Weekly Health Care Policy Update – January 31, 2023

February 7, 2023

In this update: 

  • Administration Updates
    • White House Plans to End Covid-19 PHE on May 11th
  • Legislative Update
    • Senators Send Letter to CMS Objecting to Nursing Home Staffing Mandate
  • Federal Agencies
    • CMS Finalizes Long-Delayed Rule Expanding Recoveries from MA Risk Adjustment Audits
    • HHS Announces Record Enrollment in ACA Marketplace Plans
    • CMS Issues Additional Medicaid Unwinding Guidance
    • CMMI Issues Second Evaluation Report for Vermont All-Payer Model
    • HHS Publishes Updated Federal Poverty Guidelines
    • FDA Withdraws Authorization of Evusheld
    • FDA to Ease Blood Donation Ban for Gay Men
    • FDA Advisors Recommend Updating Covid Vaccines
    • CDC Announces Organizational Restructuring
    • FCC Rules that Entities May Make Robocalls for Medicaid Redeterminations
    • ASPE Issues Report on Insulin Affordability
  • Other Updates
    • AHCA/NCAL Release Analysis on Nursing Home Workforce Shortage
    • JAMA Publishes Study Comparing System and Non-System Hospitals and Physicians
  • New York State Updates
    • Governor Hochul Vetoes Grieving Families Act
    • DOH and OMH Issue Memo Requiring Re-Opening of Inpatient Psychiatric Beds by April 1st
    • SED Adopts Regulations Expanding Scope of Practice for Nurse Practitioners and Registered Nurses
    • DOH Ends Covid-19 Flexibilities Waiving or Suspending Children’s Waiver Re-Assessments
    • OMH Notifies Medicaid MCOs of CPEP and MHOTRS Clinic Rate Adjustments
    • DOH Announces Supplemental Payment for ADHCs and Rate Adjustment for Specialty I/DD and SMI Units
    • DOH Announces Dates and Locations for In-Person Children’s Stakeholder Regional Meetings
  • Funding Opportunities
    • NY Health Foundation Extends Deadline for OpenNotes RFP in Non-Hospital Systems to February 3rd
    • DOH Releases SOI for Doctors Across New York Cycle IX Grant
    • OASAS Releases RFP for Comprehensive Low-Threshold Buprenorphine Services
    • NYC Department for the Aging Releases RFP for Geriatric Mental Health
    • SAMHSA Issues NOFO for Opioid Overdose Reversal Medication Trainings
    • SAMHSA Issues NOFO for Substance Use Treatment Services for Pregnant and Postpartum Women in Residential Settings
    • SAMHSA Issues NOFO for National Child Traumatic Stress Initiative
    • HRSA Issues NOFO for Integrated Substance Use Disorder Training Program

Administration Updates

White House Plans to End Covid-19 PHE on May 11th
On January 30th, the Biden Administration issued a statement of policy indicating that it plans to end the declarations of a national emergency and public health emergency (PHE) due to Covid-19 on May 11th. The White House issued the statement to convey its objection to recent Congressional proposals to end the emergency declarations through legislation. It gives two primary reasons for its objections: first, that “an abrupt end” to the emergencies would cause “wide-ranging chaos and uncertainty throughout the health care system,” and second, that it would immediately end Title 42 border controls, resulting in an influx of migrants.

Under the 2022 year-end omnibus spending bill, the PHE is no longer tied to the unwinding of continuous Medicaid enrollment. However, the end of these two declarations will still trigger various changes in health care policy, including: 

  • The expiration of various state emergency flexibilities for Medicaid available under Section 1115, Section 1135, Section 1915(c) Appendix K, or disaster State Plan Amendment (SPA) authorities;
  • The end of various Medicare and Medicaid blanket waivers issued by the Centers for Medicare and Medicaid Services (CMS);
  • The end of requirements for insurers in the commercial market to cover Covid-19 tests free of charge and without cost-sharing;
  • The shift of the cost of Covid-19 vaccines and treatments to the private market; and
  • The end of the 20% increase to Medicare inpatient payments for patients diagnosed with Covid-19 and of the add-on payment for new Covid-19 treatments.

The full statement can be viewed here.

