There’s a new proposed (federal) rule to cut Supplemental Security Income (SSI) benefits, and strip eligibility for hundreds of thousands of low-income older people and severely disabled adults and children. Under the rule, nearly 400,000 SSI beneficiaries living with family or friends experiencing their own financial struggles (referred to as ‘struggling households’) likely would have their benefits cut — typically by hundreds of dollars per month — or lose eligibility altogether. And yet the average annual savings from these benefit cuts would barely pay for a single day of the massive tax cuts for the wealthy that are part of the Republican megabill enacted in July.  At the same time, the rule would make it harder for eligible people to get and keep SSI, creating new red tape for beneficiaries, and more work for the Social Security Administration’s (SSA) already depleted and overburdened staff.

CBPP ANALYSIS:

https://www.cbpp.org/research/social-security/trump-administration-poised-to-cut-ssi-benefits-for-nearly-400000-low

 ——————————

Recently the National Black Harm Reduction Network led by our friend and colleague Tracie Gardner hosted a Webinar entitled, ‘Know Your Supply:  A Black Harm Reduction Dialogue”.  Check it out and share it with those you think need to hear this information.  

As a Network communication recently stated: “This webinar wasn’t just a discussion about drug checking and toxic supply, it truly was a reflection of how our people continue to survive, resist, and build safety in the face of systems designed to harm us. That’s what Black harm reduction is about: truth-telling, protecting each other, and fighting for care where punishment has tried to take its place.”

Click here to access the webinar replay.

You’ll find the presentation slides, links, and a recap of the Q&A on our website. Check it all out here.

————————–

The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the June 2025 Medicaid Update. Please find the interactive issue as a PDF (Portable Document Format) file available to be downloaded at: https://health.ny.gov/health_care/medicaid/program/update/2025/docs/mu_no06_jun25.pdf. A print-ready version is also available on the Medicaid Update web page.

You may also go straight to an article or topic that pertains to you by selecting from the current issue’s table of contents below.

All Providers

• New York State Recipient Restriction Program and Health Home Care Management Program Services (Cover)
• New York State Department of Health Announces New Advisory Boards: Medicaid Advisory Committee and Beneficiary Advisory Council
• Notification of Pregnancy to Medicaid Managed Care Plans
• New York State Office of the Medicaid Inspector General to Perform Compliance Program Reviews Using a 12-Month Review Period

Policy and Billing

• Payment Error Rate Measurement Upcoming Request for New York State Medicaid Provider Documentation
• Update and Reminder: Medicaid Policy on Loss of Records Due to Unforeseen Events

Pharmacy

• Notice for Upcoming Over-the-Counter Coverage Changes
• Attention Providers: Disclosure of Ownership and Control Information

————————

HRSA:  FY 2026 FQHC Service Area Competition (SAC) 
On July 22^nd, the Health Resources and Services Administration (HRSA) posted a new Service Area Competition (SAC) opportunity for FY 2026. Through the SAC, organizations may apply to participate in the federally qualified health center (FQHC) program by taking over a grant in an existing service area. FQHCs are typically approved for a three-year period and, if they seek to renew, must reapply to the SAC. In this instance, there are additional SACs open in Manhattan and Staten Island.

Applications are due September 22^nd. More information is available here:  https://www.grants.gov/search-results-detail/360116

————————-

(Following from SOMH, 8/6):

Per the FY 2026 State Budget, new language will go into effect tomorrow to protect vulnerable New Yorkers living with mental illness and guide clinicians when they are evaluating individuals brought in for psychiatric assessment to community-based hospitals, emergency rooms and comprehensive psychiatric emergency programs. Effective Aug. 7, the amended language specifies that involuntary admission is permitted for treatment of those individuals who are at a substantial risk of physical harm due to “an inability or refusal, as a result of their mental illness, to provide for their own essential needs such as food, clothing necessary medical care, personal safety, or shelter.”

Adopted as part of the state budget process this spring, the change brings New York in line with 43 states with similar standards. While this standard has previously appeared in case law and clinical practice, the amendments expand the statutory involuntary admission criteria to ensure the clinicians can protect the state’s most vulnerable residents by connecting them to life-saving treatment.

This guidance supersedes prior versions. Please review the new guidance and share with others in your organization or the community to help educate and communicate on this important statutory change.

