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Govt. Affairs

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The Philadelphia Department of Health has issued clarification on the vaccine status of Direct Support Professionals (DSPs) being in Phase 1A. In their initial letter, they incorrectly left out Behavioral Health DSPs and only mentioned those who are working with individuals with ID/Autism. This was an oversight, and they have now corrected it both on their website and in the letter.

Hence, all DSPs are considered to fall into Phase 1A, regardless of what service line they work in. Please contact your RCPA Policy Director for further clarification.

The Pennsylvania House Appropriations Committee held its Department of Drug and Alcohol Programs (DDAP) budget hearing on Wednesday, Feb. 24. The entire hearing, which took just under 45 minutes, can be viewed here. In addition, DDAP budget documents, including the governor’s executive budget (known as the Bluebook), a list of the agency’s contracts, and its request for approval of federal funds can be viewed here.

At the hearing, DDAP Secretary Jennifer Smith and Deputy Secretary Ellen DiDomenico answered questions from the committee.

Pennsylvania Legislative Services wrote the following summary:

Committee members present included Chairman Stan Saylor (R-York), Minority Chairman Matt Bradford (D-Montgomery), and Representatives Rosemary Brown (R-Monroe), Lynda Culver (R-Northumberland), Torren Ecker (R-Adams), Jonathan Fritz (R-Susquehanna), Keith Greiner (R-Lancaster), Doyle Heffley (R-Carbon), Johnathan Hershey (R-Juniata), Lee James (R-Venango), John Lawrence (R-Chester), Zach Mako (R-Northampton), Natalie Mihalek (R-Allegheny), Tim O’Neal (R-Washington), Clint Owlett (R-Tioga), Chris Quinn (R-Delaware), Greg Rothman (R-Cumberland), Meghan Schroeder (R-Bucks), James Struzzi (R-Indiana), Ryan Warner (R-Fayette), Jeff Wheeland (R-Lycoming), David Zimmerman (R-Lancaster), Amen Brown (D-Philadelphia), Donna Bullock (D-Philadelphia), Morgan Cephas (D-Philadelphia), Austin Davis (D-Allegheny), Elizabeth Fiedler (D-Philadelphia), Marty Flynn (D-Lackawanna), Ed Gainey (D-Allegheny), Patty Kim (D-Dauphin), Emily Kinkead (D-Allegheny), Stephen Kinsey (D-Philadelphia), Leanne Krueger (D-Delaware), Ben Sanchez (D-Montgomery), Peter Schweyer (D-Lehigh), and Joe Webster (D-Montgomery).

Rep. Heffley commented that the General Assembly passed legislation in the previous session to create a bed registry for drug rehabilitation facilities to announce openings. He noted that the registry is not open to the public. He asked what percentage of those facilities are listed on the website. Sec. Smith answered that the open bed website has not been used as widely this year as in prior years; rather, she said, “our hotlines are really the most important mechanism for folks to access treatment services.” She explained that those who operate the hotlines work with their provider network on a daily basis. “Even with a bed registry type of pool, without it being absolutely real-time, there’s still a need for single county authorities or hotlines to comb through providers and figure out if open beds are really available or not available,” she said. Sec. Smith lauded the single county authorities in Pennsylvania for their close relationship with providers.

Rep. Heffley pointed out that there still is a disconnect between wait times for treatment. He added that many hospitals keep bed registries in case of disaster emergencies through a federal program and asked if Sec. Smith had inquired if that system could be expanded for drug rehabilitation openings. Sec. Smith responded that DDAP partnered with the Department of Health (DOH) to send a letter to the federal government; however, they were advised that the federal bed registry system was not available for states to use.

Rep. Heffley explained that his conversations with law enforcement and other officials have revealed the expansion of methamphetamine use during the pandemic. He asked what DDAP has done to aid in reducing the expansion. Sec. Smith stated that she had previously spoken about the reemergence of methamphetamine and reported that Pennsylvania is one of the few states that has hosted symposiums on addressing the issue. She noted that law enforcement started to report higher seizure rates of both methamphetamine and cocaine several years prior. “We know that there’s a very strong correlation between drug seizures and what follows is the usage of those substances and people presenting themselves for treatment with those issues,” she said. Sec. Smith detailed that many drug users are using several different drugs, which compounds their addiction and may deteriorate the success rate of treatment or the use of naloxone. She noted that while opioid addiction may be treated through medication, there is no available medication for methamphetamine. Sec. Smith expounded that DDAP has worked to roll out information about addiction to multiple substances and there are programs available for individuals through the provider community. “Stimulants, in combination with COVID-19, is what has contributed to an increase of overdose deaths in 2020,” she said.

