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Children's Services

RCPA will host its annual conference at the Hershey Lodge on September 27–30, 2016. At this large-scale, statewide event, the RCPA board of directors wants to continue the important tradition of recognizing individuals and organizations/facilities for their dedication and commitment to service. The following award categories have been created for this event and recognition:

  1. RCPA Innovation Award. Presented to an individual or organization in recognition of significant innovation. Examples include cross-systems integration, physical/behavioral health integration, and implementation of new technologies. Up to three awards may be given in any year.
  2. Exemplary Service to RCPA Award. Presented to an individual or organization/facility that has shown a strong commitment and dedication in service to the association, its members, and related issues.
  3. Legislative Leadership Award. Presented to an individual who has shown significant leadership and commitment to government affairs and legislative issues, on behalf of RCPA and its members.
  4. Community Leadership Award. Presented to an individual in recognition of extending service and knowledge to the community at large, and efforts in helping the community understand the needs of individuals served by RCPA members. This can be for specific or short-term significant acts, or to recognize a career-long body of work.
  5. Lifetime Achievement Award. Presented to an individual in honor of his/her significant, consistent, and enduring contribution throughout his/her career in support and furthering of the field.

At this time, RCPA is accepting nominations through an open solicitation of members (e.g., designated contact person, CEOs/executive directors, staff) and RCPA committees. Members may nominate one or more individuals/organizations in one or more categories. Nominations will be reviewed by a sub-group of the board of directors to make recommendations for final selection and approval by the full board.

Include the name/organization (if applicable) of the nominee, the award category, and a statement about why you believe the individual/organization should be honored. Nominations should be made by Monday, May 16. Please send nominations to Cindy Lloyd.

Award recipients are not limited to RCPA members and every award may not be presented annually. Please join the association in continuing this tradition and in offering nominations for those who deserve recognition for their significant contributions.

SAMHSA and the Centers for Medicare & Medicaid Services (CMS) invite you to join a presentation of the final rule on mental health and substance use disorder parity for Medicaid and CHIP, to be held on Thursday, April 14, 1:00 – 2:00 pm.

This rule implements the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) for 23 million beneficiaries enrolled in Medicaid managed care organizations (MCOs), Medicaid alternative benefit plans (ABPs), and the Children’s Health Insurance Program (CHIP), ensuring that benefits for mental health and substance use disorder treatments and services are offered on equal footing with medical and surgical benefits. This presentation will include a discussion of the application of parity to Medicaid and CHIP programs, key changes from the Notice of Proposed Rulemaking, and answers to frequently asked questions.

RCPA has become aware that there have been higher than normal claims denials by both Medicare and Medicaid related to certain diagnoses. Those diagnoses are Schizophrenia and Post Traumatic Stress Disorder (PTSD) as defined by the DSM-V and ICD-10.

The DSM-V only identifies Schizophrenia Not Otherwise Specified (NOS) and PTSD NOS, versus the ICD-10 which offers eight schizophrenia diagnoses and three PTSD diagnoses. As a result, our practitioners are likely choosing Schizophrenia or PTSD NOS, since they are mostly using the DSM-V. Billing staff have options of eight or three diagnoses respectively, but will use what the practitioner has selected, the only DSM-V diagnosis available. It is highly probable that the individual being evaluated meets something other than NOS. There are very specific criteria for the NOS diagnosis which can certainly be used as the criteria is met, but when the criteria is not met, the claims are accurately denied. RCPA wants to hear from you about how this is affecting your business.

The second billing issue is related to electronic health records (EHR) that have not yet loaded the ICD-10 codes for billing. It is our understanding that there are at least two vendors doing business in Pennsylvania who have not loaded the ICD-10 billing codes into the EHR. RCPA wants to hear from members about how they are billing in the absence of the EHR, not having the ICD codes, and other universal billing concerns.

Please find more information about claims rejections here. Send comments to Sarah Eyster by Friday, April 15.

The Department of Human Services (DHS) has announced the selection of 16 locations to participate in the Certified Community Behavioral Health Clinic (CCBHC) planning grant. The federal grant encourages states to adopt innovative approaches to community-based behavioral health services.

