Pennsylvania is easing some requirements for drug and alcohol treatment providers with a goal of “expanding access to more Pennsylvanians and meeting them where they are.” Gov. Josh Shapiro announced this week that the state’s Department of Drug and Alcohol Programs will allow treatment providers to apply for a telehealth-only license, which effectively eliminates the need for a physical location.
“This new provider license is breaking down one of the largest barriers to treatment, closing the health equity gap that currently exists, and strengthening supports for some of our most vulnerable Pennsylvanians,” said DDAP Secretary Dr. Latika Davis-Jones in a statement.
Telemedicine has been lauded as a key component of health care systems across the world, particularly since the onset of the COVID-19 pandemic. As fatal overdoses increased during the pandemic due to higher rates of isolation and disrupted care, states changed the rules to allow medication assisted treatment to be prescribed without an in-person visit. The Drug Enforcement Administration has repeatedly extended the rules that provide that flexibility since.
As some of those policies have been allowed to sunset, Pennsylvania is making the telehealth addiction treatment option permanent and expanding who can become a provider with its new telehealth license.
Prior to the new licensure program, treatment providers were required to maintain a physical location in Pennsylvania in order to receive an operations license. The new license allows providers to serve Pennsylvanians virtually who are seeking intake, evaluation and referral, partial hospitalization or outpatient treatment without a brick-and-mortar location.
Existing state-licensed drug and alcohol programs do not need to apply for an additional or different license to serve people through telehealth platforms, according to the state. But their facility must still comply with federal, state and local laws.
A facility seeking a telehealth-only license without a physical location will be required to maintain client records on a web-based electronic health record program and maintain an electronic system for personnel files. The provider must also agree to provide the state with remote access to facility files and client records in accordance with federal auditing requirements.
Though the Shapiro administration touts the new license as a tool to broaden access to substance use disorder treatment, at least one provider association has misgivings about how a proliferation of virtual providers could impact patient safety and quality of care.
The Rehabilitation and Community Providers Association (RCPA) — a statewide medical association that represents providers of health and human services — told WESA they have “serious concerns” about the new license category and its potential to delay in-person treatment.
“When complex issues arise, or a patient is in crisis and in need of in-person services, or patients simply decide they want to be seen in-person, the best [a] provider with no physical presence in Pennsylvania will be able to do is refer to another provider, if it even happens,” said Jason Snyder, policy director of substance use disorder treatment services at RCPA.
“Community-based providers understand very well the communities they serve because of their very presence in those communities,” he argued.
Synder said patients seeking care from virtual providers who may need to refer them to unaffiliated physical locations could experience disjointed treatment and may be more likely to discontinue treatment altogether.
RCPA also expressed concern about how more virtual providers could further thin out an already understaffed workforce at current treatment facilities. “This [new] license category negatively affects those providers, not only in terms of potential loss of referrals but loss of workforce in a time when we’re already in a workforce crisis,” he said.
Pennsylvania currently has about 800 DDAP-licensed brick-and-mortar substance use disorder treatment facilities and more than 350 licensed recovery houses.
In its announcement this week, the Shapiro administration encouraged those interested in seeking care in Pennsylvania to make use of the state’s Get Help Now helpline at 1-800-662-4357 or search for local providers with the online Treatment Atlas locator tool.
