April 18, 2025

SAVE THE DATES!!!!  SAVE THE DATES!!!! 

On May 15 and May 23, the NYS Council will host ‘Members Only’ Webinars facilitated by Health Management Associates (HMA) consultants that are designed to:

1) Assist our members with ongoing challenges associated with maintaining internal and external messaging that speaks to your  core values and mission while avoiding unwanted attention from the Trump Administration and others.  (May 15 from 9:15-10:15) and,

2) Strengthen your ability to quickly assess and take action when unexpected federal policies/executive orders create a potential crisis for your organization that threatens continued viability of core programs and services, and access to care for the New Yorkers who depend on your services.  (May 23 from 9:15-10:15)

More details to follow but for the time being we wanted to make sure you block the time on your calendar for these Webinars.  Registration information to follow shortly.
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FEDERAL CHAOS

Following is an article from today’s Washington Post with early reporting regarding a new Trump Admin policy ironically referred to as “Defend the Spend” that is being implemented by DOGE and is (in our opinion) designed to curb federal spending by requiring that federal officers representing federal agencies (largely Trump appointees) must review grant payments going to awardees from BEFORE the funds are disbursed to providers.  Apparently they are looking for alignment between the payment and how these funds advance Trump policy goals and objectives. 

This new requirement appears to be spreading across an increasing number of federal agencies, and it is resulting in delays in receipt of funds (to awardees).   Please let us know if you are caught in this tornado.   Apparently grantees are being told to contact the awarding federal agency.  

DOGE begins to freeze health-care payments for extra review

DOGE is putting new curbs on billions of dollars in federal grants, requiring officials to manually review and approve payments that were previously routine., 4/18/25

April 17, 2025 at 7:25 p.m. ED
By Dan Diamond, Carolyn Y. Johnson and Hannah Natanson

The U.S. DOGE Service is putting new curbs on billions of dollars in federal health-care grants, requiring government officials to manually review and approve previously routine payments — and paralyzing grant awards to tens of thousands of organizations, according to 12 people familiar with the new arrangements.

The effort, which DOGE has dubbed “Defend the Spend,” has left thousands of payments backed up, including funding for doctors’ and nurses’ salaries at federal health centers for the poor. Some grantees are waiting on payments they expected last week.The Trump administration is pushing to cut federal spending and crack down on grants that political officials say conflict with White House priorities.DOGE, which stands for the Department of Government Efficiency, said the new initiative, which is being rolled out across parts of the Department of Health and Human Services, will force grantees and officials to justify spending and create transparency.“Thanks to the great work by @HHSGov, for the first time ever, the American people will be able to see line-by-line payment descriptions & justifications — coming soon to the DOGE website,” the group posted on X last Saturday.

Typically, an organization that has been awarded a grant does not receive the funding up front. The money is held in a secure account managed by the government, and an organization will request “drawdowns” — tranches of money periodically throughout the year — to cover expenses such as salaries or research costs.Under Defend the Spend, organizations must now include a justification for each transaction. Federal officials then review the justification before deciding whether to approve the payment.The process has been abruptly instituted at the National Institutes for Health, the Administration for Children and Families, and other parts of HHS, with inconsistent instructions on how to proceed, said the people familiar with the arrangements, who, like others, spoke on the condition of anonymity because of fear of reprisal. They also described immediate backlogs in processing payments.HHS said in a statement that the DOGE effort would not threaten “support for critical programs” and was intended to root out fraud and abuse. “The era of rubber stamping is over,” the HHS statement said.Current and former federal officials said the process would create bottlenecks.“Instead of cutting red tape, they are strangling grantees with it,” said Robert Gordon, who served as the HHS assistant secretary of financial resources during the Biden administration.Some officials have been told that only Trump political appointees can sign requests to disburse funds, even if a career official has already approved it, adding an additional layer of review. The justification for each payment also must include an explanation of how the money will be used to advance Trump administration priorities, according to two employees in separate agencies who received high-level briefings on the process.Federal officials also have been instructed to use a website run by DOGE to approve grant payments, according to an email sent by defendthespend@hhs.gov and obtained by The Washington Post.NIH officials on Thursday were still determining who would approve grant payments at their agency and did not expect to finalize the process until next week, two NIH officials said.Some outside organizations have been told their delayed payments are “in transit,” but several federal officials said that is not true. It is unclear whether all the federal health-care grants will be approved and when.“All funding is on hold,” an NIH official told colleagues at a meeting on Thursday, according to audio obtained by The Post. “The bottom line is no one is getting any money right now. But they don’t know they’re not getting any money because it just says that it’s ‘in transit.’”In the first months of the Trump administration, government officials have taken multiple steps to delay or halt federal grants. Those include slow-walking billions of dollars in research grants issued by agencies such as the NIH, and freezing or terminating grants to higher-education institutions, on the grounds that the universities did too little to combat antisemitism on campus, did too much to support transgender athletes or for other, indeterminate reasons.DOGE engineers also recently inserted themselves into the government’s long-established process to alert the public about potential federal grants and allow organizations to apply for funds. The group — which is backed by billionaire Elon Musk and stocked with young engineers and Musk allies — has said it is focused on cutting wasteful spending and making the government more efficient.But the new initiative is creating holdups, staffers who award grants at the health agencies said in interviews. They described a hurried, uncertain process to roll out Defend the Spend, which involves fields added to Payment Management Services, a centralized system that processed nearly 500,000 transactions and more than $850 billion in payments last year. A DOGE engineer was given access to the system on Jan. 22 and was made an administrator, according to a Trump administration court filing last month.At a meeting of grants management staff Wednesday, NIH officials explained that DOGE’s process was instituted the previous Friday and that they would halt all payments until they had been through an extra layer of review, according to an NIH staffer.The freeze had been put in place without any sort of formal announcement, leaving thousands of payment requests backed up and confusing organizations waiting for federal funds.Catholic Charities of Fort Worth last week referred to the new requirements in a court filing that is part of its lawsuit against the Trump administration, saying it was “concerned” by the requests for additional information before drawing down funds. Catholic Charities of Fort Worth did not immediately respond to requests for comment.Another grantee said they had requested funds in the last week but hadn’t received them. An unsigned email told them to reach out to the agency.“The payments are going through extra review,” the email said.Until this month, grantees had to provide progress reports and quarterly reports for federal review, but government staffers did not examine every single “drawdown” of funds requested, said one HHS employee.Thousands of such “drawdowns” take place every day, the employee said. The DOGE system has imposed an extreme workload on government staff, the employee said.Among those immediately suffering consequences are federal health centers, which provide services for low-income people and those who lack insurance, the employee said. Those centers rely on regular drawdowns for their operational expenses, such as doctors’ and nurses’ salaries and basic medical supplies.If the funding delay continues much longer, the situation will grow dire for such centers, imperiling their ability to assist the poor, the employee said.

STATE BUDGET

Governor Hochul and the Legislature enacted legislation yesterday to fund state operations with $9.6 billion through Wednesday – the sixth such “extender” bill they have passed since the budget missed its April 1 deadline.  Here’s more on the status of budget negotiations from City and State (4/17) and State of Politics reports (4/18).

(City and State, 4/17)    The debate over discovery blessedly appears almost settled (barring a last-minute blowup while finalizing language), which hopefully means that the stalled state budget can finally start moving towards completion again. Legislative leaders and the governor had also managed to come to a tentative agreement earlier about banning cellphones in schools, which means they have two items down and… basically everything else left to go. 

On the policy side – much to the continued chagrin of Assembly Speaker Carl Heastie, who would prefer a straightforward spending plan – Gov. Kathy Hochul still has at least two more priority items she wants to get included: expanding the state’s involuntary commitment laws and enacting some version of a mask ban. Both have faced resistance in the state Senate and Assembly, much like the governor’s proposal to roll back parts of the 2019 reforms to the discovery laws. 

Although Hochul has recently spent much of her and her surrogates’ political capital and public appearances pushing the discovery issue, her team did put together a small press conference to discuss the involuntary commitment issue in Albany last week. It featured Dr. Ann Sullivan, commissioner of the state Office of Mental Health, as well as Albany Mayor Kathy Sheehan and Albany County Executive Dan McCoy. “We hear from the mental health professionals that they need more tools… and we have far too many people who are dying on our streets,” Sheehan said. “Because let’s put this out there – the alternative to the changes that the governor is proposing is that people will continue to die on our streets.”

On the mask side, Hochul kept a potential ban out of her executive budget proposal released in January and only injected it to the conversation after budget negotiations had already begun. Supported by several civil rights and Jewish groups, the measure would reinstate a version of the state’s ban on wearing masks in public that lawmakers repealed during the pandemic. Supporters of the proposed ban charge that people are wearing masks in order to conceal their identities while intimidating others or engaging in hateful acts. They say that the issue has become more prevalent since the surge in pro-Palestine protests, although they are careful to say that the measure is not a response to any particular protest and is not meant to curb free speech. But opponents of the proposed mask ban like the New York Civil Liberties Union say it would have a chilling effect on protests and lead to disproportionate enforcement against people of color. 

The mask issue has deeply divided Democratic lawmakers in the Legislature, with some vehemently opposed and others advocating for it strongly. State Sen. James Skoufis, who sponsors the legislation that has served as the basisfor negotiations so far, told City & State that he is “cautiously optimistic” that some version of the mask bill will make it into the final budget. 

As the budget talks have dragged on, other potential policy items have wormed their way into the discussion as well. As has happened in the past, opponents of the state’s substantial equivalency standards for private schools have quietly tried to include language to delay the implementation of new rules, or roll them back in other ways. The rules in particular affect yeshivas and have faced strong pushback from the Orthodox Jewish community. Legislators both for and against new changes suggested last week that the matter is not yet settled.

Setting aside the rest of the finances of the budget, legislative leaders and the governor also have a $30 billion question to answer when it comes to funding the Metropolitan Transportation Authority’s 2025–2029 capital plan. Officials have flitted around the question while making assurances that they’ll find the money and offering few concrete details. But at the very least, Heastie told reporters last week that he and his negotiating partners were close to agreeing on some form of tax hike to fund the plan. He described a menu of options at their disposal without disclosing where they landed, though a payroll tax hike on New York City businesses has emerged as the most likely option.
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FEDERAL The Supreme Court will hear a pivotal case on April 21 that could end the Affordable Care Act’s requirement for insurers to cover certain preventive services at no cost. The lawsuit, brought by Texas-based Braidwood Management, challenges the constitutionality of the U.S. Preventive Services Task Force (USPSTF), arguing its members are improperly appointed. If the Court sides with the plaintiff, it could jeopardize access to cancer screenings, HIV prevention, and other services for over 150 million Americans (Article here)

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Brooklyn Food Pantry Loses Federal Migrant Aid Grants — for Feeding Migrants

The Federal Emergency Management Agency yanked $1.3 million in funds from the Campaign Against Hunger, accusing the group of aiding “illegal aliens.”

BY SAMANTHA MALDONADO APRIL 17, 2025, 6:08 P.M

The Trump administration has cancelled more than $1.3 million in federal emergency grants awarded to a Brooklyn food pantry to feed migrants, after advising the nonprofit it was suspected of violating U.S. law by serving food to “illegal aliens.”

The move leaves the Campaign Against Hunger — which each year serves 17 million meals to over 1.5 million New Yorkers, including thousands of new arrivals — in a lurch.

“To take that much money from any organization that does not have an endowment or a large budget is to take food out of the mouths of those that need it the most,” said Melony Samuels, the CEO and founder of Bedford-Stuyvesant nonprofit. “For those that need food, it’s tough. We are in a sad, tough time.”

