Weekly Health Care Policy Update – August 14, 2023

August 21, 2023

In this update:

  • Legislative Updates
    • Senators Probe IRS on Hospitals Tax Exempt Status
    • Senate Majority Leader Outlines Fall Agenda
  • Federal Agencies
    • CMS Pauses No Surprises Dispute Resolution Following District Court Ruling
    • CMS Issues FY 2024 Hospital Inpatient Payment Final Rule
    • DEA to Hold Listening Sessions on Telemedicine Prescription of Controlled Substances
    • CMS Leaders Describe Accountable Care Strategy in Health Affairs Post
    • CMS Issues FY 2024 SNF Payment Final Rule
    • CMS Releases 2024 Projected Part D Premium and Bid Information
    • HHS Releases Report Showing All-Time Low Uninsured Rate
    • HRSA Awards $100 Million For Nursing Workforce
    • HRSA Awards $30 Million to Expand Early Childhood Services 
  • Other Updates
    • KFF Publishes Reports on Medicare Advantage Trends
    • ASPE Releases Hospital Ownership Data Analysis
    • U.S. News Publishes 2023-2024 Hospital Honor Roll
  • New York State Updates
    • DOH Announces Continuation of Medicaid Telehealth Coverage Policies
    • OMH Releases Telehealth Standards of Care Document
    • SED Issues Emergency Rule on Referral Requirements for Occupational Therapists
    • OPWDD Requests Stakeholder Survey Responses on Five-Year Strategic Plan
  • Funding Opportunities
    • NYHealth Opens RFP Process for 2024 Special Projects Fund
    • OMH Releases RFP for Housing First Scattered Site Supportive Housing for Homeless Adults
    • DOH Releases SOI for Provision of Harm Reduction Services Via Telemedicine
    • OASAS Releases RFA for Comprehensive Integrated Outpatient Treatment Programs
    • OMH Issues School-Based Mental Health Satellite Clinic Expansion RFA

Legislative Updates

Senators Probe IRS on Hospitals Tax Exempt Status 
On August 7th, Senators Elizabeth Warren (D-MA), Raphael Warnock (D-GA), Bill Cassidy (R-LA), and Charles Grassley (R-IA) sent letters to IRS Commissioner Daniel Werfel, Tax Exempt and Government Entities Division Commissioner Edward Killen, and Treasury Inspector General for Tax Administration J. Russell George expressing their concern about high levels of medical debt and their desire for increased transparency and oversight of nonprofit hospitals that hold a portion of such debt. The authors believe that some nonprofit hospitals are taking advantage of an “overly broad definition of ‘community benefit’ and engaging in practices that are not in the best interest of the patient.” The letters highlight news reports of health systems’ aggressive debt collection practices, and question whether charity care spending is equivalent to the value of having tax-exempt status.
 
In the letters, the Senators ask for hospital community benefit information that is “standardized, consistent, and easily identifiable,” a list of the most commonly reported community benefit activities, and a list of hospitals that were flagged, penalized, or had their tax-exempt status revoked for violating community benefits standards requirements. They also seek information on whether hospitals are making reasonable efforts to determine whether patients are eligible for financial assistance before initiating collections practices.
 
Both letters are available here.
 
Senate Majority Leader Outlines Fall Agenda
On July 31st, Senate Majority Leader Chuck Schumer (D-NY) outlined his agenda for the chamber’s next work period, set to begin on September 5th. In addition to passing legislation to keep the government funded past the end of the federal fiscal year on September 30th, Schumer identified four bipartisan priorities on which the Senate will pursue legislation, one of which is insulin pricing.
 
Several senators have introduced potential insulin legislation, including a bill by Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME) and a bill by Senators Raphael Warnock (D-GA) and John Kennedy (R-LA). The Shaheen/Collins bill would cap out-of-pocket insulin costs for individuals with private insurance at $35 or 25% of the list price per month for at least one insulin in each type and dosage form. The Warnock/Kennedy bill would extend this cost cap to uninsured individuals, while the Shaheen/Collins bill includes additional provisions related to biosimilars.

