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The Substance Abuse and Mental Health Services Administration (SAMHSA) announced today it is extending its opioid treatment program (OTP) exemption for an in-person physical evaluation for buprenorphine treatment for a period of one year from the end of the COVID-19 Public Health Emergency (PHE). The extension goes into effect upon the expiration of the COVID-19 PHE.

Read the full announcement.

Message from The Council for Mental Wellbeing:

988 — the new, nationwide three-digit number for crisis response and mental health crisis care — is going live on July 16. Are you ready?

In early 2022, the Substance Abuse and Mental Health Services Administration (SAMHSA), in co-sponsorship with the National Association of State Mental Health Program Directors (NASMHPD), worked with partners across critical sectors to develop 988 Implementation Guidance Playbooks. These playbooks are designed to help programs and providers prepare for and implement 988-related services.

Join us on Wednesday, July 6, 1:00 pm – 2:30 pm ET for an in-depth overview of the playbooks. We’ll share strategies for implementation, case studies, and other resources and outline SAMHSA’s five-year plan for the continued implementation and enhancement of 988 and other services across the crisis continuum.

Following the webinar, you will be able to:

  • Understand the overarching vision of 988 as a resource for everyone and identify how 988 is different from other systems.
  • Outline SAMSHA’s five-year plan for 988 and the Crisis Continuum.
  • Identify SAMHSA’s success criteria for its five-year plan.
  • Identify examples of programs that have successfully implemented workforce and financing solutions related to 988 and the crisis continuum.
  • Have a better understanding of the bi-directional impacts of states and providers and how they can work together to help solve each other’s challenges.

Presenters:

  • Chuck Ingolia, MSW, President and CEO, National Council for Mental Wellbeing
  • John Palmieri, M.D., MHA, Senior Medical Advisor, SAMHSA; Acting Director, 988 and Behavioral Health Crisis Coordinating Office
  • Brian Hepburn, M.D., Executive Director, NASMHPD

Register today!

*CEU credits are not available for this session, but attendees will be able to download a letter of attendance during the evaluation after the webinar is complete. 

This webinar is supported by funding from SAMHSA.

Closed captioning is available for this webinar.

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The Pennsylvania Department of State (DOS) has reversed course and extended its waiver allowing for an initial prescription of buprenorphine without an in-person physical exam. DOS had announced previously that the waiver would expire on June 30, 2022; however, DOS’s waiver will now continue until the last day of the federal public health emergency declaration, unless the exemptions are ended sooner by the Substance Abuse and Mental Health Services Administration (SAMHSA) or the US Drug Enforcement Administration (DEA).

On Sept. 4, 2020, DOS issued a waiver suspending the State Board of Medicine’s regulation at 49 Pa. Code § 16.92(b)(1), which requires an initial physical examination of a patient prior to prescribing buprenorphine for the treatment of opioid use disorder. This waiver was sought specifically to complement the Department of Drug and Alcohol Programs’ (DDAP) suspension of 28 Pa. Code § 715.9(a)(4) and “relates to Federal exemptions granted under the Federal public health emergency (PHE) declaration,” specifically the exemptions granted by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) and the U.S. Drug Enforcement Agency (DEA).

Therefore, in accordance with section 2102-F(a.3) of the Pennsylvania Administrative Code of 1929 (amended by Act 14 of 2022), the Department of State’s waiver will continue until the last day of the federal public health emergency declaration, unless the exemptions are ended sooner by SAMHSA or the DEA. This waiver will not expire on June 30, 2022. More information about the federal public health emergency can be found here.

It is important to note that, to be considered within the acceptable and prevailing standard of care, the physician/prescriber must be following the applicable SAMHSA/DEA guidelines.

Pennsylvania has not received notification that the PHE will be terminated on July 15. The commonwealth expects the PHE to be extended again. If this occurs, this waiver and others tied to or related to the PHE will be extended until mid-October 2022.

Additional information:

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With Senate Bill 1019 passed into law as Act 14, the Department of Drug and Alcohol’s (DDAP) regulatory suspensions are also extended. These regulatory suspensions are “related to federal exemptions granted under the federal public health emergency declaration” until “the last day federal exemptions granted under the federal public health emergency declaration are authorized.” In addition to three DDAP regulatory suspensions, one additional regulation from the Department of State, also relevant to the field, is included in the chart below and also remains suspended.

