Tags Posts tagged with "DDAP"

DDAP

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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.

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On September 4, 2014, the Independent Regulatory Review Commission (IRRC) passed the first set of regulations advanced by the Department of Drug and Alcohol Programs (DDAP). As reported, a small group of RCPA members worked for several months reviewing the regulations line-by-line. RCPA is pleased to report that all of the recommendations from the association were accepted by DDAP and, after a long process, the Drug and Alcohol Facilities and Services and companion Standards for Licensure of Freestanding Treatment Facilities were approved unanimously by IRRC.

It appears that this information has not yet reached some providers. A final copy of each set of new regulations is available online through the above links. Contact Lynn Cooper with any questions.

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RCPA sent a letter to the leadership and support of the Office of Mental Health and Substance Abuse Services (OMHSAS) and the Department of Drug and Alcohol Programs (DDAP), requesting that a task force be formed to review and change the extremely outdated drug and alcohol medical assistance outpatient regulations, Chapter 1223 Outpatient Drug and Alcohol Clinic Services. OMHSAS did an outstanding job of organizing a task force and developing regulation changes for mental health outpatient services. These much improved regulations are in the last stages of being finalized. The same process needs to be implemented for drug and alcohol outpatient services. As stated many times before, outpatient treatment in Pennsylvania is at risk of collapse.

A number of years ago, RCPA (known as PCPA at the time) developed a white paper, which highlights the value of outpatient services, reviews the current challenges/threats to services, and outlines what needs to happen to assure the viability of these critical services. The paper emphasizes that when utilized appropriately, outpatient treatment can save millions of dollars in inpatient and emergency room costs. The paper also highlights specific clinical, regulatory, and financial challenges, and makes recommendations for changes in both mental health and drug and alcohol services.

As with the mental health outpatient regulation changes, changes in the drug and alcohol outpatient regulations will save money, improve access and services, reduce unnecessary paperwork, update clinical terminology, update treatment trends, and improve outcomes.

RCPA requested that a time limited group of stakeholders be convened to evaluate drug and alcohol outpatient medical assistance regulation issues and make recommendations for much needed changes. Given the current issues that exist, this task force needs to be implemented as soon as possible. Contact Lynn Cooper with questions or for any additional information.