DHS COVID-19 PROVIDER RESOURCES // OMHSAS
COVID-19 Frequently Asked Questions (FAQs) Supplement 1
Issued: May 5, 2020
All Behavioral HealthChoices Managed Care Organizations (BH-MCOs),
Fee-For-Service (FFS) Providers, and County Mental Health Authorities –
The purpose of this memorandum is to issue additional Frequently Asked
Questions (FAQs) for delivery of behavioral health services in the Medical Assistance
(MA) program during the 2019 novel coronavirus (COVID-19) disaster emergency
declaration period. This memorandum supplements the initial set of COVID-19 FAQs
issued by the Office of Mental Health and Substance Abuse Services (OMHSAS) on
March 25, 2020.
1. Does the use of telehealth need to be documented in the client’s
Yes. The participant’s medical record must indicate
when a service is provided using telehealth, including the type of telehealth
(audio-video or telephone only) and the start and end time of the service.
2. Do individual practitioners (such as Licensed Professional
Counselors (LPC), Licensed Clinical Social Workers (LCSW), Licensed
Psychologists (LP), Licensed Marriage and Family Therapists (LMFT),
Psychiatric Nurse Practitioners (PNP), and Medical Doctors (MD) ) have to be
trained in telehealth service delivery for behavioral services?
No specific training for telehealth is required by
OMHSAS for individual practitioners; however, individual practitioners should
know how to use telehealth technology before delivering a service using
3. Can services be provided through telehealth without securing a
written consent from the client?
At a minimum, providers should obtain verbal consent
from the client at the start of each telehealth session and document the date
and time of the verbal consent in the individual's medical record.
4. In-person group therapy sessions have largely been canceled as part
of mitigation efforts for COVID-19. Can individual sessions, both in-person and
through telehealth, be used to provide therapy that would have otherwise been
delivered in a group setting?
Individual therapy sessions provided in-person or
through telehealth are acceptable service delivery modalities while group
services are unavailable. Individual therapy sessions should be designed
to meet the individual’s treatment needs that would have otherwise
been addressed in a group setting. Group services may also be provided
through audio-video telehealth during the disaster emergency declaration
5. Can Intensive Behavioral Health Services (IBHS) and Behavioral
Health Rehabilitation Services (BHRS) be provided through telehealth during
the COVID-19 disaster emergency declaration period?
Yes, IBHS and BHRS can be provided through
telehealth. Providers of IBHS and BHRS must comply with OMHSAS-20-02
Guidelines for the Use of Telehealth Technology in the Delivery of Behavioral
Health Services, issued February 20, 2020 and OMHSAS memorandum
“Telehealth Guidelines Related to COVID-19”, re-issued May 5, 2020. In
addition, if providing Therapeutic Staff Support (TSS) services, Behavioral
Health Technician (BHT) services, BHT-Applied Behavior Analysis (BHTABA) services, Assistant Behavior Consultation-ABA services, IBHS group
services and group services approved through the program exception
process through telehealth, the provider must submit a proposal explaining
how services will be delivered before delivering the services. Further
information can be found in OMHSAS-20-03 Instructions and Guidelines for
the Delivery of BHRS and IBHS Through Telehealth,” issued May 5, 2020.
6. Are Opioid Centers of Excellence (COEs) able to utilize telehealth
services during the COVID-19 disaster emergency declaration period?
Yes, COEs are able to utilize telehealth services
during the COVID-19 disaster emergency declaration period consistent with
the Managed Care Operations Memo #3/2020-005 Requirements Related to
COVID-19 issued by the Office of Medical Assistance Programs (OMAP) to
physical health managed care organizations on March 25, 2020. The
Operations Memo includes the following: “Consistent with the updates to the
telemedicine policies, and in order to facilitate the practice of social
distancing, for purposes of compliance with the requirements in Appendix G
of the HealthChoices Agreement, COEs may provide case management
services to COE clients through telemedicine or telephonic contact and these
contacts will qualify for the per-member per-month (PMPM) payments,
effective with the March 2020 PMPM, as if the encounter had taken place in
“It is also critical for COEs to ensure that they have sufficient office and clinic
hours to meet the needs of new patients and established patients who either
do not choose or cannot use telemedicine or receive services in their homes.
