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The Departments of Labor, Health and Human Services, and the Treasury recently released their 2022 Report to Congress on the Mental Health Parity and Addiction Equity Act. (MHPAEA ) The report includes findings that health insurance plans are still not providing parity for mental health and substance use disorder benefits to consumers. MHPAEA requires that insurance coverage for mental health or substance use disorder benefits cannot be more restrictive than that of medical and surgical benefits. However, the report provides examples of continuing disparities, including an instance of an insurance company covering nutritional counseling for conditions such as diabetes but not for conditions such anorexia or binge-eating disorder. In response, the report also provides information on the departments' recent emphasis on greater MHPAEA enforcement as well as makes recommendations to strengthen protections for consumers. The report outlines the Departments' efforts to enforce the amendments to MHPAEA made by the Consolidated Appropriations Act 2021. The act provided the departments with an important new MHPAEA enforcement tool and additional funding to implement it. The law also requires the departments to report findings annually. Ongoing efforts to engage with stakeholders to reduce the stigma associated with mental health and substance abuse disorders are also listed. The Ohio Department of Insurance (ODI), in partnership with the Ohio Department of Mental Health and Addiction Services (OhioMHAS), also recently announced their 2022 Annual Mental Health Parity Report. The report, which includes information on consumer outreach activities, barriers to access and coverage in this state, and more, is required by law.

COLUMBUS, OHIO –The Ohio Department of Job and Family Services (ODJFS) today celebrated the fourth anniversary of Ohio’s Bridges program, which empowers former foster youth to achieve success in adulthood. Since its launch in 2018, Bridges has connected more than 3,100 former foster youth between the ages of 18 and 21 to safe housing and supportive services. “Helping youth aging out of the foster system transition into their community is critical to their long term success,” said ODJFS Director Matt Damschroder. “To date, Bridges has helped more than 3,100 youth on their road to long term success.” ODJFS administers Bridges through a contract with the Child and Family Health Collaborative of Ohio, which works in partnership with experienced provider agencies throughout the state. Through regular meetings with Bridges representatives, participants develop goals, learn skills, and access services related to employment, education, health care, and household maintenance. “A few years ago, this program was just a concept, inspired by countless voices of foster youth and alumni,” said Mark Mecum, CEO for the Child and Family Health Collaborative of Ohio. “Today, we are engaging young people in every corner of Ohio. Youth are setting goals, graduating from high school, enrolling in college, securing job training and even landing competitive jobs. Their success – and the program’s success – is inspiring and we look forward to another impactful year. Approximately 1,000 youth age out of foster care annually. If they don’t qualify for Bridges, or if they choose not to participate, they still can seek supportive services from their county public children services agency. For more information about Bridges, visit bridgestosuccess.jfs.ohio.gov.

At the end of January, the Counselor and Social Worker (CSWMFT) Board voted to extend the temporary suspension of enforcement of certain provisions of Rule 4757-5-13 (Teletherapy) until July 20, 2022. A revised rule was filed to match this decision and is currently moving through the regulatory process. During the temporary suspension of enforcement, the following provisions of current Rule 4757-5-13 are waived: Requirement to hold an initial face-to-face meeting (in-person or via video). Requirement to obtain written consent prior to treatment. Use of a HIPAA-compliant platform that exceeds current U.S. Department of Health and Human Services guidance regarding remote communications during the federal COVID-19 nationwide Public Health Emergency. The Board has stated that the suspension of enforcement should not be considered a permanent change to the Rule. However, we have been told that the CSWMFT Board is continuing to review the rule and anticipates some changes to support access to services, while ensuring the public is protected.