Federal Agencies

CMS Pauses No Surprises Dispute Resolution Following District Court Ruling
On August 8th, the Centers for Medicare & Medicaid Services (CMS) paused the independent dispute resolution process, established under the No Surprises Act, in response to a U.S. District Court ruling invalidating portions of that process. The case is the fourth challenge to the No Surprises Act brought by the Texas Medical Association.

On August 3rd, U.S. District Court for the Eastern District of Texas Judge Jeremy Kernodle vacated portions of the dispute resolution process. Specifically, Kernodle ruled that increasing the administrative fee to $350 (from $50) and “batching requirements,” which bundle multiple claims with the same service code into one dispute, violated federal rulemaking requirements. As a result, CMS paused the independent dispute resolution process for all disputes except those initiated in 2022 as well as those initiated in 2023 where the administrative fees were paid before August 3, 2023. This is the second time this year the agency has paused the process in response to lawsuits. CMS is evaluating its dispute resolution processes and procedures and indicates more information will be available soon.

The District Court ruling is available here. Information from CMS about the pause in the independent dispute resolution process is available here.

CMS Issues FY 2024 Hospital Inpatient Payment Final Rule 
On August 1st, CMS issued the fiscal year (FY) 2024 Medicare Hospital Inpatient Prospective Payment System (IPPS) final rule. Overall, general acute care hospitals will receive a 3.1% increase in operating payment rates, or a total of $2.2 billion, so long as they participate in the Hospital Inpatient Quality Reporting (IQR) program and are meaningful electronic health record (EHR) users. This increase is the result of a 3.3% market basket update and a 0.2 percentage point productivity adjustment. CMS notes that hospitals may be subject to additional payment adjustments within the Hospital Readmissions Reduction Program, the Hospital Acquired Condition Reduction Program, or the Hospital Value-Based Purchasing Program.

Disproportionate share hospital (DSH) payments and Medicare uncompensated care payments are projected to decrease by $957 million. In addition, CMS estimates that additional payments for inpatient cases involving new medical technologies will decrease by $364 million, due to the expiration of new technology add-on payments for several technologies. Additional policies include: 

  • Low-Wage Policy: CMS will continue temporary policies finalized in the FY 2020 IPPS/LTCH PPS final rule to address wage index disparities affecting low-wage index hospitals.
  • Health Equity: CMS is adding 15 new health equity hospital categorizations.
  • Social Determinants of Health: CMS finalized a change to the severity designation of the three diagnosis codes describing homelessness from non-complication or comorbidity (NonCC) to complication or comorbidity (CC), based on the higher average resource costs of cases with these diagnosis codes compared to similar cases without these codes.
  • Hospital Inpatient Quality Reporting (IQR): CMS is adding three new measures (pressure injury, acute kidney injury, and excessive radiation dose or inadequate image quality for diagnostic computed tomography) and removing three measures (hospital-level risk-standardized complication rate following elective primary total hip/knee arthroplasty, Medicare spending per beneficiary hospital, and elective delivery prior to 39 weeks’ gestation).
  • HCAPS: CMS will allow for three new web-first modes of survey implementation, removal of the survey’s prohibition on proxy respondents, extension of the data collection period from 42 to 49 days, limiting the number of supplemental survey items to 12, requiring the official Spanish translation for Spanish language-preferring patients, and removing two administration methods that are not used by participating hospitals.
  • Hospital-Acquired Condition Reduction Program: CMS will establish a validation reconsideration process for hospitals that failed to meet data validation requirements. Additionally, it will modify the targeting criteria for data validation to include hospitals that received an Extraordinary Circumstances Exception (ECE) during the data periods.
  • Hospital Value-Based Purchasing (VBP) Program: CMS will adopt the severe sepsis and septic shock management measure, a health equity scoring change for rewarding excellent care in underserved populations, and make changes to the MSPB Hospital measure, as well as the total knee/hip complication measures.

The final rule is available here and a fact sheet is available here.

