Under Section 5121 of the Consolidated Appropriations Act of 2023, states will be required to provide screening, diagnostic, and targeted case management services to young people who are reentering from incarceration. CMS recently posted a slide deck on the requirements, which outlines relevant State Plan Amendment processes. CMS also recently issued a Notice of Funding Opportunity (NOFO) for planning grants to promote continuity of care during reentry. Grant funds can be used to support Medicaid and reentry efforts, including establishing claims processing systems at correctional facilities, investing in IT to establish bidirectional data exchange between Medicaid and corrections, and setting up processes to screen for Medicaid and CHIP eligibility in correctional facilities. There are two application deadlines for this funding: November 26 for Cohort 1, and March 17 for Cohort 2.

Pennsylvania Governor Josh Shapiro signed legislation that would extend Medicaid coverage to doula services in the state. Under the new law, introduced as HB 1608, Medicaid will reimburse certified doulas for providing childbirth education and support services, including physical and emotional support, during pregnancy, labor and delivery and up to one year postpartum. The law also establishes a Doula Advisory Board to set standards and requirements for doulas practicing in Pennsylvania. The board would include a diverse membership, including practicing providers and representatives from various state agencies. In January 2024, DHS released MA Bulletin 13-24-01 on how Doula’s can enroll in the Medicaid Program. DHS expects to issue an MA Bulletin in the coming months with billing instructions for doulas enrolled in Medicaid. DHS anticipates doulas will be able to bill Medicaid beginning January 1, 2025.

Funding secured in multistate opioid settlements by then-Pennsylvania Attorney General Josh Shapiro, now Governor Shapiro, continues to help Pennsylvania prevent substance use disorder.

 The Pennsylvania Department of Drug and Alcohol Programs (DDAP) announced the availability of $2 million in funding to implement community-based prevention services throughout Pennsylvania to prevent opioid use disorder (OUD). Funding for these grants is provided from the Mallinckrodt Opioid Settlement, which was the result of a multistate investigation spearheaded by then-Attorney General Josh Shapiro that led to billions in settlement agreements with opioid manufacturers and distributors.

“Prevention really is our first line of defense in ensuring substance use disorder doesn’t develop,” said DDAP Secretary Dr. Latika Davis-Jones. “The Shapiro Administration is committed to providing critical prevention supports and resources throughout Pennsylvania’s cities, neighborhoods, towns, and communities as a whole. With this $2 million investment, DDAP will award approximately 10 grants of up to $200,000 each to eligible community-based organizations.”  

Applicants are required to propose activities that focus on the primary prevention of OUD. Primary prevention refers to programs or activities that prevent the initiation of substance use/misuse or prevent use beyond initial experimentation. In addition, all proposed activities must take place in community settings or post-secondary education settings including colleges or universities.

Examples of allowable prevention activities include:

• Community anti-drug coalitions that engage in drug use prevention efforts;
• Supporting community coalitions in implementing evidence-informed prevention, such as reduced social access and physical access, stigma reduction – including staffing, educational campaigns, support for individuals in treatment or recovery, or training of coalitions in evidence-informed implementation, including the Strategic Prevention Framework developed by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA);
• Engaging non-profits and faith-based communities as organizations to support prevention;
• Evidence-based or evidence-informed community education programs and campaigns for youth, families, and others;
• Youth-focused programs or strategies that have demonstrated effectiveness in preventing drug misuse and seem likely to be effective in preventing the uptake and use of opioids;
• Community-based education or intervention services for families, youth, and adolescents at risk for OUD and any co-occurring substance use disorder and mental health conditions; and
• Evidence-informed programs or curricula to address mental health needs of young people who may be at risk of misusing opioids or other drugs, including emotional modulation and resilience skills.

DDAP is placing a focus on health equity as a part of this grant opportunity. Based on a variety of criteria from the Pennsylvania Department of Health’s 2022 overdose death data, DDAP will select three grantees located in Philadelphia, three grantees located in Allegheny County and four grantees from the remaining 19 qualifying counties located within Pennsylvania with a crude death rate higher than the state average.

All applications must be submitted electronically by 12:00 PM on Friday, December 13, 2024. Applications will be competitively reviewed and scored based upon the applicant’s adherence to the funding announcement guidelines, and a timely submission to DDAP.

Questions regarding the grants and the application process should be forwarded to RA-DAGrantsMgmt@pa.gov.

The Centers for Medicare & Medicaid Services (CMS) has released a new toolkit to help partners share information with DACA recipients who will be able to enroll in health coverage through the Affordable Care Act (ACA) Health Insurance Marketplace ® for the first time starting November 1, 2024. DACA recipients who meet the eligibility criteria for coverage will qualify for a 60-day Special Enrollment Period (SEP) to select and enroll in a health plan through the Marketplace. Eligible DACA recipients who want 2024 coverage should select a plan by November 30, 2024, to have coverage that begins on December 1, 2024. DACA recipients who need 2025 coverage should enroll during Open Enrollment, which runs from November 1, 2024 – January 15, 2025 on HealthCare.gov.

This toolkit is designed to help you reach uninsured, qualified DACA recipients and inform them on how to enroll in Marketplace coverage. You can use these resources on social media, in listservs, and in other modes of communication.

The toolkit includes the following resources:

• Drop-In Article
• Fact Sheet
• Fillable Flyer
• Frequently Asked Questions (FAQs)
• Postcard
• Social Media Messages
• Social Media Graphics

Help CMS spread the word about this new opportunity for DACA recipients to apply for and select an affordable health plan on HealthCare.gov.

Visit healthcare.gov/immigrants/coverage/ for more information on health coverage for immigrants, and visit the Partners Tools & Toolkits page for additional Marketplace Open Enrollment resources, including a Spanish version of the new toolkit that will post soon.

Open Enrollment for Pennie.com plans starts today!

That means it’s time to enroll in health insurance for 2025, now through January 15th. For plans starting January 1st, make sure you enroll by December 15.

Nine out of 10 Pennsylvanians qualify for financial assistance! These tax credits save the average person more than $500 a month on a health insurance plan.

Now is the time to shop around! Plans and prices change from year to year, so don’t wait until the last minute to look at your options for 2025.

If you need help or want to know if you qualify for financial assistance, call or text our FREE, statewide helpline:

FOR FREE HELP, CALL OR TEXT:  877-570-3642