Alliance Alert: This week, the federal Centers for Medicare and Medicaid Services (CMS) announced it will no longer approve or extend workforce development initiatives through Medicaid 1115 Waivers — a decision that could dramatically impact New York’s long-term plans to address our state’s health and behavioral health workforce crisis.
While this change does not affect services currently offered through New York’s NYHER 1115 Waiver, it will directly influence whether the state is approved for an extension when the current demonstration period ends in March 2027, and what provisions can be included in that extension.
New York’s existing waiver includes a $694 million investment in recruiting, training, and supporting health, mental health, and social care workers, especially community health workers and community-based providers — all critical to reversing years of workforce shortages and building a more equitable health system. CMS’s decision to end future workforce waivers cuts off the possibility of extending these efforts past 2027, despite growing needs and proven success in implementation.
Additionally, just last week, CMS signaled it intends to remove the continuous coverage provision for children aged 6 and under from all future waiver applications — another core piece of New York’s current NYHER waiver aimed at ensuring stability and access for young children in low-income families.
These federal rollbacks threaten the very heart of what makes the NYHER waiver innovative and impactful: its focus on prevention, equity, and real-life needs.
On July 22, the Alliance for Rights and Recovery and Public Health Solutions’ WholeYou NYC hosted an in-person event at Brooklyn Borough Hall to help Medicaid members and families understand how to access NYHER’s life-changing supports. With partners from the NYC Department of Health and Mental Hygiene and the NYS Office of Mental Health, we delivered crucial information and encouraged participation across communities.
Key Takeaways from the Event:
- Medicaid members can now get help with social needs like transportation, food, and housing through the waiver.
- A screening is required to receive services.
- Screenings can be completed:
- Through a Community-Based Organization (CBO) working with a local Social Care Network (SCN)
- Via an online self-screener
- With help from SCN staff or the lead SCN organization
- It’s safe to share your needs with screeners and navigators — they’re here to support you.
- We need widespread participation to show these services work and reduce disparities.
- SCNs and CBOs are ready to help people connect to whole-person care, not just clinical services.
The federal shift should motivate all of us to make full use of these supports now — while they’re available. It also underscores the urgent need for continued advocacy to protect and expand community-based Medicaid services that prioritize housing, food, transportation, workforce equity, and continuity of coverage for children.
Let’s make the most of the NYHER waiver while we have it — and fight to keep what works.
Learn more:
https://rightsandrecovery.org/take-action/1115-waiver
https://www.wholeyou.nyc/find-services
CMS to End Medicaid Program Used to Boost NY’s Health Jobs
By Ethan Geringer-Sameth | Crain’s Health Pulse | July 24, 2025
The federal government will no longer approve workforce development initiatives funded through Medicaid, closing a short window in which states like New York took advantage of hundreds of millions of available dollars.
The Centers for Medicare and Medicaid Services issued a letter to states saying that new projects aimed at expanding the health care workforce under a Medicaid pilot program, known as the 1115 waiver, which covers a wide swath of non-clinical uses, will not be approved. The decision ends a program that only five states have taken advantage of, for a total of $1 billion, since 2022.
The largest of those projects is a $694 million initiative Gov. Kathy Hochul announced last year to boost New York’s beleaguered workforce in the aftermath of the pandemic, when there was an exodus of workers from the state’s health care system. The state hopes to recruit and train thousands of health, mental health and social workers over three years, under the funds, which will be used for tuition, apprenticeships and job placement. The funding is part of the larger $7.5 billion 1115 waiver approved for the state at the beginning of 2024.
The state had hoped to continue the program beyond 2027 but the CMS decision will prevent that, said spokeswoman Danielle DeSouza. “It emphasizes the need to maximize the benefits of these programs during the current demonstration period,” she said. Currently authorized programs will not be impacted, she said.
The letter, from Deputy Administrator and Director of Medicaid and CHIP Services Drew Snyder, who resigned in June and formally stepped down on Monday, according to CMS, states that already approved projects would be allowed to “run their course” but would not be extended.
“In order to ensure scarce federal resources prioritize providing quality care to our nation’s most vulnerable, at this time CMS does not anticipate approving new state proposals…or extending existing” workforce initiatives, the letter reads. The letter states the agency is communicating directly with states that have already been approved for the funding to inform them that those projects will not be extended.