DEA to Hold Listening Sessions on Telemedicine Prescription of Controlled Substances
On August 7th, the Drug Enforcement Agency (DEA) announced it will conduct two public listening sessions on telemedicine prescription of controlled substances. Earlier this year, DEA proposed to return to pre-Covid regulations on telemedicine prescription which would have required an in-person patient evaluation to be conducted first in almost all cases, which was met with significant public opposition. As a result, on March 1st, DEA retracted its proposal and extended Covid-era flexibilities.

DEA now seeks feedback on safeguards that could “effectively prevent and detect diversion of controlled substances prescribed via telemedicine.” In the meeting notice, DEA offers several specific questions for public feedback, including: 

  • What safety framework should DEA establish for prescribing Schedule III-V medications without a requirement for an in-person examination?
  • Are there any situations for which DEA should establish exceptions allowing prescribing of Schedule II medications without an in-person examination?
  • What data reporting requirements related to telemedicine prescribing should be placed on (1) prescribers and (2) pharmacies?

DEA further notes it “is open to considering” a Special Registration that would allow certain controlled substances to be prescribed via telemedicine without an in-person patient evaluation.

The listening sessions will be held September 12th and 13th at DEA’s headquarters in Arlington, Virginia, with remote participation also available via livestream. Registration is required and is available here. The meeting notice is available here and a press release is available here.

CMS Leaders Describe Accountable Care Strategy in Health Affairs Post
On July 31st, Purva Rawal, Douglas Jacobs, Elizabeth Fowler, and Meena Seshamani, all leaders at CMS, published a Health Affairs blog post describing the progress toward CMS’s accountable care strategy and areas CMS is exploring in 2023 to accelerate access to accountable care organizations (ACOs), especially for beneficiaries in rural and underserved areas.

CMS remains focused on its goal that by 2030, 100% of beneficiaries in traditional Medicare should be in accountable care relationships. The authors note that the rate of primary care providers in ACOs is an important predictor of success. As a result, the agency may explore ACO-based primary care models that provide prospective payments and support innovations that meet beneficiary needs and increase access to primary care in underserved areas. The authors also note the need for data sharing to facilitate the integration of specialty care with primary care. The Innovation Center is exploring providing CMS-generated standardized episode data and asking ACOs how this data could help them assess specialty care patterns to better manage beneficiary care needs and costs. Finally, the authors describe the importance of ACOs in advancing health equity, the first pillar of CMS’ strategic plan. There has been a “significant increase” in ACO participation among safety net providers, such as critical access hospitals, federally qualified health centers, and rural health centers.

The blog post may be found here.

CMS Issues FY 2024 SNF PPS Final Rule
On July 31st, CMS issued a final rule outlining changes to the PPS and Consolidated Billing for Skilled Nursing Facilities (SNFs) for FY 2024. The final rules are generally effective October 1, 2023, with the exception of changes to billing by certain mental health providers, which are effective January 1, 2024. Notably, this final rule does not include regulations related to minimum staffing requirements, which will be issued separately.

CMS estimates that payments to SNFs will increase by approximately 4.0%, or $1.4 billion, in FY 2024, resulting from a 6.4% increase in the net market basket update ($2.2 billion), a negative 0.2% productivity adjustment, and a negative 2.3% decrease in PPS payment rates resulting from the second phase of the Patient Driven Payment Model (PDPM) parity adjustment recalibration. The 6.4% market basket update is itself comprised of a 3.0% SNF market basket update plus a 3.6% market basket forecast error adjustment.

As required by the Consolidated Appropriations Act of 2023, CMS is finalizing regulatory changes to exclude marriage and family therapist (MFT) and mental health counselor (MHC) services from SNF consolidated billing so that these services may be billed separately by the clinician. These changes are effective January 1, 2024.

