OMHSAS is resending this email with an updated “OMHSAS Request For Waiver Form”. It was brought to our attention that the document sent in the original email on 4/22/22 was not the fillable .pdf we meant to include. The attached form is now fillable.
OMHSAS has developed the attached “Information and Guidelines for Providers Regarding Waiver Submission” document and “Request for Waiver Form” to assist providers when submitting a request to waive an OMHSAS licensing regulation or Bulletin. The Information and Guidelines document provides detailed information on how to complete the request for waiver form to ensure a comprehensive submission with all required information that is needed for OMHSAS to review and make a decision. This will help to ensure that OMHSAS gets all of the information needed on the first submission and will hopefully reduce delays that are created when additional information must be requested of the provider before OMHSAS can make a determination on approval. These documents are also available on the Department of Human Services (DHS), Mental Health Programs Licensing website at Mental Health Programs Licensing (pa.gov). Any questions can be directed to your licensing representative or applicable OMHSAS Regional Field Office.
For more information, please see the attachments below: