April 15, 2025
FEDERAL BUDGET: Congress is on recess this week making this an excellent time to secure an appointment to meet with your representatives in Washington. To help, here are some excellent resources from Community Catalyst.
This guide can help you choose the most effective tactics for your organization to use to engage MoCs during this recess. It offers tried and true options for making an impact and makes recommendations for how to be most effective in your organizing.
This calendar lists important advocacy peaks in our collective work to defend Medicaid from massive cuts, and links relevant resources so you can easily find what you need to join in any action. This Google Calendar can also be synced to an Outlook or iCalendar app for easy access using this link.
Use this guide to highlight the ways that work reporting requirements hurt access to care.
View the Resource
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STATE BUDGET — TAKE ACTION TODAY TO SECURE FLEXIBLE 7.8% INCREASE
ACTION ALERT Please call your legislators Tuesday, April 15threquesting a flexible 7.8 % targeted inflationary rate and contract increase for BOTH wages and operating expenses for mental health and substance use disorder services and supports is included in the final budget.
Please make three calls on Tuesday, April 15th:
Governor Hochul (518) 474-8390
Senate Majority Leader Andrea Stewart-Cousins (518) 455-2585
Assembly Speaker Carl Heastie (518) 455-3791
Message Please support a 7.8% flexible targeted inflationary increase in rates and contracts for mental health and substance use disorder staff and operations in the final budget. Without this additional funding, countless adults, children, and families will not get the services and support they desperately need.
MORE ON STATE BUDGET: Albany insiders think the state budget might drag into May as legislative leaders appear incapable of coming to a meaningful compromise on policy items after weeks of closed-door negotiations. Gov. Kathy Hochul said she wouldn’t mind spending her summer negotiating in Albany, but so far it’s been a dreary spring. This wouldn’t be the first time that Hochul has delayed a budget until May; in 2023, the budget was held up due to fierce debates over rolling back bail reform and only passed on May 3. There are a few deadlines, legal and spiritual, that Hochul has to contend with as she holds firm on her budget goals. The first was April 1, the date that the state is supposed to have a budget in place – though it’s more of a suggestion than an actual deadline at this point. Hochul and the Legislature easily blew past that deadline. The next was Passover on April 12, which normally marks the start of a two-week holiday for the Legislature. But without an on-time budget, they’ll now be back in Albany passing temporary extenders for a few more weeks. At this point, the only people truly aware of the lack of progress are Albany politicos and state lawmakers who had to cancel a spring getaway. If there isn’t a budget in place by May 20, though, it will impact school boards in New York and the communities they serve, which will need to vote on their own budgets by then. Without a firm answer on Foundation Aid – the main mechanism to fund state public schools – districts will be in a sticky position and could be left wondering why they can’t get a firm answer on the resources they’ll have to work with. According to legislative leaders like Assembly Speaker Carl Heastie, substantive work on the fiscal sections of the state budget has taken a backseat to policy debates, which have yielded little progress as lawmakers prepare to pass a fifth budget extender on Tuesday. There is talk that Hochul’s cheery outlook on protracted negotiations will lead to a budget that comes in noticeably later than last year’s April 20 agreement.
Discovery reform is the main sticking point in budget negotiations, although an expansion of involuntary commitment and a mask ban are also gumming up the works. In her executive budget proposal, Hochul included changes to the state’s discovery law meant to address prosecutors’ concerns that too many cases were being dismissed on technicalities. The governor’s proposal would allow judges to impose less severe penalties for prosecutors who fail to turn over evidence on time and would also allow prosecutors to only turn over materials to the defense that they deem “relevant” to the case, rather than all material “related” to the case. Lawmakers and criminal justice reformers are concerned that the changes would create a more unjust legal system and reduce any impetus for prosecutors to act in a timely fashion, and some are prepared to dig in their heels. The dynamic is creating a situation where policies that the average New Yorker might not even know about, let alone fully grasp, are affecting their day-to-day lives and contributing to a sense of Albany’s inherent dysfunction. Blair Horner, senior policy advisor at the New York Public Interest Group, said that a budget so late that it calls back to the Pataki era – when the budget often wasn’t finalized until June or July – could set back public trust. “It is obviously an important component, not only to the schools, but to the communities that these lawmakers are elected from, and there’s no getting around it,” Horner told City & State. “It makes Albany look bad. The budget being late makes Albany look bad. And it does throw a sort of body blow to the public’s trust in their own government. They’re supposed to get the budget done by April 1.”(SOURCE: STATE OF POLITICS, 4/14/25)
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Here’s a story on a topic we informed our members about last Sunday night (4/6) when we read the CMS Press Release indicating that the Trump Administration had ordered HHS to discontinue federal matching funds (going forward) for certain Medicaid state health programs. We think the primary impact is to Medicaid services that do not fit the Administration’s unenlightened definition for what constitutes a Medicaid-reimbursable service. It appears this action will have no immediate impact on the current 1115 HER Waiver set to expire in 2017, however, future extensions of the Waiver are now highly unlikely to include federal matching assistance, and any desire to obtain a new 1115 waiver (complete with federal matching funds) is likely to be met with a rejection by CMS.
State could lose billions in future Medicaid dollars amid federal policy change
AMANDA D’AMBROSIO , Crain’s Health pulse, 4/15
The federal government is planning to stop funding Medicaid programs that cover non-medical needs such as housing, transportation or food, putting billions of future dollars for New York’s Medicaid pilot programs in jeopardy.The U.S. Centers for Medicare and Medicaid Services sent letters to state Medicaid directors on Thursday saying that it would no longer match funding for certain state health programs that request to spend Medicaid dollars on needs outside of the program’s original scope. Such programs, which are funded through the 1115 waiver mechanism, have sparked “renewed concerns” from CMS about whether they are an appropriate use of federal dollars, Drew Snyder, deputy administrator and director at the agency, wrote in the letter
The announcement raises concerns for New York, which is in the middle of rolling out a three-year, $7.5 billion Medicaid pilot program that allows community organizations such as food banks or housing programs to get reimbursed through Medicaid for non-medical purposes. The program, which relies on $4 billion in federal matching funds over the next few years, was designed to reimburse needs like housing and food to address health inequities and ultimately help the state reduce its medical costs.
Though the federal government has not rescinded any funding for the Medicaid pilot program, future support for state initiatives to expand Medicaid is now in jeopardy. States have designed waiver programs under the assumption that the federal government would continue to invest in the health care workforce and social needs through future requests, said Adam Herbst, partner at the law firm Sheppard Mullin and former deputy commissioner at the Department of Health.“
I think there’s a lot of question marks now,” Herbst said, adding that the federal policy shift raises questions about the long-term sustainability of such efforts and how states will adapt going forward. Danielle De Souza, a spokeswoman for the Health Department, confirmed that the agency received the letter from the federal government outlining a “prospective policy change that will affect future federal 1115 waiver approvals.”
“The state Health Department remains committed to using its current federally approved 1115 waiver authority to improve health outcomes for eligible New Yorkers, while working to assess the impact this change may have on future 1115 waiver renewals,” De Souza said. States’ use of Medicaid dollars for social needs has been on President Donald Trump’s radar since his first term. In 2017, the administration phased out funding for some state Medicaid pilot programs, noting that such “demonstrations have not made a compelling case” that federal funding is necessary to continue and that they were inconsistent with state-federal relationships defined under Medicaid statute, according to CMS.
The Biden administration reinstated such funding in 2021, albeit with some guardrails. The administration limited the size and scope of 1115 waiver demonstrations and required states to contribute more funding.
Still, nationwide spending on the programs has grown. The federal government contributed $886 million to state Medicaid programs in 2019, but by 2025 that number jumped to $2.5 billion, according to CMS.
New York has several programs funded through 1115 waivers, including a workforce training program and diversity in medicine programs. The federal government’s move to cease funding could put the onus on the state to fill in the gaps.“
Clearly, the state is in a position to continue these programs if it wants to,” said Michael Kinnucan, senior health policy advisor at the think tank Fiscal Policy Institute, pointing to continued reimbursement rate increases for hospitals in the state budget. “But is it going to want to?”
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(Notice from OMH)
An external stakeholder meeting on the plan to establish the Credentialed Mental Health Support Specialist paraprofessional credential for the public mental health system -originally scheduled for Wednesday, April 23 –has been rescheduled for Wednesday, May 21.
If you already registered, you do not need to register again.
The new Mental Health Support Specialist paraprofessional credential will provide a career identity for existing and new paraprofessionals. Mental health paraprofessionals will be able to work toward the credential by obtaining relevant job experience, training on the identified core competencies, a college education, or a combination of these objectives. Credentialed paraprofessionals who wish to climb the career ladder will have extensive experience, making them desirable candidates for higher education programs focused on behavioral health and higher-level roles in community settings.
The target population for the credential is:
· Currently employed paraprofessionals in OMH-licensed, designated, or funded provider agencies,
· Individuals seeking to enter the public mental health system workforce and who may not have a college degree; or
· People with a degree or experience in an area unrelated to mental health but want to obtain a career in the public mental health system.