Changes to the SNF Quality Report Program (QRP) and Value-Based Purchasing (VBP) Program include: 

  • SNF QRP: CMS finalized changes to the SNF QRP including adopting two measures (Discharge Function Score and Percent of Patients/Residents Who Are Up to Date on COVID-19 Vaccine), removing three measures (Application of Functional Assessment/Care Plan, Change in Self-Care Score, and Change in Mobility Score), and modifying one measure (Health Care Personnel COVID-19 Vaccine). After considering public comments, CMS is not adopting the COREQ: Short Stay Discharge measure. Further, beginning in FY 2026, CMS is increasing the SNF QRP Data Completion thresholds for the Minimum Data Set.
  • SNF VBP: Changes to the SNF VBP program include adopting four new measures (Nursing Staff Turnover, Discharge Function Score, Long Stay Hospitalization, and Percent of Residents Experiencing One or More Falls with Major Injury), replacing  one measure (Skilled Nursing Facility 30-Day All Cause Readmission will be replaced with Skilled Nursing Facility Within Stay Potentially Preventable Readmission), and finalizing several policy changes, including adopting a Health Equity Adjustment beginning with the FY 2027 program year and increasing the payback percentage policy beginning with the FY 2027 program year.

The final rule is available here and a fact sheet is available here.

CMS Releases 2024 Projected Part D Premium and Bid Information
On July 31st, CMS announced the 2024 projected Part D premium and national average bid amount. Based on submitted plan bids, CMS projects that the national average monthly premium for Medicare Part D will be approximately $55.50 in 2024, a decrease of 1.8% from 2023, when the national average monthly premium was $56.49. CMS attributes the decline in premiums largely to two policies from the Inflation Reduction Act: (1) a premium stabilization provision and (2) improvements to the basic Part D benefit, including the cap on annual out-of-pocket costs, limited cost-sharing for covered insulin products, and zero cost-sharing for adult vaccines.

A press release on the projected Part D premium is available here and a fact sheet is available here. Information on the Part D national average monthly bid amount and other rates and benchmarks that influence plan bids is available here.

HHS Releases Report Showing All-Time Low Uninsured Rate 
On August 3rd, HHS released a report showing that the national uninsured rate hit at an all-time low of 7.7% in the first quarter of 2023. The report analyzes data from the National Health interview survey and the American Community Survey. It shows that 6.3 million Americans have gained coverage since 2020. Split by age group, the uninsured rate was 11.0% for adults and 4.2% for children.

The Administration attributes the low rate to the American Rescue Plan Act’s enhanced Marketplace subsidies, the Inflation Reduction Act’s continuation of such subsidies, the continuous enrollment condition in Medicaid, recent state Medicaid expansions, and substantial Marketplace enrollment outreach. Insurance gains were largest among individuals with incomes below 100% of the federal poverty line (FPL) and those between 200% and 400% FPL.

More information, including a link to the full report, is available here.

HRSA Awards $100 Million For Nursing Workforce
On August 10th, the Health Resources and Services Administration (HRSA) announced the award of more than $100 million to address the increasing demand for registered nurses, nurse practitioners, certified nurse midwives, and nurse faculty. The goal of the funding is to train more nurses and grow the nursing workforce. The money will be distributed across four programs: 

  • $8.7 million for the Nurse Education, Practice, Quality and Retention-Pathway to Registered Nurse Program;
  • $34.8 million for the Advanced Nursing Education Workforce Program;
  • $30 million for the Advanced Nursing Education-Nurse Practitioner Residency and Fellowship Program; and
  • $26.5 million for the Nurse Faculty Loan Program.

Funding recipients in New York include The Research Foundation for the State University of New York, Community Healthcare Network, The Institute for Family Health, Mary Imogene Bassett Hospital, the University of Rochester, Columbia University, Adelphi University, and Pace University.

More information is available here.

HRSA Awards $30 Million to Expand Early Childhood Services  
On August 9th, the Health Resources and Services Administration (HRSA) announced the award of $30 million to 151 HRSA-funded health centers to improve developmental outcomes among children ages 0 to 5. The funding is intended to strengthen and expand the availability of early childhood services including increased screenings and follow-up services, with a goal of reducing gaps in school readiness and improving children’s ability to succeed.

