Weekly Health Care Policy Update – September 13, 2022

September 20, 2022

In this update: 

  • Administration Updates
    • Biden Administration Requests Supplemental Covid and Monkeypox Funding, Outlines Fall Vaccine Plan
    • Biden Issues Executive Order on Biotechnology and Biomanufacturing
  • Federal Agencies
    • CMS Seeks Feedback on Payment Policies and Quality Programs
    • CMS Announces Approval of Oregon SPA for BH Crisis Services, Encourages Other States to Apply
    • DHS Finalizes Reversion of Public Charge Rule to Pre-Trump Standards
    • CMS and CFPB Issue Report and Letter on Nursing Homes and Debt Collectors
    • CMS Issues Notice to MA and Part D Plans on Reflecting New Limits on Cost-Sharing for Insulin and Vaccines
    • OIG Finds Hispanic and Dual Eligible Beneficiaries Were More Likely to Use Medicare Telehealth Under Covid Flexibilities
    • OIG Releases Report on Medicare Telehealth Program Integrity Risks
  • Other Updates
    • Texas Judge Invalidates Parts of ACA’s Preventive Care Provisions
    • MACPAC Announces Agenda for September Meeting
  • New York State Updates
    • Governor Hochul Plans to End Covid and Health Care Staffing Shortage Emergency Declarations
    • Governor Hochul Announces Availability of Bivalent Vaccines
    • Governor Hochul Declares Statewide Disaster Emergency due to Polio
    • DOH Revises Requirements for Indoor Masking in Health Care Settings
    • NYS Submits 1115 New York Health Equity Reform Waiver Amendment Proposal to CMS
  • Funding Opportunities
    • OMH Releases RFP for Round 7 of ESSHI Supportive Housing Operating Funding
    • SAMHSA Announces NOFO to Support Violence Prevention and Community Youth Engagement
    • SAMHSA Announces NOFO to Support Mental Health and Wellness of School-Aged Youth

Administration Updates

Biden Administration Requests Supplemental Covid and Monkeypox Funding, Outlines Fall Vaccine Plan
On September 2nd, the Biden Administration announced that it will work with Congress on developing a short-term continuing resolution (CR) to continue funding the government after the end of the federal fiscal year on September 30th. As part of this request, the Administration included a supplemental funding request of about $47 billion in emergency funding “to meet four critical needs”: Covid, monkeypox, support for Ukraine, and natural disaster recovery. Roughly half of the funding, $22.4 billion, would be dedicated to purchasing and developing next-generation vaccines and treatments for Covid. Another $4.5 billion would be dedicated to purchase and distribution of Jynneos, the monkeypox vaccine. However, Senate Republicans have already indicated their opposition to the public health funding, largely eliminating the chance it will be enacted before the midterm elections.
 
On September 8th, the Administration outlined its plan for rolling out updated Covid vaccines in the fall, which includes continuing to offer free vaccinations at community sites, offering the flu shot and updated Covid vaccine at the same time, engaging in outreach and education activities, stockpiling at-home tests, and expanding Test to Treat sites (including a telehealth Test to Treat pilot program). The plan notes that “to the extent that Congress fails to fund ongoing needs, we are forced to accelerate transitioning procurement and distribution” of Covid tests, treatments, and vaccines to the commercial market.
 
A fact sheet on the Administration’s fall plan is available here. A summary of the Administration’s funding request is available here.
 
Biden Issues Executive Order on Biotechnology and Biomanufacturing
On September 12th, President Biden issued an Executive Order to launch a National Biotechnology and Biomanufacturing Initiative whose goal is to “ensure we can make in the United States all that we invent in the United States.” As part of the Initiative, the Department of Health and Human Services (HHS) will develop a report assessing how biotechnology and biomanufacturing can be used “to achieve medical breakthroughs, reduce the overall burden of disease, and improve health outcomes.” HHS will also establish a Biosafety and Biosecurity Innovation Initiative seeking to reduce biological risks related to life sciences research.
 
The full text of the Executive Order is available here. A fact sheet on the proposal is available here.

Legislative Update

Senate Passes Inflation Reduction Act
On August 7th, the Senate passed the Inflation Reduction Act of 2022 on a party-line vote (51-50). The major health care provisions in this version of the Act were largely unchanged from the previous draft versions, focused on prescription drug pricing and an extension of the enhanced Marketplace subsidies from the American Rescue Plan (ARP) through plan year 2025. The major prescription drug provisions include:

  • In Medicare Part D, removal of the 5 percent coinsurance above the catastrophic threshold in 2024, and establishment of an overall $2,000 cap on out-of-pocket Medicare Part D costs starting in 2025.
  • The Drug Price Negotiation Program, which will allow the Centers for Medicare and Medicaid Services (CMS) to negotiate drug prices for certain high-cost drugs in Medicare. 
    • The Program would begin in 2026, with negotiations on up to 10 drugs, increasing by 2028 to cover up to 20 drugs.
    • Only single-source drugs that have been approved for at least 9 years (or 13 years for biologicals) and are among the 50 highest-cost drugs (by total expenditures) under Part B or Part D would be eligible for selection, except for insulin products, which would be eligible throughout.
    • The Program would establish a ceiling for possible negotiated prices. The ceiling would be a percentage (between 40 and 75 percent) of the average manufacturer price in 2021, adjusted for inflation.
    • Manufacturers who do not offer a price under the ceiling may be subject to civil monetary penalties. Additionally, if negotiations continue for too long, an increasing excise tax on the drug’s revenues may be applied.
    • 340B purchasers would be able to purchase drugs at the lower of the 340B price or the Medicare negotiated price.
  • A requirement that manufacturers of drugs whose prices increase faster than inflation provide a rebate to Medicare (whether Part B or Part D), starting in 2023. Unlike in the original version, this will not apply to private insurance.
  • A maximum monthly cost-sharing for insulin of $35 in Medicare, starting in 2023. Starting in 2026, the cap could be lowered to either 25 percent of the established maximum fair price or 25 percent of the negotiated Medicare price, if these are lower than $35.
  • Removal of the phase-in of the Low Income Subsidy (LIS) between 135 and 150 percent of the federal poverty line (FPL), so that all individuals with incomes up to 150 percent of FPL are eligible for the full LIS.
  • A cap of 6 percent on premium increases in Part D.

The bill will now move back to the House of Representatives for consideration this week. The full text of the bill is available here.

Federal Agencies

CMS Seeks Feedback on Payment Policies and Quality Programs
On September 6th, the Centers for Medicare and Medicaid Services (CMS) issued a Request for Information (RFI) seeking feedback from stakeholders, including patients and providers, to better understand experiences with CMS payment policies and quality programs. CMS is particularly interested in “how existing and proposed CMS payment policies and quality programs impact the experience of healthcare” in the areas of: 

  • Accessing healthcare and related challenges: “Personal perspectives and experiences” of challenges related to accessing care. These could include different types of services (including long-term care, home and community-based services, and behavioral health services) and challenges related to geography, culturally appropriate care, or plan enrollment and insurance coverage, among other topics.
  • Understanding provider experiences: “Factors impacting provider well-being,” such as burnout and fatigue. CMS cites the increasing use of digital health technology, feedback on compliance with payment policies, and impact of policies on patient panel selection or willingness to serve certain populations.
  • Advancing health equity: “Individual and community-level burdens, health-related social needs, and recommended strategies to address health inequities.” This includes how CMS can mitigate any disparities caused by its policy and program requirements; how CMS can address potential algorithmic bias in health technology; and “how CMS coverage and payment policies impact providers, suppliers, and patients,” especially with respect to the treatment of chronic conditions and care for dual eligibles.
  • The impact of Covid waivers: CMS wants to understand which flexibilities offered under public health emergency (PHE) were helpful, “including requested waivers/flexibilities to make permanent,” as well as any unintended consequences of such flexibilities.

Stakeholders can download the full RFI and submit comments here. The RFI will be open until November 4th.
 
CMS Announces Approval of Oregon SPA for BH Crisis Services, Encourages Other States to Apply
On September 12th, the Centers for Medicare and Medicaid Services (CMS) announced the approval of the Oregon Health Authority’s proposal for a State Plan Amendment (SPA) to cover community-based mobile behavioral health crisis intervention services in Medicaid. These services are intended to be integrated with law enforcement responses, allowing trained behavioral health crisis teams to substitute for police in cases where individuals do not pose a danger to others. The American Rescue Plan (ARP) offers states an 85 percent Federal Medical Assistance Percentage (FMAP) for such services for five years, from April 2022 through March 2027. Providers will be reimbursed through a statewide fee schedule. The SPA is estimated to draw down approximately $5.7 million in federal funding per year.
 
Oregon submitted the SPA in July 2022 and is now the first state to have such a SPA approved. These services have operated in Eugene, Oregon as the Crisis Assistance Helping Out on the Streets (CAHOOTS) program since 1989. In the press release, CMS “strongly encourages other states to follow Oregon’s model” in expanding these services.
 
The proposed SPA is available here and the approval package is here. A press release is available here.
 
DHS Finalizes Reversion of Public Charge Rule to Pre-Trump Standards
On September 8th, the Department of Homeland Security (DHS) issued a final rule updating DHS’s process for making determinations that an immigrant is inadmissible due to being a “public charge.” The final rule reverts to the understanding of “public charge” used for decades prior to the Trump Administration.
 
Under the public charge framework, a noncitizen could be considered inadmissible if they were “likely at any time to become a public charge,” meaning someone “likely to become primarily dependent on the government for subsistence.” However, this definition generally does not include non-cash benefits such as Medicaid or nutrition assistance. This final rule formally codifies this historical understanding of the term. The determination will now return to being based only on personal criteria (such as age, health, family status, and assets) and a limited subset of public services. Specifically, an individual may still be considered a public charge if the individual has received or is receiving: 

  • Cash assistance through Supplemental Security Income;
  • Income maintenance under the Temporary Assistance for Needy Families program;
  • Assistance under State, Tribal, territorial, or local cash benefit programs for income maintenance; or
  • Long-term institutionalization at government expense.

This determination will not consider benefits received by family members. DHS will be developing a Policy Manual update to help with the application of this regulation.
 
The final rule will be effective December 23rd. More information is available here.
 
CMS and CFPB Issue Report and Letter on Nursing Homes and Debt Collectors
On September 8th, CMS and the Consumer Financial Protection Bureau (CFPB) issued a report highlighting “some of the difficulties and experiences heard from caregivers about being pursued over friends’ or family members’ alleged debts from nursing home facilities.” The report highlights how certain “questionable” contract provisions and debt collection tactics have subjected caregivers to wage garnishment and even loss of their homes.
 
In addition to issuing the report, CMS and the CFPB sent a letter to nursing facilities and debt collectors reminding them of their responsibilities under the Nursing Home Reform Act, the Fair Debt Collections Practices Act, and the Fair Credit Reporting Act. Together, these laws: 

  • Prohibit nursing facilities from requesting or requiring a third party to personally guarantee payment to a facility as a condition of a resident’s admission or continued stay in the facility;
  • Prohibit debt collectors from attempting to collect invalid debts based on unenforceable contract provisions; and
  • Prohibit all persons from reporting such invalid debts to consumer reporting agencies

The letter warns that nursing facilities that violate such requirements may be subject to enforcement action by state agencies and by CMS.
 
The report can be found here. The letter can be found here. 
 
CMS Issues Notice to MA and Part D Plans on Reflecting New Limits on Cost-Sharing for Insulin and Vaccines
On September 6th, CMS issued a notice through the Health Plan Management System (HPMS) to Medicare prescription drug plan sponsors on new requirements for marketing materials related to drug provisions in the Inflation Reduction Act. Under the Act, Part D plans must limit insulin cost-sharing to $35 and may not require any out-of-pocket spending for vaccines, among other changes. The memorandum requires that Medicare Advantage (MA) and Part D enrollee materials—including benefit summaries, member handbooks, and websites—reflect the changes made by the law before open enrollment begins on October 15th, and requires that insurers notify enrollees about the new insulin and vaccine coverage policies by September 30th. CMS says it will not take compliance action to enforce the requirements in the notice.
 
CMS’s archive of HPMS memos is available here, although this memo has not yet been posted.
 
OIG Finds Hispanic and Dual Eligible Beneficiaries Were More Likely to Use Medicare Telehealth Under Covid Flexibilities
On September 7th, the HHS Office of Inspector General (OIG) issued a data brief examining the characteristics of Medicare beneficiaries (including MA enrollees) who used telehealth during the first year of the Covid-19 pandemic (March 1, 2020, to February 28, 2021). The brief is a companion to a March 2022 OIG report that quantified a dramatic increase in telehealth use during the first year of the pandemic. The brief notes that telehealth users were more likely to live in urban areas. In addition, beneficiaries who were dually eligible, Hispanic, younger, or female were all more likely than others to use telehealth.
 
Almost one-fifth of telehealth users utilized audio-only services, and the “vast majority” of such beneficiaries did not use audiovisual or other telehealth services. Older beneficiaries, dual eligibles, and Hispanic beneficiaries were more likely to be in this category.
 
Based on these findings, OIG recommends that: 

  • CMS should establish long-term policies that support use of telehealth in urban areas and from a beneficiary’s home.
  • CMS should temporarily extend the use of audio-only telehealth services.
  • CMS should require a code modifier to identify audio-only telehealth services (to facilitate evaluation of their impact).
  • CMS should use telehealth to advance health care equity.

The most recent report on characteristics of Medicare telehealth users is available here, while the earlier March 2022 report that quantified telehealth use is available here.
 
OIG Releases Report on Medicare Telehealth Program Integrity Risks
On September 2nd, the HHS OIG released a report on program integrity risks in Medicare telehealth services during the first year of the Covid-19 pandemic. With this investigation, OIG analyzed Medicare provider billing and identified ways to safeguard Medicare from waste, fraud, and abuse related to telehealth services. OIG analyzed Medicare fee-for-service claims and MA encounter data from March 1, 2020 to February 28, 2021, focusing on approximately 742,000 providers who billed for a telehealth service. OIG established very high thresholds for seven measures that may indicate fraud, waste, and abuse in telehealth billing and identified 1,714 providers whose telehealth billing poses a high risk to Medicare. This group of providers billed telehealth services for approximately 500,000 Medicare beneficiaries, and many were part of the same medical practice as at least one other provider with high-risk billing activities. OIG notes that these providers represent a small proportion of all providers who billed for telehealth services.
 
OIG offered five recommendations to CMS, including that it should: strengthen monitoring and targeted oversight of telehealth services; provide additional provider education on appropriate billing; improve transparency of “incident to” services; identify telehealth-specific companies that bill Medicare; and follow up on the 1,714 providers OIG identified in its report.
 
The OIG report is available here.

Other Updates

Texas Judge Invalidates Parts of ACA’s Preventive Care Provisions
On September 7th, Judge Reed O’Connor of the United States District Court for the Northern District of Texas ruled that the process established under the Affordable Care Act (ACA) for deciding what services must be covered by health insurance companies at no cost under the law’s “preventive care” provision is unconstitutional. Judge O’Connor’s ruling claims that the U.S. Preventive Services Task Force, which under the ACA is responsible for making recommendations about what preventive services should be covered, violates the Constitution because its members are not yet appointed by the president or confirmed by the Senate. The ruling also agreed with the claim that requiring mandatory coverage of the HIV drug regimen PrEP violated the religious freedom of the plaintiff.
 
Judge O’Connor has a history of rulings against the constitutionality of the ACA, including his 2018 ruling that the entire ACA was unconstitutional because of the reduction of the individual mandate penalty to $0, which was overturned in 2021 by the Supreme Court in California v. Texas. The Biden Administration is expected to appeal.  
 
MACPAC Announces Agenda for September Meeting
On September 9th, the Medicare and CHIP Payment and Access Commission (MACPAC) released the agenda for its September meeting, which will be held on September 15th and 16th. Some notable topics to be covered include: 

  • Medicaid race and ethnicity data collection and reporting;
  • State processes and stakeholder engagement for unwinding the PHE’s Medicaid continuous coverage requirement;
  • Improving rate setting and risk mitigation in Medicaid managed care;
  • Principles for assessing Medicaid nursing facility payments relative to costs; and
  • Integrating care for dually eligible beneficiaries in Medicaid fee-for-service.

The full agenda can be found here.

New York State Updates

Governor Hochul Plans to End Covid and Health Care Staffing Shortage Emergency Declarations
On September 12th, Governor Hochul said that she will no longer extend New York’s emergency declarations related to Covid and health care staffing shortages. These declarations were established in, respectively, Executive Order 11, which declared an emergency due to projected spread of the Omicron variant, and Executive Order 4, which reinstated many workforce and scope of practice flexibilities that applied during the original New York State public health emergency related to Covid. Several provisions within these orders, such as those relating to the suspension of prior authorization and utilization review, had already been lifted.
 
Executive Order 11 expired today (September 13th), while Executive Order 4 is scheduled to expire September 27th. The expiration of Executive Order 11 ends the activation of the Surge and Flex Health Coordination system, which has required the postponement non-essential elective procedures for hospitals or systems with limited capacity (defined as having below 10% staffed bed capacity available). When Executive Order 4 expires, staffing flexibilities such as the ability for practitioners licensed out of state or in Canada to practice in New York and the ability for paramedics and emergency medical technicians (EMTs) to administer Covid vaccines will expire. More details on these flexibilities are described in SPG’s October 1, 2021 update here.
 
SPG will distribute an updated Waiver Timeline Tracker document detailing these changes next week.
 
