August 8, 2025

New from our attorneys at Feldesman re: new White House Executive Order (released yesterday).  

New Executive Order Mandates More Federal Funding Scrutiny

By Phillip A. Escoriaza, Mindy B. Pava|Published On: August 8, 2025, Feldesman, LLP

“Improving Oversight of Federal Grantmaking” Gives Agency Heads More Control Over Federal Grant Review and Provides for Uniform Guidance Revisions

A new Executive Order (EO) issued Thursday, August 7 continues—and expands upon—the Trump Administration’s efforts to intensify control and oversight over federal grant funding.

The EO, entitled “Improving Oversight of Federal Grantmaking,” tasks federal agencies with ensuring, among other things, that all new funding announcements are consistent with the Administration’s policy priorities. It also instructs the Office of Management and Budget (OMB) Director to revise the Uniform Guidance to further clarify new grant requirements.

While many aspects of the EO are focused on directing agency heads to develop set policies for stricter reviews of grant funding announcements, certain provisions undoubtedly will trigger immediate and significant impacts for federal funding recipients:

• Section 3(a) mandates that “each agency head shall promptly designate a senior appointee who shall be responsible for creating a process to review new funding opportunity announcements and to review discretionary grants to ensure they are consistent with agency priorities and the national interest.” Notably, Section 3(c) provides that until the review process is in place “agencies shall not issue any new funding opportunity announcements without prior approval from the senior appointee designated . . . except as required by law.” While it is unclear how narrowly this section will be construed in practice, we may see a slower pace in Notice of Funding Opportunities (NOFOs) being issued under this new rubric, at least in the short term.
• Section 4 provides a list of considerations that agencies should utilize when reviewing funding opportunity announcements and abides by all the previous guidance issued by the Administration relating to ensuring grant awards are not used to fund or promote racial preferences, racial discrimination, gender ideology promotion, illegal immigration, or other initiatives that “compromise public safety or promote anti-American values.”
• Section 5 focuses on revisions to the Uniform Guidance “to streamline application requirements and to further clarify and require all discretionary grants to permit termination for convenience, including when the award no longer advances agency priorities or the national interest.”
• Section 6 requires a deep-dive review of grant terms and conditions by agency heads within 30 days of the date of the EO. The review must encompass whether the agency’s terms and conditions for discretionary awards include the termination provisions described in 2 C.F.R. 200.340, which provide that an award may be terminated if it “no longer effectuates the program goals or agency priorities.” While certain funding agencies have used this rationale in grant terminations over the past six months, the authority often has not held up during litigation challenges. The EO instructs that agency heads shall take steps to revise terms and conditions of existing grants to permit the immediate addition of the “termination for convenience” provision. See Section 6(b).
• Section 6(c) also authorizes tighter controls over funds drawing down: the EO (i) permits agency heads to insert language in grant agreements that prohibits recipients from directly drawing down general grant funds for specific projects without affirmative authorization from the agency and (ii) requires grantees to provide written explanations, with specificity, for drawdown requests.
• Moreover, the EO contains several provisions that target research institutions and science-related grant funding. In Section 4, “Considerations for Discretionary Awards,” the EO provides that preference for discretionary awards should be given to institutions with lower indirect cost rates, “all else being equal.” The EO also advises that agencies should prioritize grant applications from institutions that implement Gold Standard Science and that new Uniform Guidance revisions should “limit the use of discretionary grant funds for costs related to facilities and administration.”

Of course, agencies must implement the EO before its provisions become applicable to recipients of federal funding, and we expect each agency to have a different process for doing so. However, it is clear that the EO demands increased accountability from agency heads in ensuring that discretionary grants are stringently reviewed to align with agency priorities—and we expect that this heightened review will cause even greater concern for grantees who have grappled with ever-evolving changes to federal funding under the Trump Administration. While we do expect to see a considerable amount of litigation attempting to block some of these changes—and such litigation could delay the timetable for agency implementation, district courts now are more limited in their authority to issue nationwide injunctions, which adds yet another wrinkle to the uncertainty facing federal funding recipients.

Feldesman attorneys will continue to monitor agency implementation of the EO and the long-term impact on grant terms and conditions—and issue additional guidance as available. For questions, please contact Mindy B. Pava or Phillip A. Escoriaza.