Downstate New York recipients include the Bronx Community Health Network, Union Community Health Center, Sunset Park Health Council, Charles B. Wang Community Health Center, William F. Ryan Community Health Center, Northern Oswego County Health Services, and Refuah Health Center.

More information on the grant is available here. A list of grantees is available here.

Other Updates

KFF Publishes Reports on Medicare Advantage Trends
On August 9th, the Kaiser Family Foundation published a pair of reports on the Medicare Advantage (MA) program, analyzing enrollment and premium information, as well as other trends, for 2023. This year, 30.8 million beneficiaries are enrolled in an MA plan, more than half (51%) of the eligible Medicare population. MA accounted for 54% ($454 billion) of total federal Medicare spending (net of premiums). This year, beneficiaries have access to an average of 43 MA plans, the largest choice set ever. The share of beneficiaries enrolled in Medicare Advantage varies widely by county and enrollment is highly concentrated among a small number of firms, with UnitedHealthcare and Humana accounting for nearly half (47%) of enrollment nationwide and at least 75% of enrollment in nearly one-third (32%) of all counties.

More than seven in 10 (73%) of enrollees in individual MA plans with prescription drug coverage pay only the Medicare Part B premium (no additional premium is required for enrollment), and most enrollees have access to benefits not covered by traditional Medicare, such as vision, hearing, and dental benefits. Seventy-one percent of MA enrollees are in plans with four or more stars. More than half of all MA plans earned 4 stars or higher for 2023.

The report on MA enrollment and key trends is available here, and the report on premiums, supplemental benefits, star ratings, and more is available here.

ASPE Releases Hospital Ownership Data Analysis
On August 7th, the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) published a report analyzing data on hospital ownership. The analysis is based on CMS’s December 2022 publication. The report finds that: 

  • Of the 4,644 Medicare-enrolled hospitals, 49% are not-for-profit, 36% are for-profit, and 15% are government-owned.
  • Most hospitals (56%) are part of a chain or system of hospitals with at least three separate hospital facilities. Nine chains have at least 50 hospitals each.
  • Individuals have about 8% ownership of hospitals, as opposed to nearly 50% of ownership of SNFs. Most SNF and hospital ownership does not overlap.

The full report is available here.

U.S. News Publishes 2023-2024 Hospital Honor Roll 
On August 1st, U.S. News and World Report published its 2023-2024 list of “Honor Roll” hospitals. For the first time, the publication did not rank hospitals based on overall performance, instead recognizing 22 hospitals “with unusual competence taking into account the full range of adult inpatient care.” In New York, Honor Roll hospitals included Mount Sinai Hospital, New York-Presbyterian Hospital-Columbia and Cornell, North Shore University Hospital at Northwell Health, and NYU Langone. 

New York hospitals also rated highly on these specialty lists: 

  • NYU Langone: Cardiology & Heart Surgery (#5), Diabetes & Endocrinology (#2), Gastroenterology & GI Surgery (#4), Geriatrics (#2), Neurology & Neurosurgery (#1), Orthopedics (#4), Pulmonology & Lung Surgery (#3), Rehabilitation (#5), Rheumatology (#8), Urology (#3)
  • New York-Presbyterian: Cardiology & Heart Surgery (#6), Diabetes & Endocrinology (#3), Gastroenterology & GI Surgery (#7), Geriatrics (#7), Neurology & Neurosurgery (#3), Orthopedics (#5), Psychiatry (#3), Rheumatology (#2), Urology (#6)
  • Mount Sinai: Cardiology & Heart Surgery (#4), Gastroenterology & GI Surgery (#6), Geriatrics (#1), Neurology & Neurosurgery (#9)
  • North Shore University Hospital – Northwell: Orthopedics (#10), Pulmonology & Lung Surgery (#10)

The full rankings are available here.

