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Drug & Alcohol

RCPA received notice that Ellen DiDomenico, currently Special Assistant for the Department of Human Services (DHS), has been selected as Acting Deputy Secretary of the Department of Drug and Alcohol Programs (DDAP) during Secretary Smith’s upcoming extended (two month) medical leave of absence.

The announcement from Lynn Kovich, MEd, Deputy Secretary of DHS, Office of Mental Health & Substance Abuse Services (OMHSAS), stated that Ms. DiDomenico was asked to serve in this role because of her key involvement in certain initiatives that bring DDAP and OMHSAS together, such as the 21st Century Cures grant, Certified Community Behavioral Health Clinics (CCBHC) initiative, the AHRQ Medication Assisted Treatment in rural communities grant, and the Opioid Use Disorder-Centers of Excellence (OUD-COEs). In addition, it is hoped that in this role, she will be able to further bridge the gap between the two agencies. Ellen will continue to play a leadership role in the major initiatives that span both agencies, following her move to DDAP. Effective Monday, January 8, Ms. DiDomenico will officially be part of DDAP staff, but will physically be located at OMHSAS until after DDAP’s relocation downtown later this month.

RCPA looks forward to working with Ellen in her new position and wishes the best to Jennifer Smith during her leave.

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RCPA is pleased to report that the Department of Drug and Alcohol Programs (DDAP) has announced that the XYZ Rate Setting Committee has completed work on documents related to the rate setting process for the 2018/19 state fiscal year. Providers of non-hospital detox and rehabilitation, to include halfway houses, can find the 2018/19 materials on PACDAA’s web page.

RCPA has been informed that once the XYZ packet is completed and submitted, the rate that is determined is the rate that must be used. Other important changes have been made that will benefit providers and end up accomplishing the all-important goal of covering the costs of the services provided.

RCPA sends a special thank you to Jon Wolf, President and CEO of Pyramid HealthCare Inc.; his strong participation and leadership in this critical task force are greatly appreciated. RCPA also thanks Jennifer Smith, Acting Secretary and Terry Matulevich, Director, both from DDAP, for their commitment to assisting providers in obtaining fair rates that actually covered costs.

Below is the revised time frame for the rate setting process, as outlined in the XYZ package. Providers should direct questions to your single county authority (SCA).

November 1 Provider audits due to SCAs, unless otherwise specified in the DDAP/SCA Grant Agreement
By or before February 1 Providers submit the completed XYZ package to the SCA
By or before March 16 SCAs respond to providers with the approved rates
Between March 16 – April 16 Provider appeals are submitted to the SCA
April 16 – April 30 Appeals that are unable to be resolved at the SCA level are submitted to DDAP
By or before May 1 SCA posts rates to PACDAA’s web page

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The Department of Health (DOH), in cooperation with the Department of Drug and Alcohol Programs (DDAP), and the Department of Human Services (DHS), will be convening six regional meetings with stakeholders across the state to address the issue of providing a warm hand-off for opioid overdose survivors. The purpose of these meetings will be to develop the framework for localized plans, ensuring seamless transfer of care from first responders to the emergency department and then to the local treatment providers.

RCPA has been invited to meet with representatives of DOH, DDAP, and DHS to discuss the association’s perspective as the departments move forward with their planning efforts. A number of RCPA members have successfully established warm handoffs with first responders and/or their local emergency rooms; others have tried and encountered obstacles. Please take a few minutes of your time and email Lynn Cooper with any successes, challenges, or other experiences you are able to share. Thank you, as always, for your assistance and input.

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RCPA received a letter from Department of Drug and Alcohol Programs (DDAP) Acting Secretary Jennifer Smith on November 22, which provided an update on the Commonwealth’s transition to the American Society of Addiction Medicine (ASAM) Criteria placement guidelines. DDAP is progressing with this transition and remains on track for full implementation as of July 1, 2018. As previously reported, all ASAM Criteria training will be conducted by ASAM’s official training partner, The Change Companies™, and their sister organization, Train for Change.