———————————-

Questions Over Wisconsin Spending of Opioid Settlement Money

BY ALEXANDER LEKHTMAN, FILTER MAGAZINE, AUGUST 6

Issues include lack of transparency, geographic disparities and funds allocated to law enforcement.

Under the nationwide legal settlements with major opioid manufacturers and distributors, the state of Wisconsin and its local governments will be receiving a total of $780 million by 2038. Of that total, 30 percent is set aside for the state government while the remainder goes to 71 counties and 16 municipalities. But critically, how has it been allocated and how will it be spent?

Wisconsin state law ring-fences what governments can spend the money on: It’s meant to be for an approved use related to reducing opioid-related harms. But despite records requests from reporters, governments have failed to provide accurate information when asked, or have delayed doing so, reports Wisconsin Watch.

Reporting levels vary. Milwaukee County, for instance, published 30 pages of data when reporting its opioid spending to the state. But multiple county and municipal governments have shared few details, published information years after state deadlines, or released nothing until they were forced to by journalists. According to the state Department of Justice, it reviews and monitors local governments’ opioid settlement spending, but has no enforcement mechanism. The legislature’s Joint Finance Committee is also responsible for reviewing the spending.

“One of the important parts of effective spending is transparency on how decisions are made.”

Advocates want more transparency, given the widely varying known uses of the money Wisconsin governments have already spent—ranging from jail recovery programs to law enforcement—and the fact that this is just a fraction of the money so far received, with another $400 million incoming.

Adrienne Hurst is the senior technical advisor and Wisconsin team lead for the Vital Strategies Overdose Prevention Program, which conducts policy work and research in the state.

“Wisconsin has posted annually their spend plans and reports for the 30 percent of funding that goes to [the state health department],” she told Filter. “The other 70 percent goes to [counties and cities]. Counties are required to post the activities they fund, and largely they have through the Wisconsin Counties Association. There is a public database [available]. One of the important parts of effective spending is transparency on how decisions are made.”

The Wisconsin Department of Health Services has an online tracker indicating how governments have spent money on different priorities. Here’s what it shows for 2025:

* $6 million for tribal nation abatement, for prevention, harm reduction, treatment and recovery services for the state’s different Indigenous nations.

* $6 million overall for harm reduction including naloxone, fentanyl test strips, and peer support services. The purchased naloxone is for community organizations and public health departments statewide, to be given away free to people in need. $300,000 of this money was used to purchase electronic lockboxes for drug storage in prisons.

* $7.7 million in capital expenditures, or building and renovations, for treatment and other services. This money has paid for a residential drug treatment facility in Appleton to expand to a 70-bed facility; and for a new, 16-bed residential treatment center in Milwaukee.

* $1 million for school based prevention in K-12 schools, and $1 million for after-school programs including a grant to the Boys and Girls Club.

* $1.5 million for community-based prevention programs to nonprofit and faith-based organizations.

* $3 million for medications for opioid use disorder. The state prison department has received half of this money to increase medication treatment to people in residential services and community supervision statewide.

* $2.75 million to pay for room and board for Medicaid recipients in residential drug treatment. By law, Medicaid cannot reimburse for housing costs for patients in these programs.

* $3 million for law enforcement agencies, for stated purposes including drug disposal, keeping opioid users out of jail, staff and training on medications for opioid use disorder, and opioid treatment in jails. 

“Wisconsin has dedicated a good chunk of its funding to things like naloxone, fentanyl and xylazine test strips, and providing technical assistance,” Hurst said, detailing the investments in harm reduction. “Obviously the state not only invested in harm reduction, but also treatment interventions.”

“We focus on medication for opioid use disorder because it is life-saving,” she continued. However, “There is investment in less effective interventions like naltrexone which has an inferior outcome.”

“There have also been interventions in things like police-driven harm reduction … We say those are less effective.”

Settlement money going to law enforcement is particularly objectionable to many harm reduction advocates.

“There have also been interventions in things like police-driven harm reduction and naloxone, [which they sometimes] leave behind or carry,” Hurst said. “We say those are less effective at investing in communities worst affected by the War on Drugs and overdose.”