New York State Updates

DOH Announces Continuation of Medicaid Telehealth Coverage Policies
On July 31st, the New York State Department of Health (DOH) announced that New York State Medicaid will continue to provide comprehensive coverage of telehealth through December 31, 2024. Prior to the federal Covid-19 public health emergency (PHE), which ended May 11th, Medicaid permitted a more limited range of providers to provide certain types of telehealth services, including audio-visual, store-and-forward, and remote patient monitoring at certain facilities. Since then, however, DOH has: 

  • Expanded coverage of audio-only telephonic services;
  • Added virtual patient education and virtual check-ins; and
  • Authorized all Medicaid providers to provide telehealth, if telehealth services are within the provider’s scope of practice and are an appropriate option for the required care.

DOH last updated specific telehealth guidance for the post-PHE period in February 2023 (available here). This extension is expected to continue these policies until final guidance is issued or until the end of 2024.

DOH’s press release is available here.

OMH Releases Telehealth Standards of Care Document
On August 2nd, the New York State Office of Mental Health (OMH) released a Telehealth Standards of Care (SOC) document (available here), which outlines core and exemplary telehealth practices. Failure of an OMH provider to comply substantially with core standards may result in the provider being required to develop a performance improvement plan or be subjected to other regulatory enforcement actions. The standards align with the current 14 NYCRR Part 596 Telehealth regulations (available here) and OMH Telehealth Services Guidance for Providers, which was released in April (available here; SPG’s summary is available here).

The SOC is effective as of May 12th, and OMH will begin using the SOC in certification reviews starting August 1st.

SED Issues Emergency Rule on Referral Requirements for Occupational Therapists 
On August 2nd, the New York State Education Department (SED) issued an emergency rule to allow licensed occupational therapists to provide treatment for a limited time without a referral from a physician or nurse practitioner. Treatment can be provided for 10 visits or 30 days, whichever occurs first, provided that the: 

  • Occupational therapist has at least three years of full-time practice experience; and
  • Each patient receives written notice that the therapy may not be covered by a health plan without a referral. A form attesting to the patient’s notice of such advice must be maintained in the patient’s record.

It is anticipated that the rule will be presented to the Board of Regents for permanent adoption at the November 2023 Regents meeting. Public comments can be submitted to Sarah S. Benson at REGCOMMENTS@nysed.gov by October 1st. The text of the proposed regulations is available in the State Register (available here).

OPWDD Requests Stakeholder Survey Responses on Five-Year Strategic Plan
On August 8th, the New York State Office for People with Developmental Disabilities (OPWDD) issued a survey, available here, to gather input from stakeholders and community partners on the progress of OPWDD’s 2023-2027 Strategic Plan, which describes the agency’s policy goals for supports and services for individuals with developmental disabilities, their families, and service providers.

The strategic plan was published last November and is available here. Feedback will be used to assist in future planning efforts and communications.

DOH Proposes Relaxed Requirements for Expanded Syringe Access Programs
On August 2nd, DOH proposed a rule to remove certain regulatory requirements for Expanded Syringe Access Programs (ESAPs), which are pharmacies, health care facilities, and health care practitioners that furnish hypodermic syringes/needles without a prescription, in order to prevent the reuse of syringes and decrease the spread of HIV and hepatitis C.

Specifically, the proposed rule aims to:   

  • Remove the requirement that ESAPs may only furnish a quantity of 10 or fewer syringes at a time;
  • Remove the requirement that ESAP providers must register with DOH; and
  • Allow ESAPs to advertise to the public the availability of syringes.

Public comments can be submitted to Katherine Ceroalo at resqna@health.ny.gov by October 1st. The text of the proposed regulations is available in the State Register (available here).

Funding Opportunities

NYHealth Opens RFP Process for 2024 Special Projects Fund 
On August 8th, the New York Health Foundation (NYHealth) released a Request for Proposals (RFP) for the first cycle of the 2024 Special Projects Fund, which provides one-time, nonrenewable grants for the implementation of innovative projects that support NYHealth’s mission to improve the health of all New Yorkers, especially populations who have been historically marginalized.

Eligible applicants are not-for-profit 501(c)(3) organizations or for-profit organizations with a significant ability to have impact in New York State. Applicants can request funding amounts between $50,000 to $300,000, with most grants in the $250,000 range. Approximately five to fifteen awards are made annually.