DDAP has stated that all individuals working in the substance use disorder treatment and case management field, whose primary, day-to-day work function involves assessment and level of care placement, and who have not previously had ASAM Criteria 3rd Edition training, must have the two-day, in-person training. This is creating a significant financial burden. A two-day, in-person training will incur high costs to providers, given that the in-person requirement takes staff out of the clinic, and renders them unavailable to provide services which the agencies need to bill for in order to keep their doors open. Several members have estimated that the cost to train all of their staff in the in-person model will be upwards of $100,000, which includes time away from the office, travel costs, and training costs. Some managed care companies, Single County Authorities, and oversight bodies are purchasing ASAM books and funding the actual training. While this is much appreciated and helpful, it does not come close to addressing the overall cost to the provider.

RCPA is working on a formal request to DDAP to allow staff trained in and knowledgeable about the Pennsylvania’s Client Placement Criteria (PCPC) to be allowed to do the training via eTraining. Apparently, the Change Companies have high quality webcasts available for ASAM training. We are in the process of gathering data that supports this training format. We have received some helpful information from IRETA and are looking for more to support our position. If you are aware of additional supportive data available, please send it to Lynn Cooper as soon as possible.

The Department of Human Services has been working in collaboration with Managed Care Organizations (MCOs), county oversight organizations, and RCPA regarding the concerns and challenges with implementing federal Ordering, Referring and Prescribing (ORP) requirements by the January 1, 2018 deadline. The Department of Human Services has informed RCPA of the following:

  • The ORP requirements for Fee-for-Service continue to apply; i.e., allORP practitioners must be enrolled in the Pennsylvania Medical Assistance (MA) Program or the rendering provider will not be paid.
  • In the HealthChoices managed care delivery system, if a rendering network provider submits a claim to an MCO with the National Provider Identifier (NPI) information that results in edits identifying that the non-networkORP is not enrolled in MA, the claim can be paid. However, if the non-MA enrolled ORP has a high volume of claims, the MCO will work with the network provider and non-MA enrolled ORP to have them enroll in MA or work to transition the member to an enrolled MA provider.

Contact your contracting BH-MCO for additional information.

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RCPA received a letter from Department of Drug and Alcohol Programs (DDAP) Acting Secretary Jennifer Smith on November 22. The purpose of the letter was to provide an update on the Commonwealth’s transition to the American Society of Addiction Medicine (ASAM) Criteria placement guidelines. DDAP is progressing with this transition and remains on track for full implementation as of July 1, 2018. Since the announcement of this training, DDAP was made aware of recently published ASAM copyright restrictions which make the creation of a Pennsylvania-specific ASAM training cost-prohibitive; therefore, DDAP will not be designing and providing this training. All ASAM Criteria training will be conducted by ASAM’s official training partner, the Change Companies™.

Individuals working in the substance use disorder (SUD) treatment and case management field, whose primary, day-to-day work function involves assessment and level of care placement, and who have not previously had ASAM Criteria 3rd Edition training, must have the two-day, in-person training.

Despite potential price reductions based on regional scheduling as described in the ASAM FAQ, DDAP is asking providers to contact their SCAs, BH-MCOs, and HealthChoices contract administrators immediately, to discuss options related to timeline of training delivery, scheduling, and cost. The letter from Acting Secretary Smith and the FAQs provide further detail.

Ms. Smith will be attending the RCPA Drug and Alcohol Committee meeting on December 5 at 12:30 to discuss this issue, among numerous others, with RCPA members. All members providing substance use disorder treatment are encouraged to attend.

RCPA will be doing further research to ascertain ways that the association may be of assistance to members.

(From OMHSAS)

The Department of Human Services is making available for public review and comment the proposed Federal Section 1115 Demonstration waiver application for substance use disorder (SUD) services.

The purpose of this Demonstration is to afford continued access to high quality, medically necessary treatment for opioid use disorder (OUD) and other substance use disorders (SUDs). Pennsylvania recognizes the importance of a full continuum of treatment services, including residential services that are provided in a cost-effective manner and for a length of stay that is governed by appropriate clinical guidelines.  This Demonstration is critical to provide the necessary funding to support the continuation of medically necessary services.