This initiative will further the Wolf Administration’s goal of improving the delivery of care for behavioral health and substance use treatment in the community where people live, providing Pennsylvanians with easier and more consistent access to the services they need. In an effort to provide CCBHC access to all affected Pennsylvanians, the 16 locations are comprised of both rural and urban locations throughout the state.

The federal Excellence in Mental Health Act established the CCBHCs as a way to improve quality and use evidenced-based practices in behavioral health.

The CCBHCs will provide nine core services:

  • Crisis services;
  • Targeted case management;
  • Outpatient mental health and substance abuse services;
  • Patient-centered treatment planning;
  • Screening, assessment, and diagnosis;
  • Psychiatric rehabilitation services;
  • Peer and family support;
  • Care for veterans and members of the military; and
  • Outpatient primary care screening and monitoring.

The following clinics were selected:

  • Berks Counseling Center, Berks
  • Cen Clear Child Services, Clearfield
  • Cen Clear Child Services, Jefferson
  • Cen Clear Child Services, Blair
  • Community Council Mental Health and Mental Retardation, Philadelphia
  • Community Counseling Center of Mercer County, Mercer
  • Community Guidance Center, Clearfield
  • Creative Health Services, Montgomery
  • Kidspeace, Monroe
  • NHS Delaware County, Delaware
  • Northeast Treatment Centers, Philadelphia
  • Pittsburgh Mercy, Allegheny
  • Public Health Management Corporation, Philadelphia
  • Resources for Human Development, Philadelphia
  • Safe Harbor, Erie
  • The Guidance Center, McKean

As part of being selected as a CCBHC, the CCBHC Assessment and Readiness Review webinar is taking place on Friday, April 8 at 9:00 am. You are welcome to join DHS in person in the Clothestree Conference Room. To join via webinar, please register using this link. Once registered, you will receive a confirmation email with your connection link. Please note, this link will be unique to you and should not be shared with others.

RCPA, through the National Council, will be offering support to all selected CCBHCs. In addition, all selected CCBHCs are welcome to attend a monthly nationwide call with National Council and state leaders. More information will be available later this week.

RCPA congratulates all selected CCBHC providers. Please contact Sarah Eyster for more information.

In recent years, the Office of Mental Health and Substance Abuse Services (OMHSAS) had received concerns regarding the Bureau of Children’s Behavioral Health Services (Children’s Bureau). Four major themes emerged from this feedback relating to communication, regulations and policy, operational consistency, and system partner engagement. Last spring, OMHSAS engaged Mercer Consulting to conduct a study of the Children’s Bureau that included three two-hour focus groups with OMHSAS system partners, including representatives from RCPA. The primary goal of the review was to identify ways in which OMHSAS can improve internal operations as well as communication and collaboration.

On Tuesday, Deputy Secretary Dennis Marion shared both an executive summary of the Mercer Independent Study as well as his description of the steps forward that OMHSAS has initiated in response to the concerns and findings. The action items outlined by Deputy Secretary Marion are:

  • Review and consolidation of regulations related to Behavioral Health Rehabilitation Services (BHRS). OMHSAS will engage with stakeholders to draft regulatory changes with the expectation that proposed BHRS regulations will be released for public comment in mid-2017.
  • Strategic reorganization of OMHSAS leadership. On March 7, Shannon Fagan joined OMHSAS as Children’s Bureau director, and Sherry Peters became director of the Bureau of Policy, Planning, and Program Development.
  • Organization-wide effort to improve consistency and quality. Moving forward, OMHSAS senior staff will focus on identifying areas of potential improvement, developing strategies to strengthen internal and external processes, promoting an organizational culture of collaboration, coordination, communication, and cohesiveness, and monitoring progress towards addressing the concerns voiced by OMHSAS stakeholders.
  • Emphasis on family and stakeholder engagement. The involvement of PACA, RCPA, BH-MCOs, and their contractors, played an integral role in working to identify issues of concern.
  • A redefining of “customer service.” To address concerns relating to responsiveness and professionalism, internal meetings have been held to stress the importance of holding OMHSAS staff to high standards of customer service.
  • Renewed focus on communications. In response to concerns regarding effectiveness of internal and external communications, Shanna Klucar was appointed as executive assistant to the deputy secretary on January 30.