Legislative Update

Senators Send Letter to CMS Objecting to Nursing Home Staffing Mandate
On January 20th, a bipartisan group of thirteen Senators sent a letter to CMS Administrator Chiquita Brooks-LaSure expressing their concerns about CMS’s intent to issue staffing mandates for nursing homes. CMS launched a staffing study in August 2022 (described in SPG’s update here) with the intention to propose a rule establishing a minimum staffing requirement in spring 2023.
 
In the letter, the Senators express concern that a “one-size-fits-all staffing mandate would undermine access to care for patients,” particularly in rural communities with severe workforce challenges. The letter argues that staffing mandates would not account for each facility’s operational capacity, differing patient needs and conditions, and the skills of current staff. It also suggests that such mandates would “place nursing homes in financial jeopardy,” leading to the potential closure of facilities and an overall reduced access to care.
 
The letter is available here.

Federal Agencies

CMS Finalizes Long-Delayed Rule Expanding Recoveries from MA Risk Adjustment Audits
On January 30th, CMS issued a final rule on the Risk Adjustment Data Validation (RADV) program under Medicare Advantage (MA). CMS conducts contract-level RADV audits of MA plans to verify that the diagnoses reported for risk adjustment purposes are appropriately documented, and to recover improper payments made due to unverifiable diagnoses. The final rule says that: 

  • RADV audits will be extrapolated to recover overpayments from the entire MA contract; and
  • CMS will not apply an adjustment to account for data differences between fee-for-service (FFS) Medicare and MA (a “FFS Adjuster”).

Unlike the proposed rule, the final rule will not apply extrapolation to contract years between 2011 and 2017. Extrapolation will begin with payment years starting in 2018. MA plans will be required to remit overpayments back to CMS through offsets to their monthly capitation amounts.
 
Historically, CMS has only attempted to recover overpayments that are due to explicitly identified unverified diagnoses for enrollees within the RADV sample, which typically include no more than 200 enrollees. Under the final rule, CMS intends to use statistically valid methods to extrapolate the findings of the RADV audit to MA plans’ entire enrollment.
 
When CMS first proposed to use extrapolation in 2010, stakeholders objected that CMS’s proposed RADV process would violate the statutory requirement for actuarial equivalence, because capitation payments to plans would be risk adjusted based on unaudited data from traditional Medicare FFS, but overpayments across the whole contract would be recovered based on audited data. CMS responded in 2012 by proposing the use of a “FFS Adjuster” which would reflect potential missing diagnoses in FFS data. The FFS Adjuster would be an “offset to the preliminary recovery amount,” essentially setting a minimum threshold under which MA plans would not be subject to recoveries based on risk adjustment. However, after conducting a study, CMS concluded that using a FFS Adjuster would not be necessary because “errors in Medicare FFS data do not lead to systematic payment error in the MA problem.”
 
In the final rule, CMS emphasizes that although it believes the study supports its conclusion, it is “not relying on the study” in making its conclusion that an FFS Adjuster is unnecessary and that statutory provisions, including the actuarial equivalence requirement, do not prohibit the use of extrapolation as proposed. Finally, CMS noted that a related issue was litigated in the D.C. Circuit Court, which agreed with CMS’s position.
 
CMS’s press release is here. The full text of the final rule is available here.
 
CMS Announces Record Enrollment in ACA Marketplace Plans
On January 25th, CMS announced that 16.3 million people selected an Affordable Care Act (ACA) Marketplace plan during the 2023 Open Enrollment Period between November 1, 2022 and January 15, 2023. This is the highest enrollment number since the inception of the program, and a 13% increase from last year. Overall, 22% of enrollees were new to Marketplace plans and 78% of enrollees had active coverage for 2022 and made a selection for 2023 or were automatically re-enrolled. Most of these enrollees had access to three or more insurance companies, and four out of five people returning to HealthCare.gov found a plan for $10 or less after tax credits.
 
More information is available here.
 
CMS Issues Additional Medicaid Unwinding Guidance
On January 27th, CMS issued a State Health Official letter providing more detailed guidance on how states should unwind the Medicaid continuous enrollment provisions that were enacted in 2020 in the Families First Coronavirus Response Act (FFCRA). This is the second guidance document CMS has released since the passage of the 2022 year-end omnibus spending bill, which established new conditions and an explicit deadline of March 31st for the end of continuous enrollment, as well as a quarterly phase-down of the enhanced Federal Medical Assistance Percentage (FMAP) through December 31st.
 
States must begin unwinding by initiating eligibility redeterminations between February and April of this year, and must complete renewals for all individuals within 14 months. New York plans to start unwinding in April, such that members whose eligibility needs to be renewed in June will start to receive communications between late March and May. Such members, if disenrolled, would have their Medicaid coverage end on June 30th.
 
Notable policy elaborations in the letter include:
 
Maintenance of Effort and Coverage

  • States must continue to meet the “maintenance of effort” requirements (i.e., no increased eligibility standards) through December 31st to continue receiving enhanced FMAP.
  • States may not impose higher premiums in their premium schedules through December 31st. However, starting March 31st, states may charge higher premiums to individual enrollees if they would have been subject to them under an existing premium schedule (i.e., if their income increases or if they are moved to a new eligibility group with a premium).
  • CMS believes that requirements in the American Rescue Plan (ARP) will substantially supersede the FFCRA’s requirement for Medicaid programs to cover Covid-19 testing, treatment, and vaccines. The ARP’s requirements will expire on the last day of the first calendar quarter that starts one year after the last day of the Covid-19 PHE. Since the PHE is expected to end May 11th, this would be September 30, 2024.

Renewal Requirements

  • States must comply with various existing federal requirements, including: 
    • States must conduct ex parterenewals where possible;
    • States must provide pre-populated renewal forms where necessary to MAGI-eligible beneficiaries;
    • States must provide 10 days of advance notice and fair hearing rights before ending Medicaid eligibility;
    • If a state determines an individual is ineligible for Medicaid, it should assess that individual for eligibility for other programs, including the Basic Health Plan or Marketplace coverage; and
    • States must reconsider eligibility without a new application for MAGI-eligible beneficiaries who return a renewal form within 90 days after coverage is terminated (and may do so for non-MAGI groups).
  • States must have a “comprehensive plan” for confirming that enrollees’ contact information is up-to-date before initiating a redetermination. This includes using the Postal Service’s National Change of Address (NCOA) database as well as other sources of contact information, including managed care organizations (MCOs). All sources should be documented.
  • States must have made a “recent attempt” to ensure up-to-date contact information. CMS notes that acceptable examples would include a quarterly data match with NCOA or applying for waiver authority to update records using MCO data without needing to confirm the change with the enrollee.
  • If a state receives returned mail in response to a redetermination, it must make a “good faith effort” to use at least two other modalities to contact the individual, if available. States may determine which modalities to use (e.g., mail, phone, email, text messaging, etc.).

Reporting Requirements

  • CMS believes that new reporting requirements will be satisfied by the data tools it has previously published for states to submit. These include CMS’s Unwinding Data Report and identified State-based Marketplace (SBM) priority metrics. CMS will process data from states that use Healthcare.gov for their Marketplace (i.e., have a federally-facilitated Marketplace or a state-based one that uses Healthcare.gov for eligibility or enrollment).
  • CMS “will publish all data that is reported” to comply with statutory requirements.

The full letter is available here.
 
CMS also issued guidance on a Special Enrollment Period (SEP) allowing individuals who are disenrolled from Medicaid due to the unwinding to enroll in Marketplace coverage. The SEP will run from March 31, 2023 through July 31, 2024. Consumers will not be required to provide documentation, other than an attestation that they were disenrolled from Medicaid coverage. It applies in any state that uses Healthcare.gov for eligibility and enrollment. SBMs may elect to offer this SEP as well.
 
This guidance is available here. CMS expects to issue further guidance in the future.
 
CMMI Issues Second Evaluation Report for Vermont All-Payer Model
On January 27th, the Center for Medicare & Medicaid Innovation (CMMI) issued its second evaluation report of the Vermont All-Payer Accountable Care Organization Model (VTAPM). The Model is intended to test whether scaling an ACO model across all major payers in a state can lead to delivery transformation, reduced spending, and improved population health outcomes. The report evaluates the model over its first three performance years: 2018, 2019, and 2020.
 
Overall, the report concludes that the initial findings provided limited evidence for the impact of the Model, in part due to the impact of the Covid-19 PHE and a major ransomware cyberattack.  Over the three years, the ACO showed gross Medicare spending reductions of $655 per beneficiary per year (PBPY), or 6%. After shared savings and incentive payments from Medicare are accounted for, the model resulted in Medicare savings of $577 PBPY (5.3%), which was not statistically significant. After excluding the fourth quarter of 2020 to account for the cyberattack, these savings were further reduced to $471 and $382 PBPY. Statewide, however, the model achieved $783 per beneficiary per year savings in Medicare Parts A and B spending. Utilization declined steeply, but that was likely due to the pandemic, as it occurred in the test and control groups. The Model did, however, achieve continued progress towards performance targets.
 
