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Drug & Alcohol

Certified Community Behavioral Health Clinics (CCBHCs) are changing the very business of health care. Established by the Excellence in Mental Health Act, CCBHCs are designed to provide a comprehensive range of mental health and substance use disorder services, particularly to vulnerable individuals with the most complex needs. New federal standards for CCBHCs will take effect in 2017 in eight states, ultimately selected to participate in a two-year demonstration.

Time is running out; the deadline for revalidating is Thursday, March 24, 2016. Numerous RCPA members have already gone through this process, but it appears that large numbers of providers have not yet done so. A special provider revalidation webinar will be held by RCPA on Wednesday, January 6 at 10:00 am. Jamie Buchenauer, from the Department of Human Services, will be presenting the webcast.

Dr. Dale Adair held a pre-meeting with the steering committee on December 15, primarily focused on the letter of interest seeking information from eligible entities interested in applying to be a CCBHC, as well as the timeline of activities. Key activities include the request for letters of intent, due on Tuesday, January 5, 2016. On February 1, the Office of Mental Health and Substance Abuse Services (OMHSAS) will release the request for application, which will be due back by February 22. CCBHC selections will likely occur by the middle of March.

Dr. Adair recommitted to selecting a minimum of two CCBHCs (one urban, the other rural) as required by the act, but up to as many as twenty. Eligible providers include community mental health clinics and federally qualified health clinics. As DHS looks to make improvements to the quality of care that is offered to the individuals we serve, they would like a letter of interest containing the following:

  • Interest in becoming a CCBHC;
  • Indication of rural, urban, or suburban setting;
  • Willingness to complete the National Council Certified Clinic Readiness Tool;
  • Commitment to submit an application to become a CCBHC; and
  • Willingness to commit to participate in a CCBHC learning community.

Letters of interest must be submitted by 5:00 pm on Tuesday, January 5, 2016. Please submit responses electronically to Dr. Dale Adair, project director.

RCPA continues to support the use of the MTM and National Council readiness review tool. A full kickoff meeting of the CCBHC Steering Committee will be held at the end of January.

This article from Capitolwire is a good and extensive overview of what is going on with the budget here in Harrisburg. Health and Human service budget line items are still fluid until the House and Senate negotiate a final budget deal. RCPA will provide updates on any budget deal, and RCPA encourages members to continue to contact the governor and state legislators to inform them why it’s necessary for them to pass a state budget sooner rather than later. Questions, contact Jack Phillips.

The College for Behavioral Health Leadership will be hosting a symposium to focus on population health for behavioral and physical health on Wednesday, January 20, 2016, in Washington, DC. During this one day event, the focus will be on the components of population health, and how behavioral and physical health can work together to impact the triple aim of improving care for individuals, reducing costs, and improving health. Please consider joining us on January 20 to learn more and become part of the solution.

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The Department of Drug and Alcohol Programs (DDAP) is concerned about the rise in hepatitis C cases in Pennsylvania (PA), particularly among persons who inject drugs (IDU).  The Centers for Disease Control and Prevention recommends hepatitis C virus (HCV) testing for those who currently inject any type of drug (Opioids, Methamphetamine, Cocaine, etc.) or have injected drugs in the past, including those who injected once or a few times many years ago.  PA has experienced a dramatic increase in hepatitis C infections in individuals with injection opioid and/or heroin addiction who are 18 to 35 years of age.  DDAP recommends that all licensed drug and alcohol addiction treatment facilities perform a risk assessment for HCV and refer to medical or community based providers for necessary screening/testing as appropriate.

 

Because many individuals you serve are at high risk for hepatitis C, you play an important role in combating this public health issue.  If you have current practices that you believe are effective in combating this disease, we would appreciate you sharing these with us so we can promote them across the field.  Please send this information to DDAP Treatment, Prevention & Intervention Bureau Director, Angela Episale, at aepisale@pa.gov.   

 

Through improved identification and treatment of individuals with hepatitis C, we can begin to reduce the spread of this disease.  Please remember to obtain consumer consent and maintain confidentiality when sharing test results with the consumers’ primary care physicians or other physical health specialists involved in hepatitis treatment.  In some cases, you may be able to utilize a Qualified Service Organization Agreement (QSOA) to permit the exchange of patient identifying information.  If you have questions about when this is possible, please contact our Division of Licensing Acting Director, Gary Stauffer, at gstauffer@pa.gov.

 

For more information regarding hepatitis C testing of IDU clientele, please contact:

 

Charles Howsare, MD, MPH

Viral Hepatitis Prevention Coordinator

PA Department of Health

717-787-3350

chowsare@pa.gov

 

Thank you for your critical assistance in controlling hepatitis C in PA.

 

Contact Person: Angela Episale, 717-736-7438

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The Department of Drug and Alcohol Programs (DDAP) has determined there is a need to remove barriers to treatment access and to assist facilities in their efforts to effectively utilize physical plant and human resources to best meet the needs of individuals entering residential treatment.

With this goal in mind, DDAP has decided a facility may be permitted, upon request and approval by DDAP, to utilize empty beds in one activity to conduct services provided in the other activity, otherwise referred to as ‘flex beds’.

This process only applies to a facility already licensed to provide both Residential Detoxification (hospital or nonhospital) and Residential Rehabilitation (hospital or nonhospital) at the same location.  This process does not apply to any non-residential treatment activities.

The Department assigns each treatment activity with a specific capacity limit.  Residential Detoxification and Residential Rehabilitation Activities are assigned capacities based on the number of beds in a facility in relation to the required square footage in each room.

Prior to the ‘flex bed’ approach, when a facility had several empty beds in one activity, but was overflowing in the other, the facility was required to remain within the capacity granted by the Department for that activity and would need to refer the patients elsewhere or turn them away from treatment.

The ‘flex bed’ approach will allow the facility to place additional individuals in empty beds of the other licensed activity.  For example, a facility in need of an additional detoxification bed would be allowed to utilize an empty residential bed, thus more fully utilizing the available beds.  The reverse would also be permitted.  For personnel purposes, facilities may utilize counselors as primary care staff on the detox unit when utilizing the additional detox beds; however, staff from detox must meet staffing regulations to qualify for residential program (i.e., an LPN qualifies as detox primary care staff; however, does not meet qualifications as primary care staff in residential programs).  This approach may assist facilities from turning clients away from treatment or needing to refer them elsewhere.

A facility must submit an exception request to be considered for approval to flex beds between the residential detoxification and residential rehabilitation activities.  Please refer to Licensing Alert 4-97 on the Department of Drug and Alcohol Programs web page at www.ddap.pa.gov for specific instructions on how to submit an exception request.  Further clarification regarding ‘Licensed Capacity’ can be found at Licensing Alert 1-94.

Facilities approved to flex beds will be subject to a review of that approval during the annual licensing inspections or other on site reviews.  When a facility finds it is constantly utilizing a set number of beds in excess of the approved capacity for any particular activity, the facility is encouraged to submit a capacity increase request for that activity.

Any questions should be directed to Gary Stauffer, Acting Director, Program Licensure Division, at 717-783-8675.