Rep. Cephas inquired about how DDAP addresses maternal mortality. She noted that the media has elevated the interest in maternal mortality and several solutions have received bipartisan support. “As much as we’re paying attention to the issue and as much as we’re shifting policy, we are still nowhere near out of the woods in terms of reversing the trends in Pennsylvania,” she said. She stated that a recent report found that maternal mortality has increased in the commonwealth, with 60 percent due to accidental poisoning, which includes drug overdoses. She asked what DDAP is doing to reduce accidental poisoning deaths. Sec. Smith pointed out that the State Opioid Response grant is delivering a large amount of federal funds to address opioid overdoses. “One of the grant opportunities that we provided is focused on pregnant and parenting women, specifically,” she said. “That grant was able to serve 500 mother and child combinations just during the first year of the grant.” She added that several intrastate workgroups have also been formed to create solutions. She explained DDAP created a perinatal quality collaborative, which works to reduce maternal fatality and improve care for women who have recently given birth or are still pregnant. “What this project really does is pull together teams that create learning sessions. They work together to create different quality improvement projects to access coaching and resources to specifically improve the programs they have in place,” she said.

DiDomenico added that the quality improvement project focuses on the issue of maternal mortality from a systematic level, such as working with health care providers to ensure that patients “don’t fall through the cracks.” Particularly, DiDomenico stated that the program seeks to help children born with substance use disorder.

Rep. Rothman questioned how DDAP met the needs of those seeking treatment during the pandemic. Sec. Smith replied that DDAP was fortunate that the federal government made quick changes to allow for increased access to medication, such as increasing the allotted time for an individual taking medication like Suboxone from 14 days to 28 days and waiving face-to-face evaluations.

Rep. Rothman asked for Sec. Smith’s professional opinion on the legalization of recreational marijuana within Pennsylvania. Sec. Smith responded that although she fully supports the decriminalization of marijuana, the legalization of recreational marijuana must be accompanied by stringent reporting methods, strict control and deep studies.

Rep. Rothman asked if marijuana is a gateway drug and if those who use marijuana at a younger age are more likely to become addicted. Sec. Smith explained that she is unsure if it is a gateway drug but studies have shown that individuals who have stayed at rehabilitation facilities very often report using marijuana.

Rep. Kinsey asked for Sec. Smith to explain the Pennsylvania Coordinated Medication-Assisted Treatment (PaCMAT) program. Sec. Smith detailed that the program is geared to allow physicians who do not specialize in substance abuse disorder to treat their patients with opioid abuse disorder through an organization that is able to provide advice to those doctors. She added that the program is funded through a federal grant.

Rep. Struzzi cited recent statistics on opioid deaths and overdoses, which have reported that while deaths are down from 2019, overdoses have doubled. He asked for an overview of DDAP’s plans to address the issue. Sec. Smith responded that the number of deaths in 2020 from overdose has not been fully realized due to delays in reporting. She elucidated that she expects the number to be as high as the peak of the opioid epidemic. She explained that the increased rate of overdose without death is due to DDAP’s efforts to make Narcan more readily available. She stated that the hotlines have also been indispensable in providing treatment. “We’re going to continue this work and I’m hopeful that we will see those numbers turn the other direction in 2021,” she said.

Rep. Schroeder inquired about Act 59 of 2017, which requires DDAP to regulate alcohol and drug recovery houses that receive public funds. She explained that the licensing was supposed to start by June 2020. She asked why DDAP’s policy was not sent to the Independent Regulatory Review Commission (IRRC). Sec. Smith stated that although COVID-19 contributed to the delay at the end of the process, the majority of the delay is attributed to DDAP engaging in a public comment period due to the amount of interest in the policy. She announced that DDAP is working this week to meet with the oversight chairs in the House and Senate for delivery of the final regulations for review.

Rep. Schroeder asked if the 40 to 60 recovery houses still receive public funds. DiDomenico confirmed that fact. She added that once the regulations are published DDAP will begin accepting applications for licensing, and staff has already been hired to begin the on-site inspection. Sec. Smith stated that the fee for the license is $200.

Rep. James asked if drug users are experimenting with a cannabidiol oil that becomes a potent chemical substance comparable to methamphetamine when refined. Sec. Smith replied that she was unaware of that trend but will examine the topic.

Rep. James asked if Suboxone is still being abused by those who have been given a prescription for the medication. Sec. Smith explained that it has become rare due to the high purity of heroin on the streets of Pennsylvania. She detailed that Suboxone is ineffective at reaching a high, therefore it is cheaper to simply buy and use heroin instead. She added that Suboxone is effective at reducing the effects of withdrawal and should be dispensed as widely as possible, especially given the increase in deaths and overdoses due to heroin.

