Weekly Health Care Policy Update – June 13, 2023

In this update:

• Federal Agencies
  • CMMI Announces New Making Care Primary Model
  • HHS Issues New Guidance and Flexibilities on Medicaid Unwinding
  • CMS Releases Quality Measure Information for 12 CMMI Models
  • CMS Issues Final Rule Establishing DSH Medicare Advantage Days Policy
  • CMS Announces Lower Coinsurances for 43 Prescription Drugs
  • CMS Publishes Data on Characteristics of the Part D Low Income Subsidy Population
  • FDA Announces Steps to Modernize Clinical Trials
• Other Updates
  • Merck Sues Federal Government Over Medicare Drug Price Negotiation Program
  • Supreme Court Rules Medicaid Enrollees Can Sue States in Certain Circumstances
  • CBO Says Uninsurance Dropped to 8.3% Nationally; Publishes 2023-2033 Projections
  • AHA Publishes Survey on TEFCA
  • Aetna and OptumHealth Face Class Action Lawsuit
  • Appeals Court Hears Arguments in ACA Preventive Care Case
• New York State Updates
  • NYS Legislative Session Ends, But Assembly Will Return Later
  • Governor Hochul Extends Statewide Healthcare Staffing Shortages Emergency
  • Dr. James McDonald Confirmed as DOH Commissioner
  • DOH to Host Webinar on Enacted State Medicaid Budget
  • NYC Council Passes Legislation to Promote Hospital Price Transparency
  • CMS Approves Rate Increases for CPEP Extended Observation Bed Services
  • CMS Approves Medicaid Coverage of Gambling Disorder Treatment
• Funding Opportunities
  • DDPC Offers $150,000 for Statewide Community of Practice on DEI in Developmental Disabilities
  • DOHMH Announces Concept Paper for Re-procurement and Expansion of Clubhouse Programs  
  • HRSA Announces $15 Million Pediatric Specialty Loan Repayment Program

Federal Agencies

CMMI Announces New Making Care Primary Model
On June 8^th, CMMI announced a new primary care model, Making Care Primary (MCP), to be tested in eight states, including New York. The other seven states are Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, North Carolina, and Washington.

The model is planned to last for 10.5 years, beginning July 1, 2024 and running through December 31, 2034. Building upon previous primary care models, such as Comprehensive Primary Care (CPC), CPC+, and Primary Care First (PCF), MCP has three major goals: 

1. Ensuring provision of integrated, coordinated, person-centered and accountable primary care;
2. Creating a pathway to enter value-based care arrangements, especially for small, independent, rural, and safety net organizations; and
3. Improving care quality and health outcomes while reducing expenditures.

The model provides three progressive tracks designed to align with participants’ experience with value-based care arrangements, starting with fee-for-service (FFS) only and moving up to a per-member per-month (PMPM) primary care payment. The FFS-only Track 1 is reserved for participants with no value-based payment experience. Eligible participants must bill for at least 125 attributed Medicare beneficiaries.

CMS anticipates releasing a Request for Applications (RFA) later this summer. More information about MCP is available here. SPG published a standalone summary of this opportunity here.

HHS Issues New Guidance and Flexibilities on Medicaid Unwinding
On June 12^th, the Department of Health and Human Services (HHS) announced new guidance and flexibilities for the ongoing unwinding of Medicaid continuous enrollment, with the aim of reducing procedural disenrollments. HHS Secretary Xavier Becerra wrote a letter to the nation’s governors encouraging them to take advantage of Section 1902(e)(14) waivers, which allow states to use expanded strategies for managing enrollment. Such strategies may include incorporating data sources like the Supplemental Nutrition Assistance Program (SNAP) to verify eligibility and partnering with outside organizations (including managed care plans) to update enrollees’ contact information. New or updated options include: 

• Performing ex parte renewal for individuals with income at or below 100% of the federal poverty line (FPL);
• Suspending the requirement to apply for other benefits as part of Medicaid applications;
• Suspending the requirement to cooperate with the program in establishing the identity of a child’s parents (medical support cooperation);
• Establishing a new eligibility period whenever contact is made with hard-to-reach populations;
• Allowing managed care plans to provide assistance to enrollees to complete and submit Medicaid renewal forms;
• Designating the State Medicaid Agency and/or community providers (e.g., pharmacies, community-based organizations) as a qualified entity to make presumptive eligibility (PE) determinations for MAGI-based enrollees who have been disenrolled for a procedural reason; and
• For individuals who are procedurally disenrolled and then re-enrolled after redetermination, reinstating eligibility retroactive to the first termination date.