The full report is available here.
 
HHS Publishes Updated Federal Poverty Guidelines
On January 24th, the Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) posted updated Federal Poverty Guidelines for 2023. Federal poverty guidelines are used to determine financial eligibility for certain government programs. Poverty guidelines in the contiguous 48 states will be as follows: 

  • 1 person in family/household: $14,580
  • 2 persons in family/household: $19,720
  • 3 persons in family/household: $24,860
  • 4 persons in family/household: $30,000
  • 5 persons in family/household: $35,140
  • 6 persons in family/household: $40,280
  • 7 persons in family/household: $45,420
  • 8 persons in family/household: $50,560

For families/households with more than 8 persons, add $5,140 for each additional person. Poverty guidelines for Alaska and Hawaii are slightly higher.
 
The Federal Register will publish the guidelines next week. More information is available here.
 
FDA Withdraws Authorization of Evusheld
On January 26th, the Food and Drug Administration (FDA) withdrew the authorization of Evusheld, an antibody therapy for Covid-19. Evusheld was intended as a pre-exposure treatment for individuals at risk for severe disease, but the ongoing mutation of the virus has rendered Evusheld ineffective as a therapy. The FDA first warned in October that the Omicron variant was undermining the efficacy of Evusheld, but awaited further data to remove its authorization. That data showed that 90% of current infections are caused by sublineages not neutralized by Evusheld. AstraZeneca, Evusheld’s manufacturer, said it is working on a new antibody to neutralize all variants, potentially available later this year. Covid-19’s evolution has rendered all other antibody treatments for infected patients ineffective as well, leaving only antiviral treatments like Paxlovid available.
 
More information is available here.
 
FDA to Ease Blood Donation Ban for Gay Men
On January 26th, the FDA issued draft recommendations to change federal guidelines that banned gay men from donating blood. The recommendations focus on sexual behaviors that pose a higher risk of contracting and transmitting HIV, regardless of gender. Donors will be able to give blood if they have not had a new anal sexual partner in the prior three months, with no exception for those who consistently wear condoms, no exception for presenting a negative HIV test, and no exception for those taking pills that significantly reduce the risk of contracting HIV. To this point, FDA rules have made no exception for gay men in monogamous relationships. The ban dates back to 1985, was modified in 2015 to allow gay men to donate if they had abstained from sex with other men for 12 months, and then modified again in April 2020 reducing the period to three months.
 
More information is available here.
 
FDA Advisors Recommend Updating Covid Vaccines
On January 26th, the FDA’s Vaccines and Related Biological Products Advisory Committee met to chart the future path of Covid-19 vaccines. Advisors supported the FDA’s plan to move to a single annual shot for most Americans, matched annually to circulating strains, as is done with the influenza vaccine. Two doses would be recommended for older people, immunocompromised individuals, and young children. The panel also voted unanimously to support directing all Covid-19 vaccine manufacturers to align the primary series of their vaccines to include the new booster shots containing both the original and Omicron strains of the virus. To date, while 75% of Americans received the original two-dose vaccine, only 16% of those eligible have received the bivalent booster.
 
CDC Announces Organizational Restructuring
On January 24th, Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky announced key organizational changes at a town hall at CDC headquarters in Atlanta. The changes were prompted by an internal review to identify cultural and organizational challenges during the agency’s pandemic response, which concluded that CDC needed to improve communications, share data and findings more quickly, and strengthen its partner relationships. Major changes include: 

  • Establishing an Office of Public Health Data, Surveillance, and Technology led by Acting Director Jennifer Layden;
  • Establishing an Office of Health Equity, led by Acting Director Leandris Liburd;
  • Establishing a new National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce (consolidating two existing centers underneath it);
  • Moving the Office of Science and Office of Laboratory Science and Safety to report directly to the Director’s team;
  • Renaming the Center for Preparedness and Response to the Office of Readiness and Response;
  • Creating a Director of External Affairs position;

CDC’s goal is to have the new structure in place by the end of February. Other previously announced changes include Maine CDC director Nirav D. Shah (not the former New York Commissioner of Health, Nirav R. Shah) joining as Principal Deputy Director, and Debra Houry shifting to the position of Chief Medical Officer and Deputy Director for Science and Programs.
 
