Changes to NY’s Home Health Care Program Faces Criticism

Lawmakers put administrators for the state’s controversial home health care program in the hot seat Tuesday as concerns over the newest iteration of the program mount.

For years, the Consumer Directed Personal Assistance Program, or CDPAP, which is the state’s Medicaid-run home health care program for the elderly and disabled, had allowed hundreds of different private insurance companies to administer the program as fiscal intermediaries.

But the state budget enacted last year changed the model for the program so that one fiscal intermediary, Public Partnerships LLC or PPL, would oversee the program starting April 1.

Some states, such as Massachusetts, have similarly switched to single fiscal intermediary systems for home health care patients, but for far fewer patients. While health care advocates say other states’ transitions spanned approximately two years, PPL began the process of enrolling New York’s 280,000 CDPAP consumers less than three months before they needed to make the switch.

While state officials said about 22,000 individuals are fully enrolled in the new system as of Jan. 31, about 5,000 people must successfully enroll each day to meet the April 1 deadline.

“Right now, it’s ahead of schedule and working as designed,” James McDonald, the commissioner for the state Department of Health, said during a state hearing.

But during a heated exchange with Gustavo Rivera, the chair of the Senate’s Committee on Health, Medicaid Director Amir Bassiri conceded for the first time that the state might not make that deadline.

“We’re monitoring it very, very closely,” Bassiri told Rivera regarding patient enrollments. “There is the potential that we don’t meet the date.”

Rivera, who’s opposed to having one fiscal intermediary, said the deadline is unrealistic and pleaded that the state extend it.

“The math is not mathing,” Rivera said. “It is incredibly important that you all get this right, and if you insist on the single [fiscal intermediary], then please reconsider April 1. It does not work out by April 1.”

McDonald, Bassiri, and Gov. Kathy Hochul have said having one fiscal intermediary for all patients streamlines administrative processes and cuts redundant costs for the state. But patients have maintained they prefer a more personalized approach by working with their current fiscal intermediaries.

Ilana Berger, who is the political directory for Caring Majority Rising, said the state’s selected vendor, Public Partnerships LLC or PPL, has had issues with their rollouts of similar programs in other states, including Pennsylvania, Colorado and New Jersey. Several lawsuits lodged against the company allege it failed to pay caregivers and abruptly dropped customers.

New York’s transition to PPL so far has been “a disaster,” Berger said.

Mary Brundege, who is the caregiver for her significant other, Sean Fultz, who has cerebral palsy and had strokes in recent years, finds PPL’s history concerning.

“There’s no reason to trust PPL,” she said.

She sees Hochul’s defense of PPL as a sign that she does not “care” about people with disabilities like Fultz, who had to get five brain surgeries as part of his treatment.

“Every year she puts on a big thing about disability awareness at her mansion, and she invites us there every year. And then she screws over everybody with disabilities,” Brundege said.

Criticisms regarding the program have not abated, and the most recent volley at CDPAP came in the form of a $10 million ad blitz from the Alliance to Protect Home Care and two other nonprofits.

While WNYC and the New York Public News Network reported that Hochul has asked the state attorney general to investigate the organizations and their lobbying tactics, the top legal office in the state said it would not take on the inquiry because it represents the state in lawsuits related to the rollout of the new CDPAP program.

Story by Jeongyoon Han
Jeongyoon Han is a Capitol News Bureau reporter for the New York Public News Network, producing multimedia stories on issues of statewide interest and importance.

Image: Department of Health Commissioner James McDonald fields questions from lawmakers Tuesday, Feb. 11, 2025. (Credit: Screenshot/New York Public News Network)