States may also choose to delay procedural terminations for beneficiaries for one month while conducting targeted renewal outreach, without the need for an (e)(14) waiver but with CMS concurrence.

CMS’s press release is available here. The list of strategies is available here.

CMS Releases Quality Measure Information for 12 CMMI Models 
On June 9^th, the Centers for Medicare and Medicaid Services (CMS) announced the release of quality measure information for CMS Innovation Center (CMMI) models and demonstrations through the CMS Measures Inventory Tool (CMIT). The CMIT provides extensive descriptions of each measure, such as definitions of numerators and denominators, evidence and rationales for their inclusion, and how they are tailored for specific models (if applicable).

The new release includes details about the measures that are used in the following CMMI models: 

• Global and Professional Direct Contracting
• Bundled Payment for Care Improvement Advanced Model
• Comprehensive Care for Joint Replacement Model
• Independence at Home Demonstration
• Integrated Care for Kids Model
• Kidney Care Choices
• Maryland Total Cost of Care Model
• Oncology Care Model
• Pennsylvania Rural Health Model
• Primary Care First Model
• Value in Opioid Use Disorder Treatment Demonstration Program
• Vermont All-Payer Accountable Care Organization Model

The CMIT (including all the new data) is available here.

CMS Issues Final Rule Establishing DSH Medicare Advantage Days Policy
On June 7^th, CMS issued a final rule addressing the treatment of Medicare Advantage patient days in the Medicare Disproportionate Share Hospital (DSH) calculation. By statute, Medicare DSH payments are based in part on a facility’s percentage of Medicare days, defined as “Medicare SSI days” divided by “total Medicare days”. In 2019, the Supreme Court ruled that CMS could not include Part C days in the Medicare DSH calculation without adequate notice and comment rulemaking, rejecting CMS’ previous attempt to include Part C days.

In this final rule (originally proposed under the Trump administration), CMS includes Part C days in the calculation through retroactive rulemaking, placing Medicare Advantage days in the Medicare fraction of the DSH calculation for discharges before October 1, 2013.  They argue that Medicare Advantage beneficiaries remain entitled to various Part A benefits and should therefore be included in the Medicare fraction.

The final rule is available here. It will become effective 60 days from publication.

CMS Announces Lower Coinsurances for 43 Prescription Drugs 
On June 9^th, CMS announced a list of 43 prescription drugs for which Part B beneficiary coinsurance may be lower between July 1^st and September 30^th. Savings would range between $1 and $449 per average dose, depending on a beneficiary’s coverage. The reductions are the result of the Medicare Prescription Drug Inflation Rebate Program passed in the Inflation Reduction Act, which allows Medicare beneficiaries to potentially pay lower coinsurance for Part B drugs if their price increases faster than the rate of inflation.

More information, including the full list of drugs and their inflation-adjusted coinsurance percentage, is available here.

CMS Publishes Data on Characteristics of the Part D Low Income Subsidy Population
On June 12^th, CMS announced the release of a new Public Use File (PUF) describing socioeconomic characteristics of enrollees in the Low Income Subsidy (LIS) program, also known as Extra Help, which provides additional subsidies for Part D drug coverage to low-income enrollees. The data, which comes from the Medicare Current Beneficiary Survey, finds that about 24% of Medicare enrollees are enrolled in LIS. However, it also estimates that almost 1.8 million people who are eligible for full LIS are not enrolled (almost 14% of eligible people).

The data is available here.