FCC Rules that Entities May Make Robocalls for Medicaid Redeterminations
On January 23rd, the Federal Communications Commission (FCC) issued a Declaratory Ruling providing guidance to federal and state governmental agencies and their partners, such as Medicaid Managed Care Organizations, enabling them to make Medicaid enrollment calls and send text messages without violating robocall and robotext prohibitions. The ruling came in response to an April 28, 2022, letter from HHS Secretary Xavier Becerra regarding whether certain types of communication with Medicaid beneficiaries regarding enrollment redeterminations would be permissible under the Telephone Consumer Protection Act. In the Declaratory Ruling, the FCC confirms that enrollees’ provision of a telephone number on an application for coverage constitutes prior express consent to be contacted at that number regarding enrollment eligibility.
 
The Declaratory Ruling is available here. The original letter is available here.
 
ASPE Issues Report on Insulin Affordability
On January 24th, ASPE issued a report identifying savings Medicare beneficiaries would have accrued if the new $35 monthly cap on insulin products were in effect in 2020. Under the Inflation Reduction Act (IRA), Medicare beneficiaries’ out-of-pocket costs for insulin were capped at $35/month under Part D, starting January 1st. A similar cap takes effect under Part B on July 1st.
 
Overall, the ASPE report estimates that 1.5 million Medicare beneficiaries would have saved approximately $734 million in Part D and $27 million in Part B if the IRA insulin provisions had been in effect in 2020. While the report does not provide a similar estimate for individuals with private insurance, it does note that in 2019, patients with both private insurance and Medicare paid an average of $63 per insulin fill. However, variation in patient cost is quite wide, as only 35% of individuals with private insurance had cost-sharing that exceeded $35 per fill (with a similar 37% rate in Medicare).
 
The report is available here.

Other Updates

AHCA/NCAL Release Analysis on Nursing Home Workforce Shortage
On January 19th, the American Health Care Association and the National Center for Assisted Living released an analysis of Bureau of Labor Statistics (BLS) data showing the severe workforce challenges nursing homes are facing. Overall, the report states that nursing homes have lost 210,000 jobs over the course of the pandemic, the worst job losses of any health care sector. Nursing homes are also struggling to bounce back, adding an average of only 3,700 jobs per month over the last nine months. At that rate, nursing homes will not return to pre-pandemic levels until 2027. The report notes that a recent study showed that 96% of nursing homes are experiencing difficulty hiring, with nearly half reporting that their workforce shortage situation has worsened since May 2022. As a result, long term care facilities have had to limit resident admissions, causing a backlog in hospital patient discharges as well.
 
More information is available here. 
 
JAMA Publishes Study Comparing System and Non-System Hospitals and Physicians
On January 24th,  JAMA published a study entitled “Organization and Performance of US Health Systems.” Using 2018 data, the authors compared the differences in cost and quality between physicians and hospitals in and outside of health systems. Overall, the authors found quality to be modestly higher in health systems, using measures of preventive care, clinical quality, and patient experience. However, prices paid to hospitals and physicians within health systems were significantly higher than those paid to non-system hospitals and physicians (12-26% higher for physician services, 31% higher for hospital services). The authors suggest these data indicate that health systems have not, on average, achieved their potential for better care at an equal or lower cost.
 
The article is available here.

New York State Updates

Governor Hochul Vetoes Grieving Families Act
On January 30th, Governor Kathy Hochul vetoed the Grieving Families Act (S. 74A), which would have significantly expanded the scope and potential damages of wrongful death lawsuits. The Act proposed to:

  • Extend the time period during which wrongful death actions could be brought;
  • Allow damages for emotional loss, rather than only for economic losses (i.e., lost earnings); and
  • Expand the range of family members who could sue for wrongful death to include anyone determined by a fact finder to be a “close family member.”

Hochul said that the bill would have resulted in “significant unintended consequences” for the health care system. Health care stakeholders had argued that it could dramatically increase medical malpractice premiums. Earlier that day, the Governor had taken the unusual step of publishing an editorial in the New York Daily News in which she urged the legislature to agree to a compromise solution, which would have taken a “first step” by restricting the bill to expanding emotional loss damages to cases involving children under 18, and exempting medical malpractice claims “for the time being.”
 
The editorial is available here.
 