The goals of this Demonstration are to:

  1. Improve the overall population health outcomes for Medicaid beneficiaries diagnosed with a substance use disorder by:
    1. Reducing overdose deaths
    2. Increasing the number of Medicaid beneficiaries who access substance use treatment
    3. Increasing the rate of retention in treatment across all levels of care
  2. Decrease utilization of high-cost emergency department and hospital services by:
    1. Decreasing the number of emergency department visits and inpatient admissions
    2. Decreasing the number of readmissions to the same level of care or higher levels of care for a primary SUD diagnosis
  3. Improve care transition across the continuum of substance use services by:
    1. Enhancing coordination of care with other behavioral and physical health services
    2. Enhancing the process for transitions between levels of care

The 1115 Demonstration waiver application is available here. In addition, copies of the application are available upon written request to the Director, Bureau of Policy, Planning, and Program Development, Office of Mental Health and Substance Abuse Services, 11th Floor Commonwealth Tower, 303 Walnut Street, Harrisburg, PA 17101.

The Department will hold four public hearings throughout the Commonwealth to accept testimony on the proposed 1115 Demonstration waiver application.  The Department will also present updates and solicit comment on the waiver application at the Medical Assistance Advisory Committee meeting on December 14, 2017.

The schedule of dates, times and locations for the public hearings is listed below:

Public Hearing Schedule

December 4, 2017, 10:00 a.m. to 12 noon
OMHSAS NE Field Office Conference Room
100 Lackawanna Avenue
Scranton, PA

December 5, 2017, 10:00 a.m. to 12 noon
Norristown State Hospital Auditorium
1001 Sterigere Street
Norristown, PA

December 8, 2017, 8:00 a.m. to 10:00 am
Child Welfare Resource Center
403 East Winding Hill Road
Mechanicsburg, PA

December 11, 2017 from 1:00 p.m. to 3:00 pm
Shenango Crossing
2520 New Butler Road
New Castle, PA 16101

Public Comment

The Department seeks public input on the proposed 1115 Demonstration waiver application for SUD services.  The 30-day public comment period began on November 18, 2017 and ends on December 18, 2017.  Persons who wish to testify on the proposed 1115 Demonstration waiver application at one of the public hearings should schedule a time by telephoning (717) 772-7900.  Persons from outside the Harrisburg area may send a written request, including telephone number, to Satoko Hariyama, Bureau of Policy, Planning, and Program Development, Office of Mental Health and Substance Abuse Services, 11th Floor, Commonwealth Tower, 303 Walnut Street, Harrisburg, PA 17101.

Individuals also may submit written comments at any of the public hearings or by email or by mail to the address of the contact person identified above.  The Department will consider all comments received by December 18, 2017 in developing the final waiver application.

Persons with a disability who require auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

The Substance Abuse and Mental Health Services Administration (SAMHSA) offers 14 self-paced online business courses to behavioral health organizations and providers through BHbusiness. The courses are available at no cost and participants can earn continuing education credits at their own pace.

New courses include Value-Based Purchasing and Bundled Payments. Other course offerings include:

  • Data-Driven Decision Making;
  • New Business Planning;
  • Assessing Your Readiness in Integrating Primary Care;
  • Costing Out Your Services;
  • Effectively Marketing Your Services;
  • Exploring Affiliations and Mergers;
  • Improving Your Third Party Billing System;
  • Planning For the Next Generation of HIT (Health Information Technology);
  • State Assessment on Sustaining SUD Service for Safety Net Populations;
  • Strategic Business Decision Making;
  • Third Party Contract Negotiations; and
  • Eligibility and Enrollment: The ACA, Insurance Eligibility, and Your Business.

The link to the registration page can be found here.

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The Department of Drug and Alcohol Programs sent the following notice out regarding transition of support for PA Web Infrastructure for Treatment Services (PA WITS) to ensure your agency maintains client confidentiality.

Effective today, November 1, 2017, DDAP will begin providing support and help desk functioning for all issues related to PA WITS. Prior to November 1, support had been provided by FEi, Inc. Given there was an established Business Associate and Qualified Service Organization Agreement (BAQSOA) between each provider and FEi, there were no issues related to confidentiality, so identifying issues by client name was acceptable. This is an important reminder that per 4 Pa Code § 255.5, DDAP is a government agency, and therefore cannot access or view client identifying information. Please ensure when requesting support from DDAP that your staff are only using client numbers and abiding by electronic communication policies that protect this client information.

PA WITS users are encouraged to contact DDAP’s PA WITS Service Desk directly for all requests. Providers and SCAs can contact the Service Desk during normal business hours (Monday – Friday, 8:00 am – 4:30 pm, except on state holidays), via email or phone 717-736-7459.

More information is available on the DDAP website: