Weekly Health Care Policy Update – April 15, 2022

In this update: 

• Covid-19 Updates
  • HHS Extends Public Health Emergency through July 15^th
  • HRSA Announces $1.75 Billion in Provider Relief Fund Payments
  • Department of Agriculture Announces $43 Million for Rural Health Providers
• Administration Update
  • White House Announces Initiative on Medical Debt
• Congressional Updates
  • Lawmakers Unveil Insulin Priorities
• Federal Agencies
  • CMS Releases FY 2023 Skilled Nursing Facility Proposed Payment Rule
  • CMS Updates Independent Dispute Resolution Guidance, Launches Portal
  • CMS Says “Birthing-Friendly” Hospital Designation Will Initially Represent Participation in Maternal QI Collaborative
  • HHS Issues RFI on Environmental Justice Strategy and Implementation Plan
• Other Federal
  • MedPAC Holds Monthly Meeting
  • MACPAC Holds Monthly Meeting
  • Lown Institute Says Most Nonprofit Hospitals’ Tax Exemptions Are Greater Than Charity Care
• Congressional Hearings
• New York State Updates
  • DOH Releases Strategic Health Equity Reform Payment Arrangements 1115 Waiver Amendment Proposal
  • NYS Legislature Passes FY 2023 Enacted Budget
  • Brett Friedman Stepping Down as NYS Medicaid Director
  • CMS Approves SPA Adding Pharmacy Interns as Immunizers and Office-Based Reimbursement for Diabetes Self-Management Training
• Funding Opportunities
  • Mother Cabrini 2022 Statewide Grants Program Application Period Begins April 18^th
  • HRSA Announces $226.5 Million for the Community Health Worker Training Program
  • HRSA Issues NOFO for $9 Million to Expand State Maternal Health Innovation Program
  • OMH Offers One-Time Grants for Community and Treatment Supports

COVID-19 Updates

HHS Extends Public Health Emergency through July 15^th
On April 13^th, Secretary of Health and Human Services (HHS) Xavier Becerra renewed the federal Covid-19 Public Health Emergency (PHE) declaration under the Public Health Service Act for another 90 days. The PHE is now scheduled to expire July 15^th, if not further extended.
 
HHS has continued its commitment to providing at least 60 days’ notice of the expiration of the PHE. When the PHE expires, various Covid-19 policies will also lapse or begin to phase out. Specifically, if the PHE expires on July 15^th: 

• Coverage of Covid-19 testing, vaccines, and (in some cases) certain treatments without cost-sharing in Medicare, Medicaid, and private insurance will end.
• Medicare payment flexibilities, including the 20% increase in payment rates for inpatient stays with a Covid-19 diagnosis, will end.
• Emergency waivers, such as Appendix K and Disaster State Plan Amendments, will expire or begin to phase out based on their individual provisions.
• State Medicaid programs would be required to begin initiating eligibility redeterminations no later than August 1^st.
• The 6.2% enhanced federal Medical Assistance Percentage (FMAP) would expire at the end of the quarter (September 30^th).
• Current Medicare telehealth flexibilities, including the lifting of geographic restrictions, would expire 151 days after the PHE (December 13^th).

The HHS announcement is available here. 
 
HRSA Announces $1.75 Billion in Provider Relief Fund Payments
On April 13^th, the Health Resources and Services Administration (HRSA) announced more than $1.75 billion in Provider Relief Fund (PRF) payments to 3,680 providers across the country. To date, HRSA has distributed $21 billion of the $25.5 billion in Round 4 PRF and rural funding for which HHS opened applications in September 2021. Approximately 92% of all Phase 4 applications have now been processed. The remaining applications require additional manual review. PRF payments received in the first half of 2022 can be used until June 20, 2023.
 
The HHS press release, including links to state-by-state breakdowns of Phase 4 and American Rescue Plan Rural payments, as well as a public dataset on all individual providers who have agreed to the terms and conditions of Phase 4 payments, can be found here.
 
Department of Agriculture Announces $43 Million for Rural Health Providers
On April 13^th, the U.S. Department of Agriculture announced the establishment of a new initiative under the Emergency Rural Health Care Grants program to expand access to Covid-19 vaccines, testing, and supplies for rural hospitals and providers. Initial awards will total $43 million and will be distributed to 93 rural health care organizations and community groups across 22 states, including one entity, Lewis County General Hospital, in New York. The funds are being made available through the American Rescue Plan Act with additional awards announcements planned for the coming months.
 
The list of awardees can be found here. More information on the Emergency Rural Health Care Grants program can be found here.

Administration Updates

White House Announces Initiative on Medical Debt
​​On April 11^th, the Biden Administration announced an initiative to “protect consumers and lessen the burden of medical debt.” Most notably, the Administration announced that HHS will request data from a set of “more than 2,000” providers on their billing practices, including: 

• Collection practices;
• Lawsuits against patients;
• Financial assistance;
• Financial product offerings; and
• Third party contracting or debt buying practices.

HHS intends to use this information as a factor in future grantmaking decisions. It will also publish data and policy recommendations and share potential violations with enforcement agencies.
 
Other parts of the Administration’s initiative include: 

• The Administration will issue guidance to federal agencies to disregard medical debt as a factor for underwriting in credit programs, whenever possible and consistent with law.
• The Veterans Administration (VA) will streamline processes to forgive medical debt. This accompanies a recent rule under which the VA will no longer report its medical debts to credit reporting agencies.
• The Consumer Financial Protection Bureau (CFPB) will increase efforts to educate consumers on their rights and the ability to submit complaints on medical debt through the CFPB website.

More details on the initiative are available here.

Congressional Updates

Lawmakers Unveil Insulin Priorities
On April 11^th, a bipartisan group of lawmakers released a proposed set of policy priorities intended to address insulin costs. The group included Senate Diabetes Caucus Co-chairs Jeanne Shaheen (D-NH) and Susan Collins (R-ME), in partnership with House Diabetes Caucus Co-chairs Diana DeGette (R-CO) and Tom Reed (R-NY). The proposal specifically prioritized the following policies:

• Incentivizing insulin manufacturers to roll prices back to 2006 or equivalent levels by prohibiting insurance plans and pharmacy benefit managers from collecting rebates on insulins at those prices;
• Making such insulins eligible for cost-sharing protections, including a waiver on any applicable deductible and a limit on copays or coinsurance of $35 per month;
• Ensuring that prior authorization or other medical management requirements cannot be imposed to limit beneficiary use; and
• Ensuring that group and individual market health plans waive any deductible and limit cost-sharing to no more than $35 per month, for at least one insulin of each type and dosage form. 

The proposal can be found here. Other stakeholders are invited to submit feedback to insulin@shaheen.senate.gov by April 20^th. In addition, Senators Shaheen and Collins invited other Senators to provide feedback as they finalize the proposed legislation. Their Dear Colleague letter is available here.

Agency Updates

CMS Releases FY 2023 Skilled Nursing Facility Proposed Payment Rule
On April 11^th, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule updating Medicare payment policies and rates for skilled nursing facilities (SNFs) in fiscal year (FY) 2023. Overall, Medicare Part A payments to SNFs would decrease by approximately $320 million in FY 2023. This amount reflects the net impact of a proposed increase in payment rates of 3.9%, due to market basket and productivity adjustments, and a 4.6% reduction in rates related to recalibration of the Patient Driven Payment Model (PDPM). The PDPM, when implemented, was intended to be budget-neutral, but CMS has observed an increase in payments of approximately 5% ($1.7 billion in FY 2020), and the 4.6% reduction adjusts for this. CMS notes that this proposed adjustment reflects stakeholder feedback to better account for the impact of Covid-19 on SNFs.
 
The proposed rule also includes several Requests for Information (RFIs), notably: 

• Revising Staffing Requirements for Long-Term Care (LTC) Facilities: CMS seeks input on establishing minimum staffing requirements for LTC facilities. CMS intends to propose minimum staffing standards within one year.
• Coding Infection Isolation: CMS seeks comment on the degree to which the current criteria for coding infection isolation should be expanded to allow cohorts of patients to be included and to ensure consistency of the payment rate impact of infection isolation with the increase in the relative costliness of patients who require isolation.
• SNF Value-Based Payment (VBP) program: CMS seeks comment on including a staffing turnover measure in the FY 2024 SNF PPS proposed rule. CMS also seeks input on guiding principles to assess disparities in health care quality in the SNF VBP program and on how to tie equity outcomes to SNF payments.

The rule also includes several direct policy proposals: 

• Permanent cap on wage index decreases: As in in other recent proposed payment rules, CMS proposes a permanent 5% cap on annual wage index decreases to help smooth annual changes in these payments.
• Proposed changes to PDPM ICD-10 code mapping: CMS proposes changes to how ICD-10 codes are used to assign patients to clinical categories under several PDPM components, including the Physical Therapy, Occupational Therapy, Speech Language Pathology, and Non-Therapy Ancillary components.

The rule also proposes several changes to the SNF Quality Reporting Program (QRP), including: 

• Adopting the Influenza Vaccination Coverage among Healthcare Personnel (HCP) measure, beginning in FY2025;
• Revising the compliance date for some SNF QRP reporting requirements, including the Transfer of Health Information measures and some standardized patient assessment data, to October 1, 2023;
• Seeking input on two future measure concepts: 
  • A functional outcome measure that includes both self-care and mobility items, and
  • A Covid-19 vaccination coverage measure assessing whether SNF residents are up to date on Covid-19 vaccination; and
• Requesting information on the development and inclusion of a health equity measure for the SNF QRP.

Finally, the rule proposes changes to the SNF VBP program, including: 

• Suppressing the SNF 30-day all-cause readmission measure for FY 2023, due to the impact of Covid-19;
• A proposed special scoring policy which would result in all qualifying SNFs receiving an identical incentive payment multiplier and eliminate ranking for the FY 2023 SNF VBP program; and
• Adding three new measures: 
  • In FY 2026, a SNF Healthcare Acquired Infections (HAI) Requiring Hospitalization measure and a Total Nursing Hours per Resident Day Staffing measure, and
  • In FY 2027, adding a Discharge to Community-Post-Acute Care measure.

The proposed rule may be found here. Comments are due June 10^th. In addition, a fact sheet on the proposed rule is available here and a press release may be found here.
 
CMS Updates Independent Dispute Resolution Guidance, Launches Portal
On April 12^th, CMS issued new guidance for independent dispute resolution (IDR) entities participating in the federal IDR process. This process was established under the No Surprises Act to handle disputes between providers and payers involved over: 

• Out-of-network charges for emergency services;
• Nonemergency services provided by an out-of-network individual provider at an in-network facility; and
• Out-of-network air ambulance services (emergency or nonemergency).

The original guidance was struck down by a federal judge in February. The new guidance revises the controversial provision that the median in-network rate should generally be the IDR’s presumption for resolution. Instead, IDRs must now take into account any “credible information” submitted by the parties. Credible information may not include a provider’s usual and customary charges or the amount that would be paid by government payers, including Medicare or Medicaid.
 
These provisions largely do not apply in New York because it has its own state-based IDR process, which is being brought into compliance with the No Surprise Act through legislation included in the 2023 Enacted Budget. Current guidance from the Department of Financial Services (DFS) indicates that in New York, only air ambulance services will be subject to the federal IDR process.
Today (April 15^th), CMS launched the web-based Federal IDR Portal. By submitting information through the Portal, organizations may begin the IDR process for covered services within 4 business days after the end of the 30-business-day open negotiation period between the provider and payer.
 
The new IDR guidance is available here. The federal IDR portal is available here.
 
CMS Says “Birthing-Friendly” Hospital Designation Will Initially Represent Participation in Maternal QI Collaborative
On April 13^th, CMS released more details about its proposed “Birthing-Friendly” hospital designation to assist consumers in choosing hospitals that have “demonstrated a commitment to maternal health and the delivery of high-quality maternity care.” Initially, the Birthing-Friendly designation will be based on a hospital’s attesting to the Hospital Inpatient Quality Reporting (IQR) Maternal Morbidity Structural Measure. CMS views this measure as a first step and will expand the criteria required for the Birthing-Friendly designation in the future.
 
The Maternal Morbidity Structural Measure assesses whether a hospital: 

• Participates in a Statewide or National Perinatal Quality Improvement (QI) Collaborative Program, such as the Alliance for Innovation on Maternal Health (AIM); and
• Implements patient safety practices related to maternal morbidity from that QI Collaborative.

The IQR began collecting this data in October 2021, and CMS will issue the first release of the measure data in fall 2022. CMS will then make the first Birthing-Friendly designations in fall 2023. Additional details will be released as part of the Hospital Inpatient Prospective Payment System (IPPS) proposed rule.
 
The announcement is available here.
 
HHS Issues RFI on Environmental Justice Strategy and Implementation Plan
On April 8^th, HHS issued an RFI seeking input on a draft outline of its 2022 Environmental Justice Strategy and Implementation Plan, which seeks to “identify priority actions and strategies to best address environmental injustices and health inequities.” The plan includes six strategic elements. Some goals HHS has established within these areas include:

1. Services 
   • Expand funding opportunities to disadvantaged communities for economic development and social services.
   • Raise awareness of the availability of technical assistance for applying for HHS funding to persons with disproportionately high and adverse environmental exposures.
2. Partnerships and Community Engagement 
   • Establish partnerships with disadvantaged communities to assess potential health risks.
   • Seek partnerships to ensure that disadvantaged communities can effectively participate in and benefit from federally funded public health and social service programs without discrimination.
3. Policy Development and Dissemination 
   • Provide home cooling, weatherization, and energy assistance to communities disproportionately affected by extreme weather events.
   • Fund and implement training and workforce development programs in relevant areas.
4. Research and Data Collection, Analysis, and Utilization 
   • Support research that explores factors contributing to minority health disparities, including but not limited to environmental factors.
   • Create an environmental justice and social vulnerability data dashboard to track and address environmental burden and health inequities in disadvantaged communities.
5. Education and Training 
   • Provide training and technical assistance to disadvantaged communities at higher risk for exposure to harmful environmental and health hazards.
6. Performance Measures 
   • Develop milestones and provide periodic progress to demonstrate accountability and progress.

HHS seeks feedback on these six strategic elements, as well as any additional strategies to include in the Environmental Justice Strategy and Implementation Plan.
 
The RFI can be found in the Federal Register here. Comments will be accepted until May 19^th.

Other Federal

MedPAC Holds Monthly Meeting
On April 7^th and 8^th, the Medicare Payment Advisory Commission (MedPAC) held its monthly meeting. Commissioners did not take any formal votes during the meeting, but discussed staff presentations and offered guidance on future work. The Commission considered the following topics: 

• Part B drug pricing: Commissioners seemed generally supportive of staff recommendations regarding a cap on Part B payments for drugs based on comparative clinical and cost effectiveness and modifications to the average sales price add-on payment. However, the Chair pointed out that this was a preliminary discussion and did not include all the policy options the Commission is considering.
• Part D data on drug rebates and discounts: Staff provided an update on initial steps taken to validate and analyze direct and indirect remuneration (DIR) data collected by CMS, to which MedPAC was recently granted access.
• Segmentation in the stand-alone Part D Prescription Drug Plan market: Staff presented on practices used by Part D plans to target different segments of the market within a Part D region. Commissioners seemed to agree that the proposal to require insurers to treat enrollees as a single risk pool requires further examination.
• Policies to address social determinants of health (SDH): Staff presented their research into Medicare’s incentives for addressing SDH and findings that value-based payments are a useful tool in driving work to address SDH of Medicare beneficiaries.
• Streamlining alternative payment models (APMs): Commissioners continued an ongoing conversation on how to operationalize its June 2021 recommendation to Congress that CMS harmonize its portfolio of APMs and conduct fewer models. In general, Commissioners favor reducing the number of population-based payment model tracks, eliminating the “rebasing” of ACO spending benchmarks, using an exogenous growth factor to trend ACO spending benchmarks forward, and operating a national episode-based payment model concurrently with ACOs.
• Aligning fee-for-service (FFS) payment rates across ambulatory settings: Commissioners discussed Medicare’s separate payment systems for three ambulatory settings, how payment often differs for the same service provided in a different setting, and issues that must be addressed when attempting to align rates across settings.

MedPAC’s annual report to Congress is due this June. The Commission’s next public meeting is scheduled for September 1^st and 2^nd.  Slides from the April meeting may be found here.
 
MACPAC Holds Monthly Meeting
On April 7^th and 8^th, the Medicaid Access and Payment Advisory Commission (MACPAC) held its monthly public meeting. Commissioners voted to approve a package of recommendations to: 

• Create new approaches to monitoring access to care for Medicaid beneficiaries;
• Improve vaccine access for adult Medicaid beneficiaries;
• Improve oversight and transparency of directed payments in Medicaid managed care; and
• Encourage adoption of health information technology (HIT) in behavioral health.

These recommendations will be included in MACPAC’s June 2022 report to Congress.
 
The Commission also discussed other topics, including: 

• MACPAC’s response to the CMS RFI on Access to Care and Coverage (covered in SPG’s February 18^th update here).
• A draft chapter on advancing health equity in Medicaid.
• A review of state-directed payments, which included recommendations that HHS should publicly publish directed payment approvals, managed care rate certifications, and evaluations and otherwise tighten disclosure and evaluation requirements on such payments.
• An analysis of churn and coverage transitions for Medicaid beneficiaries. Staff noted that, prior to the Covid-19 PHE, about 8 percent of Medicaid enrollees churned (enrolled and re-enrolled) within a 12-month period, and only about 4 percent of disenrolled beneficiaries enrolled in Exchange coverage.
• A review of state practices for Medicaid managed care procurement.

Slide presentations from the meeting are available here. The Commission will next meet on September 15^th and 16^th.
 
Lown Institute Says Most Nonprofit Hospitals’ Tax Exemptions Are Greater Than Charity Care
On April 12^th, the Lown Institute released a report on “fair share deficits” among not-for-profit health systems, which found that more than 80% of such systems have such a deficit, defined as spending less on charity care and community investment than the value of their tax exemptions. The report studied 275 health care systems, 227 of which had a deficit, totaling $18.4 billion in aggregate. It was based on calculations using 2019 IRS Form 990 data, using a “fair share” standard of 5.9% of overall expenditures on charity care and community investment compared to the estimated value of the health system’s tax exemption. Among the 50 states and the District of Columbia, New York was ranked 49^th out of 51 in terms of total fair share deficit (not taking into account population or total spending).
 
The full report is available here.

Congressional Hearings

No major health care-related hearings are scheduled next week. The House and Senate are in recess through April 22^nd.

New York State Updates

DOH Releases Strategic Health Equity Reform Payment Arrangements 1115 Waiver Amendment Proposal
On April 13^th, the New York State (NYS) Department of Health (DOH) published its proposal for a new 1115 Waiver amendment entitled “Strategic Health Equity Reform Payment Arrangements” (SHERPA), which is based on the concept paper DOH submitted to CMS in August 2021. Through this proposal, DOH is requesting $13.52 billion to be reinvested over five years with the goal of “addressing health disparities and systemic health care delivery issues” and transforming the Medicaid program’s approach to paying for services to address both health needs and social care needs (SCN). Specifically, the waiver proposal seeks to achieve the following four goals: 

• Build a more resilient, flexible, and integrated delivery system that reduces racial disparities, promotes health equity, and supports the delivery of social care;
• Develop and strengthen supportive housing services and alternatives to institutions for the homeless and long-term care populations;
• Redesign and strengthen system capabilities to improve quality, advance health equity, and address workforce shortages; and
• Create statewide digital health and telehealth infrastructure.