So far, a vendor has been secured and work has begun to establish the credential.Feedback from current paraprofessionals, agencies who employ paraprofessionals, licensed professionals and other external stakeholders is crucial as we develop this credential. To ensure the credential is applicable in OMH settings, we are inviting stakeholders to join us at this meeting.
Please register in advance using the link below; the registration page also includes an opportunity to begin to provide feedback.
MEETING DETAILS
Wednesday, May 21, 2025, noon to 1:30 p.m.
Registration Link:
https://meetny-gov.webex.com/weblink/register/rd91f9607d7c6279e7189fd1660447d49
If you have any questions regarding the paraprofessional credential, we invite you to include your feedback when prompted in the registration link or email planning@omh.ny.gov.
Sincerely,
The Workforce Development Team
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City plan to find firms to oversee federal health grants coincides with new funding landscape
ETHAN GERINGER-SAMETH, 4/14/25, Crain’s Health Pulse
A long term bid to establish a “master administrator” to oversee federally-funded programs run through the city Health Department is now coinciding with deep cuts from the Trump administration.
The Department of Health and Mental Hygiene is considering vendors for a $15 million three-year contract to manage subcontracts with providers funded by the federal government, according to hearing notices published in the city record. While the department began seeking vendors last summer, before President Donald Trump took office, the contract, which will run through most of his current term, comes as the department reels from whiplash federal cuts in recent weeks that officials say impact the city’s core public health and infectious disease functions.The master administrator will be responsible for designing, implementing and administering subcontracts for federally funded initiatives. The city is considering at least two vendors, the Fund For Public Health In New York and Public Health Solutions, according to separate hearing notices in the city record. The department is also looking for a master administrator for non-federally funded programs under another $15 million contract.
The Health Department did not say what the position would do that is not being done under the agency’s current contract management process. The new role was not a response to the Trump administration’s recent changes to federal funding streams as requests for proposals were issued before the cuts, said spokeswoman Chantal Gomez.
The city is considering awarding the contract to multiple vendors, including Public Health Solutions, an offshoot of the Health Department, which already manages many of its federal programs. The company brings in over $300 million in annual revenue, 97% of which comes from government sources. The other company, Fund for Public Health in New York, is a public-private partnership with the department for public health initiatives with the private sector. It received $63.6 million in city contracts so far in the current fiscal year, according to records kept by the comptroller’s office, and its tax filings show it had $123 million in revenues in 2023 of which 97%, again, were from government grants.
The new contract, which is set to begin in August, is now landing at a time when the department is on far less certain financial footing after the president signed an executive order that cut $100 million from the city’s infection control budget as part of a roughly $12 billion reduction in pandemic-era aid to state and local health agencies. The city had recently been granted an extension to spend that money, something Interim Health Commissioner Michelle Morse had days earlier described as one positive in an anticipated decline in funding.DOJ
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TRUMP MASTER PLAN ON DEREGULATION:
An agency proposes a regulation — say, establishing minimum staffing levels for nursing homes. Then economists analyze it, the public comments on it, lawyers revise it and, finally, the agency enacts the rule. It generally takes a few years, start to finish, and the same is true for the process to repeal a rule.
President Trump has no patience for that pace. During his first term, he wanted to erase hundreds of rules on the environment, financial oversight and more. But he grew frustrated when some of the rollbacks took almost the entirety of his term to complete. Then, to his chagrin, the Biden administration restored many of them.
So this time around, Trump plans to quickly and permanently kill rules across the more than 400 federal agencies that regulate almost every aspect of American life, from flying in airplanes to processing poultry.
The White House’s first step is to identify regulations it can cut. Federal agencies must put together lists of rules that might run afoul of recent Supreme Court decisions — or that just don’t align with the administration’s priorities. (SOURCE: NY TIMES)
Here’s much more from the NY Times on the Trump master plan to halt hundreds of regulations:
and here is an example of Trump movement on this front:
DOJ Announces Anticompetitive Regulation Task Force
On March 27th, the Department of Justice (DOJ) launched an Anticompetitive Regulations Task Force within the Antitrust Division. The objective of the Task Force is to identify and undo laws and regulations that stifle competition in accordance with two recent executive orders (EOs). As a first step, the Task Force will seek information from the public on laws and regulations that make it more difficult for businesses to compete across five key sectors, including health care. The DOJ will look into policies that encourage overbilling and consolidation, while threatening access to affordable care. These efforts are in step with goals of the Federal Trade Commission (FTC). The public will have 60 days to submit comments. The announcement is available here.