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Federal

Photo by René DeAnda on Unsplash

RCPA provided some late updates yesterday on the Federal funding freeze, and late last evening, the National Council for Mental Wellbeing provided members a legal interpretation on the rescinding of the Office of Management and Budget (OMB) M-25-13 and the issuance of the new memorandum M-25-14.

The following is from the National Council:

On Wednesday afternoon, the White House Office of Management and Budget issued a new memorandum—M-25-14 — that rescinded the pause to federal funding contemplated in a previous memorandum first issued on Monday night.

The new memorandum, which was directed to “heads of executive departments and agencies,” features a two-sentence statement reading: “OMB Memorandum M-25-13 is rescinded. If you have questions about implementing the President’s Executives Order, please contact your agency General Counsel.”

In the short term, M-25-14 certainly relieves some of the confusion and anxiety that swept across the federal grants world since Monday night. Our previous client alerts have chronicled the chaos that emerged late Monday and throughout the day on Tuesday.

However, in our review, there are still five key Executive Orders issued by the Trump Administration not affected by the rescission of M-25-13. Those EOs include:

While the upheaval following the issuance of M-25-13 may have prompted the Trump Administration to change course and move away from pausing all federal funding, we certainly anticipate that federal grants in the above-listed areas will remain subject to a comprehensive review and new standards. Federal grantees with programs in these specific areas should undertake a detailed review and be prepared for future agency actions.

Federal grantees should continue to keep apprised of the Administration’s actions, orders, and statements relating to federal funding — as the rescinded memorandum likely foretells future clashes as the Administration attempts to exert control over federal spending.

Chuck Ingoglia
President & CEO
Strategic Leadership
National Council for Mental Wellbeing


In addition, ANCOR sent the following information last night:

In what’s turning from a whirlwind couple of days into a whirlwind week, there were notable updates today on the OMB memo on the freeze of certain federal funding issued earlier in the week. 

Today OMB withdrew the memo with a simple rescission statement after a federal judge temporarily blocked the funding freeze for open awards and current spending. The order remains in effect until February 3 when a hearing is scheduled to determine next steps.  

As you may have seen, later in the day, Press Secretary Karoline Leavitt posted to X, “[t]his is NOT a rescission of the federal funding freeze. It is simply a rescission of the OMB memo. Why? To end any confusion created by the court’s injunction. The President’s EO’s on federal funding remain in full force and effect, and will be rigorously implemented.” Without further specificity regarding the implicated executive orders, the situation remains fluid with the potential for later memos or other interpretive guidance which the White House maintains is authority held within the executive branch.

In other litigation, U.S. District Judge Jack McConnell made statements in court today indicating that another restraining order may be coming. With the memo rescinded, the Department of Justice Special Counsel argued the case is no longer relevant. However, the judge did not appear persuaded and asked for a draft protective order for response and consideration. 

We’ll continue to keep you posted as we know more and hope to see you Friday (1/31) for our extended Members-Only Weekly Briefing at 12:30 pm ET to provide updates and review all available information together. See login information below:
Join Zoom Meeting: ancor-org.zoom.us/j/… 
Meeting ID: 870 2745 7284 
Passcode: 977618 


In recent communications from the OMB, these actions will not impact programs that provide direct benefits to individuals and are explicitly excluded from the pause and exempted from this review process. In addition to Social Security and Medicare, already explicitly excluded in the guidance, mandatory programs like Medicaid and SNAP will continue without pause.

RCPA will continue to communicate new developments with members as they emerge. If you have any questions, please contact your RCPA Policy Director.

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RCPA, in working with ANCOR and the National Council for Mental Wellbeing, has learned that the Office of Management and Budget (OMB) has rescinded the memorandum sent yesterday by the Trump Administration, which announced the pausing of distribution of federal funding.

Per National Council:
Moments ago, the Office of Management and Budget (OMB) reversed course on a memorandum instructing all agencies to temporarily pause the obligation and distribution funds for a wide swathe of federal programs, officially rescinding the order that spurred widespread confusion yesterday. The White House’s decision to rescind the memo comes after U.S. District Court Judge Loren AliKhan issued a brief temporary stay that would have delayed OMB’s directive from taking effect until Monday, Feb. 3, with the potential for further legal action beyond that date.