ODJFS has released its first Procedure Letter allowing for compliance flexibilities since the State of Emergency was lifted in June of 2021. The Department was recently able to obtain additional guidance from the Federal Children’s Bureau, and released Family, Children, and Adult Services Procedure Letter No. 382 which provides updated guidance regarding the COVID-19 pandemic. Flexibility in following requirements will be permitted: Foster Home Capacity Foster Care Training CPR and First Aid Training for Residential Agencies It also allows PCSAs and Title IV-E courts to utilize videoconferencing between a child or parent and caseworker in limited situations and timeframes where the public health crisis makes it impossible or unsafe to meet face-to-face. Keep in mind that this guidance is specific to agency interactions with families affected by COVID-19. More information can be found here.

Ohio Children’s Alliance is now accepting workshop proposals and early bird registration for the 46th Annual Conference scheduled for May 4-5. The conference will be held at Renaissance Columbus Westerville-Polaris, 409 Altair Parkway, with in-person and virtual options. Workshops will focus on advocacy and public policy, best practices in child welfare and/or behavioral health diversity, equity, and inclusion, and strategy, innovation, and leadership. Click HERE for more information. The deadline for workshop proposals is Monday, Feb. 7.

On behalf of the Child and Adolescent Behavioral Health Center of Excellence (CABH COE), the Ohio Children’s Alliance announces the availability of 50 scholarships for qualifying behavioral health providers to receive the Board Certified-TeleMental Health Provider credential (BC-TMH). Scholarship funding will be in the form of reimbursement and will include 9 CEU hours of training through the New STAR Institute as well as the cost of the exam. For the purpose of this funding, qualifying behavioral health providers include: Licensed Professional Counselors (LPC) Licensed Mental Health Counselors (LMHC) Licensed Clinical Professional Counselors (LCPC) Licensed Professional Clinical Counselors of Mental Health (LPCC) Licensed Clinical Mental Health Counselors (LCMHC) Licensed Mental Health Practitioners (LMHP) Licensed Social Worker (LSW) Licensed Independent Social Worker (LISW) To apply for this scholarship, click here. Applications will be accepted on a first-come, first-served basis, and scholarship awards are limited to no more than two (2) practitioners per agency. The application deadline is February 18, 2022. The Ohio Children’s Alliance will release agreements to scholarship recipients’ organizations on February 25 to be signed and submitted by March 8. Agencies will be responsible for paying for the trainings and the exam, and will be reimbursed by the Ohio Children’s Alliance upon the recipient’s approval from the testing organization to take the exam. Both the trainings and notification of approval to take exam must be completed by June 1, or the reimbursement may be forfeited. All questions regarding this opportunity can be directed to Lauren.Barco@ohiochildrensalliance.org.

Ohio House Bill 442, sponsored by Representatives Sharon Ray and Jason Stephens, and Ohio Senate Bill 239, sponsored by Senator Bill Blessing, are companion bills that would expand the list of individuals qualified to be home assessors and professional treatment staff, On December 8, HB 442 passed the House 90-1. Before its passage, an amendment was included that would require an unlicensed home assessor to have one year of experience working with children and families in addition to having a bachelor’s degree in a human services-related field. Mirrored home assessor language was also placed into Ohio House Bill 4, legislation sponsored by Representative Phil Plummer and Representative Susan Manchester that would make several changes to children services delivery, including child abuse and neglect reporting. This bill has recently passed out of the Senate Judiciary Committee and now moves to the full Senate for a vote. Stay tuned for more updates!

