Department of Health Launches Pilot Program to Provide Drug Coverage for Uninsured Pennsylvanians with Hepatitis C and HIV
Pennsylvania Secretary of Health Dr. Karen Murphy and Secretary of Aging Teresa Osborne announced today the Special Pharmaceutical Benefits Program (SPBP) is implementing a pilot program offering no cost coverage of hepatitis C antiviral medications for individuals with a dual diagnosis of HIV and hepatitis C. This pilot program will be a collaboration between the Department of Health (DOH) and the Department of Aging (PDA).
“Protecting Pennsylvania’s more vulnerable residents is one of the Wolf Administration’s primary objectives,” said Secretary Murphy. “Providing drug coverage for individuals suffering from hepatitis C or HIV who couldn’t otherwise afford the proper medical treatments is a part of our goal to ensure that every resident of the commonwealth has the ability to access needed medication.”
The $13 million, six-month program will be made available to hundreds of low-income Pennsylvanians with both hepatitis C and HIV and is funded through additional pharmaceutical liability recoveries made by the Department of Aging’s Pharmaceutical Assistance Contract for the Elderly program (PACE), which offers low-cost prescription medication to qualified residents, age 65 and older.
“The opportunity to partner with the Department of Health on this pilot program is an exciting opportunity to leverage 30-plus years of experience administering an effective prescription drug program with the Wolf Administration’s steadfast commitment to support the health of and improve the quality of life for all Pennsylvanians,” said Secretary of Aging Teresa Osborne.
The SPBP is Pennsylvania’s AIDS Drug Assistance Program (ADAP), which is funded by a federal grant through the Health Resources and Services Administration Ryan White HIV/AIDS Part B Program.
The SPBP plays a vital role in providing access to medications for people living with HIV, including those with hepatitis C co-infection. The program serves low to moderate income individuals who are underinsured or uninsured and have a diagnosis of HIV.
In addition to HIV viral load suppression, maintaining optimal overall health is equally vital to the management of HIV disease and increases the quality of life for commonwealth citizens.
Individuals eligible for or enrolled in other prescription plans must utilize those benefits prior to SPBP.
For a full list of the medications, the approval criteria, request form and additional details, please go to the SPBP website at: www.health.pa.gov/spbp.
For more information about the PACE program, call 1-800-225-7223.
Department of Human Services and ACLU Reach Settlement Agreement Regarding Forensic Mental Health Services
The Department of Human Services (DHS) today announced that it has entered into a settlement agreement with the American Civil Liberties Union (ACLU) regarding individuals served through Pennsylvania’s forensic mental health system.
“This agreement puts the focus exactly where it needs to be, on providing the highest level of services we can for those served by the forensic system,” said DHS Secretary Ted Dallas. “I would like to thank the ACLU for their professionalism and willingness to compromise. By working together, we have taken a good first step towards addressing a long-standing issue that both sides agree has affected Pennsylvanians for too many years.”
The forensic mental health system serves individuals who have been declared incompetent by the courts to stand trial on criminal charges and who have been ordered to be committed to Norristown State Hospital (“Norristown”) or Torrance State Hospital (“Torrance”) for treatment to help them attain competence. On October 22, 2015, the ACLU filed a class-action lawsuit challenging the amount of time individuals served by the forensic system stay in jail before being transferred to Norristown or Torrance.
The agreement focuses on increasing placement options for those who have been committed by the courts to ensure that they can get the mental health services they need more quickly and to reduce the negative impact that prolonged stays in jail have on their mental health and competency for trial. Highlights of the agreement include:
“A well-functioning forensic mental health system is not only a critical part of a well-functioning human services system, but also of a well-functioning criminal justice system,” said Secretary Dallas. “Today’s agreement will help improve both systems and make it easier for all of those involved to achieve the best possible result for the individuals they serve.”
Department of Human Services (DHS) Secretary Ted Dallas today announced that the state received 74 letters of interest for participation in the recently received Certified Community Behavioral Health Clinic (CCBHC) planning grant, a federal grant that encourages states to adopt innovative approaches to community-based behavioral health services.
The federal CCBHC grant is one of the most significant investments in community behavioral health in decades and has the potential to transform the way these services are delivered nationwide. CCBHCs will allow individuals to access a wide array of services at one location and remove the barriers that too often exist across physical and behavioral health systems. For the adults and children with serious mental illnesses and substance abuse disorders that will primarily be served by these community clinics, the increase in coordination and individualized care has the potential to greatly improve the quality of life for those served and loved ones.
“This grant from the federal government is a rare opportunity to dramatically rethink the way we provide behavioral health services, particularly for those who have very complex needs and those who can sometimes be reluctant to seek help,” said DHS Secretary Ted Dallas. “The high level of interest we have received is a clear indicator of the interest out there to find better ways to serve this population. The Department is committed to working closely with providers and stakeholders on ways that we can reshape our current approach.”