DOH proposes for the waiver amendment to go into effect on January 1, 2023.
 
SPG’s summary of the proposal is available here. The full text of the draft amendment is here. DOH is holding two virtual hearings as opportunities for public feedback, on April 28^th from 1pm-4pm (registration here) and May 3^rd from 1pm-4pm (registration here). DOH will accept written comments or requests to testify at the hearings at 1115waivers@health.ny.gov.
 
NYS Legislature Passes FY 2023 Enacted Budget
On April 9^th, the NYS Legislature passed the Enacted Budget for State FY 2022-23. Total spending across all sources (including NYS and federal funds) is estimated at approximately $221 billion, up from the Executive Budget’s proposal of $216 billion, and a year-over-year increase from SFY 2022 of about $9 billion. 
 
Some notable changes in the Enacted Budget from Governor Hochul’s Executive Budget include:  

• Medicaid Procurement: The proposed competitive procurement of Medicaid managed care organizations (MCOs) has been removed, but DOH will commission an independent study on this topic to be delivered by October 31^st.
• Medicaid Eligibility: The Budget proposed to expand eligibility thresholds and abolish resource limits in Medicaid. The former proposals have been accepted and extended to create new definitions for partial dual eligibles and to include adults over 65 regardless of immigration status. However, the abolition of resource limits has been removed.
• Workforce and Scope of Practice: The Budget does not include the Governor’s proposals to:  
  • Join the Interstate Medical and Nurse Licensure Compacts;
  • Move oversight of health care professions from the State Education Department (SED) to DOH; and
  • Reform emergency medical services and implement community paramedicine.
• Home Care Minimum Wage: The Budget includes a commitment to increase minimum wages for home care aides by $3 per hour by October 2023.

Other major proposals have been included, but with modifications. These include:  

• Capital Funding: The Budget includes the proposed $1.6 billion for health care capital projects, with a wider array of eligible providers.
• Workforce Bonuses: The Budget includes the proposed $1.2 billion for health care workforce bonuses, with more specific requirements for implementation.

SPG’s detailed summary of the Enacted Budget is available here.
 
Brett Friedman Stepping Down as NYS Medicaid Director
On April 8^th, New York Medicaid Director Brett Friedman submitted a letter of resignation (available here) to DOH Commissioner Mary T. Bassett. Friedman will step down effective May 27^th after being with DOH for over two and a half years. His responsibilities will transition to Deputy Medicaid Director Amir Bassiri.
 
A statement from Commissioner Bassett is available here.
 
CMS Approves SPA Adding Pharmacy Interns as Immunizers and Office-Based Reimbursement for Diabetes Self-Management Training
On April 11^th, CMS approved a Medicaid SPA submitted by New York which sought to: 

• Add pharmacy interns to “Other Practitioner Services,” allowing them to administer immunizations, effective July 1, 2021; and
• Reimburse for Diabetes Self-Management Training (DSMT) services in an office-based setting when ordered by certain health care professionals, effective October 1, 2021.

The SPA is available here. The CMS approval letter is available here.

Funding Opportunities

Mother Cabrini 2022 Statewide Grants Program Application Period Begins April 18^th
The Mother Cabrini Foundation online grants portal for its Statewide Grants Program will open on April 18^th and will accept Letters of Inquiry through May 13^th. Through this program, the Foundation annually provides awards to support not-for-profit organizations based in New York that sponsor activities, programs, and initiatives to enhance access to affordable, high-quality health care and related services. The Foundation focuses on funding programs that provide services to the following communities:  

• Young children, pregnant women, and new mothers;
• Low-income individuals and families;
• Youth and young adults;
• Older adults;
• Persons with special needs;
• Immigrants and migrant workers;
• Veterans; and
• Formerly incarcerated individuals.

In 2021, the Foundation awarded $140 million across 450 grantees (full list available here), in addition to $20 million for emergency Covid-19 programs (full list available here). The application process has not changed from prior years. Current grantees will be required to submit a Letter of Inquiry for any renewal requests.
 