DOH and OMH Issue Memo Requiring Re-Opening of Inpatient Psychiatric Beds by April 1st
On January 10th, the New York State (NYS) Department of Health (DOH) and Office of Mental Health (OMH) issued a memo requiring hospitals to restore inactive inpatient psychiatric beds in accordance with hospital operating certificates, some of which were taken offline as a result of the Covid-19 public health emergency and some of which were offline prior to the emergency. Accordingly, by February 10th, hospitals must either: 

  • Re-open all non-operational licensed inpatient psychiatric beds; or
  • Submit a plan to OMH to bring all non-operational inpatient beds online by April 1st.

DOH and OMH expect all beds to be re-opened by April 1st. Failure to comply may result in fines or other enforcement actions, including disqualification from future OMH and DOH funding opportunities.
 
The memo is available here. Notifications and plans should be sent to certification@omh.ny.gov. Technical support to facilitate the re-opening of inpatient psychiatric beds is available from OMH and DOH.
 
SED Adopts Regulations Expanding Scope of Practice for Nurse Practitioners and Registered Nurses
On January 25th, the New York State Education Department (SED) adopted regulations that: 

  • Authorize nurse practitioners with more than 3,600 hours of qualifying nurse practitioner experience to provide nurse practitioner services without a collaborative practice agreement with a physician or a collaborative relationship with one or more licensed physicians or a hospital; and
  • Permit registered professional nurses to administer Covid-19 or influenza tests pursuant to a non-patient specific order issued by a licensed physician or a certified nurse practitioner.

Additional details are available in the State Register here.
 
DOH Ends Covid-19 Flexibilities Waiving or Suspending Children’s Waiver Re-Assessments
On January 26th, DOH issued guidance announcing that effective January 2023, the flexibilities to waive or suspend the Annual Re-Assessment and Significant Life Event Re-Assessment for Home and Community Based Services (HCBS) Level of Care (LOC) eligibility determinations have immediately ended. As a result, Children’s Health Home Care Managers (HHCM) and Children and Youth Evaluation Services (C-YES) assessors must ensure that all currently enrolled and eligible members of the HCBS Children’s Waiver have a timely Annual Re-Assessment and a Significant Life Re-Assessment (when necessary) within 2023. If the member’s annual Re-Assessment was due in January 2023, the care manager has until the end of February 2023 to complete the re-assessment.
 
DOH is also requesting all Health Home Care Management Agencies and C-YES to report all Annual Re-Assessments that were not completed during 2020, 2021, or 2022 by February 10th using the spreadsheet here. This information must be submitted regardless of whether the member has a current Annual Re-Assessment.
 
The DOH guidance is available here. Questions may be submitted to BH.Transition@health.ny.gov.
 
OMH Notifies Medicaid MCOs of CPEP and MHOTRS Clinic Rate Adjustments
On January 26th, OMH sent a memorandum to Medicaid managed care plans (MMCPs) alerting the plans of the following rate adjustments: 

  • Increased reimbursement for the Comprehensive Psychiatric Emergency Program (CPEP), including Extended Observation Beds (EOB) – effective July 1, 2022.
  • Weight updates for the Mental Health Outpatient Treatment Rehabilitation Services (MHOTRS) clinic self-help/peer services (individual and group) – effective January 1, 2023.

MMCPs must complete necessary systems edits to ensure that claims are reimbursed at the newly effective rates. MMCPs are also required to conduct retrospective reconciliation to adjust payment for claims as necessary by April 26th.
 
The memorandum is available here. Questions may be submitted to BHO@omh.ny.gov.
 
DOH Announces Supplemental Payment for ADHCs and Rate Adjustment for Specialty I/DD and SMI Units
On January 25th, DOH issued a public notice announcing that, effective on or after February 1st, DOH will provide supplemental payments to Adult Day Health Centers and AIDS Adult Day Health Centers in accordance with the State’s Home and Community Based Services (HCBS) plan, under the enhanced HCBS matching funds available under the ARP. Facilities will receive the supplemental payment after completing an attestation of fund use and sustainability. Facilities must provide the medical model of services; facilities that only provide the social model are not eligible for supplemental payments.
 
DOH also announced that, effective on or after February 1st, DOH will adjust the operating reimbursement rate for specialized inpatient psychiatric units that provide treatment for adults with a diagnosis of both developmental disability and serious mental illness.
 
The public notices are available here. Comments may be submitted to spa_inquiries@health.ny.gov. 
 