OMHSAS invites RCPA members and other stakeholders to share comments and concerns regarding Children’s Behavioral Health Services to Shannon Fagan, bureau director, as well as the RCPA Children’s Division. In addition, members may contact OMHSAS leadership Sherry Peters and Shanna Klucar with more general comments and concerns.

The Department of Human Services (DHS) Medical Assistance Online Provider Enrollment Application information is now electronic, online, and available to provider organizations. The improvements and modernization of the PROMISe system have been strongly encouraged by RCPA and a significant goal of DHS. Some of the benefits of online enrollment application submissions are:

  • Allowing documents that previously had to be mailed or faxed to be uploaded directly to the portal;
  • Permitting providers see the status of their submissions; and
  • Decreasing wait time to review applications.

The information you will need to submit an application for enrollment:

  • Access the online enrollment application
  • Review the training guide
  • Review the frequently asked questions document for important clarifications
  • A “Help” feature is available at any time during the completion of an application
  • Supplemental Services require the Behavioral Health Managed Care Organization to attest that a provider is credentialed

CCBHCs will transform how behavioral health care is financed and reimbursed. As states and providers embark on this transformation, they face many questions, including:

  • How do we decide which prospective payment methodology to use – and what will its impact on behavioral health providers be?
  • How will we finance the state’s contribution?
  • How do state licensure and CCBHC certification requirements intersect?

 

Clearly understanding the unique financial opportunities and challenges associated with CCBHCs is a key ingredient to a successful implementation. This webinar will provide attendees with straightforward explanations of hot topics related to CCBHC financing and reimbursement. Our expert presenters will translate the current SAMHSA and CMS guidance to ensure all attendees are familiar with the relevant federal instructions and guidance.

 

The webinar will focus on the following topics:

  1. Prospective Payment Systems: explanation of the principles of PPS1 and PPS2 and overview of challenges identified in each approach, including a deep dive into the costs that go into your payment rate;
  2. Certification vs Licensure: clarification of the difference between certification and licensure and explanation of federal guidance on this point; and
  3. State Financing Strategies: description of state level financing mechanisms for their share of the Medicaid match, including the use of Certified Public Expenditures.

 

COST REPORTING, CLINIC LICENSURE, STATE FINANCING, AND MORE

Date: Monday, March 28, 3:00 pm EDT

Presenters: Steve Kohler, senior manager, McBee Associates, Inc.; Steve Rosenberg, president, Community Oriented Correctional Health Services; Dan Mistak, general counsel, Community Oriented Correctional Health ServicesSusannah Vance Gopalan, partner, Feldesman Tucker Leifer Fidell LLP.  Register here.

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The Juvenile Court Judges’ Commission (JCJC) and the Awards Committee of the PA Council of Chief Juvenile Probation Officers are pleased to announce that nominations are now being accepted for the 2016 JCJC Awards Program. This year program categories for which your program may be eligible include:

  • Residential Program of the Year
  • Community Based Program of the Year
  • Meritorious Service Award

As in previous years, all nominations must be submitted by county juvenile probation departments. If you would like to have your program or volunteer nominated, please contact a chief juvenile probation officer to discuss the possibility of submitting a nomination. Formal nomination materials must be postmarked by Monday, May 2, 2016.

The JCJC will once again sponsor a Youth Awards Program as part of this year’s Annual Training and Awards Program, to honor the youth selected as winners. The Youth Awards Committee is accepting nominations for the Outstanding Achievement Contest and the Creative Expression Contest. The Creative Expression Contest category will include either a written, poster, or video entry in two age categories; 15 & under and 16 & over. Entry forms for this category will be available soon on the JCJC website. Please contact Keith A. Graybill at (717) 705-9006 or by email if you have any questions or need assistance.