If Congress is unable to pass a funding bill before midnight on Friday, the federal government will again experience a shutdown. Should that occur, HHS will furlough a large percentage of its staff (FY26 HHS Contingency Staffing Plan). HHS staff who administer mandatory programs, including Medicare and Medicaid, will continue to work and emergency surveillance operations will continue. We anticipate Medicaid and Medicare reimbursements would continue uninterrupted during a shutdown. However, with staff furloughs, certain Medicaid operations would slow and Medicaid-related rulemaking, along with activity related to approval of Medicaid waivers, would be suspended for the length of the shutdown.

SAMHSA Contingency Staffing Plan
The Substance Abuse and Mental Health Services Administration (SAMHSA) will retain 98 staff (13% of its workforce): 5 exempt staff, 93 excepted staff, 39 civil service staff, 54 Commissioned Corps Officers

SAMHSA Activities That Will Continue

Certain core behavioral health programs will remain active, including:

• Disaster behavioral health response teams
• Disaster Distress Helpline (24/7/365 crisis counseling)
• 988 Suicide & Crisis Lifeline

Previously funded operations, including the following, will continue using available balances:

• The Treatment Services Locator
• The Treatment Referral Line

While we have not yet been able to confirm that this will remain true in the case of another shutdown, during the previous shutdown in fall 2025, SAMHSA grants from the prior year (e.g., 988 crisis services, state opioid response, mental health/substance use block grants) had funds that remained available to be spent by the grantees. SAMHSA retained Commissioned Corps Officers to help manage administration of these grant programs, and states were able to continue drawing down funds for state programs that relied on federal funding that had been awarded prior to the start of the shutdown.

Staff will remain available to:

• Route letters indicating suicidal ideation to local crisis services.
• Respond to opioid treatment program regulation exception requests and emergencies. 

Activities That Will Not Continue

Because many Government Publishing Office staff would be furloughed, a shutdown would likely mean delays for:

• Responses to grant recipient requests (e.g., prior approvals).
• Summary statements for unfunded applications.
• Release of new Notices of Funding Opportunity (NOFOs), reducing turnaround time for applicants. 

Medicare Telehealth Update

As it was during the fall shutdown, if the telehealth waivers expire on Jan. 30, absent Congressional action, the statutory limitations that were in place for Medicare telehealth services before the COVID-19 public health emergency would retake effect for most telehealth services beginning Feb. 1. HHS has posted a summary of Medicare telehealth flexibilities and the Centers for Medicare and Medicaid Services has an FAQ.The conferenced FY26 bill for Labor, Health and Human Services, Education and Related Agencies included a two-year extension for Medicare telehealth flexibilities.We know the uncertainty caused by a potential shutdown makes planning difficult, and we are committed to provide updates, answer any questions you may have and provide additional resources needed to make this process as smooth as possible.If you have any questions related to the potential shutdown or any other policy issues, contact the National Council Policy Team at Policy@TheNationalCouncil.org.

Notice from OMH:
To our valued partners, As part of new investments in the public mental health system and to help address the workforce shortage, the Office of Mental Health is creating a new website to connect job seekers to provider organizations across New York and to inspire the next generation of mental health professionals. Please forward this email to staff at all levels of your organization, so they have the opportunity to complete our brief survey. 

Brief Overview

OMH is partnering with Brandemix,an experienced workforce marketing and website development firmto lead this project. The final product will be a public website highlighting the various professions, programs, and settings in New York’s public mental health system, with a job search feature, and an accompanying marketing campaign to promote careers in this field.  Seeking InputWe are seeking input from local provider organizations that are licensed, designated, or funded by OMH to ensure this website is a valuable resource. Please take this brief survey, which will help us design the website and guide our marketing strategy. This survey should also be forwarded to staff working in your organization at any level –people who are passionate about working in this field and any staff involved with recruiting or human resources. The survey takes about 10 minutes and can be completed any time before Monday, Feb. 23. Project Kickoff

Additionally, OMH is hosting an optional webinar from 1 p.m. to 2 p.m. on Thursday, Feb. 12 to kick-off this website project, introduce the vision, and answer questions. If you are interested, please register in advance. Please contact Planning@omh.ny.gov if you have any questions. Thank you for your time and partnership!