DOH Announces Dates and Locations for In-Person Children’s Stakeholder Regional Meetings
On January 24th, DOH announced dates and locations for a series of in-person Children’s Stakeholder Regional Meetings. These meetings are being conducted by DOH to allow for in-person collaboration regarding children’s services, policies, processes, and specific regional topics. Registration is required for individuals who plan to attend in-person. The meeting will also be streamed at most venues.
 
The DOH announcement is available here. DOH is soliciting questions and topics to cover during  the discussions, and responses may be submitted here through February 3rd. Questions may be submitted to BH.Transition@health.ny.gov.

Funding Opportunities

NY Health Foundation Extends Deadline for OpenNotes RFP in Non-Hospital Systems to February 3rd
The New York Health Foundation (NYHealth) extended to February 3rd the deadline for its Request for Proposals (RFP) for non-hospital systems seeking to implement OpenNotes. OpenNotes is a national effort to give patients access to the visit notes written by their doctors, nurses, or other clinicians. Through this RFP, NYHealth will provide non-hospital systems with funding, tools, and technical assistance to effectively implement and share visit notes.
 
Applicants may request $50,000 per site for up to two sites ($100,000 in total) to supplement the costs associated with implementing OpenNotes during a 12-month period. NYHealth anticipates awarding grants to up to 16 non-hospital systems. Eligible providers include federally qualified health centers (FQHCs), multi-specialty group practices, hospital-affiliated physician groups, independent physician practices, and other non-hospital health systems. Priority will be given to applicants that are in the early phases of OpenNotes adoption.
 
The full RFP is available here. Questions may be submitted to OpenNotesRFP@nyhealthfoundation.org.
 
DOH Releases SOI for Doctors Across New York Cycle IX Grant
On January 18th, the DOH Division of Workforce Transformation released a Solicitation of Interest (SOI) for the Doctors Across New York (DANY) Physician Loan Repayment (PLR) and Physician Practice Support (PPS) programs. These programs provide funding to help recruit physicians to and encourage them to remain in medically underserved areas of the State.
 
Up to $15.8 million in total funding is available to: 

  • Eligible physicians to help pay for educational debt or the costs of establishing or joining medical practices; or
  • Eligible health care facilities to recruit or retain physicians by providing sign-on bonuses, funds to repay educational debt, or enhanced compensation (100% of funding ultimately must be distributed to the physician or physician’s practice).

Both PLR and PPS awards will provide up to $40,000 annually for three years to or on behalf of a physician who agrees to practice in an underserved area for the three-year period (DANY service obligation period). DOH anticipates awarding approximately 132 three-year awards. One-third of funding will be allocated to physicians practicing in New York City (in any of the five boroughs). The remaining two-thirds will go to physicians practicing in the rest of the state. At least 50% of available funds will be awarded to physicians working in general hospitals.
 
The SOI is available here. Applications will be accepted on a rolling basis until March 5th. Questions may be submitted to DANY2018@health.ny.gov through February 1st.
 
OASAS Releases RFP for Comprehensive Low-Threshold Buprenorphine Services
On January 20th, the NYS Office of Addiction Services and Supports (OASAS) released a Request for Applications (RFA) for the development of Comprehensive Low-Threshold Buprenorphine Services. These services aim to increase access to person-centered, comprehensive substance use disorder (SUD) treatment and Medication for Opioid Use Disorder (MOUD) services.
 
Eligible applicants are not-for-profit organizations that are: 

  • OASAS-certified, funded, or otherwise authorized SUD treatment programs;
  • OMH-licensed mental health service programs;
  • Hospitals;
  • Syringe service programs; or
  • Federally Qualified Health Centers (FQHCs).

Eligible applicants must also have a NYS-licensed provider (APN, MD/DO, PA) with a federal Drug Enforcement Agency (DEA) registration. OASAS will award $7.5 million in total funding to up to 15 applicants during the first year of the program. An additional two years of funding may be provided as available. OASAS seeks to award at least one program in each of the 10 Empire State Development (ESD) Regions.
 
The RFA is available here. Applications are due on February 22nd. Questions may be submitted to OASAS.sm.Grants@oasas.ny.gov with the subject line “RFA – SETT – 23001” by February 3rd. There will be an applicant conference on February 1st from 10am-12pm, details for which will be available on the OASAS website.
 