In the last month, The Ohio Department of Job and Family Services (ODJFS) has released several updates pertinent to the family and children services sector. Here's a roundup of their announcements: The Department has recently released Family, Children, and Adult Services Procedure Letter No. 382 which provides updated COVID-19 guidance for agencies and reflects new information obtained from the Children's Bureau. Agencies will need to determine how to best apply the provided guidance to local conditions and clearly document this decision-making rationale in the case record. You can also find additional information from the Ohio Department of Health as agencies determine how to respond to the pandemic conditions within their local communities. It is critical to recognize that this guidance is specific to agency interactions with families affected by COVID-19. If you have any additional questions, ODJFS recommends reaching out to your Licensing Specialist. ___________________________________________________________________________________________ Two Procedure Letters, (PL) as well as policy and practice guidance, have been published that clarify information regarding placements in a non-QRTP after QRTP compliance is reached. PL 381 further clarifies that a placement can be Title IV-E reimbursable in a non-QRTP upon becoming QRTP compliant, as long as the required 30-day CANS assessment and 60-day judicial determination timeframes are met. PL 384 clarifies that for each IV-E eligible child placed in a non-QRTP setting on/after October 1, 2021, the requirements outlined in rule 5101:2-42-12 must be followed beginning on the effective date the agency is considered QRTP compliant. Procedure Letter 381, as well as Procedure Letter 384, can be found here. In addition, Policy and Practice Guidance Document #18, which can be found here, provides comprehensive guidance regarding each area impacted by the latest federal guidance on non-QRTPs becoming QRTP compliant. ____________________________________________________________________________________________ As many of you know, HB 110, Ohio's most recent state budget bill, allocated $5 million dollars in SFY 22 and SFY 23 each ($10 million total) for the purpose of foster care recruitment and retention. The Department has recently announced that they are utilizing this funding to provide an opportunity to support public and private agency foster home recruitment and retention efforts. More details will be included in a forthcoming procedure letter, but it has been indicated that applications including plans to elevate treatment foster care providers will be prioritized. ____________________________________________________________________________________________ As you may know, ODJFS and OhioMHAS are seeking input on training topics pertinent to the key QRTP requirements. They ask that you please take a moment to complete this needs survey to identify training topics and potential training partners to best meet your needs. This survey will be available until Friday, February 18, 2022.

The Ohio Department of Medicaid and Aetna invite youth and families, advocates, community stakeholders, and providers to attend OhioRISE listening sessions in February 2022. During these listening sessions, participants will be able to give their recommendations and feedback on how to best support OhioRISE starting in July 2022. The feedback gathered will be reviewed and considered in the implementation of policy and process development to ensure a more comprehensive readiness before go-live. Sessions for Providers are as follows: 2/16/2022 – 11:30 a.m. to 1:00 p.m. 2/23/2022 – 11:30 a.m. to 1:00 p.m. 2/24/2022 – 12:00 p.m. to 1:30 p.m. If you are interested in joining one of the sessions, you can register HERE ____________________________________________________________________________________________ Over the next few months, trainings facilitated jointly by the Ohio Department of Medicaid, Aetna, the Child and Adolescent Behavioral Health Center of Excellence, and state agencies are scheduled to help providers prepare to implement OhioRISE in July 2022. Each session will cover a range of topics including implementation, systems, and operations. Providers are invited to attend module 1 of the OhioRISE community and provider training series. All local system partners and providers that serve multi-system youth are encouraged to attend and includes staff of all levels. This first module covers an overview of OhioRISE and eligibility and enrollment. Each module will be presented live, and recordings will be available on the OhioRISE webpage a week after the live session. They are also offering Office Hours for you to ask questions and make suggestions to OhioRISE subject matter experts. Below are dates, times, and links to register. February 2022 Module 1 Training 2/18/2022 - 8:00am-12:00pm Click Here to Register Module 1 Office Hours 3/1/2022 - 1:00-2:00pm Click here to Join 3/2/2022 - 8:00-9:00am Click here to Join 3/2/2022 - 3:30-4:30pm Click here to Join

The FosterCare Young Leaders Team is currently accepting applications for the 2022 All-Star Internship. Eligibility Requirements: Have firsthand experience in the child welfare system/foster care. Be between the ages of 18 and 24. Be able to be photographed. Have the ability to obtain high-speed internet (we will work with folks to ensure you have adequate bandwidth) FosterClub values foster youth lived experience and sees it as expertise to contribute to improving foster care. This year the All-Star internship will take place virtually and in-person due to the ongoing COVID-19 Pandemic. You can find the application here.

