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Legislative Briefing Addresses the Challenges of Substance Use Disorder in Rural Pennsylvania 

October 25, 2017

At the invitation of HAP, Jack Cahalane, PhD, MPH, Chief, Adult Services at UPMC Western Psychiatric Institute and Clinic, presented testimony during the Pennsylvania Rural Health Association’s annual legislative briefing, sharing insight about the effectiveness of using telepsychiatry to address the crippling impact of the opioid crisis in rural Pennsylvania.

Dr. Cahalane explained that telepsychiatric services can be provided securely on a desktop or laptop computer, any tablet, or handheld device with Internet access. This model of care allows patients to meet with health care providers without having to endure extensive travel or long waits for appointments, and most importantly, without fear or stigma.

In his testimony, Dr. Cahalane outlined regulatory and legislative obstacles that prevent telepsychiatry from being fully utilized. Specifically, he said requiring patients in rural areas to travel to a local community mental health center for their telepsychiatric appointment—as they are not allowed to access telepsychiatry from their homes—is problematic as it creates a stigma about their care. While there is a wavier process for home telepsychiatric visits, it is cumbersome. Also, he expressed concern that commercial insurer’s coverage of behavioral health, telepsychiatry, and substance abuse services is inconsistent throughout Pennsylvania, and recommended that more be done to ensure consistency and fairness.

Dr. Cahalane stressed that, with available treatments and community-based support programs, such as the 12-Step and Peer Support programs, the health care community has the tools to give individuals the necessary resources for recovery. He explained that individuals can receive help at home, a federally qualified health center, a community mental health center, a probation office, or a primary care office if the policy impacting care was more flexible.

Representative Matthew Baker (R-Tioga) and Senator Lisa Baker (R-Luzerne) co-chaired the briefing. Meaghan Sprout from the Pennsylvania Partnerships for Children gave testimony about addressing the immediate and long-term needs of the youngest victims of addiction. John “Jack” Martin, Owner and Supervisor of Dusckas-Martin Funeral Home, Inc., in Erie discussed the challenge for morticians in meeting increased demand for services.

Telemedicine is a HAP key legislative advocacy priority. Legislation to support expanded use of telemedicine is being considered in the Pennsylvania House of Representatives and the Senate. For more information about telemedicine and state legislative advocacy, contact Scott Bishop, senior vice president, legislative advocacy. For more information about HAP’s grassroots advocacy efforts, contact Tim Ohrum, vice president, grassroots advocacy. 

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