FDA Announces Steps to Modernize Clinical Trials 
On June 6^th, the Food and Drug Administration (FDA) announced draft updated recommendations for good clinical practices (GCPs) to “modernize the design and conduct of clinical trials.” GCPs are intended to ensure safety of trial participants and integrity of the data generated from trials. The changes included in the draft guidance aim to modernize how trials are conducted, allowing for incorporation of rapidly developing technological and methodological innovations. The changes are also intended to make trials “more agile without compromising data integrity or participant protections” and would be applicable to a broad range of clinical trials including those with innovative design elements.

Additional changes include:

• Emphasizing the use of risk-based and proportionate approaches across the lifecycle of a clinical trial: Determining which data and clinical trial processes are most important to participant safety and data integrity, and focus efforts accordingly; and
• Encouraging sponsors to be proactive when it comes to a trial’s quality considerations: Focusing on protection of participants, the reliability of trial results and the decisions made based on those trial results.

The full document is available here. The draft guidance will be open for public comment for 60 days.

Other Updates

Merck Sues Federal Government Over Medicare Drug Price Negotiation Program
On June 6^th, Merck sued the federal government over the Inflation Reduction Act’s program to allow Medicare to negotiate drug prices. The Medicare Drug Price Negotiation Program allows Medicare to negotiate directly with pharmaceutical companies over the price of certain high expenditure Medicare Part D and Part B drugs that do not have generic or biosimilar competition. The program goes into effect in 2026, though the government will announce the first ten drugs subject to negotiation this September.
 
The lawsuit that the program is unconstitutional on two grounds. First, by coercing the company to sell at government-set prices, Merck claims the program violates the Fifth Amendment, which prohibits the government from taking private property for public use without just compensation. Second, Merck claims that the program violates the company’s right of free speech by forcing it to sign a contract it would not agree with at the end of the price negotiation. Two of Merck’s blockbuster drugs, Januvia and Keytruda, are likely targets for inclusion in the program within its first several years.
 
Supreme Court Rules Medicaid Enrollees Can Sue States in Certain Circumstances
On June 8^th, the Supreme Court ruled 7-2 in Health & Hospital Corp. of Marion County v. Talevski that Medicaid beneficiaries have the right to sue state agencies if those agencies break federal law. The plaintiffs, the family of Gorgi Talevski, argued that Valparaiso Care and Rehabilitation, a state-owned nursing home caring for Mr. Talevski, violated the Federal Nursing Home Reform Act of 1987 (FNHRA) by inappropriately medicating and discharging him.
 
The Supreme Court ruled that FNHRA unambiguously confers individual federal rights including related to residents’ health, welfare, and medical needs, and that Health & Hospital Corp. failed to show that Congress intended for FNHRA to provide an exclusive enforcement mechanism. The decision upholds the 2021 ruling of the U.S. Court of Appeals for the Seventh Circuit, and the case now returns to the district court. Justice Jackson authored the affirming decision. Justices Alito and Thomas dissented.
 
The decision is available here.
 
CBO Says Uninsurance Dropped to 8.3% Nationally; Publishes 2023-2033 Projections
On May 24^th, the Congressional Budget Office (CBO) published an article in Health Affairs describing its updated projections on national health insurance coverage rates for individuals under 65, finding a record low uninsurance rate of 8.3%. CBO attributes the decrease to increased enrollment in Medicaid and marketplace plans, driven by temporary pandemic policies. However, the CBO anticipates a decline in Medicaid enrollment and projects that 6.2 million people will become uninsured due to the Medicaid unwinding. By 2033, it expects the uninsurance rate to rise again to 10.1%. The report also highlights the expected growth in private health insurance premiums and estimates federal subsidies for health insurance to reach $1.6 trillion by 2033. CBO plans to publish a comprehensive report expanding on these findings soon.
 
The CBO post is available here.
 
AHA Publishes Survey on TEFCA 
On May 31^st, the American Hospital Association (AHA) published a survey of hospital executives about the Trusted Exchange Framework and Common Agreement (TEFCA). TEFCA is intended to establish a universal floor for interoperability across the country, allowing for users in different networks to securely share basic clinical information with each other. In response to the survey, 51% of respondents said they would join TEFCA, 25% were unaware of TEFCA, 23% said they knew about TEFCA but were unsure they’d join, and 1% said they were aware of the project but didn’t plan to take part.
 
Notably, almost half of independent and critical-access hospitals did not know what TEFCA was. Only 29% of independent hospitals plan to participate, compared to 61% of multi- hospital systems. In response to this data, the Office of the National Coordinator for Health IT said it would continue to craft educational resources about TEFCA to boost awareness.
 
More information is available here.
 
Aetna and OptumHealth Face Class Action Lawsuit 
On June 7^th, a district court judge for the Western District of North Carolina certified a class of nearly 88,000 individuals and 2,000 health insurance plans in a lawsuit against Aetna and OptumHealth. The plaintiffs allege that Aetna and OptumHealth charged more cost-sharing for physical therapy services by using a “dummy code” to disguise administration fees as medical expenses. The legal battle began in 2015 when retiree Sandra Peters sued Aetna and OptumHealth (which built Aetna’s network of physical therapists and chiropractors) because her out-of-pocket physical therapy costs doubled. Discovery in that case yielded emails in which the two companies agreed to create a “dummy code” to pass off administrative expenses as medical costs. The insurers received a favorable ruling in that case, but that verdict was overturned by a federal appeals court. Last year, the Supreme Court affirmed the appeals court’s reversal of the decision and remanded the case back to the district court.
 
Appeals Court Hears Arguments in ACA Preventive Care Case
On June 6^th, a three-judge panel for the Fifth Circuit Court of Appeals heard oral arguments in the federal government’s appeal of the nationwide application of a lower court decision in Braidwood Management v. Becerra. The Braidwood decision struck down the Affordable Care Act (ACA) requirement that health plans cover preventive care items and services with an A or B rating from the U.S. Preventive Services Task Force (USPSTF) and Pre-Exposure Prophylaxis (PrEP) for HIV without cost-sharing.
 
On May 15^th, a different panel of judges from the Fifth Circuit issued an administrative stay, allowing the federal government to continue enforcing the preventive care requirements for all insurers except the plaintiffs in the case while the court considers the government’s appeal. This most recent hearing focused narrowly on whether the government may continue enforcing preventive care coverage requirements nationwide while the appeals process continues. Press reports from the hearing suggest that the judges were skeptical that the coverage requirements should be lifted while the legal battle continues. Legal experts say the court’s decision could come as soon as this week.

New York State Updates

NYS Legislative Session Ends, But Assembly Will Return Later
The New York State legislative session for 2023 ended on June 10^th with the passage of hundreds of bills which will be sent to the Governor for her consideration over the course of the year. Some of the legislation which has now been passed by both houses that, if signed by the Governor, would have a significant impact on health care includes: 

• The updated Grieving Families Act (A.6698/S.6636): Similar to but somewhat narrower than last year’s Grieving Families Act, this bill would: 
  • Allow uncapped emotional loss damages in wrongful death cases;
  • Expand the range of eligible litigants to include close family members (defined as grandparents, parents, siblings, children, or grandchildren); and
  • Extend the time permitted to bring wrongful death actions by 18 months.
• Extension of temporary licenses for one year (A.6697B/S.7942B): This bill would allow physicians and nurses with out-of-state licenses practicing in New York per Executive Order 4 to continue temporarily providing services for 180 days, provided that they apply for licensure in New York during this time.
• Permanent authorization of non-patient specific orders (A.6030C/S.6886A): This bill would permanently allow registered nurses (RNs) to perform certain additional services under non-patient specific orders from a physician or nurse practitioner (NP), including: 
  • Electrocardiogram tests for acute coronary syndrome;
  • Point-of-care blood glucose tests for hypoglycemia;
  • Tests and intravenous lines in cases of severe sepsis and septic shock; and
  • Pregnancy tests.
• Extension of community paramedicine pilots (A.6683B/S.6749B): This bill directs the Department of Health (DOH) to establish a community paramedicine demonstration program under which emergency medical technicians (EMTs) and advanced EMTs may operate in additional settings and provide additional services. The program would enable current paramedicine initiatives enabled by Executive Order 4 to continue operating for two years. DOH would also form a stakeholder panel to establish criteria and rules for such programs, and report annually on the status of this program.
• Medicaid managed care organization (MCO) rate transparency (A5381/S6075): This bill requires DOH to provide additional information and/or an explanation to Medicaid MCOs who request a review of their capitation rates for actuarial soundness. It also requires additional information to be in the state’s actuarial certification.
• Codification of MCO quality pools (A6021/S3146A): This bill establishes the Medicaid mainstream and long-term care quality pools in statute, and directs DOH to consult with MCOs and other stakeholders to determine criteria for the distribution of funds. It does not set a minimum required level of funding.

