Governor Hochul’s Executive Order on COVID-19 Vaccine Access | |
Dear Friends and Colleagues,
On September 5th, Governor Kathy Hochul issued an Executive Order declaring a Statewide Disaster Emergency to protect access to COVID-19 vaccines in New York, following recent federal actions that have threatened vaccine access. This order is currently effective through October 5, 2025.
Key provisions of the Executive Order expand vaccine access by enacting the following in New York State:
- Physicians and nurse practitioners may issue patient-specific or non-patient-specific orders authorizing pharmacists to administer COVID-19 vaccines to people aged three (3) and older.
- Pharmacists are authorized to prescribe and administer COVID-19 vaccines for people aged three (3) and older.
- A statewide standing order will be issued by the New York State Commissioner of Health to support timely access across pharmacies.
Together, these actions ensure that all eligible New Yorkers can continue to receive COVID vaccinations at their local pharmacy without delay.
COVID-19 continues to cause significant illness and hospitalization, particularly during fall and winter when respiratory viruses such as influenza and Respiratory Synctial Virus (RSV) are also circulating. Vaccination remains the most effective defense against severe illness, hospitalization, and death from COVID-19.
Please also see OPWDD Respiratory Viral Illness Guidance:
OPWDD continues to encourage providers, people receiving OPWDD services, their families, and staff to receive the COVID-19 vaccine, consistent with the above guidance. We also urge providers to continue promoting vaccines as a key tool in protecting vulnerable populations against severe respiratory illness.
You can read more about Executive Order 52: Declaring a Disaster in the State of New York Due to Federal Actions Related to Vaccine Access here.
For questions pertaining to the guidance and standing orders issued by the Department of Health, please contact them via email at covid19vaccine@health.ny.gov.
In Health,
Willow Baer, Commissioner
| | FROM OUR FRIENDS AT SACHS POLICY GROUP: NYS Announces Intention to Terminate Essential Plan Waiver, Revert to BHP 1331 Authority | |
On September 10th, Governor Hochul announced her intention to terminate New York’s 1332 State Innovation Waiver that had expanded eligibility for the Essential Plan. This action is expected to allow New York to access a reserve fund frozen during the waiver to replace federal funding lost as a result of the One Big Beautiful Bill Act (OBBBA).
The Essential Plan is a health insurance option for adults aged 19 to 64 with incomes too high for Medicaid, or those with lower incomes but who are ineligible for Medicaid (e.g., certain immigrants). The Essential Plan has no monthly premium, no deductible, and minimal cost-sharing for enrollees.
In 2015, New York State first created the Essential Plan as a Basic Health Plan (BHP) authorized under Section 1331 of the Affordable Care Act (ACA). In 2024, the federal government approved the State’s request to switch to a 1332 State Innovation Waiver and replace the BHP with a mirror plan. This plan, also called the Essential Plan, expanded the upper income eligibility limit from 200% of the Federal Poverty Level (FPL) to 250% of FPL (a group also known as EP5). New York’s waiver was later amended to distribute cost-sharing reduction subsidies (unavailable under the 1331 authority) to individuals between 250% and 400% of FPL. As a condition for 1332 waiver approval, a reserve fund that New York accumulated under the original Section 1331 authority (from 2015-2024) was frozen, preventing the state from accessing over $10 billion dollars while the waiver is in effect.
The OBBBA eliminates federal support for a large group of Essential Plan enrollees, namely those who are not lawful permanent residents (green card holders) or who are not eligible for Medicaid due to immigration status. As a result, the State expects to lose federal funding for nearly half of current Essential Plan enrollees, approximately 730,000 individuals. Because of this lost federal support, the state has decided to revert the Essential Plan back to a BHP and access the BHP reserve fund to maintain benefits for those with incomes up to 200% FPL who are losing federal funding.
The State intends to implement these changes by July 1, 2026. Adults with incomes from 200%-250% of FPL will be transitioned to Qualified Health Plans, with higher cost-sharing and higher premiums, affecting approximately 440,000 New Yorkers. The State seeks to collaborate with CMS to design and provide affordable coverage options for these members who will no longer qualify for the Essential Plan.
Additional information is available here. Public comment may be submitted to NYSOH.Team@health.ny.gov through October 10th.
| | OPWDD: Updated #MoreThanWork Recruitment Toolkit Now Available | |
Dear OPWDD Providers,
We are excited to let you know that the #MoreThanWork DSP Recruitment Campaign toolkit has been updated with refreshed Year 2 graphics and a digital marketing guide to assist you with enhancing your outreach and recruitment process.
You can find the updated toolkit on the www.directsupportcareers.com website under the Recruitment Toolkit for Participating Providers link on the bottom of the home page.
If your agency isn’t currently participating in this free to you, joint state and nonprofit provider recruitment campaign, but would like to, please complete the online provider profile form and you will be added. Be sure to send a complete profile, provider logo and a photo to be included in your agency’s profile as this helps jobseekers get a feel for your organization as a potential employer.
We have a year and a half left of the advertising portion of the campaign which is driving traffic to the directsupportcareers.com website. To date, more than 1.4 million jobseekers have clicked through to the website and of those, more than 78,000 have taken the next step to visit one of the 240 participating providers seeking more information about job opportunities.
Additionally, the campaign continues to seek DSPs and provider agencies to highlight in media stories and social media posts related to the DSP role and DSP recruitment. Please let us know if your agency is interested in being featured in either of these opportunities by completing the brief form linked below. Once you fill out the form, campaign administrators will be in touch with you.
Media Interest Form
Thank you for your continued participation in this important recruitment effort which is not only driving more interest in the career of direct support but also drawing attention to the very important work that our field does.
Sincerely,
Willow Baer
Commissioner
| | Reminder: NYDA Legislator In-District Challenge - Are You Participating? Challenge Ends September 30th | |
NYDA is pleased to announce an exciting new opportunity for provider agencies to enhance and grow their relationships with state Senators and Assembly members, while at the same time competing for a chance to win a $2,500 donation to their agency for their efforts! The challenge begins NOW and ends on September 30. Please see the flyer linked here for more information.
It is more important than ever to build on your existing relationships OR start new ones as we start to ramp up our State advocacy efforts for the upcoming year.
We look forward to receiving your submissions and seeing your participation in this important challenge.
| | Request for Applications (RFA): Regional Disability Health Clinic Program (RDHCP) - OPD-2025-49 | |
OPWDD is issuing the attached Regional Disability Health Clinic Program (RDHCP) Request for Applications (RFA). The goal of this grant opportunity is to improve health care for people with developmental disabilities by increasing access to care and better coordinating and integrating services. The RDHCP will provide grants in support of capital projects to expand access to quality health care for people with developmental disabilities by reducing accessibility barriers and increasing access to healthcare services, including medical, dental and other physical health services such as those provided at Article 16 Clinics (e.g., dental, medical, nursing, physical therapy, occupational therapy, speech and language pathology) and Article 28 Clinics (e.g. medical, dental, nursing).
This opportunity is available in the Statewide Financial System (SFS) and can be found by searching for SFS Event ID: OPD-RDHC-1. Applicants interested in participating in this program must apply via SFS.
This RFA and related documents, including Q&A and Addenda, will also be posted on both the NYS OPWDD Procurement Opportunities website at https://opwdd.ny.gov/procurement-opportunities and on the NYS Contract Reporter (NYSCR) website at https://www.nyscr.ny.gov/.
Important Dates
RFA Release Date: September 11, 2025
Email Registration for Pre-Application Conference: September 17, 2025
Pre-Application Conference: September 19, 2025
Deadline for Submission of Questions: September 25, 2025
Issuance of Responses to Questions: October 8, 2025
Application Due Date: November 5, 2025, by 4:00 p.m. ET
NOTE: Applications must be submitted in the Statewide Financial System (SFS) by the due date and time. Late applications will not be accepted under any circumstances. Applicants are strongly encouraged to submit applications 24 to 48 hours prior to the due date to avoid the risk of ineligibility resulting from unanticipated delays or other computer or technical problems. See Section 8.4 of the RFA for additional details.
Information on SFS Registration and Prequalification are available on the NYS Grants Management website.
For assistance with your application and any questions regarding SFS, contact the SFS Help Desk at 518-457-7717 or helpdesk@sfs.ny.gov.
| | Nominations for ANCOR's 2026 Direct Support Professional of the Year Awards are Now Open! | |
This week, during Direct Support Professional Recognition Week 2025, you've been helping to showcase the life-changing, yet often unsung work of the incredible DSPs who support people with disabilities to access and participate fully in our communities.
There are so many stories to tell about the essential work that DSPs do each and every day, and we want to uplift and celebrate these stories of incredible people providing exemplary service in the profession.
You are invited to share these stories by nominating outstanding DSPs for a 2026 DSP of the Year Award! Submitting a nomination is important for a variety of reasons:
- It shows DSPs you appreciate their hard work throughout the year.
- It enables ANCOR to advance its policy goals by raising the visibility of the work DSPs do in service of people and community.
- It raises awareness among people in your community about the ways in which people with I/DD enhance the diversity and vibrancy of all communities.
Nominations are due October 31, 2025, and nominators of DSPs selected to receive an award will be notified in January 2026. Together, we'll celebrate the 2026 class of honorees in a ceremony on April 23 at ANCOR Connect '26 in Boston, MA.
Nominate a DSP Today!
| | CMS Issues Guidance to Strengthen Oversight of Medicaid State Directed Payments | |
New federal payment limits to combat fraud, waste, and abuse while preserving access to care
The Centers for Medicare & Medicaid Services (CMS) is issuing preliminary guidance for states regarding the implementation of new federal payment limits for State Directed Payments (SDPs) in Medicaid managed care. Providing this guidance now, while CMS works to issue a final rule, allows states additional time to plan their efforts to meet the requirements laid out in the One Big Beautiful Bill Act. The letter sent today provides states with information on the reduced payment, details on eligibility for a temporary grandfather period, and additional next steps.
“Medicaid is a federal and state partnership and for years states have skirted their responsibilities to draw down more federal funds while contributing less state dollars. President Trump’s One Big Beautiful Bill Act will hold states accountable and make sure the federal government isn’t left to pick up the tab,” Health and Human Services Secretary Robert F. Kennedy, Jr. said.
“Protecting Medicaid’s long-term fiscal integrity is at the heart of the Trump Administration’s promise to the American people,” said CMS Administrator Dr. Mehmet Oz. “By implementing safeguards required in the One Big Beautiful Bill Act, CMS is helping states continue to use state directed payments as a tool, while ensuring they are sustainable, transparent, and fully aligned with our mission to protect beneficiaries and preserve Medicaid for future generations.”
Under Medicaid managed care, states can direct how managed care plans pay providers through SDPs. These arrangements originally were not widespread, but they have ballooned in recent years. While only two states used them in 2016, 39 states use them today, and CMS projected that annual SDP spending would exceed $124.3 billion for FY 2025 and $144.6 billion for FY 2026.
By implementing the new required safeguards effective for rating periods beginning on or after July 4, 2025, CMS aims to ensure Medicaid resources are directed appropriately to strengthen program integrity and protect patient care. The letter to states provides key program elements and preliminary guidance on section 71116:
- Payment Limits: Beginning with rating periods on or after July 4, 2025, SDPs for inpatient hospital services, outpatient hospital services, nursing facility services and qualified practitioner services at an academic medical center must not exceed 100% of Medicare rates in Medicaid expansion states, or 110% of Medicare rates in non-expansion states. In the absence of a Medicare rate, the Medicaid state plan rate applies.
- Grandfathering Period: Certain eligible SDPs submitted or approved before July 4, 2025, may qualify for temporary grandfathering until rating periods beginning January 1, 2028, followed by a phased reduction until they meet the new payment limits.
- Next Steps for States: States must revise any pending or future SDP preprints that do not qualify for grandfathering to comply with Section 71116 before CMS will continue review. For applicable SDPs that are currently under review by CMS, CMS will notify states of whether an SDP likely qualifies for grandfathering in our approval letters for the SDP once CMS has completed its review.
For more information, states and stakeholders can review the full guidance letter at: https://www.medicaid.gov/medicaid/managed-care/guidance/state-directed-payments
| | MAHA Commission Unveils Sweeping Strategy to Make Our Children Healthy Again | |
The Make America Healthy Again Commission released the Make Our Children Healthy Again Strategy, a sweeping plan with more than 120 initiatives to reverse the failed policies that fueled America’s childhood chronic disease epidemic. The strategy outlines targeted executive actions to advance gold-standard science, realign incentives, increase public awareness, and strengthen private-sector collaboration.
Chaired by U.S. Health and Human Services Secretary Robert F. Kennedy Jr., the Commission is tasked with investigating and addressing the root causes of America’s escalating health crisis, with a focus on childhood chronic diseases.
“Today’s MAHA Commission report is another historic milestone for our country and a testament to President Trump’s leadership and commitment to Make America Healthy Again,” said U.S. Secretary of Agriculture Brooke L. Rollins. “America’s farmers and ranchers are at the heart of the solution — alongside doctors, parents, and communities - to fight chronic disease and protect future generations. Under this Administration, we are not just talking about healthy outcomes; we are delivering them by securing voluntary commitments to remove artificial food dye from major brands, providing technical assistance to States interested in restricting junk food and soda from SNAP, and providing growers with new tools to maintain and improve soil health, including the introduction of a regenerative farming practice pilot program. Together with our partners at HHS and EPA, we are charting a new course, strengthening the health of our families, and ensuring the United States leads the world with the safest, strongest, and most abundant food supply.”
“The Trump Administration is mobilizing every part of government to confront the childhood chronic disease epidemic,” Secretary Kennedy said. “This strategy represents the most sweeping reform agenda in modern history—realigning our food and health systems, driving education, and unleashing science to protect America’s children and families. We are ending the corporate capture of public health, restoring transparency, and putting gold-standard science—not special interests—at the center of every decision.”
Key Focus Areas of the Strategy:
Restoring Science & Research: Expanding NIH and agency research into chronic disease prevention, nutrition and metabolic health, food quality, environmental exposures, autism, gut microbiome, precision agriculture, rural and tribal health, vaccine injury, and mental health.
Historic Executive Actions: Reforming dietary guidelines; defining ultra-processed foods; improving food labeling; closing the GRAS loophole; raising infant formula standards; removing harmful chemicals from the food supply; increasing oversight and enforcement of direct-to-consumer prescription drug advertising laws; improving food served in schools, hospitals, and to veterans; and reforming Medicaid quality metrics to measure health outcomes.
Process Reform & Deregulation: Streamlining organic certification; easing barriers to farm-to-school programs and direct-to-consumer sales; restoring whole milk in schools; supporting mobile grocery and processing units; modernizing FDA drug and device approval; and accelerating EPA approvals for innovative agricultural products.
Public Awareness & Education: Launching school-based nutrition and fitness campaigns, Surgeon General initiatives on screen time, prioritizing pediatric mental health, and expanding access to reliable nutrition and health information for parents.
Private Sector Collaboration: Promoting awareness of healthier meals at restaurants, soil health and land stewardship, and community-led initiatives, and scaling innovative solutions to address root causes of chronic disease.
With this strategy, the MAHA Commission leads the most ambitious national effort ever to confront childhood chronic disease and Make America Healthy Again.
| | Care Coordination Informational Session: Supporting New Americans to Access OPWDD Services | |
When: On Demand
Where: In SLMS enroll here or under class code: OPWDD-EL-CCO-SNA
What: The New York State Office for New Americans (ONA) assists all new Americans with accessing and navigating a variety of free services and supports through its statewide network of community-based providers. ONA, NYS Council on Developmental Disabilities (CDD), and OPWDD will partner for this training.
CCO staff will learn about new Americans, their contributions to New York State, and ways to support them. They will be able to understand what immigration status is and how it affects access to OPWDD services, public benefits, and work authorization.
Care Managers and CCO staff will apply their knowledge to assist new Americans through training examples.
| | Dowling Law: Important Update: DOJ Investigations Regarding DEI Efforts | |
The Department of Justice (DOJ) Civil Division has begun a new investigative effort enforcing the provisions of the President’s executive order upending existing affirmative action requirements and prohibiting illegal Diversity, Equity and Inclusion (DEI) efforts for federal contractors and grant recipients.
False Claims Act
Pursuant to Executive Order 14173, government agencies are adding provisions to new contracts and grants and inserting provisions into existing contracts and grants, making them subject to the enforcement provisions of the False Claims Act (FCA).
The FCA is an anti-fraud statute that, among other things, allows whistleblowers to sue on behalf of the federal government and receive a percentage of the proceeds if the case is successful.
The FCA clauses give the government an additional means of enforcing its DEI priorities and encourage employees of contractors and grant recipients to monitor their employers and bring violations to the attention of the DOJ.
Civil Investigative Demands
A Civil Investigative Demand (CID) is an investigative mechanism that demands information, including documents and deposition testimony, before the DOJ brings an FCA action against a party. A CID can also be used when a whistleblower brings a suit on behalf of the government.
Conclusion
Given the current administration’s intent to vigorously enforce its vision of civil rights and the increased opportunities for litigation under the FCA, any business or organization receiving a CID should review their DEI practices to ensure compliance with the new requirements and check with legal counsel before responding.
Questions? Reach out to a member of the Dowling Law team today
| | Fall 2025 Virtual Learning Institute - Registration Now Open for a Three-Week Option! | |
The NYS Department of Health is pleased to announce a virtual Person-Centered Planning Learning Institute opportunity! The Learning Institutes are truly unique offerings that make it possible to gain uncommon insights, to create meaningful connections, and to support action for real change in your work and organization. Please keep reading for more information about these exciting new opportunities!
A three-week Virtual Individual Learning Institute is being offered this fall. Sessions will take place on Tuesdays and Thursdays from 10am-12pm and begin October 28th. A detailed description of the Individual Learning Institutes and how they differ from Organizational Learning Institutes is included below.
| | Medicaid and CHIP Payment and Access Commission (MACPAC) September 2025 Public Meeting | |
The Medicaid and CHIP Payment and Access Commission (MACPAC) September 2025 meeting will be webcast live.
Thursday, September 18
9:30 am – 4:30 pm EDT
Friday, September 19
9:30 am – 12:00 pm EDT
As part of the September meeting, join us for a special panel discussion on community engagement and work requirements in Medicaid.
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Additional Topics include:
- Overview of the 2025 Budget Reconciliation Act (P.L. 119-21);
- Medicaid payment policies to support the home- and community-based services (HCBS) workforce;
- Findings from a federal and state policy scan on Children and Youth with Special Health Care Needs coverage transitions;
- Background on Medicaid for justice-involved youth;
- Health care access for children in foster care;
- Medicaid coverage of behavioral health services;
- The American Rescue Plan Act funding for HCBS; and
- Medicare-Medicaid plan transition monitoring.
MACPAC will request public comments at designated points during the webcast; please see the meeting agenda for more information. We also accept comments on a continuing basis by email to comments@macpac.gov. As always, we welcome your feedback and suggestions.
Sign up to attend the September MACPAC meeting on our meetings page, where you will find the full agenda and meeting information. After registering, you will receive a confirmation email with instructions on how to join the meeting. If you need special accommodations to participate remotely in the meeting, please email macpac@macpac.gov.
Click here to register
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Arc Delaware Holds Food Drive for National Day of Service and Remembrance
Among many other monikers, September 11th marked the National Day of Service and Remembrance, and many organizations held events to mark the occasion. In particular, Arc Delaware timed their annual Stuff the Bus food drive to coincide with the day. Representatives from the organization parked vans at two different locations in Walton and Margaretville, taking donations of nonperishable foods to fill up the vans for local food pantries.
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Add Your Story to the E-News Members Corner!
Members are encouraged to share stories and pictures with Charlotte Horwath at rhorwath@nyalliance.org to be featured in our E-News Members Corner.
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6th Annual Data, Finance & AI Virtual Summit - Registration & Agenda Available!
September 17-18, 2025
10th Annual FI/Self-Direction Conference - Registration Now Open!
October 29-30, 2025 at the Hilton Garden Inn, Troy, NY
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About the NY Alliance E-News
The NY Alliance E-News briefing is a weekly update containing pertinent news items to members of the NY Alliance. This service is for NY Alliance members only. Please email nyaii@nyalliance.org to register others to receive this e-news briefing.
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