In addition, ANCOR reached out to members and said the following:

Hi everyone,

We wanted to make sure to update you that today OMB rescinded its memo from January 27 requiring a freeze on federal financial assistance: White House rescinds freeze on federal grants – The Washington Post. You can see the notice of rescission hereThank you to all of you who reached out and helped push back on this yesterday! We are so grateful for your advocacy.

Thanks,
Elise

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Elise Aguilar
Senior Director of Federal Relations
American Network of Community Options and Resources
Alexandria, VA
703-535-7850

RCPA will continue to communicate with our members as developments occur or if changes are made. As a reminder, this will not affect funding services that directly impact individual Americans, including Medicaid, Medicare, Social Security, and SNAP. If you have any questions, please contact your RCPA Policy Director.

Image by David Mark from Pixabay

RCPA continues its efforts to update members on the White House funding freeze while partnering with the National Council for Mental Wellbeing and ANCOR in examining the implications stemming from the White House Office of Management and Budget’s (OMB) January 27 memorandum temporarily freezing federal disbursements to many federal programs.

The National Council has provided the following update:


Federal agencies have been directed to fill out a spreadsheet as part of an analysis by Feb. 7 to ensure compliance with the president’s most recent executive orders. This is a breakdown of which health programs are included in this latest action.

Notably, we recognize conflicting guidance has been issued. While the above report identifies Medicaid programs, a Q&A document from the administration notes that Medicaid will continue without pause. As of Tuesday morning, all 50 states reported outages of their Medicaid online portals, and the Trump administration has stated they are aware of the outages and expect the portals to be back online shortly.

Also, several groups have taken action to block this funding freeze. As of this writing, several Democratic state attorneys general said they would ask a court to block the freeze from taking effect. Several groups representing nonprofits, public health professionals and small businesses have already filed suit in D.C. asking the court to prevent the freeze from continuing. On Tuesday evening, U.S. District Court Judge Loren L. AliKhan issued a temporary stay on the funding freeze until Feb. 3 at 5:00 pm ET.

The funding freeze may lead to project delays or cancellations, resulting in layoffs of workers involved in these programs, and may ultimately increase the unemployment rate, making it vital lawmakers understand the impact of this freeze on communities across the country.


Most notable are the concerns with the intersects of Medicaid funding though the information that has been released. The Q&A document states:

Q: Is this a freeze on benefits to Americans like SNAP or student loans?

A: No, any program that provides direct benefits to Americans is explicitly excluded from the pause and exempted from this review process. In addition to Social Security and Medicare, already explicitly excluded in the guidance, mandatory programs like Medicaid and SNAP will continue without pause.

RCPA will continue to communicate new developments with members as they emerge. If you have any questions, please contact your RCPA Policy Director.

RCPA will be hosting our 2025 Capitol Day on Wednesday, March 26. We will hold a press conference/rally from 10:00 am – 11:00 am in the Capitol’s Main Rotunda. Members are requested to schedule appointments with their State Senate and House legislators to discuss the state budget, legislation, and regulations that affect the day-today activities of our members. For your convenience and use in legislative meetings, RCPA has developed a brochure highlighting our legislative and regulatory priorities. More information will follow, but if you have questions or suggestions regarding our 2025 Capitol Day, please contact Jack Phillips, Director of Government Affairs.

Pennsylvania saw a large Election Day turnout in certain areas of the Commonwealth, so before sending out the Election Day update, RCPA wanted to wait so we could report to you the most accurate information available.

As of today, November 8, 2024, there are still two seats in question. One is the US Senate race between the Incumbent Sen. Bob Casey (D) and his opponent, Dave McCormick (R). The other seat in question is in Cambria County between Incumbent State Rep. Frank Burns (D) and his opponent, Amy Bradley (R).  More information on these two races is available below.

Election Results

President

Trump (R) – 50.5%
Harris (D) – 48.5%

Donald Trump won the race to be the 47th President of the United States. Trump saw increased support this election with Black and Latino men. The rural areas of the Commonwealth offset any Democrat leads in the urban areas, and in many urban areas Trump limited the Democrats’ winning margins.

US Senate

McCormick (R) – 49%
Casey (D) – 48.5%

This race has been called by the Associated Press (AP) in favor of Dave McCormick, but Sen. Casey has not conceded the race yet. According to AP, McCormick is currently winning by about 30,000 votes. AP believes the remaining votes will break in favor of McCormick. We will keep the members posted as events unfold.

The Republicans have flipped the US Senate and currently have a 52-seat majority, with the possibility of gaining two more seats (Pennsylvania and Arizona).

US House

The US House is projected to stay in Republican control by a 222–213 majority. In Pennsylvania, two  US House seats flipped from Democrat to Republican in Northeast PA and the Lehigh Valley (see results below).

District 7 (Lehigh Valley)
Ryan MacKenzie (R) – 50.7%
Incumbent Susan Wild (D) – 49.3%

District 8 (NEPA)
Rob Bresnahan (R) – 51%
Incumbent Matt Cartwright (D) – 49%

District 10 (Cumberland, Dauphin, Perry, York Counties)
Incumbent Scott Perry (R) – 50.8%
Janelle Stelson (D) – 49.2%

PA Senate

The Republicans went into Election Day with a 28–22 seat majority and came out of the election with the same majority.

PA House

The House Democrats went into Election Day with a majority of seats, 102–101. As of today, November 8, 2024, one race will decide whether the Democrats maintain control of the House or the Republicans assume majority control.

The race in question is in Cambria County, between Incumbent Democrat Frank Burns and his Republican opponent, Amy Bradley. As of today, Burns holds a 936 vote lead with approximately 97% of the vote in. As of this writing, the AP called the race for Rep. Burns, but challenges will probably be filed by the Bradley campaign.

Next Week

The House will be in session next Tuesday and Wednesday, and the Senate will be in session Wednesday and Thursday. It is believed no major legislation will be voted on and both chambers will hold leadership elections for the 2025/26 legislative session.

If you have any questions, please contact Jack Phillips, Director of Government Affairs.

Removes Barriers to Delivering Telehealth Outside the Clinics

On Friday, November 1, the US Centers for Medicare and Medicaid Services (CMS) released a final rule for calendar year 2025 that will give states the option to cover Medicaid telehealth behavioral health clinic services delivered outside the “four walls.” Previously, under 42 CFR § 440.90, the “Four Walls Rule,” it was required that during Medicaid outpatient behavioral health clinic telehealth services, either the patient or the clinician had to be physically onsite at the clinic.

CMS waived this requirement during the Public Health Emergency (PHE). Now that the PHE has ended, CMS has released this final rule to allow states to cover behavioral health outpatient clinic services outside the four walls. The final rule should take effect on January 1, 2025. In the meantime, it is the expectation that telehealth services will continue to be delivered as per current operating standards to ensure service access to individuals.

CMS amended the Medicaid clinic services’ regulation to authorize Medicaid coverage for clinic services furnished by IHS/Tribal clinics outside the “four walls” of their facility. In addition, states implementing the Medicaid clinic services’ benefit can opt to cover clinic services furnished outside the “four walls” of behavioral health clinics or clinics located in rural areas. For clinics located in rural areas, based on comments received, CMS is finalizing an approach to defining “rural area” where states will select either a definition used by a federal agency for programmatic purposes, or a definition adopted by a state agency with a role in setting state rural health policy.

For more information, view the CY 2025 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule (CMS 1809-FC) Fact Sheet and the full Final Rule.

RCPA will be reviewing the implications of this final form ruling for Pennsylvania and our ongoing efforts to expand telehealth services through legislative action. RCPA offers thanks to our members, as well as DHS/OMHSAS, County Primary Contractors, BH-MCOs, the National Council on Mental Wellbeing, and our stakeholder groups and associations for their collaborative advocacy to remove the “4 Walls” barriers to equity and access through telehealth.

If you have any additional questions, please contact RCPA COO and Mental Health Division Director Jim Sharp.