Governor Hochul Announces Availability of Bivalent Vaccines
On September 7th, Governor Hochul announced the availability of bivalent Covid vaccine boosters, which are formulated to protect against Omicron BA.4 and BA.5 variants and bolster previous vaccination protection. To be eligible to receive the updated bivalent Covid booster, individuals must have completed their original vaccine series or received a booster at least two months before. Providers who pre-ordered and received the COVID-19 bivalent booster doses are now authorized to begin administering them in accordance with the FDA’s EUA. In accordance with federal guidance, monovalent mRNA COVID-19 vaccines are no longer authorized for use as boosters for people ages 12 years and older. The monovalent mRNA Pfizer COVID-19 vaccine remains authorized for use as boosters in children ages 5 through 11 and for all primary series vaccinations.

The Governor’s press release is available here.
 
Governor Hochul Declares Statewide Disaster Emergency due to Polio
On September 9th, Governor Hochul issued an Executive Order declaring a State Disaster Emergency due to the emerging poliovirus outbreak. DOH has detected poliovirus in wastewater samples collected in several counties, indicating community spread, and routine vaccination rates against polio have decreased throughout the COVID-19 pandemic. Although there is significant variance in vaccination rates among counties, the statewide vaccination rate against polio among 2-year-old children is 79%, which falls far short of DOH’s goal vaccination rate of over 90%. 
 
To facilitate efforts to administer vaccinations, the Executive Order implements the State Comprehensive Emergency Management Plan and temporarily suspends or modifies various regulations to: 

  • Allow certified emergency medical technicians (EMTs), paramedics, and advanced emergency medical services providers that provide community paramedicine to administer vaccinations against poliovirus pursuant to a non-patient specific order, including in non-emergency locations;
  • Allow midwives to administer vaccinations against poliovirus pursuant to a non-patient specific order under the medical supervision of licensed physicians, licensed physician assistants, or certified nurse practitioners;
  • Allow pharmacists to administer vaccinations against poliovirus pursuant to a non-patient specific order;
  • Permit physicians and certified nurse practitioners to issue a non-patient specific regimen to nurses or any individuals authorized by this Order to administer vaccinations against poliovirus;
  • Suspend the requirement that health care providers (including registered nurses, midwives, certified emergency medical technicians-paramedics, advanced EMS providers and pharmacists) who administer the poliovirus vaccine to individuals 19 years of age and older obtain consent of the vaccinee in order to report the vaccination to the City or State; and
  • Require all poliovirus vaccinations for any individual (child or adult) to be reported to the New York State Immunization Information System (NYSIIS) or the Citywide Immunization Registry (CIR) within 72 hours of administration.

The Executive Order is available here. The Order is effective through October 9th unless otherwise extended. The Department of Health has issued a press release on the outbreak, available here.
 
DOH Revises Requirements for Indoor Masking in Health Care Settings
On September 7th, the Department of Health (DOH) issued an updated determination on masking requirements, subject to applicable CDC exceptions. Under the new determination, mask requirements are rescinded in correctional facilities, shelters, and public transportation. However, in health care settings, mask requirements will continue as follows:

  • In hospitals, nursing homes, and other health care settings regulated by DOH and clinical and hospital settings regulated by the Office of Mental Health (OMH): 
    • All personnel, regardless of vaccination status, shall wear an appropriate face mask,
    • All visitors, regardless of vaccination status, who are at least 2 years old and who are able to medically tolerate a face covering/mask shall be required to wear a face covering/mask.
  • In adult care facilities (ACFs), Office for People with Developmental Disabilities (OPWDD)-Certified Specialty Hospitals, and Addiction Services Facilities regulated by the Office of Addiction Services and Supports (OASAS): 
    • All personnel providing direct medical care, regardless of vaccination status, shall wear an appropriate face mask. Other staff must wear, at a minimum, a cloth face covering.
    • All visitors, regardless of vaccination status, who are at least 2 years old and who are able to medically tolerate a face covering/mask shall be required to wear a face covering/mask.

The determination does not prevent local governments or health departments from imposing more stringent requirements.
 
The determination is available here.
 
NYS Submits 1115 New York Health Equity Reform Waiver Amendment Proposal to CMS
On September 2nd, the New York State Department of Health (DOH) submitted a final version of its proposal for a new Section 1115 demonstration amendment, now titled the New York Health Equity Reform (NYHER), to CMS.
 