 ———————-
As states shoulder much of the responsibility for funding and staffing the 988 Suicide & Crisis Lifeline, cracks are emerging in crisis response systems that can leave people in acute distress waiting too long or disconnecting before help arrives. Staffing shortages, funding pressures, and operational disruptions have contributed to higher call abandonment rates and fewer calls being answered locally, even as demand for mental health support continues to rise. Experts warn that inconsistent access to timely, in-state counselors can undermine trust in the system and increase risks for people experiencing severe mental health crises, particularly as broader policy changes threaten access to care. (Article here)
———————
With few opioid users getting medication, NYC Health + Hospitals bets training could make a difference

NEW YORK — The city’s public hospital network is trying to get more patients on medication for opioid addiction before they leave the emergency room. A simulation training program is teaching NYC Health + Hospitals’ emergency medicine providers how to identify patients who are experiencing opioid withdrawal, determine if buprenorphine treatment is appropriate and counsel patients about the medication. “This ground-breaking simulation training will support a cultural and clinical shift in understanding patients living with opioid use disorder, representing a major step forward,” Dr. Omar Fattal, deputy chief medical officer and system chief of behavioral health, said in a statement. “It will help our clinicians approach these cases with a roadmap and medical best practices that will help our patients recover.”

Why it matters: Buprenorphine is considered a first-line treatment for patients with opioid use disorder and is associated with a decrease in fatal overdoses, but the medication has been vastly underused. Even experienced clinicians struggle to initiate buprenorphine treatment with patients, in part due to the risk of increased or prolonged withdrawal symptoms, researchers have found. Patients must be in a state of withdrawal to start the medication, and the proper dosage depends on the severity of their symptoms and their recent opioid use. People with substance use disorders have been found to primarily access health care through emergency services, so clinicians in those settings are well positioned to start them on treatment. Patients who start buprenorphine in emergency departments are also more likely to engage in follow-up care after being discharged, studies show. The fast pace of emergency departments, however, means health care practitioners can easily miss signs of opioid withdrawal, and the setting is not typically conducive to the relatively time-intensive process of counseling patients about buprenorphine. NYC Health + Hospitals’ simulation training is meant to help ER doctors, nurses and physician assistants recognize when patients are in the ideal window for starting buprenorphine and feel more comfortable pitching it.“With tens of thousands of patients presenting to our medical emergency departments annually, we have an opportunity to make a positive and lasting impact during each and every one of those encounters,” said Dr. Daniel Schatz, medical director of addiction services.

Details: The simulation program is part of a broader workforce training initiative supported by $2.4 million in opioid settlement funds allocated to New York City by the state. Each simulation has an actor playing the role of an emergency room patient. One participant, acting as their provider, has to decide whether the patient meets the criteria for initiating buprenorphine and how to raise it in conversation. Afterward, everyone in the room discusses how the interaction unfolded, and a facilitator goes over the best treatment regimen for the patient in that scenario. About 350 health care workers with prescribing authority have completed the optional three-hour training, according to NYC Health + Hospitals data as of December. The program is offered at four facilities, including the system’s simulation center.

What’s next: To measure the simulation training’s success, NYC Health + Hospitals is monitoring rates of buprenorphine initiation in its emergency departments.

The New York State Office of Mental Health has issued a request for proposals to increase awareness, improve care coordination, and enhance the delivery of quality mental health services to Ukrainian communities throughout the state. As Ukrainian communities continue establishing themselves in the United States, it is critical to ensure that they have access to timely, culturally responsive, and linguistically appropriate mental health care. Mental health providers, interpreters, and disability assistance partners serving Ukrainian populations should be knowledgeable about the cultural contexts and unique challenges that may affect access to and engagement with services. Details on the Ukraine Refugee Health Program can be found on the OMH website: https://omh.ny.gov/omhweb/rfp/2026/urhp/index.html