions, please contact RCPA Policy Director Jim Sharp.

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On Friday, October 1, the Department of Drug and Alcohol Programs (DDAP) resubmitted to the Independent Regulatory Review Commission (IRRC) its Final-Omitted Regulations on Standards for Drug and Alcohol Recovery House Licensure, as well as its response to IRRC’s disapproval order of Aug. 24, 2021.

The regulations are publicly available on IRRC’s website.

The submitted regulatory package includes the updated regulations (p. 98–129), as well as:

  • a regulatory analysis (p. 1–12);
  • IRRC’s disapproval order (p. 86–92);
  • DDAP’s response to IRRC’s disapproval order (p. 93–97);
  • a preamble that includes public comments and DDAP’s response to comments (p. 48–85);
  • a sample recovery house licensing application (p. 13–14);
  • a sample recovery house licensing checklist (p. 15–22); and
  • additional DDAP forms (p. 23–35), as well as a description of forms that must be provided by the recovery house (p. 36–46).

The above linked documents reflect the changes made to the regulations since DDAP appeared at IRRC’s public meeting in July. The revised regulations are scheduled to be considered at IRRC’s next public meeting on Thursday, October 21.

Upcoming Timeline:

  • DDAP expects that the new regulations will be in effect by October 2021.
  • DDAP expects to require compliance with the new regulations by April 2022.

Which Recovery Houses Will Need a License?

Once the new licensing program is in place, drug and alcohol recovery houses must have a license to:

  1. Receive referrals from state agencies or state-funded facilities; or
  2. Receive federal or state funding to deliver recovery house services.

In addition, the law imposes two additional requirements on referrals to recovery houses:

  1. People whose treatment is funded with state or federal funds shall only to be referred to licensed recovery houses.
  2. Courts shall give first consideration to licensed recovery houses when residential recommendations are made for individuals under their supervision.

Additional information on drug and alcohol recovery house licensing can be found here.

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On June 14, 2021, the Pennsylvania Department of Drug and Alcohol Programs (DDAP) resubmitted to the Independent Regulatory Review Commission (IRRC) its Final-Omitted Regulations on Standards for Drug and Alcohol Recovery House Licensure. As of yesterday afternoon, they are publicly available on IRRC’s website.

The submitted regulatory package includes:

  • the updated regulations (p. 49–78);
  • a regulatory analysis (p. 1–11);
  • a preamble that includes public comments and DDAP response to comments (p. 13–48);
  • a sample recovery house licensing application (p. 79–80);
  • a sample recovery house licensing checklist (p. 81–88);
  • additional DDAP forms (p. 89–101); and
  • a description of forms that must be provided by the recovery house (p. 102–112).

DDAP expects that the new regulations will be in effect by July 2021 and will require compliance with the new regulations by January 2022. More information on drug and alcohol recovery house licensing is available on DDAP’s website.

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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.

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