In general, only limited changes have been made to the original draft, which was posted for public comment in April. The waiver still requests a total federal investment of $13.52 billion over five years. However, it now identifies a single “central goal” of reducing health disparities, advancing health equity, and supporting the delivery of social care, with the four previous goals relabeled as “strategies.”
 
SPG has prepared a document outlining changes between the draft and final submitted versions, which is available here. Our updated full summary of the waiver proposal is available here.

Funding Opportunities

OMH Releases RFP for Round 7 of ESSHI Supportive Housing Operating Funding
On September 8th, OMH released a Request for Proposals (RFP) for the seventh round of funding for supportive housing units under the Empire State Supportive Housing Initiative (ESSHI). As part of the State’s $20 billion housing plan to ensure that New Yorkers have access to affordable and safe housing, this RFP contributes to the goal of developing at least 20,000 supportive housing units over 15 years for individuals identified as homeless with special needs, conditions, or other life challenges.
 
This RFP will provide up to $35 million in service and operating funding for 1,400 units of permanent supportive housing for qualifying individuals identified as homeless with special needs, conditions, or other life challenges. Proposals may receive up to a maximum of $25,000 per qualifying individual/unit, and there is no maximum or minimum number of units that applicants may apply for. Support services that accompany the housing units may include, but are not limited to, employment and training opportunities, parenting education, primary and mental health care, and child care.
 
Eligible applicants are not-for-profit organizations with demonstrated experience in providing housing for the RFP’s target populations, including families, individuals, and/or young adults who are: 

  • Homeless or are at risk of homelessness;
  • Have an unstable housing history;
  • Have health, mental health, intellectual or developmental disability, and/or substance use disorders;
  • Have significant histories of mental health, foster care or criminal/juvenile justice involvement;
  • Have disabling conditions or life challenges that require specialized support services to become and remain stably housed.

Applications where more than 50% of ESSHI units are dedicated to the following underserved populations will be scored more favorably: 

  • Chronically homeless persons;
  • Families, individuals, and/or young adults that have mental health and/or substance use disorders; and
  •  Victims/survivors of domestic violence.

No capital funds are available through this RFP. Therefore, applicants are expected to secure capital funding sufficient to fully finance the housing project for which they are requesting ESSHI funding within 24 months from the receipt of the conditional funding award. Applicants may use capital funding mechanisms such as the New York State Homes and Community Renewal (HCR), government agencies, private sources, or partnerships with a project developer.
 
The RFP is available here. Applications are due by October 26th at 2pm. A bidder’s webinar will be held on September 13th at 2pm. Registration is available here. Written questions are due by September 26th at 2pm and should be emailed to Carol Swiderski at carol.swiderski@omh.ny.gov.
 
SAMHSA Announces NOFO to Support Violence Prevention and Community Youth Engagement
On September 1st, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a Notice of Funding Opportunity (NOFO) for the 2022 Resiliency in Communities After Stress and Trauma (ReCAST) initiative. This program supports evidence-based violence prevention and community youth engagement programs in communities that have recently faced civil unrest, community violence, and/or collective trauma. ReCAST initiatives should be guided by community-based coalitions of residents, not-for-profit organizations, and other entities (e.g., health and human service providers, schools, local government, etc.).
 
Through this opportunity, SAMHSA will award $10 million in total annual funding to 10 awardees (up to $1 million annually per awardee). Contracts will last for four years, starting on December 31st. Eligible applicants include public or private not-for-profit community-based organizations. Awarded entities will be responsible for convening and engaging a diverse coalition of community stakeholders, conducting a community needs and resource assessment, developing and implementing a community strategic plan, and identifying and implementing trauma-informed behavioral health services.
 
The NOFO is available here. Applications are due on October 17th.
 
SAMHSA Announces NOFO to Support Mental Health and Wellness of School-Aged Youth
On August 26th, SAMHSA released a NOFO for the 2022 Project AWARE (Advancing Wellness and Resiliency in Education) program. This program supports the development of a sustainable infrastructure for school-based mental health programs and services. Grant recipients will be expected to build collaborative partnerships with education agencies, the State Mental Health Agency, community-based behavioral health care providers, schools, community organizations, and school-aged youth and their families. Programs will leverage these partnerships to implement mental health-related promotion, awareness, prevention, intervention, and resilience activities.
 
Through this opportunity, SAMHSA will award $37.6 million in annual funding to 20 awardees (up to $1.8 million annually per awardee). Contracts will last for four years, starting on December 31st. Eligible applicants include health facilities and domestic public or private not-for-profit entities.
 
The NOFO is available here. Applications are due on October 13th.