The Campaign Against Hunger received a letter on April 1 from the Federal Emergency Management Agency with news that its grants under the Shelter and Services Program were terminated immediately.  Myriam Vargas picks up fresh produce at The Campaign Against Hunger food pantry in Ocean Hill, Brooklyn, April 17, 2025. Credit: Ben Fractenberg/THE CITY

The Shelter and Services Program provides funding to nonprofits and government entities to support “noncitizen migrants” after they are released from Department of Homeland Security custody and while they wait for rulings on immigration proceedings. Congress appropriated $650 million for the program in Fiscal Year 2024, including $512,000 for the Campaign Against Hunger and another $60 million to New York City’s budget office, to reimburse the city for costs related to sheltering new arrivals.

In the letter, the FEMA acting administrator Cameron Hamilton wrote, “the individuals receiving these services often have no legal status and are in the United States unlawfully, such as those awaiting removal proceedings. This, in turn, provides support for illegal aliens and is not consistent with DHS’s current priorities. For these reasons, DHS/FEMA is terminating your awards.”

New York City received a Shelter and Services Program termination letter, too, for $188 million in grants it was awarded. That sum included the $80 million seized from the city’s bank account, which New York City is now suing to recoup.

“We will continue working to ensure our city’s residents receive every dollar they are owed and to prevent this funding clawback from taking effect,” Liz Garcia, a spokesperson for Mayor Eric Adams said in a statement.

The Campaign Against Hunger had previously received a letter from Hamilton on March 11,  — just days after a judge issued a temporary injunction to halt the Trump administration’s attempt to freeze of federal funds and grants — advising that the group’s FEMA funds would be frozen pending an investigation Hamilton cited “significant concerns that Shelter and Services Program funding was going to entities “engaged in or facilitating illegal activities.” FEMA sought information about the migrants as well as an affidavit from the nonprofit’s executives attesting they had not participated in crimes.
Volunteers stock food essentials at The Campaign Against Hunger food pantry in Ocean Hill, Brooklyn, April 17, 2025. Credit: Ben Fractenberg/THE CITY

The Campaign obtained a pro-bono lawyer to plead its case to try to get the funding back.

“We were chosen and asked to do this. I was excited because already migrants were coming in. It was not new,” Samuels said. “We were doing an essential service to our city.”

The nonprofit says it has already spent about $600,000, most of it on food, for which it may not be reimbursed.

At a supermarket-style food SuperPantry in Bedford-Stuyvesant, people pick up food, baby formula and even clothing during open hours five days a week. Families typically come to the pantry biweekly, but given their budget uncertainty, the Campaign in April began limiting visits to once a month.

“What we had to do, which was very hard, knowing that families are hungry, we had to change the way we distribute so that the little that we had could go a long way,” Samuels said. “How long will we have to continue this trend? I hope not long.”

Typically, about 13,000 people each week visit the Campaign’s locations, but Samuels estimated her organization would serve about half as many families as usual this month. Some of the Campaign’s regulars complained, she said, but most understood.

“Some people told us that they’ve been here for years, and so they know if we could do better, we would,” she said.Dr. Melony Samuels works out her office at The Campaign Against Hunger food pantry in Ocean Hill, Brooklyn, April 17, 2025. Credit: Ben Fractenberg/THE CITY

Samuels said she wakes up in the wee hours of the morning, dreading the day to come, her mind spinning through the challenging decisions she’ll have to make.

“What am I going to do? Will I be able to meet the needs? How many people will be turned away? Are we going to ration the amount of food?” she said. “We have gotten funding in — thank God, that’s why we’re still open — but it’s not enough to cover the gap.”

The FEMA grants weren’t the only source of federal funding yanked from the Campaign. Samuels said over $600,000 that came through the state’s New York Food for New York Families, funded by the U.S. Department of Agriculture, was rescinded when the USDA cancelled the program in March. In addition, the Campaign is owed some money from the Emergency Food and Shelter Program, also funded by FEMA, which the Trump administration suspended in February. 

The Campaign Against Hunger is just one of several food banks across the city scramblingto meet an urgent and growing need in the wake of federal cuts to programs and funding streams.

In the meantime, Samuels has been begging for donations to keep the organization afloat.

“We’re hoping that individuals and corporations will see The Campaign Against Hunger and the injustices that have been done to us, and would just roll up their sleeves and help,” she said. “We are not peripheral. We are a lifeline.”