Projects selected for funding should have a strong potential for replication and should be sustainable after the grant period. Projects are not permitted to address any of the following areas, which are addressed by separate NYHealth grants: 

  • Healthy Food, Healthy Lives;
  • Veterans’ Health; and
  • Primary Care.  

A list of previously awarded projects is available here. The full RFP is available here and an FAQ is available here. Online letters of inquiry (LOIs) are mandatory and are due on September 12th by 1pm. Selected applicants will be invited to submit full proposals, which are due by November 16th. The Foundation will open a second funding cycle in 2024.

OMH Releases RFP for Housing First Scattered Site Supportive Housing for Homeless Adults 
On August 9th, the New York State Office of Mental Health (OMH) released an RFP for the development and operation of 10 Housing First scattered-site Supportive Housing programs serving individuals experiencing homelessness and who have been referred by Safe Options Support (SOS) Teams or Assertive Community Treatment (ACT) teams. While mental health or other diagnostic criteria are not required to access housing through this initiative, referred individuals may have a mental illness diagnosis, a substance use disorder, and/or physical health care needs.

The supportive housing programs will be sited in 10 counties/county groupings, including Nassau/Suffolk, Westchester, and Ulster/Sullivan. The remaining counties are listed in the RFP. Each awarded applicant is expected to provide 25 scattered-site units per county/county grouping. Units are typically studios or one-bedroom apartments. Supportive housing staff will work with tenants on housing retention, community integration and recovery.

Eligible applicants are 501(c)(3) not-for-profit agencies that have demonstrable experience in operating housing social services for individuals experiencing homelessness. Funding will be a combination of client rent payments (with residents required to pay 30% of their net income) and OMH operating funding, as described below:   

  • Nassau/Suffolk: $30,000 annually per unit
  • Westchester: $28,000 annually per unit
  • Ulster/Sullivan: $23,000 annually per unit

Funding amounts for the remaining counties are listed in the RFP. Operating contracts are for five years. Awarded agencies have eight months from the date of contract approval to develop all awarded units.

The full RFP is available here. Applications are due by September 27th. Questions may be submitted to Carol Swiderski at OMHLocalProcurement@omh.ny.gov with the subject line “Housing First Scattered Site Supportive Housing for Homeless Adults” by August 28th.

DOH Releases SOI for Provision of Harm Reduction Services Via Telemedicine
On August 8th, the DOH AIDS Institute announced a solicitation of interest (SOI) for a not-for-profit licensed medical practice to provide telehealth services for medications for addiction treatment or medications for opioid use disorder (MAT/MOUD) for individuals experiencing opioid use disorder throughout NYS.

The awarded organization must meet the following criteria: 

  • Has a minimum of five years of experience providing MAT/MOUD, at which at least two years should include experience with telemedicine modalities;
  • Has a minimum of two years contracting with a government entity;
  • Has experience with the AIDS Institute Reporting System (AIRS);
  • Provides medical services and social services to underserved populations, including low-threshold access to buprenorphine and naloxone, mental health services, trauma-informed care, primary care, and sexual and reproductive health services; and
  • Has experience working with syringe service programs.

Funding for this project is not guaranteed and is contingent on the availability of State funds. The anticipated contract term is two years, beginning December 1st, and the resulting contract will be a cost-reimbursable contract.

The SOI is available here. Interested eligible organizations should submit a completed Checklist, Application Cover Sheet, and a document (no more than four pages) describing the organization’s background, capacity and experience via email to Michele Kerwin at AIGPU@health.ny.gov by August 29th.   

OASAS Releases RFA for Comprehensive Integrated Outpatient Treatment Programs
Last month, the Office of Addiction Services and Supports (OASAS) released a Request for Applications (RFA) for the development of Comprehensive Integrated Outpatient Treatment Programs. These programs consist of co-located OASAS Part 822 Outpatient Services and Part 822 Opioid Treatment Programs (OTP) and make available all covered outpatient services (including assessments, counseling, MAT services other than methadone, medical services, and support services) to enrolled patients. The outpatient and OTP programs must be fully integrated in terms of services, programmatic space, and staffing; however, they separately submit billing and reporting through two Program Reporting Units (PRUs). A total of $8.382 million is available in one-time funding for 15 awards.