—————————

Regarding NYS DoH CON process for construction, renovation and other service changes within healthcare facilities:

DOH Adopts Final Regulations Updating the CON Process (for Health Care Facilities)  Source: Sachs Policy Group

On 8/6, the New York State Department of Health adopted final regulations that update the Certificate of Need (CON) process, which governs construction, renovation, and other service changes within health care facilities. Governor Hochul’s 2024 State of the State directed DOH to make updates to the CON process, including increasing the financial thresholds that require projects to undergo more detailed reviews and streamlining the application and approval processes.

The adopted regulations replace the existing regulations at 10 NYCRR Section 710.1, making changes to thresholds and policies within each of the review tiers, as follows:

Full Review

• Increase the Full Review monetary threshold for projects by general hospitals from $30 million to the greater of:
  • $60 million; or
  • 10% of operating costs, capped at $150 million.
• Increase the Full Review monetary threshold for projects by other facilities (e.g., nursing homes, diagnostic and treatment centers) from $15 million to:
  • $20 million; or
  • 10% of operating costs, capped at $30 million.
• Require Full Review for projects that add or convert more than 10% of existing beds to a higher level of care, regardless of cost.
• Remove certain specific services from requiring Full Review, including Therapeutic Radiology, Cardiac Catheterization, Bone Marrow Transplantation, Burn Care, AIDS Centers, and Epilepsy Services.
• Add Lung Transplantation as requiring Full Review.

Administrative and Limited Review

• Increase Administrative and Limited Review thresholds from $15 million to $30 million for general hospitals.
• Increase Administrative and Limited Review thresholds from $6 million to $8 million for other facilities.
• Make any project funded primarily by state grants eligible for Administrative Review.
• Remove projects involving emergency room space from requiring Administrative Review to reduce approval times and support providers in meeting heightened demand for such services.

Notice Only

• Increase the threshold for non-clinical projects requiring notice only to DOH from $6 million to $12 million.
• Allow any project that is otherwise eligible for Limited Review, but is architecturally self-certified by the applicant, to be eligible for notice only as long as it does not involve a change in beds or services that would otherwise require an update to the operating certificate.
• Require notice only for the addition or renovation of exam rooms in facilities where such space already exists within or adjacent to previously certified space, regardless of project costs.

There were no significant changes made between the proposed and final regulations.

The regulations are available here: https://regs.health.ny.gov/sites/default/files/pdf/recently_adopted_regulations/Approval%20of%20Medical%20Facility%20Construction.pdf  

Public comments received on the proposed regulations are available here: https://dos.ny.gov/system/files/documents/2025/08/080625.pdf

——————–

Trump’s Assault on Social Services Is Taking Aim at New York’s Elderly

By Jie Jenny Zou | New York Focus | August 6, 2025

Retirement isn’t working out as Sherlea Dony planned.

Last year, a scam decimated the 74-year-old’s savings from decades of working as an American Sign Language interpreter and a copy editor.

“I didn’t have to worry a lot about my future until this past year,” said Dony, who lives in Rochester with her cat, Peaches. “I’m worried for myself and my friends. I could see myself potentially on the street.”

Like many struggling seniors, Dony relies on a variety of social services to stay afloat. Medicaid helps pay for her Medicare premiums and reduces her medical bills. The Supplemental Nutrition Assistance Program (SNAP) covers some of her groceries. This summer, the Low Income Home Energy Assistance Program (LIHEAP) paid for a new air conditioner in Dony’s rental apartment, while federal block grants support her senior center and the nonprofit that helps her apply for benefits.

Federal support for all these programs is now under threat by Congressional Republicans, jeopardizing a delicate network of lifeline support for the state’s growing aging population.

In July, lawmakers enacted over $1 trillion in cuts to Medicaid and SNAP as part of a fast-track measure to guarantee tax breaks for America’s wealthiest. In September, they will return to Washington to deal what could be a fatal blow to long-running programs like LIHEAP as part of President Donald Trump’s agenda to root out government waste and fraud.

New York’s affordability crisis has hit seniors hard. Nearly one of every five New Yorkers is now 65 or older, and the number of them in poverty has surged by nearly 50 percent over the past decade. More than half of the seniors in Buffalo, Rochester, and Syracuse reported having no retirement income in 2022. Those numbers were even worse across New York City’s boroughs — home to over 1.3 million seniors.