The letters of interest are the first step in the planning grant process. The $886k grant will be used by DHS to certify CCBHCs, solicit input from stakeholders, establish prospective payment systems for demonstration reimbursable services, and prepare an application to participate in the demonstration program. The award is part of $22.9 million in planning grants to 24 states.
DHS will submit a request for applications on February 1, 2016.
The award is made possible through Section 223 of the Protecting Access to Medicare Act of 2014, as part of a comprehensive effort to integrate behavioral health with physical health care.
The planning grant is the first phase of a two-phase process. When the planning phase ends in October 2016, awardees will have an opportunity to apply to participate in a two-year demonstration program that will begin January 2017.
For more information on the Planning Grants for Certified Community Behavioral Health Clinics, visit www.samhsa.gov/grants.
For more information on the Section 223 Demonstration Program for CCBHCs visit http://www.medicaid.gov/medicaid-chip-program-information/by-topics/financing-and-reimbursement/223-demonstration-for-ccbhc.html.
Along with more than 200 churches in 48 states and 8 countries, Parker Hill Church, Dickson City, will be an official host for Night to Shine, for individuals with special needs 16 years and older. The event is sponsored by the Tim Tebow Foundation. More than 70,000 volunteers and 30,000 honored guests will share the same amazing prom experience on the same night around the world, February 12, from 6:00 - 9:00 PM.
Every guest of Night to Shine will enter their prom on a red carpet complete with welcoming friendly paparazzi. Once inside guests will receive VIP treatment including hair and makeup stations, shoe shining stations, corsages and boutonnieres, a karaoke room and of course, dancing! The highlight of the night will come when every one of the Night to Shine guests is crowned as a king or queen of the prom.
For more information and to register for the event, to be held 6:00 - 9:00 PM, click here.
Disability Rights Network of Pennsylvania seeks prompt access to Medicaid services for individuals to avoid institutionalization.
The Disability Rights Network of Pennsylvania (DRN) announced today that it has filed a federal lawsuit on behalf of itself and two individuals with intellectual disabilities against the Pennsylvania Department of Human Services (DHS) for violations of federal Medicaid law, the Americans with Disabilities Act (ADA), and the Rehabilitation Act, because plaintiffs, who are Medicaid beneficiaries, are unable to access prompt services to which they are entitled, which places them at serious risk of unnecessary institutionalization. The lawsuit, Miller v. Department of Human Services, was filed in the United States District Court for the Middle District of Pennsylvania today.
“The Disability Rights Network of Pennsylvania has been tracking this problem for many, many years,” said Kelly Darr, Legal Director at DRN. “DRN has spent a lot of time and resources to represent individual plaintiffs, conduct individual interventions, and advocate with DHS to avoid the unnecessary institutionalization of persons with intellectual disabilities. It was time to address this problem in a more systemic way so that the threat of institutionalization in state facilities, psychiatric hospitals, or nursing facilities come to an end.”
In the complaint, DRN identifies numerous individuals enrolled in the Consolidated Waiver, a Medicaid home and community-based services program for individuals with intellectual disabilities who were forced into institutions or had their discharges from institutions delayed because of the lack of timely access to residential and other services funded by the Consolidated Waiver necessary to enable them to remain in their own homes and the community. Many of these individuals were represented by a DRN staff attorney or had a DRN advocate working on their behalf.
The named plaintiffs are Jared Miller (37) and Albert M. Spurri (25) are Consolidated Waiver participants who have been living at home with their families. Due to their complex needs, their families have struggled to maintain them at home with quality services funded by the Consolidated Waiver. The families have sought residential services repeatedly through the Consolidated Waiver, but those efforts have been unsuccessful. Unless the families can secure residential habilitation services promptly through the Consolidated Waiver, they will resort to institutionalization.
“It is outrageous that beneficiaries of the Consolidated Waiver in Pennsylvania are entitled to services, yet cannot timely secure them,” said Kelly Darr, DRN’s Legal Director. “The lack of timely access to Consolidated Waiver services has in too many cases resulted in unnecessary institutionalization, often by Court Order. The forced institutionalization of individuals with intellectual disabilities could have been avoided had the state provided the approved services that these individuals wanted and to which they are entitled.”
In the lawsuit, DRN seeks to ensure DHS provides prompt access to Consolidated Waiver services so that persons with intellectual disabilities can remain in the community and receive necessary services to avoid institutionalization.
The Disability Rights Network of Pennsylvania (DRN) is the statewide protection and advocacy agency for Pennsylvanians with disabilities. DRN protects and advocates for the rights of people with disabilities so that they may live the lives they choose, free from abuse, neglect, discrimination, and segregation.