Eligible applicants are voluntary agencies, local governmental units (LGUs), or other not-for-profit organizations that are OASAS-certified providers. Funding will be made as one-time awards to providers under the following four group types to cover operating expenses, which may include items such as up to one calendar quarter of payroll and fringe for staff: 

  • Group A (four awards): Up to $374,000 for each existing co-located Part 822 Outpatient and Part 822 OTPs programs.
  • Group B (four awards): Up to $660,000 for each existing Part 822 Outpatient programs who have already applied or intend to apply for Part 822 OTP services.
  • Part C (three awards): Up to $402,000 for each existing Part 822 OTPs who have already applied or intend to apply for Part 822 Outpatient program services.
  • Part D (four awards) Up to $760,000 will be made available for existing Part 822 Outpatient programs OR existing Part 822 OTPs who intend to create a new Comprehensive Integrated Outpatient Treatment Programs at a new location separate from their existing location.

Providers must obtain full approval from OASAS, the United States Drug Enforcement Administration (DEA), and the Federal Substance Abuse and Mental Health Services Administration (SAMHSA) to apply for and operate an OTP. For Groups B, C, and D, providers must have applied for services or will apply within four months of the grant contract execution, or funds will be rescinded. Awarded applicants may receive up to a 25% advance of the contract value, with subsequent reimbursements contingent upon successful submittal and approval of expense reports.

The following are not eligible for funding (this applies to the specific PRU and not to all agency programs): 

  • NYS-funded Certified Community Behavioral Health Clinics (CCBHCs);
  • Outpatient rehabilitations;
  • Proprietary entities; and
  • Applicants who have Part 822 Outpatient and/or Part 822 OTPs certificate/applications that are hosted by OMH or DOH but not OASAS.

The RFA is available here. Applications are due by August 29th and should be submitted to Grants@oasas.ny.gov with the subject line: RFA – OASAS SETT-23016, “Provider Name”. Responses to current provider questions have been posted here.

OMH Issues School-Based Mental Health Satellite Clinic Expansion RFA 
On August 3rd, OMH released an RFA to support recently implemented or newly created school-based Mental Health clinic satellites that promote direct and timely access for students and their families to needed mental health treatment and coordinated care.

Each awarded satellite will receive $25,000 in start-up funding and, if established in a high-needs district, an additional $20,000 in funding, for a total of $45,000. For the purpose of this RFA, OMH has identified high-needs districts as having at least 50% of the student population classified as economically disadvantaged. OMH plans to make as many as 332 awards, totaling $8.3 million. The awarded contracts will be for two years, beginning January 1, 2024.

Eligible applicants are current OMH-licensed Mental Health Outpatient Treatment and Rehabilitative Services (MHOTRS) providers serving children/adolescents and who meet one of the following criteria: 

  • Aims to create a new school-based mental health satellite location(s) in the 2023-2024 school year;
  • Has already submitted a Prior Approval Review (PAR) to operate a satellite location; or
  • Has been issued an operating certificate for a new satellite location(s) which opened in the 2022-2023 school year or is projected to start in the 2023-2024 school year.

Applicants can submit one application for each new satellite location that will be newly opened or recently implemented. Upon approval of the application, providers that have not already submitted a PAR will be required to submit an EZ PAR for approval by OMH. To expedite processes, eligible applicants may opt to begin the PAR process concurrent to the application review. All applicants are required to secure a Letter of Support from the school where the satellite(s) will be located.

SPG’s summary of this funding opportunity is available here. The full RFA is available here. Applications are due by October 5th. Questions may be emailed to Carol Swiderski at OMHLocalProcurement@omh.ny.gov with the subject line “School Based MH Clinic RFA” by August 22nd.