DHS COVID-19 PROVIDER RESOURCES // OMHSAS
OMHSAS Bulletin 20-03: Instructions and Guidelines for the Delivery
of BHRS and IBHS Through Telehealth
Effective: May 5, 2020; Issued: May 5, 2020
This bulletin applies to: (1) approved Behavioral Health Rehabilitation Services (BHRS) providers
and Licensed Intensive Behavioral Health Services (IBHS) providers enrolled in the Medical
Assistance (MA) Program who render services in the fee-for-service (FFS) or managed care
delivery system; (2) Primary Contractors and Behavioral Health Managed Care Organizations (BHMCOs) in the HealthChoices (HC) Program.
The purpose of this bulletin is to issue instructions for the delivery of BHRS or IBHS through
telehealth during the 2019 novel coronavirus (COVID-19) disaster emergency declaration period.
On March 6, 2020, Governor Wolf issued an emergency disaster declaration in response to the
presence of the COVID-19 in Pennsylvania. COVID-19 is a new virus that causes respiratory
illness in people and can spread from person-to-person. This virus was first identified during
an investigation into an outbreak in Wuhan, China. COVID-19 is a severe respiratory disease,
resulting in illness or death, caused by person-to-person spread of the virus.
Commonly reported symptoms of COVID-19 infection include fever, cough, and shortness of
breath. While the exact incubation period for this coronavirus has not yet been determined, it
is believed that most infected people will develop symptoms 2-14 days after they were
exposed. There is no vaccine available for COVID-19. Prevention measures center on
frequent handwashing, covering coughs and sneezes, and separating people who have
Treatment for COVID-19 includes the use of over the-counter fever-relievers, drinking plenty of
fluids and resting at home to help relieve symptoms. Those with more severe symptoms may
be hospitalized to provide additional support.
Given the Centers for Disease Control and Prevention’s (CDC) recommendations related to
quarantine and isolation, both self-imposed and mandatory, the Office of Mental Health and
Substance Abuse Services (OMHSAS) is announcing a preference for use of telehealth as a
delivery method for medically necessary behavioral health services as ordered, referred, or
prescribed by a provider or practitioner, that can be delivered effectively when the patient is
quarantined, self-quarantined, or self-isolated due to exposure or possible risk of exposure to
the COVID-19 virus.
In order to ensure that individuals continue to receive necessary behavioral health services as
we bolster our efforts to mitigate the spread of COVID-19, OMHSAS has suspended certain
requirements that govern the provision of behavioral health services using telehealth. The
guidelines for the provision of telehealth in the MA Program are delineated in the bulletinOMHSAS-20-02 “Guidelines for the Use of Telehealth Technology in the Delivery of BehavioralHealth Services” issued February 20, 2020 and OMHSAS memorandum “Telehealth
Guidelines Related to COVID-19” issued May 5, 2020.
Because of the unique nature of the interventions provided through Therapeutic Staff Support
(TSS) services, Behavioral Health Technician (BHT) services, Behavioral Health TechnicianApplied Behavior Analysis (BHT-ABA) services, Assistant Behavior Consultation-Applied
Behavior Analysis (Assistant BC-ABA) services, IBHS group services and group services
approved through the program exception process, providers of these services must submit a
proposal explaining how services will be delivered through telehealth. The proposal must be
approved by the Department before the provider can begin to use telehealth to deliver these
Approved BHRS and licensed IBHS providers that wish to provide therapeutic staff support (TSS),
behavioral health technician (BHT), BHT-applied behavior analysis (BHT-ABA) or assistant
behavior consultation-ABA (assistant BC-ABA) services through telehealth should submit a
proposal for the delivery of services along with the attestation form, as described in 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 COVID19,” issued May 5, 2020, to RA-PWTBHS@pa.gov. The proposal should include, at a minimum,
the assessment process used to determine that it is appropriate to deliver TSS, BHT, BHT-ABA or
assistant BC-ABA services through telehealth, the type of caregiver participation or support, if any,
that is expected, the minimum and maximum amount of time the provider will deliver services
through telehealth, and the specific audio-video delivery technology that will be used to deliver
services. The proposal should also include any additional information that explains how the
services will be provided.
Approved BHRS and licensed IBHS providers that wish to use telehealth to deliver IBHS group
services or group services approved through the program exception process should submit a
proposal for the delivery of services with the attestation form. The proposal should include, at a minimum, the age ranges of the children, youth or young adults, the minimum and maximum
number of group members, target population, group to staff ratio, staff qualifications, specific
audio-video delivery technology that will be used to deliver services, the minimum and maximum
amount of time the provider would be delivering services through telehealth, and what type of
caregiver involvement or support is expected. The proposal should also include any additional
information that will explain how the services will be provided.
OMHSAS will inform the provider if the proposal is approved or not approved. If the proposal is
approved, the provider can begin to provide the approved services through telehealth. Before a
child, youth or young adult receives IBHS or BHRS through telehealth, the treatment team should
review the existing treatment plan with the family and determine which, if any, interventions can be
provided through telehealth during the period of the disaster emergency declaration. The review of
the treatment plan should 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.
OMHSAS has develop additional guidelines (Attachment A) to support providers in developing their
proposals for delivering TSS, BHT, BHT-ABA, assistant BC-ABA, or group services through
telehealth. Please see attachment A
This bulletin will remain in effect while a valid emergency disaster declaration authorized by the
Governor related to the COVID-19 virus remains in effect.