In November 2021, OSHA issued a federal rule mandating COVID-19 vaccinations or at least weekly testing for workers at U.S. companies with 100 or more employees. The administration also released a new rule through CMS requiring employees at health care facilities participating in Medicare or Medicaid to be fully vaccinated by January 4. After two months of legal battles in which Ohio participated, both mandates came before the United States Supreme Court. The U.S. Supreme Court struck down OSHA’s vaccine-or-test rule, declaring that the Department had exceeded its authority over large businesses. At the same time, however, the high court upheld the CMS vaccine mandate for Medicare and Medicaid providers. Many entities are listed as having to comply with the CMS mandate, including federally-defined CMHCs. However, to be considered a covered entity, an agency would have to do all of the following: Provide outpatient services, including specialized outpatient services for children, the elderly, individuals who are chronically mentally ill, and residents of its mental health service area who have been discharged from inpatient treatment at a mental health facility; Provide 24-hour-a-day emergency care services; Provide day treatment or other partial hospitalization services, or psychosocial rehabilitation services; Provide screening for patients being considered for admission to State mental health facilities to determine the appropriateness of this admission; Meet applicable licensing or certification requirements for CMHCs in the State in which it is located; and Provide at least 40 percent of its services to individuals who are not eligible for benefits under title XVIII of the Social Security Act (aka Medicare). Entities performing all of the above services and who are certified as a CMHC through CMS, are subjected to the mandate. New and updated tools and resources have been developed by CMS to help determine whether the vaccine requirements apply to you and your organization. Additionally, this infographic shows the phases and deadlines of the vaccination rule implementation state by state.

The Ohio Children’s Alliance is pleased to announce that $3.5 million in grant funds are available for the purpose of increasing access to early childhood mental health services. This one-time funding opportunity is made possible by the Ohio Department of Job and Family Services (ODJFS), the Ohio Child Care Resource and Referral Association (OCCRRA), and American Rescue Plan Act (ARPA) dollars. It will support the establishment and expansion of therapeutic child care programs for Ohio families by building upon collaboration. Selected entities will be Ohio Mental Health and Addiction Services (OhioMHAS) certified community mental health agencies that commit to partnering with a local community-based child care program licensed by the Ohio Department of Job and Family Services to design and implement the childcare program. The agencies, with their partners, will implement or expand a child care program built upon an evidence-based mental health practice. Funds must be spent by the end of State FY 24. There will be a virtual Bidders’ Conference on January 14, 2022, at 10 am. You can attend the conference using this link. Letters of Intent to apply are required and are due by January 21, 2022. The full RFP can be found at https://www.ohiochildrensalliance.org/iecmh and www.occrra.org.

The passage of the American Rescue Plan Act (ARPA) brought with it an opportunity for investment in home and community-based services. (HCBS) The federal legislation included a temporary 10% federal match increase to state Medicaid-funded HCBS, for which the Centers for Medicaid and Medicare Services (CMS) required states to submit detailed spending plans. Ohio engaged in a process to solicit feedback from the community for Ohio's funding plan. In August, the Ohio Department of Medicaid (ODM) posted an RFI in August 2021 to solicit feedback from all stakeholders that was completed by the end of the month. Then, in October 2021, ODM submitted its plan. You can find it here. In total, the state proposed utilizing $529 million dollars for one-time direct payments to HCBS providers in recognition of the essential work performed and for relief from the negative economic impacts experienced during the ongoing COVID–19 public health emergency (PHE). Recently, ODM, along with several partner agencies provided a progress report on its spending recommendations and what legislative and regulatory hurdles remain before funds are released. They reported at this meeting that Ohio has received partial approval, but that the partial approval extends specifically to the provider relief component of Ohio’s ARPA plan. They also provided a provider relief track grid with detailed information as to the provider types receiving funding. The provider groups identified for this support are all direct providers of HCBS services and include Community Behavioral Health Services Provider types 84 & 95. The state has proposed that these be approximately a 10% lump sum retroactive payment for paid claims for the time period of 07/01/2020-06/30/2021. The state has further indicated that these payments to providers will be completed before March 2022. You can find all of the most up-to-date information regarding ARPA funds for HCBS in Ohio here. We also want to highlight an additional announcement Governor DeWine recently made regarding the use of ARPA funds to strengthen behavioral healthcare services, which you can read here.