Other health care bills that were passed include:

Long-Term Care

• A7328/S6897: Establishes a four-year demonstration project to incentivize nursing homes to reduce the use of temporary staffing agencies. Nursing homes in the demonstration would be eligible for a reduction in the penalties for excess revenues and staffing expenditures requirements that were established in 2021.
• A7218/S7211: Requires DOH to provide status reports on issues submitted by long-term care ombudsmen; requires such ombudsmen to receive training in cultural competency and diversity; establishes an outreach and awareness program to promote and recruit more ombudsmen.
• A4275/S5980: Directs the conduct of a multi-agency study (DOH, SOFA, OCFS, OPWDD, OMH, and DOL) on “issues impacting the continuum of caregiving in the state”, to be submitted to the governor and legislature.
• A5587/S4858: Establishes the Office of Hospice and Palliative Care Access and Quality, to be located in the DOH Office of Primary Care and Health Systems Management.

Children and Foster Care

• A6029/S2339: Permanently carves out school-based health centers (SBHCs) from Medicaid managed care.
• A7511/S7038: Expands the medically fragile pediatric nursing home demonstration to allow for two more facilities (for a total of four).
• A2176/S5897: Requires the Office of Children and Family Services (OCFS) to report biannually on youth in foster care settings.
• A1510/S1861: Establishes a Black youth suicide prevention task force.
• A5960/S5900: Establishes a task force on evidence-based treatments for children with adverse childhood experiences (ACE).

Other

• A2893A/S580A: Allows DOH to request the inclusion of violence prevention programs in the Medicaid State Plan, and establishes a certification process for such programs.
• A3113A/A3609B: Expands the scope of health equity impact assessments in the Certificate of Need (CON) process to include considering the impact of the project on reproductive health services and maternal health care.
• A7365/S6641: Allows local health departments to send nurses to provide “core public health services” in the home without need for home health licensure.
• A2190/S5100: Allows the remote witnessing of health care proxies utilizing audio-video technology or by telephone.

Bills that were not passed include: 

• Proposals to modify the Office of the Medicaid Inspector General’s (OMIG) audit processes;
• Proposed requirement for telehealth payment parity for federally qualified health centers (FQHCs); and
• Proposal to add coverage for undocumented immigrants (who would be eligible for Medicaid if not for their immigration status) to the State’s application for a Section 1332 waiver program that would expand and replace the Essential Plan.

The Assembly (but not the Senate) plans to return later in June for a special session to consider several outstanding bills, which may include the above.

Governor Hochul Extends Statewide Healthcare Staffing Shortages Emergency 
On June 8^th, Governor Hochul issued Executive Order 4.22 (available here), which extends through June 22^nd the remaining provisions in Executive Order 4 and its successors that reinstated many workforce and scope of practice flexibilities that applied during the original New York State (NYS) Covid-19 public health emergency—in particular, the ability for practitioners who are licensed in other states or Canada but lack New York licensure to practice in New York.

Executive Order 4 had been expected to expire as of the end of the legislative session on June 8^th, which would have immediately made it illegal for such practitioners to continue providing services. With this extension, such practitioners now have an additional two weeks to take advantage of the passage of legislation (described above) allowing them to apply for New York licensure and continue to practice during the following 180 days.

Dr. James McDonald Confirmed as DOH Commissioner
On June 10^th, the Senate confirmed Dr. James McDonald’s appointment as Commissioner of Health. Dr. McDonald has been acting DOH commissioner since January 1^st. Dr. McDonald joined DOH in July 2022, serving as the medical director of the Department’s Office of Public Health. He was later appointed Interim Director of the Center for Community Health. Dr. McDonald is a board-certified physician in pediatrics and preventive medicine, and has previously held multiple roles at the Rhode Island Department of Health.

DOH to Host Webinar on Enacted State Medicaid Budget
On June 15^th at 9am, the NYS Department of Health (DOH) will host an informational webinar on Medicaid-specific priorities in the State Enacted Budget for Fiscal Year 2023-2024. The Enacted Budget Medicaid Scorecard is available here. Notably, the scorecard confirms the following administrative actions: 

• Increase of Medicaid mainstream MCO and managed long-term care (MLTC) minimum medical loss ratios (MLRs) to 89%, effective April 2024 (savings of $67 million per year);
• Removal of the Nursing Home Staffing Pool (savings of $93.5 million per year);
• Discontinuation of MLTC Distressed Plan pool (savings of $15 million per year);
• Reinvestment of NYRx savings: 
  • $135 million per year for FQHCs and Diagnostic and Treatment Centers, and
  • $30 million per year for Ryan White Centers;
• “Recalibration” of Health Homes, effective October 2023 (savings of $100 million over two years);
• Establishment of integrated licensure standards, effective October 2023 (new spending of $32.6 million per year); and
• Various Medicaid rate and benefit changes.

Registration is required and available here. Questions may be emailed ahead of the webinar to mrtupdates@health.ny.gov. The webinar will be recorded and uploaded here. 

NYC Council Passes Legislation to Promote Hospital Price Transparency 
On June 8^th, the New York City Council approved legislation (available here) that establishes a new Office of Healthcare Accountability that will provide recommendations regarding healthcare and hospital costs to City and State agencies, including recommendations to stabilize safety net hospitals. The Office is required to publish an annual report that includes the following information on pricing practices of hospital systems in the city:  

• A summary of prices charged and reimbursement rates for common hospital procedures disaggregated by hospital, procedure type, and health plan/payor;
• The average rate of denial of medically necessary care by each plan/payor;
• A summary of each major plan’s/payor’s profit margin, employee headcount, overhead costs, and executive salaries and bonuses;
• A summary of the pricing transparency requirements of each hospital and plan/payor;
• A summary of each hospital’s spending on community benefits and performance in meeting the healthcare needs of their community; and
• A summary of the impact of pharmaceutical pricing, insurance premiums, and the cost of medical devices on the city’s healthcare costs and individuals’ out-of-pocket spending.

The Office is also required to audit city expenditures on healthcare costs for city employees/retirees and their dependents and to create a publicly accessible website that allows for price comparisons between hospitals.

Note that this rule’s requirements largely align and overlap with the requirements in the federal Hospital Transparency Final Rule that was published in 2021 (available here). Mayor Adams is expected to sign the bill into law shortly.

CMS Approves Rate Increases for CPEP Extended Observation Bed Services
On June 6^th, CMS approved New York’s request for a State Plan Amendment (SPA) to increase the Medicaid inpatient hospital per-diem reimbursement rate for extended observation bed (EOB) services provided in hospital-based comprehensive psychiatric emergency programs (CPEPs) when a beneficiary has remained in the CPEP for longer than 24 hours. Such reimbursement is limited to 72 hours. The updated provider-specific rates are available here.

The SPA has an effective date of July 1, 2022. The CMS approval letter is available here.

CMS Approves Medicaid Coverage of Gambling Disorder Treatment
On May 31^st, CMS approved New York’s request for a SPA to authorize Medicaid coverage and reimbursement for standalone problem gambling disorder treatment services provided to individuals receiving services from Office of Addiction Services and Supports (OASAS)-certified programs with the OASAS gambling designation. Previously, problem gambling services were only allowable as a secondary treatment for substance use disorder.