As such, there should be a balance of service delivery modalities based on
safety and the needs of individuals receiving services, staff providing services
and overall community needs.”
If a COE provides in-person services it should follow the current guidelines on
social distancing and maintaining space between individuals, the number of
people permitted to be in one location, and the use of face masks.
7. Does OMHSAS have a preferred platform for the provision of
services through telehealth (ex: Facetime, Skype, etc.)? Do platforms need to
be Health Insurance Portability and Accountability Act (HIPAA) Compliant?
OMHSAS is not recommending any specific platforms.
Providers must comply with the U.S. Department of Health and Human
Services Office for Civil Rights (OCR) guidance regarding the HIPAA
compliance during the disaster emergency declaration period. On March 17,
2020, OCR announced that it will exercise its enforcement discretion and will
not impose penalties for HIPAA violations against health care providers that
serve patients through everyday communication technologies during the
COVID-19 nationwide public health emergency, if used in good faith. OCR
also explained that this exercise of discretion applies to widely available
communications non-public facing apps, such as FaceTime or Skype, when
used in good faith for any telehealth treatment or diagnostic purpose,
regardless of whether the telehealth service is directly related to COVID-19.
It does not apply to public-facing technologies. The OCR notification can be
8. Do service providers working from their homes need to include their
address as an originating site in the telehealth attestation form?
The provider should continue to use the office location
as the originating site on the Appendix B Telehealth Attestation Form (Section
C), even if the provider is working remotely from home.
9. Can telehealth be used to provide psychiatry services
and consultation to inpatient facilities?
Yes. Telehealth may be utilized for both psychiatric
consults for patients in medical/surgical units and psychiatric services
in inpatient mental health settings.
10. Does a provider need to submit the OMHSAS-20-02 Attachment B
Telehealth Attestation Form if they currently have approval for tele-psych for
No, if a provider has a previous approval from
OMHSAS, the provider only needs to submit a new Attestation Form if they
have moved from the approved location or are adding a new originating site.
11. In conjunction with the expanded telehealth services, is there an
expectation that providers maintain some office hours and other in-person
capacity during the disaster emergency declaration period?
We recognize these are unprecedented times and
more than ever, it is incumbent upon each provider to continue to provide the
necessary behavioral health supports and services to ensure individuals
receive the services they need and in the delivery format that is necessary
during this crisis. During these times innovation is critical, such as expanding
the use of telehealth, delivering services in the home, and allowing staff to
work from home. It is also critical for a provider to ensure sufficient office and
clinic hours are available to meet the needs of new patients and established
patients who either do not choose or cannot use telehealth or receive
services in their homes. As such, each provider should balance service
delivery modalities based on safety and the needs of individuals receiving
services and staff providing services. If a provider is providing in person
services, it should follow the current guidelines on social distancing and
maintaining space between individuals, the number of people permitted to be
in one location, and the use of face masks.
12. Can providers utilize staff from services with low demand or
volume during the disaster emergency declaration period to provide support for
services with higher demand and/or staffing shortages, such as residential
Providers may utilize staff resources as needed if the
appropriate clearances are obtained or maintained and training, education
and experience requirements for the newly assigned work are met.
13. Can TSS, BHT or BHT-ABA services that were provided in a school
be provided in the home during the disaster emergency declaration period?
Children may need support when they are receiving
education in their home environment as a result of schools being closed. If
services are provided during the time the child is receiving education in the
home environment, a new authorization is not needed for services to be
delivered in the home, even if the support the child needs is different than the
support the child received when the child was in school. However, the
treatment team should review the existing treatment plan with the family and
determine if any interventions need to be changed to accommodate the new
service setting or the recommendations for social distancing. The review of
the treatment plan can be completed through telehealth during the disaster
emergency declaration period. If the review will be conducted in person,
guidelines on social distancing and maintaining space between individuals,
the number of people permitted to be in one location, and the use of face
masks should be followed.
14. During the disaster emergency declaration period, can new
admissions, psychological evaluations and re-evaluations be conducted through
During the disaster emergency declaration period it is
preferred that services be delivered through telehealth. If services cannot be
delivered through telehealth, a psychological evaluation or re-evaluation can
be conducted in-person but guidelines on social distancing and maintaining
space between individuals, the number of people permitted to be in one
location, and the use of face masks should be followed.
15. What guidance is available on take home Medication Assisted
Treatment (MAT) during the disaster emergency declaration period?
The Pennsylvania Department of Drug and Alcohol
Programs (DDAP) has released operational guidance and two licensing
alerts expanding the ability to take home medication for medication assisted
treatment. All of the documents can be found here.
16. Does the memorandum Telehealth Guidelines Related to COVID-19
issued by OMHSAS on March 15, 2020, allow for the use of text messaging for
Text messaging is not addressed in the memorandum
and may not be used to deliver services through telehealth.
17. Is it possible to receive a waiver of 55 Pa. Code § 4300.115(b), which
would allow counties to use an alternative payment arrangement to pay for
behavioral health services provided to individuals who are not enrolled in MA?
A county may submit a request to waive section
4300.115(b). Requests to waive section 4300.115(b) can be retroactive to
the date of the disaster emergency declaration so requests can include March
6, 2020 as the -effective date. Each request will be reviewed on a case-bycase basis. The Department of Human Services will not be issuing a
blanket waiver for all counties.
18. Can Federally Qualified Health Centers (FQHCs) that are
experiencing financial difficulties as a result of the COVID-19 pandemic be
included in alternative payment arrangement (APA) requests?
No, FQHCs cannot be included in APA requests.
OMHSAS will consider reinvestment plans submitted by HealthChoices
Primary Contractors for FQHCs on a case-by-case basis.
19. Question: Providers are unclear on how to offer telehealth services for
individuals who have commercial insurance and have received limited guidance
from the commercial insurance side. Can OMHSAS provide guidance on this?
The Pennsylvania Insurance Department (PID) has
encouraged commercial insurers to cover telehealth services. See point 5 in
Notice 2020-03 .
If a provider has a particular concern, they may need to work with the insurer
to address their concern. If the provider continues to have questions, they
may reach out to PID for assistance at (877) 881-6388 or here.
20. Can OMHSAS issue a blanket waiver delaying annual recertification
and training requirements related to licensure for mental health professionals for
the duration of the disaster emergency declaration period?
The licensure of mental health professionals
(including, but not limited to, physicians, certified registered
nurse practitioners, physician assistants, psychologists, licensed clinical
social workers, licensed professional counselors, licensed family and
marriage therapists, and registered nurses) falls under the authority of the
Pennsylvania Department of State (DOS). The DOS has suspended certain
regulatory requirements for licensed professionals, which can be found here.
21. Can OMHSAS suspend the Mental Health Procedures Act (MHPA),
50 P.S. § 7302, and 55 Pa. Code § 5100.23, pertaining to application, petitions,
statements and certifications for mental health treatment to allow the acceptance
of electronic signatures in place of written signatures on the application or
petition for involuntary emergency examination and treatment (Form MH-783)
during the disaster emergency declaration period.
The MHPA, 50 P.S. § 7302, and 55 Pa. Code §
5100.23, both specify that the application or petition for involuntary
emergency examination and treatment (Form MH-783) must be in writing, but
neither specifies that a written signature is required. Since neither statute nor
regulation prohibits the use of electronic signatures on the application or
petition for involuntary emergency examination and treatment, no suspension
of regulation is needed during a time of disaster emergency declaration or at
any other time.
County Administrators authorizing the use of electronic signatures on Form
MH-783 should require that that the electronic signature include the printed
full name of the petitioner preceded by “/s/”. For example: /s/Jane A. Doe.
22. During the disaster emergency declaration period, when submitting
the petition for involuntary emergency examination and treatment to the
approved facility or provider of involuntary emergency examinations, will a faxed
or secure emailed copy of the petition (Form MH-783) be permitted for
Yes. County Administrators authorizing the use of
faxed or secure emailed petitions should have written agreements with each
approved facility or provider of involuntary emergency examinations that
includes at a minimum the fax number(s) and/or email addresses that will be
used for the submission of petitions. Facsimile (fax) machines and email
address should be monitored 24 hours a day and have security features to