Image by StockSnap from Pixabay

Today, the Legislative, Budget and Finance Committee (LBFC) released a study on community mental health services. Last year, the General Assembly adopted House Resolution 515 of 2019, which directed LBFC to conduct a broad-based study of Pennsylvania’s county administered, community-based mental health (MH) services. The resolution directed LBFC to collect and present information on 10 comprehensive and complex data points.

In response to HR 515, LBFC modified the objectives and scope and focused on creating observational summaries of data, which were collected from various state agencies, including the Department of Human Services (DHS), the Department of Health (DOH), the Department of Corrections (DOC), and the Health Care Cost Containment Council PHC4). LBFC also surveyed all county MH Administrators. The report can be found on the LBFC’s website.

Pennsylvania Governor Tom Wolf signed another renewal of the state’s disaster declaration tied to the coronavirus pandemic, even as state lawmakers hope to curtail some of his broad powers in emergencies. On Friday, Wolf signed a 90-day extension of the disaster emergency, his fourth renewal of the proclamation. He signed the first order on March 6, the day the first COVID-19 cases were reported in Pennsylvania. View full article from PennLive.

FOR IMMEDIATE RELEASE
February 19, 2021

Harrisburg, PA – The Wolf Administration today provided an update on Pennsylvania’s progress administering COVID-19 vaccines to residents and staff of long-term and congregate care facilities eligible in Phase 1A. To date, more than 193,000 residents and staff of nursing facilities, personal care homes, and assisted living facilities have received their first COVID-19 vaccine dose through the federal Pharmacy Partnership Program. Additionally, nearly 10,000 residents and staff of other long-term and congregate care facilities licensed by the Department of Human Services (DHS) have received their first vaccine dose through the partnership with Pennsylvania-based Rite Aid, and this partnership is being expanded to include residential drug and alcohol treatment providers licensed by the Department of Drug and Alcohol Programs (DDAP) who identified as needing a vaccine provider.

“Vaccinating residents and staff of long-term and congregate care facilities – people who are often most at-risk of a severe case of COVID-19 if exposed – protects our most vulnerable residents who are not leaving their facilities and homes themselves but are most affected by rates of COVID-19 in our broader community,” said DHS Secretary Teresa Miller. “This progress is a much-needed reprieve for long-term care facilities that have been particularly challenged by COVID-19 and community transmission, and it’s a line of defense for our health care system as a whole.”

Pennsylvanians living in these facilities eligible for the federal program are receiving vaccines from CVS Pharmacy and Walgreens. As of February 19 all skilled nursing facilities have had their first round of COVID-19 vaccine doses, CVS has completed 100 percent of the second dose clinics and Walgreens is working to vaccinate the remaining second dose clinics before all nursing facilities are complete. More than 70 percent of personal care homes and assisted living facilities covered through the partnership have received their first round of vaccine doses, and CVS and Walgreens expect to finish first rounds before the end of the month. To date, the partnership has administered:

Vaccinations as of Feb. 19 First Doses Second Doses Total Doses
CVS Pharmacy 161,935 86,567 248,502
Walgreens 31,358 9,788 41,146

 

“Through the work of the Federal Pharmacy Partnership’s (FPP) we are able to ensure every nursing home resident and staff member who wants a vaccine can receive it – and we are proud of the progress thus far,” Acting Secretary of Health Alison Beam said. “As nursing homes finish administering the remaining second dose clinics, we know that when the federal government’s mission for the FPP program is complete we will remain committed to getting vaccine to incoming residents and staff in the future. The Department of Health and long term care facilities remain vigilant and will continue to vaccinate through existing relationships with health care providers, just as with routine medication and flu vaccinations.”

Other long-term and congregate care settings included in Phase 1A of Pennsylvania’s Interim Vaccination Plan, including group homes for people with disabilities; residential treatment facilities and long-term structured residences for adults with behavioral health needs; and private psychiatric hospitals, are not included in the federal partnership but are still in the Phase 1A due to the risk of COVID-19 outbreaks in congregate settings.

These settings serve people who have co-occurring medical needs that put them at higher risk of severe cases and death if they contract the virus. Some personal care homes and assisted living facilities also were not enrolled in the Federal Pharmacy Partnership program and may be served by the Rite Aid partnership for DHS-licensed facilities.

Vaccine clinics for these facilities are being held on-site for facilities where people served are not able to travel off-site. Additional clinics are being scheduled at centralized locations when possible to accommodate more facilities and community group homes, which are typically small, private residences. To date, the partnership has administered:

Facilities with First Doses Administered Total Doses Administered to Date Facilities Scheduled for Vaccination Expected Doses through Scheduled Clinics
Office of Developmental Programs Facilities 1,512 4,978 102 753
Office of Long-Term Living Facilities 83 3,539 32 1,920
Office of Mental Health and Substance Abuse Services Facilities 13 1,342 13 988

 

Nearly 9,900 people have been vaccinated so far through this partnership. Approximately 3,660 people living and working in 147 DHS-licensed facilities and group homes are currently scheduled to be vaccinated through this partnership. Expected reach of this partnership has shifted as some facilities have ended up receiving vaccinations through other contacts.