In 2022, the OhioRISE Center of Excellence (COE) will be fully responsible for providing statewide professional development activities related to the Ohio Children’s Initiative CANS assessment tool, including live training, technical assistance, coaching, office hours, and the development of practice communities. Please be aware that following CANS training with the COE, you must register on the Praed Foundation’s website and complete the exam to become a certified assessor. The cost of the exam will be waived with a coupon code you will receive upon completion of the training. You can find the dates/times and registration links for training and office hours here. The CANS assessment tool is a support tool in the clinical decision-making process to determine eligibility into OhioRISE and level of care and service planning. As a reminder, all assessors must maintain certification in the new Ohio CANS with the Praed Foundation, which requires completion of the TCOM (Transformational Collaborative Outcomes Management) and Ohio Children’s Initiative CANS Comprehensive training. Currently certified assessors who have completed certification on other versions of the CANS will meet Ohio CANS certification requirements if they also complete a 2.5-hour virtual Ohio CANS booster training. This “grandfathered” group must obtain the new Ohio CANS certification at their annual recertification date. Are you interested in participating in a CANS focus group to help ODM understand the usability and efficacy of the assessment tool? You can register using this form.

A federal appeals court panel recently lifted the stay on the U.S. Occupational Safety and Health Administration’s COVID 19 Emergency Temporary Standard which set forth vaccine and testing requirements for private employers with 100 employees or more.. The 2-1 decision by a panel of the 6th U.S. Circuit Court of Appeals in Cincinnati overruled a decision by a federal judge in a separate court pausing the mandate nationwide. As a result, OSHA has posted new guidance stating that covered employers must now comply with the mandate by January 10, 2022. If an employer opts to permit employees to test in lieu of vaccination, then testing of unvaccinated employees must begin by February 9, 2022. Since the ruling, the Supreme Court received at least 11 emergency applications challenging the Sixth Circuit’s decision. Unless there is a stay from the high court, these requirements will continue to move forward. As many of you know, Ohio has been at the helm of a group of 27 states claiming that the OSHA mandate is unprecedented and that OSHA does not have the authority to enforce it. After the Sixth Circuit panel ruling, Ohio Attorney General Dave Yost stated he will continue legal efforts to stop the OSHA mandate. You can read more about the Sixth Circuit’s decision here. As a reminder, decisions on the OSHA mandate do not affect the CMS mandate, which remains stayed in 24 states, including Ohio. UPDATE: On December 22, 2021, the Supreme Court of the United States issued orders granting review of legal challenges to OSHA Emergency Temporary Standard as well as the CMS Vaccine Mandate. The High Court also set an accelerated timeline for the cases, scheduling oral arguments in both cases on January 7, 2022.

The CMS COVID 19 Vaccine Mandate, which would require workers at health care facilities participating in Medicare or Medicaid to be fully vaccinated has been operating under a nationwide injunction from Louisiana Court until just a couple of weeks ago. Recently, the Fifth Circuit Court of Appeals issued an opinion partially upholding and partially reversing the Louisiana district court’s injunction. Meaning, although enforcement of the CMS Rule is still halted in the 14 states that brought the lawsuit in Louisiana, and in the 10 states that are part of a separate CMS lawsuit, for everywhere else, the injunction is lifted. As a petitioner in the Louisiana lawsuit, Ohio is one of the 24 states for whom the injunction was upheld and enforcement of the mandate remains halted. However, now that the vaccination mandate is back “on” in 26 states, CMS has not released information on when enforcement in the non-enjoined states will start back up—if at all. You can read more here. UPDATE: On December 22, 2021, the Supreme Court of the United States issued orders granting review of legal challenges to OSHA Emergency Temporary Standard as well as the CMS Vaccine Mandate. The High Court also set an accelerated timeline for the cases, scheduling oral arguments in both cases on January 7, 2022.

