Medical Director for Mental Health/Substance Abuse Services
Dr. Dale K. Adair, Medical Director
P. O. Box 2675
Harrisburg, PA 17105-2675
The Office of the Medical Director provides statewide clinical mental health and substance abuse services leadership to all DHS Program Offices. The medical director is responsible for assuring all clinical programs for individuals with mental illness or substance abuse problems served throughout the commonwealth by the Office of Mental Health and Substance Abuse Services (OMHSAS) are of the highest quality, support a unified treatment system and reflect the OMHSAS commitment to facilitating recovery in adults and resiliency in children. The Medical Director functions as the chief medical officer of the state mental hospital system and provides oversight to community services as the chief clinical officer. The medical director's responsibilities include:
- Directing and providing clinical coordination between physical and mental health and substance abuse care benefit plans.
- Directing and providing clinical consultation and technical assistance with counties, state hospitals, managed care organizations, health maintenance organizations and specialty services, such as forensic, long-term nursing care, children, and the elderly.
- Consulting and collaborating with the Bureau of Children's Services and the Bureau of Drug and Alcohol Programs regarding clinical programs and programs for special populations.
- Developing and communicating policy to community mental health facilities, programs, and managed care organizations regarding pharmacy issues.
- Leading the development and oversight of the psychotropic drug formulary, the related prior authorization policies, and the inclusion of consumers, families and advocates in the administrative process. The Medical Director is a member of the DHS Pharmacy and Therapeutics Committee.
- Leading, directing and maintaining the Drug Utilization Reporting System (DURS) that provides monthly drug usage reports from the state hospital pharmacies. In addition, the Medical Director is a member of the DHS Drug Utilization Review Board.
- Interfaces with the advocacy community to learn their needs and concerns and to assure that the clinical programs of the behavioral healthcare system are consumer responsive.
- Interfaces with the professional community to learn their needs and concerns and to inform them of major OMHSAS initiatives and enlist their support in providing high-quality care that is consumer responsive.
- Developing and implementing best practice and expert consensus models for the treatment of individuals with severe mental illness and substance abuse.
- Promoting the implementation of other best practices as they become available.
The Office of the Medical Director is also responsible for the supervision of the Division of Clinical Review and Consultation as well as the Emergency Behavioral Health Preparedness, Response, and Recovery Program.
- Associate Medical Director
- Associate Clinical Director
- Chief Pharmacist for OMHSAS
- Director of Clinical Review and Consultation
- Behavioral Health Disaster Coordinator
If you have any questions concerning a member's rights or you have a problem with your MCO, contact the Member Services department of your county's behavioral health managed care organization.
If you are not in a Medical Assistance managed care plan contact your county MH/MR office (or Office of Human Services). If you are still not satisfied, contact the state regional OMHSAS field office near you.
Members enrolled in Medical Assistance have the right to request a Fair Hearing from the Department of Human Services anytime a prescribed service or medication is changed or denied. The member will receive a letter from either the MCO or Medical Assistance whenever a medical service is denied or changed. This letter also includes directions for accessing the DHS Fair Hearing process.
Division of Clinical Review and Consultation
The Clinical Review and Consultation Division responsibilities include:
- Review Fee for Services requests for authorization of inpatient, partial hospital, residential treatment facilities for children and Behavioral Health Rehabilitation Services
- Review Omnibus Budget Reconciliation Act (OBRA) requests for nursing home placements to ensure that those with an identified mental health disorder can be effectively served within a nursing home
- Process requests for appeals of authorization determinations
- Participate in the review of complex cases, including the development of creative or alternative solutions when existing programs and services cannot meet the needs of the consumer
Emergency Behavioral Health Preparedness, Response and Recovery Program
The Emergency Behavioral Health Preparedness, Response and Recovery Program consists of Disaster Behavioral Health initiatives including preparedness, response, and recovery activities at the county and state level. The Pennsylvania Office of Mental Health and Substance Abuse Services, as well as each of the county mental health offices in the commonwealth, have initiatives in place to help Pennsylvanians prepare for, respond to, and cope with the psychosocial and emotional consequences related to disasters and public health emergencies. The efforts involve collaboration and partnerships with other national, state and local response agencies, including public and non-public sector partners. Efforts also include working with federal agencies to ensure a comprehensive, professional, disciplined, and coordinated behavioral health response for Commonwealth citizens who are victims of disasters.