Statute/Regulation Statute/Regulation Purpose

Waiver Benefit/Explanation

28 Pa. Code § 715.16(e)

Prohibits narcotic treatment programs (NTPs — methadone clinics) from permitting a patient to receive more than a 2-week take-home supply of medication In response to COVID-19, SAMHSA is allowing up to 28 days of take-home medications for patients on stable dosages, if the physician deems appropriate.
28 Pa. Code § 715.9(a)(4) Requires NTPs to make a face-to-face determination before admission to treatment, for those clients who will receive buprenorphine treatment. In response to COVID-19, SAMHSA is allowing initial evaluations for a patient who will be treated with buprenorphine to be completed via telehealth.
28 Pa. Code § 715.6(d) Requires NTPs to have narcotic treatment physician services onsite. In response to COVID-19, SAMHSA is allowing initial evaluations for a patient who will be treated with buprenorphine to be completed via telehealth.
49 Pa. Code § 16.92(b)(1)

(Department of State)

Before a patient can be prescribed any controlled substance in Pennsylvania, a person licensed to practice medicine and surgery in the commonwealth, or otherwise licensed or regulated by the State Board of Medicine, must take an initial medical history and conduct an initial physical examination, unless emergency circumstances justify otherwise.

In response to COVID-19, the Department of State suspended the initial medical history and physical examination requirement specifically for the treatment of opioid-use disorder with buprenorphine.

 

In November 2021, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced that the methadone take-home flexibilities will be extended for one year after the eventual expiration of the federal COVID-19 Public Health Emergency. DDAP has submitted its written concurrence with this exemption. SAMHSA has also indicated that they are currently considering mechanisms to make this flexibility permanent. Narcotic treatment programs do not need to do anything additional at this time to continue taking advantage of this flexibility.

Similarly, the U.S. Drug Enforcement Administration (DEA) also announced last week that they are currently working to make their teleprescribing regulations permanent. DDAP will continue to provide additional information and guidance as it becomes available.

If you have any further questions, please contact the Bureau of Program Licensure at (717) 783-8675 or via email.

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it is now accepting applications for grants to expand the Certified Community Behavioral Health Clinic (CCBHC) model. There are new two grant opportunities this year with different eligibility parameters:

Certified Community Behavioral Health Clinic – Planning, Development and Implementation Grants (CCBHC-PDI) are available to clinics that are new to the CCBHC model (i.e., clinics that have not been certified as CCBHCs by their state and have not previously received a CCBHC expansion grant). This funding opportunity is designed to assist grantees as they develop and implement a CCBHC that meets CCBHC certification criteria. Qualified applicants must be able to meet the requirements of a CCBHC within the first year of the grant.

Certified Community Behavioral Health Clinic – Improvement and Advancement Grants (CCBHC-IA) are available to CCBHCs that have been certified by their states or received previous CCBHC-Expansion grants and are designed to support current CCBHCs as they expand or improve their CCBHC services. Qualified applicants must be able to demonstrate compliance with CCBHC certification criteria through state certification or SAMHSA acceptance of CCBHC certification attestation within the past two years.

Key highlights of these opportunities include:

  • The amount of the grants for both awards will be $1 million per year for four years.
  • Applications for both grants are due Tuesday, May 17, with an anticipated project start date of Sept. 30, 2022.
  • $156 million is available for each funding opportunity ($312 million total), which will fund an anticipated 156 grantees under each grant (312 total).
  • CCBHC Expansion grant recipients that received funding under CCBHCs Expansion FOA (SM-21-013, with funding announcements made in 2021) are not eligible to apply for funding under these opportunities.

This year’s grant announcements include a number of changes from prior years’ grants, including changes to attestation timelines, required and allowable services, data collection and reporting, use of grant funds and more. The National Council is compiling a summary of all changes that will be available soon.

SAMHSA is hosting informational webinars on these funding opportunities.

We encourage interested organizations to apply for this opportunity. More information about the CCBHC model is available on our CCBHC Success Center website. Implementation support is also available from our partners: innovaTel TelepsychiatryMHRRG and NegleyMTM ServicesNetsmart and Relias.

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Folders with the label Applications and Grants

This week, SAMHSA announced the availability of $22.6 million to public and private non-profit entities through its Medication-Assisted Treatment – Prescription Drug and Opioid Addiction (MAT-PDOA) grant. Applications are due Friday, April 29. More information about applying for the grant is available on SAMHSA’s website.

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The National Council for Mental Wellbeing will host Overdose Prevention Across the Continuum of Care: Strategies from the Field, the first of a two-part series, from 3:30 pm–5:00 pm on Monday, March 21. You can register for the event here.