NYC Department for the Aging Releases RFP for Geriatric Mental Health
On January 20th, the New York City Department for the Aging (NYC Aging) released an RFP seeking qualified geriatric mental health providers to offer accessible and culturally conscious mental health services to older adults in need throughout the city. Eligible applicants must have a specialty serving older adults and must be one of the following types of organizations: 

  • Article 31 licensed mental health clinics, including hospital-based clinics; or
  • Hospitals with a faculty practice entity that allows hired faculty or staff to provide mental health services and is registered with the American Association of Medical Colleges (AAMC).

Through this opportunity, NYC Aging will award $15 million to up to six organizations over a three-year term. Contracts will last for three years starting on July 1st, with the option to renew annually for three additional years.
 
The RFP is available in the PASSPort system here by searching “Geriatric Mental Health.” Applications are due on March 2nd. Questions may be submitted to rfp@aging.nyc.gov by February 17th.
 
SAMHSA Issues NOFO for Opioid Overdose Reversal Medication Trainings
On January 23rd, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a Notice of Funding Opportunity (NOFO) for the 2023 Improving Access to Overdose Treatment program. This program aims to expand access to naloxone and other FDA-approved overdose reversal medications for emergency treatment of known or suspected opioid overdose. Award recipients will collaborate with other prescribers to implement trainings on policies, procedures, and models of care for prescribing, co-prescribing, and expanding access to FDA-approved overdose reversal medications to the specified population of focus (i.e., urban or rural).
 
Through this opportunity, SAMHSA will award up to $1.4 million in total annual funding across seven awards during the five-year program period. Projects are anticipated to begin on September 30th. Eligible applicants are Federally Qualified Health Centers (FQHCs), opioid treatment programs, and practitioners dispensing narcotic drugs.
 
The NOFO is available here. Applications are due on March 24th.
 
SAMHSA Issues NOFO for Substance Use Treatment Services for Pregnant and Postpartum Women in Residential Settings
On January 25th, SAMHSA released a NOFO for comprehensive services for pregnant and postpartum women with substance use disorders across the continuum of residential settings. Required services include case management, treatment, recovery support services, and harm reduction services. Eligible applicants include health facilities or other public or private not-for-profit entities. 
 
Through this opportunity, SAMHSA will award up to $11.55 million in total annual funding across 22 awards during the five-year program period. Matching funds (either directly or through donations) are required. Non-federal contributions may be cash or in-kind.  Contracts are expected to begin on September 30th.
 
The NOFO is available here. Applications are due on March 27th. Questions may be submitted to Andrea Harris at andrea.harris@samhsa.hhs.gov.
 
SAMHSA Issues NOFO for National Child Traumatic Stress Initiative
On January 25th, SAMHSA released a NOFO for the National Child Traumatic Stress Initiative – Category III Community Treatment and Service Centers program. This program aims to increase access to effective trauma- and grief-focused treatment and service systems for children, adolescents, and their families who experience traumatic events. Awarded applicants will be expected to provide direct mental health treatment and services for at-risk children and adolescents who have had trauma-related experiences.
 
Through this opportunity, SAMHSA will award over $16.7 million in total annual funding across 28 awards during the five-year program period. Eligibility is limited to public and private not-for-profit entities. Contracts are expected to begin on September 30th.
 
The NOFO is available here. Applications are due on March 27th.
 
HRSA Issues NOFO for Integrated Substance Use Disorder Training Program
On January 20th, the Health Resources and Services Administration (HRSA) released a NOFO for the 2023 Integrated Substance Use Disorder Training Program. This program aims to expand the number of practitioners trained to provide mental health and substance use disorder services in underserved community-based settings that integrate primary care, mental health, and substance use disorder services. Applicants must plan, develop, and operate a 12-month full-time (or 24-month half-time) training program for eligible practitioners, which may include nurse practitioners, physician assistants, health service psychologists, counselors, nurses, and social workers.
 
Eligible applicants include: 

  • FQHCs and Teaching Health Centers;
  • Community Mental Health Centers;
  • Rural Health Clinics; or
  • An existing accredited training program for one or more of the eligible disciplines.

HRSA will award over $9 million annually to approximately 17 applicants during the five-year contract period. Each applicant will receive up to $515,000 in annual funding. Contracts will last for five years, beginning on July 1st.
 
The NOFO is available here. Applications are due on March 21st. Questions may be submitted to Steve Coulter at Scoulter@hrsa.gov.