As we reported in November, ODJFS announced they are once again releasing a funding opportunity to assist agencies certified by ODJFS and OhioMHAS in obtaining and maintaining compliance with the QRTP requirements. This one-time $10,000 grant opportunity will provide resources and supports needed to meet QRTP requirements, as well as support the implementation of best practices to enhance agency programming and promote QRTP sustainability. ODJFS released FCASPL 380 detailing the eligibility criteria, menu of service opportunities, and application link through the OCCRRA dashboard HERE. The application, which opened on November 15, 2021, must be submitted by January 16, 2022. In addition, they have shared a New User Guide to support any agency who hasn’t yet created a user profile in the Ohio Professional Registry (OPR) through the OCCRRA dashboard. Questions regarding creating your new user profile can be emailed to the OPR at support@occrra.org.

In the fall of 2021, two companion Foster Care Workforce bills were introduced: House Bill (HB) 442 and Senate Bill (SB) 239. Both pieces of legislation aim to expand the current requirements for private agency treatment staff to include the prerequisites already utilized by the same staff at public agencies. It would also expand the individuals eligible to perform the duties of a Home Assessor to include individuals with bachelor’s degrees in certain relevant human services fields related to children and families. HB 442, which is sponsored by Representatives Sharon Ray and Jason Stephens, has been quickly moving through the legislature, garnering support from both sides of the aisle. This bipartisan legislation passed 84-1 on December 8 and now moves to the Senate. “This is a huge win for the foster care system,” said Stephens. “These children need our help finding more stability and this bill creates fairness and better access for home assessors to help get this children into that environment." We are appreciative of the bills' sponsors for their hard work to ensure children are placed in safe and stable homes sooner and their dedication to children services transformation.

ODJFS recently released information outlining Kinship Support Program overpayment procedures through Families and Children Letter (FCL) #017. This document provides background information and guidance regarding the process for ODJFS to identify overpayment of KSP, to notify kinship caregivers when a KSP overpayment has occurred, and the steps necessary for ODJFS to resolve or collect any overpayment of KSP. Additionally, this process includes the assurance that kinship caregivers are notified of their rights for a state hearing related to denial or termination of KSP, as well as any action related to recoupment of any overpayment of KSP. It is important that kinship caregivers, agencies, and communities be aware of this new procedural process. As a reminder, the Kinship Support Program was established as Ohio's response to DO v Glisson and was passed as an amendment added to SB 310, a capital spending bill to pay for state and local building projects in 2020. The Kinship Support Program aims to provide financial payments to kinship caregivers of kids in state custody while they work to become licensed foster caregivers.

Just days ago, Lt. Governor Husted and ODJFS Director Damschroder announced in a press conference that Ohio is the first state to implement two technology tools from Connect Our Kids to help children services connect foster youth with their forever families. They were joined by partners from InnovateOhio, Kinnect, the Dave Thomas Foundation, and Ohio CASA. The tools announced were: The Family Connections tool: a digital diagram that illustrates an individual’s family members. Professionals can use the desktop or mobile app versions to build family trees, find family contact information and engage family and supporters of children in foster care. The People Search tool: utilizes public information from over 300 sources and covers over 3 billion people to exponentially expand the pool of potential kinship caregivers, far beyond just those in current contact with the child’s parents. The tools will help children services professionals connect Ohio's 3,100 foster youth with their forever families. You can watch the press conference in its entirety here.