Last updated Friday, Sept. 20, 2024.
A new lawsuit and a new bill introduced into the New York State legislature are two of the latest moves of the growing and vocal opposition to the controversial change being made to the New York State Consumer Directed Personal Assistance Program (CDPAP).
The change, pushed through by New York Gov. Kathy Hochul as part of the New York State 2024-25 fiscal year budget passed in April 2024, would replace the state’s existing network of approximately 600 fiscal intermediaries (FIs) with one out-of-state corporation. The process of choosing the agency is being done without oversight from the NYS comptroller’s office.
The plan calls for the new agency’s contract to begin Oct. 1, 2024.
Sept. 18, 2024: Second Lawsuit Opposing CDPAP Change Filed in New York
Four plaintiffs, all home care agencies serving New York City and its suburbs, say they will lose lucrative business contracts under the impending shakeup of the state-backed Medicaid program and are suing the state Department of Health.
Sept. 16, 2024: Center for Disability Rights Joins the Growing Opposition
The non-profit calls on Governor Hochul to protect CDPAP and the disability-led organizations that established them.
Sept. 12, 2024: NYC Council Members Oppose the Change
Fifteen New York City Council Members urged the governor and legislature to rethink the change to a single FI. The letter says CDPAP is “no racket,” and encourages Hochul “to work with the state Legislature and stakeholders on ways to enhance the program, not needlessly strip benefits from our neediest population.”
This morning, I joined advocates to urge Governor Hochul and the State Legislature to rethink eliminating fiscal intermediaries for CDPAP. These cuts risk disrupting care for 250,000 people and jeopardizing 75,000 jobs. Let’s work to strengthen, not dismantle, this vital program. pic.twitter.com/f9JtX8RIEJ
— Council Member Shahana Hanif (@CMShahanaHanif) September 12, 2024
Sept. 5, 2024: The New Bill
NYS Dem. Sen. Gustavo Rivera announced that he would be introducing a bill to halt the transition to a single FI, as well as establish a licensure process and other guardrails.
New York Senate Bill 9901 reportedly also would give more power “to the commissioner of the Department of Health to require annual reporting from the home care agencies involved in the program,” according to the Times Union, where you can read more about it.
“Sen. Rivera’s legislation is a welcome effort to take into account feedback from community stakeholders and others,” Bryan O’Malley, executive director, Consumer Directed Personal Assistance Association of New York, tells The Boost. “Gov. Hochul’s plan to gift a $40 billion contract to one out of state company at the expense of the seniors and disabled people who rely on CDPAP, and the thousands who work at FIs administering the program, is flawed in every way.”
However, the bill reportedly might not be heard until January 2025 when the legislature reconvenes, “which is notably after the critical deadline of Oct. 1, 2024, for selecting the single statewide FI.”
Rivera, chair of the Committee on Health, made a statement this past July that “it is frankly appalling that the current administration is trying to destroy this program without viable alternatives.”
A still from an ad by My Health My Caregiver, a new entity reportedly launched launched by a group of FIs opposing the governor’s CDPAP changes.
Week of Sept. 2, 2024: Poll Shows Overwhelming Opposition
The new poll, commissioned by the Alliance to Protect Home Care, found that 76% of New Yorkers, and 70% of likely Democratic voters oppose the CDPAP changes.
On its website, the Alliance notes that the change to a single FI will “bankrupt hundreds of small businesses, eliminate home care jobs, and force thousands of elderly and disabled New Yorkers into nursing homes.”
Aug. 20, 2024: Bi-Partisan Coalition of Senators Reach Out to Fed Govt.
NYS Sen. John Mannion led a bipartisan coalition of more than 30 state senators in writing the Centers for Medicare & Medicaid Services to review and reject the governor’s CDPAP proposal. (You can find the letter posted on Spectrum News 1 and on Mannion’s Facebook page.)
It argues that the changes “will significantly restrict access to care [and that they are requesting] that the Centers for Medicaid and Medicare Services promptly review these changes, which we believe will deprive tens of thousands of consumers of the care they need and will likely disproportionately impact vulnerable populations.”
It also stated that “the State has not published any information regarding this transition, conducted an outreach or educational campaign to discuss the changes, nor sought federal approval, as required under federal law.”
FYI, the same Spectrum News 1 article has an interesting interview with Larry Spencer, CEO of Tempus Unlimited Inc., the sole fiscal intermediary that oversees CDPAP in Massachusetts and Pennsylvania. He says a single FI model “can be successful,” but expresses major reservations about how New York wants to implement the change.
Aug. 12, 2024: FIs Sue New York
Proposals for the single FI state contract now in the works were due on or before Aug. 2, 2024. But on Aug. 12, Save Our Consumer Directed Home Care, a not-for-profit association representing FIs and other entities participating in the program, “argued in its petition that the New York State Department of Health’s (DOH) implementation of a Request for Proposal (RFP) for FI services and the changes made to the CDPAP violate several legal and constitutional standards,” according to a blog posting on the Holland & Knight’s law firm website. (There’s also an article on the lawsuit in the Times Union.)
A judge was to hear arguments in the case Aug. 30, 2024, before making a decision to grant or dismiss petitioners’ request for an injunction to delay the bidding process. The Boost was unable to get an update on the hearing as of this posting, but what’s clear is that a ruling had yet to be made.
Aug. 12, 2024: Hochul Hints She’s Rethinking the Change
Also on Aug. 12, the governor backtracked a bit by saying the state may consider contracting with more than one FI, a remark the report says she has yet to clarify.
Background
CDPAP is an approximately (now) $9 billion Medicaid-funded popular program that provides at-home health care services for eligible chronically ill or physically disabled individuals who have a medical need for help with activities of daily living (ADLs). It gives recipients — roughly 250,000 New Yorkers participate in the program — flexibility and freedom in choosing their caregivers, and enables them to live in their communities of choice instead of, say, in institutions.
The program’s administrative duties, such as wage and benefit processing, are done via the approximately 600 New York-based fiscal intermediary (FI) companies. It’s a costly program with a growing budget, one which the governor has gone as far as to call “a racket” and “one of the most abused programs in the history of New York.”
The one out-of-state corporation that would administer the entire program reportedly will receive a five-year, multi-billion dollar contract.
The governor had first suggested, as part of her original budget proposal, “new restraints on CDPAP, including lowering hourly wages for some downstate personal care assistants. But those proposed changes [had drawn] fierce opposition from the union representing home care workers and their clients,” reported NBCnewsnewyork.com.
Stay tuned. Things are heating up.