To combat this trend, the Center for an Urban Future, a nonprofit think tank, recommended state leaders boost the same programs now at risk of being scaled back or eliminated at the federal level. Those include home-delivered meals, utility assistance, workforce development and supportive housing.

Ann Marie Cook, president of Lifespan of Greater Rochester, which helps Dony and others apply for benefits, pointed to the recent closures of several supportive housing buildings for Rochester seniors due to financial challenges. The settings provided meals, housekeeping, transportation, and personal care, allowing residents to live fairly independently. Nonprofit providers across the state have struggled to stay in business, and the federal cuts are likely to lead to more closures.

Cook said displaced residents could wind up hospitalized or in nursing homes at a much higher cost to the state. “I fear it may be the tip of the iceberg.”

“I could see myself potentially on the street.”

—Sherlea Dony

“It’s so much cheaper to provide these services to help people remain in their communities than [to pay for] the crisis situations that could happen if this funding goes away or is reduced,” she said.

Joe Stelling, associate state director of advocacy at AARP NY, said his organization is encouraging lawmakers at the state and federal levels to ensure funding for critical services.

“It’s very far from a done deal,” he said.

“A Bad Dream”

Life for Kim Hinson and her two grandsons in Staten Island is already too expensive.

“It’s getting tight,” said the 69-year-old who used to work for New York City’s Housing Authority until an on-the-job injury rendered her disabled and ushered in a host of chronic health challenges.

In addition to managing her diabetes and treatment for early-stage breast cancer, Hinson is also the primary caregiver for her teenaged grandsons, one of whom struggles with a learning disability. It’s estimated that over 130,000 grandparents in New York are the primary caregivers for their grandchildren — a growing national trend.

She and her grandsons are enrolled in SNAP, Medicaid and LIHEAP. But Hinson said it’s still not enough to keep pace with skyrocketing utility rates and rising inflation. “The rich get richer and the poor get poorer,” she said of Trump’s “Big Beautiful Bill Act.”

Food costs have been a particular challenge. Hinson said she is no longer physically capable to wait in lines at food pantries to supplement what SNAP benefits won’t cover. As a result, she and other community members are now trying to see if the local senior center will set up a delivery system for senior meal boxes.

Seniors who live with their grandchildren are much more likely to report difficulty covering household food costs. Seniors of color also report higher levels of food insecurity overall compared to white seniors.

Earlier this year, the Trump Administration abruptly cancelled shipments to food banks across the country, amounting to a loss of 16 million pounds of food in New York state. Officials have also proposed eliminating a program that provides meal boxes to 36,000 low-income seniors aged 60 and older in New York City and Long Island.

New York leaders haven’t provided details on how they plan to deal with forthcoming federal cuts to Medicaid and SNAP. The changes to SNAP will freeze monthly benefits for all enrolled households and shift a portion of the financial responsibility to states for the first time in the program’s history, which dates back to 1964. Lawmakers will need to decide whether the state will cover the decreased federal support for SNAP — or slash monthly benefits for recipients.

Both Hinson and Dony aren’t just concerned about program cuts. They also worry about the impact of policy changes to eligibility, renewal, and overall administration.

Hinson said that she was having trouble accessing summertime food benefits for her grandchildren. Children who receive SNAP are usually automatically enrolled in the state program, which provides additional food assistance during the summer months when school is not in session and children miss out on school lunches.

Dony likened staying enrolled in her current benefit programs to a full-time job, requiring constant paperwork. She said her SNAP benefits were recently discontinued due to administrative errors, and she’s currently waiting for a fair hearing to be scheduled.

“I’m grateful for the programs, but they really test your wits,” she said.

Senior advocates like Cook said the new federal changes will mean more administrative paperwork for everyone involved with fewer resources. Federal staffing across several agencies has been reduced or, in the cases of programs like LIHEAP, eliminated entirely.

“Our agency exists in large part because these rules are so complicated,” she said of Lifespan. “There’s no way the average person can navigate these systems without help.”

“I really am not a hateful person, but I really hate our government right now,” said Dony. “It’s like a bad dream that I can’t get out, that we can’t get out of.”