Wisconsin saw a significant reduction in overdose deaths of at least 35 percent in 2024, according to provisional data from the CDC, in a better trajectory than the nationwide trend of a fall of almost 27 percent. But the pain of the ongoing crisis is felt unevenly, and Wisconsin’s allocation of settlement money—which was determined by a formula intended to factor in population and impacts—doesn’t always reflect that.

State health data show that counties with the highest opioid-involved overdose rates from 2014-2023 are scattered throughout the state, from the more populous eastern and southern regions to northern counties bordering Michigan.

Milwaukee County, home to the state’s largest city, had the second highest rate, with 38.9 deaths per 100,000 population, and has received the highest percentage of settlement dollars, just over 25 percent. Up north, Menominee County, home to the Menominee Indian Reservation, has the highest rate—a devastating 76.8 deaths per 100,000 people—but receives a tiny 0.08 percent of settlement dollars.

“In Wisconsin, one third of all overdose deaths happened in Milwaukee County,” Hurst said. “You would expect resources would be heavily focused there. At the same time, sparsely populated communities like Menominee and more rural counties, even though the absolute number of deaths are small year after year, they can have a profound impact on that community. Absolutely you want to invest where most overdoses are happening, but you also want to … safeguard [rural] communities.”

“I think we need to better focus on a strategy to not just prevent overdose deaths, but get to the root.”

Glaring racial disparities are another feature of Wisconsin’s overdose crisis. Black residents have suffered the highest overdose death rate, at 79 deaths per 100,000 population, followed by Indigenous residents at 76 deaths per 100,000. White residents have had a far lower rate of 20 deaths per 100,000, illustrating how economic and social inequalities contribute to and exacerbate overdose deaths.

Alan C. Robinson, president of the Herbal Aspect cannabis brand in Madison and director of a proposed drug checking initiative in the city, urges that people directly impacted by the overdose crisis should be involved in decision-making and allocation of funds.

“Overdose prevention and harm reduction in general is really intersectional with other challenges and disparities people face in everyday life,” he told Filter. “Being unhoused, jobless, [lower] education. There’s a convergence of life stresses that sometimes drive people to self-medicate and use substances. Without a robust and holistic approach—providing housing security and food security—you’re not attacking the root of the problem of substance use. I think we need to better focus on a strategy to not just prevent overdose deaths, but get to the root.”

———————-

Feldsman alert on the DOJ memo: https://www.feldesman.com/client-alert-doj-memo-attempts-to-clarify-illegal-dei/

Client Alert: DOJ Memo Attempts to Clarify “Illegal DEI”

By Mindy B. Pava, Edward T. Waters|August 1, 2025, Feldesman, LLP

DOJ Provides Guidance to Federal Funding Recipients on Unlawful Discrimination

In an effort to eliminate the ambiguity over what constitutes “illegal DEI” or “unlawful discrimination,” the U.S. Department of Justice (DOJ) issued a memorandum earlier this week highlighting specific activities recipients of federal funding should avoid—as well as other activities that would constitute “best practices” for compliance.

The Administration’s focus on Diversity, Equity and Inclusion (DEI) initiatives and programs is well known, but to date, the Executive Orders and other issuances have been short on detail.  The more specific guidance issued this week by Attorney General Bondi, in the memorandum, “clarifies the application of federal antidiscrimination laws to programs or initiatives that may involve discriminatory practices, including those labeled as Diversity, Equity and Inclusion (DEI) programs.”  The memorandum cautions that entities receiving federal funds must ensure that their programs and activities comply with federal law and do not discriminate—“no matter the program’s labels, objectives or intentions.”  The memorandum also identifies “best practices” as suggestions to help with compliance.

At the high level, the memorandum asserts that organizations should, among other things, eliminate diversity quotas, end preferential hiring or promotion practices, prohibit “unlawful proxies” for DEI, such as cultural competence requirements or geographic targeting, and cease all trainings that “promote discrimination” based on protected characteristics.  As for best practices, the memorandum recommends focusing on skills and qualifications of applicants instead of other criteria, documenting legitimate rationales if using criteria in hiring or promotions, avoiding exclusionary training programs and including non-discrimination clauses in contracts to third parties.