Presenters will discuss a range of evidence-based strategies that have been successfully implemented across the continuum of care to prevent overdose and improve the health of people who use drugs and have substance use disorders, including those with co-occurring serious mental illness.

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RCPA will begin hosting regular meetings with Pennsylvania Integrated Care and Wellness Centers (ICWC) and Certified Community Behavioral Health Clinics (CCBHC). The first meeting is scheduled to be held on Thursday, March 31, 2022, from 1:30 pm–3:00 pm. This meeting is open to RCPA members and non-members.

The goal of the meetings is to gather together those who are currently acting as an ICWC or CCBHC as well as RCPA members and non-members who are interested in applying for a SAMHSA CCBHC Demonstration grant. The meeting format and frequency will be discussed at the first meeting.

President Biden outlined in his press release before the State of the Union address a federal strategy to address the mental health crisis and expansion of CCBHCs. This meeting is an opportunity to share challenges and successes as ICWCs and CCBHCs.

You can register for the meeting here. Please contact Sarah Eyster with questions.

American Rescue Plan Funding Will Support State Efforts to Transform Suicide and Mental Health Crisis Care

Today the Department of Health and Human Services, through its Substance Abuse and Mental Health Services Administration (SAMHSA), will make critical investments in suicide prevention and crisis care services, announcing $282 million to help transition the National Suicide Prevention Lifeline from its current 10-digit number to a three-digit dialing code – 988.

In 2020, Congress designated the new 988 dialing code to be operated through the existing National Suicide Prevention Lifeline. Converting to this easy-to-remember, three-digit number will strengthen and expand the existing Lifeline network, providing the public with easier access to life-saving services. The Lifeline currently helps thousands of people overcome crisis situations every day. The 988 dialing code will be available nationally for call, text, or chat beginning in July 2022.

Standing up the 988 dialing code is a key part of the Biden-Harris Administration’s focus on ensuring that those in crisis have someone to call, someone to respond, and somewhere to go. The 988 code is a first step toward transforming crisis care in this country, creating a universal entry point to needed crisis services in line with access to other emergency medical services.

With funds from the Biden-Harris Administration’s Fiscal Year (FY) 2022 budget and additional funds from the American Rescue Plan, SAMHSA’s $282 million investment will support 988 efforts across the country to shore up, scale up, and staff up, including:

  • $177 million to strengthen and expand the existing Lifeline network operations and telephone infrastructure, including centralized chat/text response, backup center capacity, and special services (e.g., a sub-network for Spanish language-speakers).
  • $105 million to build up staffing across states’ local crisis call centers.

“As we continue to confront the impact of the pandemic, investing in this critical tool is key to protecting the health and wellbeing of countless Americans – and saving lives. Giving the states a tool to prevent suicide and support people in crisis is essential to our HHS mission of protecting the health and wellbeing of everyone in our nation,” said HHS Secretary Xavier Becerra. “We know that remembering a three-digit number beats a ten-digit number any day, particularly in times of crisis, and I encourage every state to rev up planning to implement 988 for the sake of saving lives.”

To support the initial transition to 988, SAMHSA’s investment represents a budget increase of more than 10 times the FY 2021 budget amount of $24 million. A large portion of FY 2022 funding will be distributed to crisis centers across the country.

“This investment in states’ crisis call center operations will help strengthen our partnership as SAMHSA works with states to meet the suicide prevention and behavioral health needs of people across our nation,” said Miriam Delphin-Rittmon, Ph.D., the HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA. “Transformation of this scale is never easy – but too many Americans are experiencing suicide and mental health crises without the support and care they need. The federal government cannot do this alone.”

Suicide is the second-leading cause of death among young people and was the tenth-leading cause of death in the nation in 2019, according to U.S. Centers for Disease Control and Prevention data. In 2019, one death by suicide happened almost every 11 minutes in the US.

More recently, SAMHSA’s 2020 National Survey on Drug Use and Health (NSDUH) data show 4.9 percent of adults aged 18 or older had serious thoughts of suicide, 1.3 percent made a suicide plan, and 0.5 percent attempted suicide in the past year. Among adolescents 12 to 17, 12 percent had serious thoughts of suicide, 5.3 percent made a suicide plan, and 2.5 percent attempted suicide in the past year. The findings vary by race and ethnicity, with people of mixed ethnicity reporting higher rates of serious thoughts of suicide.