Alliance Alert: We strongly support New York’s effort to extend the 1115 New York Health Equity Reform Waiver, which has improved how Medicaid addresses the social factors that have such a profound impact on health and recovery. For people living with mental health and substance use challenges, access to transportation, nutritious food, stable housing, and other health-related social needs is often just as important as access to behavioral health services. By investing in these essential supports through Social Care Networks, New York has taken an important step toward improving health outcomes, reducing health disparities, and helping people remain healthy in their communities rather than cycling through emergency rooms and hospitals.
We are encouraged to see the state seeking a five-year extension of this innovative program and hope the federal government approves the waiver renewal. At a time when many New Yorkers are facing new barriers to healthcare and public benefits, expanding investments in health-related social needs is more important than ever. Continuing this work will strengthen community-based organizations and allow even more Medicaid members to receive the supports they need to stay healthy, recover, and thrive.
Learn more about the future of the 1115 Waiver and New York’s Social Care Networks at the Alliance for Rights and Recovery’s 44th Annual Conference. Attendees will hear directly from leaders involved in implementing the waiver about the successes achieved so far, the impact these services have had on communities across New York, and what the state is proposing as part of its renewal application to continue advancing health equity over the next five years.
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NY Pushes to Extend $7.5B Medicaid Services Pilot Program
By Ethan Geringer-Sameth | Crain’s Healthcare | August 24, 2026
A push is heating up to extend a $7.5 billion Medicaid pilot program that has poured money into health-related social services like food assistance at a time when federal cuts are restricting public benefits.
Testimony from regional coordinators of the so-called 1115 waiver program say the program has been effective in filling gaps in the social safety-net and reducing medical costs, but risks destabilizing public assistance programs if funding were to stop. The public comment period on the state’s renewal application closed on Friday leaving the New York Department of Health to draft a final proposal to submit to the Trump administration in September.
The program, which was first approved by the Biden administration in 2024, allows the state to use Medicaid dollars for non-medical services that impact health outcomes like nutrition, transportation and housing. The program authorized New York to spend $6 billion in federal funding with the state adding another $1.5 billion.
The waiver program is administered through designated coordinators, known as social care networks, responsible for screening Medicaid members for health-related social needs and supporting hundreds of local organizations that provide the services. Much of the funding in the first two years of the program has gone towards creating the infrastructure to administer the new services, catalogue and pay for them. Additional aid has gone toward the provider workforce and distressed hospitals.
With the 1115 waiver expiring in March, state officials are drafting a proposal to extend it for five years and roll-over an estimated $2.1 billion in unspent or unclaimed funding, according to a preliminary iteration released in July. The Health Department plans to submit the final application to the Centers for Medicare and Medicaid Services next month, including a summary of the public comments, according to spokeswoman Danielle DeSouza. The push comes against the backdrop of new work requirements for Medicaid and food stamps included in President Donald Trump’s reconciliation megabill last year that are expected to disrupt services for thousands of New Yorkers.
In testimony to the Department of Health, social care networks described the advancements of a new public assistance program that has delivered hundreds of millions of dollars in non-medical services while in some cases coinciding with a drop in hospitalization. But it remains a work in progress with millions of Medicaid enrollees still waiting to be screened and a need sustained funding to avoid collapse.
In Staten Island, participants receiving food services through the program saw a 22% drop in hospitals visits, including emergency and inpatient, according to testimony from Joseph Conte, executive director of the Staten Island Performing Provider System, the social care network overseeing the borough and parts of Brooklyn and Queens.
Public Health Solutions, which operates the social care network covering Manhattan and most of Brooklyn and Queens, has screened 700,000 Medicaid members and administered more than $250 million in services, including more than $200 million in food assistance. Another $42 million has gone to capital investments for community-based organizations to set up the technical infrastructure needed to provide services.
But the group has urged the Health Department for continued funding for operations, particularly workforce.
“The shift from grant funding to reimbursement remains difficult, and…providers are still worried about sustainably staffing this model,” Public Health Solutions Chief Strategy Officer Zachariah Hennessey said in public testimony citing findings from the state’s independent evaluator.
Providers under Healthy Alliance Foundation, the social care network covering much of northern New York, still rely on technical assistance and capacity-building funding from the network, according to Chief Executive Officer Erica Coletti. More money is also needed to continue supporting more than 3,000 navigators hired by social care networks statewide, who connect Medicaid recipients to services and complete documentation but who do not necessarily provide direct services, she said.
“Without continued investment, New York risks destabilizing both the infrastructure and the trusted community partners that make this model work, leaving Medicaid members without support until challenges become more complex, costly, and difficult to address,” Coletti said in her written testimony, which was reviewed by Crain’s.