Trump Administration’s Focus on DEI

The Administration’s focus on DEI activities and potential violations of antidiscrimination laws began with two Executive Orders issued at the start of President Trump’s second term, which called on federal agencies (i) to “terminate, to the maximum extent allowed by law, . . . all . . . ‘equity-related’ grants or contracts” and (ii) to include a term in grant and contract awards requiring grantees and contractors to certify that any DEI activities within their organizations comply with federal civil rights laws; and acknowledge that the certification is material to grant and contract payments for purposes of potential liability under the Civil False Claims Act, 31 U.S.C. § 3729 et seq.

In subsequent months, federal agencies commenced grant terminations and implemented updates to standard terms and conditions in grant awards in furtherance of these EOs, generally without any clarifying guidance on what would constitute impermissible conduct.  Both the HHS Grants Policy Statement (GPS) issued in April 2025 and an NIH notice issued the same month required grantees to attest to compliance with civil rights terms and conditions (including certain DEI provisions) to maintain federal funding. Although HHS dropped some of the specific DEI language in an updated version of the GPS, the July 2025 version still provided that “[b]y applying for or accepting federal funds from HHS, recipients certify compliance with all federal antidiscrimination laws… and that complying with those laws is a material condition of receiving federal funding streams.” Additionally, in May, the DOJ launched a new “Civil Rights Fraud Initiative,” aimed at pursuing DEI-related violations under the False Claims Act.

Specific Guidance from the DOJ Memorandum

The DOJ memorandum is organized by broad categories of conduct and provides examples to illustrate the types of practices that could trigger scrutiny.

• Preferential treatment based on protected characteristics: This section warns against race or sex-based scholarships, internships, hiring preferences, or promotional policies, even if they are intended to address historic inequalities. For example, scholarships offered exclusively to minority students or hiring policies prioritizing candidates from underrepresented racial groups would likely violate federal civil rights law. The memorandum also flags the use of quotas or demographic benchmarks, such as requiring a certain percentage of minority candidates in interview pools.
• Facially neutral criteria serving as a proxy for protected traits: According to the memorandum, certain policies or practices, while not explicitly race or sex based, are selected or applied in ways that disproportionately favor or disadvantage individuals based on specific characteristics. For example, requiring applicants to submit a “diversity statement” or demonstrate “lived experience” can cross the line into prohibited activities if those criteria are used to evaluate a person’s racial or ethnic identity rather than job-related qualifications. Similarly, recruiting from certain geographic regions or institutions primarily because of their racial composition—rather than for legitimate programmatic reasons—could constitute unlawful discrimination.
• Segregation based on protected traits: By focusing on race-based training sessions, lounges, or affinity groups that exclude individuals of other races or identities, the DOJ guidance provides that even if these initiatives are intended to create safe spaces, separating individuals or restricting access based on race and sex can violate federal law. The memorandum emphasizes that federally-funded entities may also violate the law by failing to maintain sex-based boundaries in bathrooms, dormitories and as part of athletic competitions.
• Training programs that stereotype or disadvantage individuals based on protected characteristics: The memorandum cautions that trainings that label entire groups as inherently privileged, biased, or oppressive can create a hostile work or education environment and expose institutions to liability. Similarly, requiring participants to affirm ideological beliefs or confess biases as a condition of participation crosses the line into unlawful discrimination.
• Recommended best practices: The memorandum concludes by highlighting certain suggestions to help federally funded organizations avoid legal risk, while acknowledging that these suggestions are not legally binding. These guideposts include focusing selection decisions on specific skills and qualifications; ensuring all programs, trainings and resources are open to all qualified individuals regardless of identity; and eliminating demographic quotas or outcome-driven targets. The DOJ also advises documenting the rationale for any selection criteria used, screening third parties for compliance and implementing strong anti-retaliation and reporting procedures.

The DOJ’s memorandum offers recipients of federal funding some concrete examples as they undertake programmatic reviews of their DEI-related policies and procedures. Entities that receive federal financial assistance “or that are otherwise subject to federal antidiscrimination laws, educational institutions, state and local governments and public and private employers” should review the guidance in detail to mitigate legal risk.

While the clarifications may be reassuring for some programs, the memorandum still leaves open questions on how implementation and enforcement will proceed. Feldesman attorneys will continue to follow the DOJ’s guidance and enforcement related to DEI activities and issue additional information as available. Please contact Mindy B. Pava or Ted Waters for questions.