Additionally, the Rite Aid partnership is expanding to vaccinate residential drug and alcohol treatment providers licensed by DDAP who identified as needing an established partnership with a vaccine provider through a survey administered by the department. Approximately 450 people will be vaccinated at 12 scheduled clinics at residential treatment providers where people served are not able to travel off site through early March.

“Often, residential drug and alcohol treatment providers are forgotten among other congregate care settings, however some of Pennsylvania’s most vulnerable citizens are receiving treatment for the disease of addiction in these facilities,” said DDAP Secretary Jen Smith. “The Rite Aid partnership is another tool in our COVID-19 toolbox to minimize community transmission and ensure all health care providers have established partnerships with vaccine providers.”

Learn more about the partnership with Rite Aid and view more data here.

COVID-19 Vaccine Distribution
Every day tens of thousands of Pennsylvanians are receiving the COVID-19 vaccine. Vaccination numbers for Pennsylvania do not include Philadelphia, which is its own jurisdiction, or federal facilities, which are working directly with the federal government.

  • This week, a total of 326,850 doses will have been allocated through February 20:
    • 183,575 first doses will have been allocated this week.
    • 143,275 second doses will have been allocated this week.
  • To date, of the 2,766,400 doses allocated through February 20, we have administered 1,867,240 doses total through February 18:
    • First doses, 86 percent (1,387,443 administered of 1,610,175 allocated)
    • Second doses, 41 percent (479,797 administered of 1,156,225 allocated) 

Vaccine Order signed Feb. 12
Last week, Sec. Beam signed an order outlining appropriate steps and recognized best practices to ensure vaccine providers deliver 80 percent of doses within seven days of receipt, provide a phone number where people can speak to an individual to make an appointment and report race and ethnicity data for everyone vaccinated.

Your Turn tool
Last week, Pennsylvania launched the Your Turn tool to help everyone understand where they fall in the vaccination prioritization effort. The Your Turn tool directs eligible residents to the department’s vaccine provider map online to locate a trusted local provider and schedule a vaccination appointment. Your Turn also allows people to register to receive updates about vaccine distribution and allows the department to let you know when it is your turn to get vaccinated.

In addition to the Your Turn tool and while vaccine supply from the federal government remains limited, the Department of Health is working to ensure the vaccine is provided in a way that is ethical, equitable and efficient.

The Wolf Administration stresses the role Pennsylvanians play in helping to reduce the spread of COVID-19:

  • Wash your hands with soap and water for at least 20 seconds or use hand sanitizer if soap and water are not available.
  • Cover any coughs or sneezes with your elbow, not your hands.
  • Clean surfaces frequently.
  • Stay home to avoid spreading COVID-19, especially if you are unwell.
  • If you must go out, you are required to wear a mask when in a business or where it is difficult to maintain proper social distancing.
  • Download the COVID Alert PA app and make your phone part of the fight. The free app can be found in the Google Play Store and the Apple App Store by searching for “covid alert pa”.

Updated Coronavirus Links: Press Releases, State Lab Photos, Graphics

Community preparedness and procedures materials

MEDIA CONTACTS: Barry Ciccocioppo, Health – ra-dhpressoffice@pa.gov
Erin James, DHS – ra-pwdhspressoffice@pa.gov
Rachel Kostelac, DDAP – 717-547-3314

On June 19, 2018, Governor Tom Wolf signed and codified the Employment First Law and established the Employment First Law for people with disabilities. Attached are the 2021 Employment First Annual Report and the 2020 Employment First Oversight Commission Report.

Additionally, the Employment First Oversight Commission Leadership beginning January 27, 2021 has been named. We are proud that RCPA member Steve Suroviec, President/CEO, Achieva, is the chair of the commission. The leadership positions are:

A link to these reports is also available on the Department of Labor & Industry’s Department of Labor & Industry’s website, under the “Employment First Act Documents & Reports” heading. Additional information or alternate formats of the reports may be obtained by contacting Edward M. Butler, OLTL Employment Specialist via email or phone (717-214-3718).

Image by Katja Fuhlert from Pixabay

The Wolf Administration has released a new order effective today to increase the administration of vaccine dosages received; ensure ease of scheduling appointments; reinforce specific reporting by vaccine providers; and ensure accountability in providers’ adherence to vaccine priorities. Key messaging around the order and specifics can be found in the order. A frequently asked questions document can be accessed here.