The Foundation will host an applicant webinar on April 26^th at 3pm. Registration is available here. Applicants will be notified in June if selected to submit a full proposal and final award decisions will be made in the fall. Additional information is available here.
 
HRSA Announces $226.5 Million for the Community Health Worker Training Program
Today (April 15^th), HRSA launched a Notice of Funding Opportunity (NOFO) for the Community Health Worker Training Program (CHWTP), which will offer a total of $226.5 million for training and employment opportunities for community health workers (CHWs). The CHWTP seeks to train 13,000 new or existing CHWs through activities including: 

• Recruitment of new CHW candidates and provision of tuition and other supports;
• Extension and upskilling of existing CHWs to include core competencies for Public Health and Essential Public Health Services;
• Implementing community-based partnerships to provide field placements and on-the-job experiential training through apprenticeship programs; and
• Addressing health equity by filling community needs that can be met by CHWs and increasing the diversity of the CHW workforce.

Applicants may apply for up to $3 million in total (up to $1 million per year over three years), for a contract period from September 15, 2022 through September 14, 2025. Eligible applicants may include: 

• Health professions schools;
• Academic health centers;
• State or local governments; or
• Any other appropriate public or private non-profit entity, such as community-based organizations.

The NOFO is available here. Applications are due June 14^th. Questions on general program issues may be submitted to MSmithey@hrsa.gov, and questions related to business, administrative, or fiscal topics may be submitted to nassar@hrsa.gov.
 
HRSA Issues NOFO for $9 Million to Expand State Maternal Health Innovation Program
On April 13^th, HRSA issued a NOFO for up to $9 million to expand the State Maternal Health Innovation and Data Capacity program. Each applicant will receive up to $1 million to support state capacity to improve maternal health by addressing critical gaps in: 

• Direct clinical care;
• Workforce training;
• Maternal health data enhancements; and
• Community engagement.

Eligible applicants may be any domestic public or private entity, but applications must be submitted in collaboration with a state or territory and will require an appropriate letter of support. The first nine awards, made in 2019, were made to seven state health or public health agencies and two universities. New York has not yet received an award under this program. Only one project will be funded per state, and the state must be one of the 44 states (including New York) participating in the Alliance for Innovation in Maternal Health (AIM).
 
Applicants will be expected to: 

• Establish a State-Focused Maternal Health Task Force to assemble data and identify service gaps;
• Improve state-level maternal health data and surveillance;
• Improve the collection, reporting, and analysis of AIM data; and
• Promote and execute innovation in maternal health service delivery.

The NOFO is available here. Applications are due June 13^th. HRSA will hold a technical assistance webinar on May 3^rd. Questions on general program issues may be submitted to KSherman@hrsa.gov, and questions related to business, administrative, or fiscal topics may be submitted to JDyson@hrsa.gov.
 
OMH Offers One-Time Grants for Community and Treatment Supports
On April 5^th, the New York State Office of Mental Health (OMH) released two Requests for Applications (RFA) for one-time funding to expand services and activities that support children and families with significant mental health needs. Through these opportunities, OMH will provide $4 million in total funding for the expansion of both treatment and non-treatment services for children and families that: 

• Have been considerably impacted by rates of Covid-19; 
• Are identified as being high needs (e.g., homelessness, food insecurity, etc.); and/or 
• Are disenfranchised or marginalized populations (e.g., racial/ethnic minorities).

This funding is made available through supplemental funding allocated by the federal Coronavirus Response and Relief Supplemental Appropriations Act to the Mental Health Block Grant program.
 
The first opportunity will provide one-time grants of $30,000 to not-for-profit community-based organizations to expand non-licensed mental health-oriented support services. The second opportunity will provide one-time grants of $40,000 to OMH licensed agencies to expand or enhance treatment support services. 
 
The community services RFA is available here (SPG summary here) and the treatment services RFA is available here (SPG summary here). Applications for both opportunities are due on July 1^st. Applications will be reviewed in the order received and funding will be distributed on a first come, first serve basis until funds are exhausted.