The SPA has an effective date of March 1^st. The CMS approval letter is available here.

Funding Opportunities

DDPC Offers $150,000 for Statewide Community of Practice on DEI in Developmental Disabilities 
On June 7^th, the Developmental Disabilities Planning Council (DDPC) announced a Request for Proposals (RFP) to fund one grantee to expand and implement a statewide Community of Practice (CoP) on Diversity, Equity, and Inclusion (DEI) in Developmental Disabilities. Specifically, the grantee will help to increase the capacity of DD providers to effectively engage and provide services for people with DD from racially, ethnically, and linguistically diverse communities by:

• Collaborating with the State’s existing CoP Advisory group on project design and development;
• Identifying and convening 5 Regional Teams, to be comprised primarily of DD provider agencies and Care Coordination Organizations (CCOs) who deliver direct services, to participate in the CoP;
• Using a Learning Community Model to provide ongoing DEI training and technical assistance to the Regional Teams to build their DEI capacity;
• Providing at least 1-3 larger statewide DEI training events to anyone in the DD field, including self-advocates, DD providers and CCO staff, and professionals; and
• Creating and maintaining a website to house a DEI toolkit and other DEI resources.  

Eligible applicants include non-profit organizations (for-profit organizations may serve as subcontractors but not as lead applicants); disability-service organizations; public or private institutions such as universities and hospitals; community-based organizations; and consortia or partnerships among organizations.
The available funding for the project is $150,000 annually, for a project period of five years. Grantees are required to ensure an in-kind match of at least 34% of the grant amount, from non-federal funding sources.

The RFP is available here. Applications must be submitted by July 7^th through Grantsgateway.ny.gov. Questions can be submitted by June 20^th to Jacqueline Hayes at Jacqueline.Hayes@ddpc.ny.gov.

DOHMH Announces Concept Paper for Re-procurement and Expansion of Clubhouse Programs  
On June 7^th, the NYC Department of Health and Mental Hygiene (DOHMH) released a Concept Paper outlining a forthcoming RFP to reprocure and expand the City’s Clubhouses for individuals with Serious Mental Illness (SMI). The clubhouses evidence-based, one-stop programs that provide an array of services in a recovery-oriented environment, including skill building, case management, supported employment, education supports, advocacy, and recreational activities.

DOHMH currently holds contracts for sixteen clubhouses serving approximately 5,000 members. DOHMH aims to reprocure Clubhouses to retain its current members and engage 10,000 additional new members within two fiscal years.

DOHMH expects to procure approximately 13 clubhouses, each serving at least 125 active members, in identified high-need areas. The term of each contract is expected to be nine years in duration. The total estimated annual value of all 13 contracts is $19.6 million. Proposers will be required to leverage other revenue sources in addition to DOHMH funding, such as Medicaid billing and in-kind contributions.

The concept paper is available here. The RFP is expected to be issued this fall. DOHMH will hold a virtual meeting for interested providers on June 16^th, from 10am -11am; for a link to the meeting, providers should email RFP@health.nyc.gov with “CLUBHOUSE RSVP” in the subject line and their attendee name/email address. Written comments can be submitted to RFP@health.nyc.gov by July 21^st, with “Clubhouse Concept Paper” in the subject line of the email.

HRSA Announces $15 Million Pediatric Specialty Loan Repayment Program
On June 9^th, the Health Resources and Services Administration (HRSA) announced the new Pediatric Specialty Loan Repayment Program, which offers a total of $15 million to recruit and retain pediatric clinicians. The program will provide up to $100,000 for each eligible clinician in pediatrics, pediatric surgery, or child and adolescent behavioral care in exchange for three years of work in an approved facility. Facilities may become approved if they operate as an outpatient or inpatient facility and:

• Are located in a health professional shortage area (HPSA) or medically underserved area (MUA), or
• Provide care to a medically underserved population.

The application is available here. Applications will be accepted through July 20^th.