On April 30, BTPM's Disability Reporter Emyle Watkins hosted a live interview with Maria Perrin, the president of PPL, the new single statewide fiscal intermediary (FI) for the Consumer Directed Personal Assistance Program (CDPAP).
During this exclusive interview, Watkins and Perrin discussed what CDPAP is, the move from 600 FIs to PPL being the only FI in New York, and the process of transitioning the hundreds of thousands of disabled people and their care workers to this company. Most importantly, Perrin answered questions submitted in advance by the disability community regarding the transition and their concerns.
Please note that technical difficulties caused a partial audio malfunction for the first 15 minutes of the live stream. Once the audio issue was corrected, Watkins re-asked the affected questions at the end of the stream. Following the conclusion of the livestream, the introduction of the show was re-recorded. An edited version of this interview fixing these technical difficulties then created and can be watched below.
WATCH THE RECORDING & ASL INTERPRETATION
All questions from the public were accepted in advance of the live interview.
TRANSCRIPT
This transcript was created by an external contractor and may be updated over time to be more accurate.
Emyle Watkins: Welcome to Disabilities Beat Live from Buffalo Toronto Public Media. My name is Emyle Watkins. I am your host and lead disability reporter for BTPM. We appreciate you joining us. Whether you are watching live, listening later or reading the transcript. The Disabilities Beat has always been committed to giving authentic resolute coverage of the disability community. As a disabled reporter, I know just how important issues impacting our access to living and staying in our communities are. One of the major focuses of my reporting over the past four years has been New York's Medicaid programs, including the Consumer Directed Personal Assistance Program, or CDPAP for short.
CDPAP has been a vital service for a quarter of a million disabled New Yorkers who hire, train and self-direct personal assistance through the program. And this program doesn't just matter to the quarter million people who currently use it, any of us could need this program at any time. This program doesn't just serve people born with disabilities, chronic health or mental health conditions, but people who will acquire those conditions through the course of their lives. If you don't need CDPAP now, but always hope to live at home, this is the program that will keep you out of a nursing home or hospital when you need assistance to do daily tasks.
The program has always allowed disabled people, who are referred to as consumers, to hire personal assistance or PAs through a fiscal intermediary. Those fiscal intermediaries are often called FIs for short. The FI makes sure the Medicaid funds used to pay workers and provide benefits are administered correctly. But last year, New York decided to move from over 600 FIs administering the program to one, Public Partnerships LLC, or PPL for short.
Which brings us to why we're here today. I'm joined via Zoom by Maria Perrin, the president of PPL, to get answers to the most pressing questions New Yorkers have about this change, which ultimately won't just impact users of the program now, but those who will use it in the future and all of us as taxpayers.
First off, Maria, thank you for joining us.
Maria Perrin: Thank you, Emyle.
Emyle Watkins: And before we get too deep into conversation, I want to share a few notes about accessibility. This livestream includes American Sign Language interpretation. A recording and human-made transcript of this interview will also be available on our website after the stream. I also want to briefly provide a visual description for our listeners with vision disabilities, and I will invite Maria to do the same. I am a white person with medium-length brown hair and freckles. I am wearing purple glasses, a black shirt, gold necklace, and black blazer. I am in a tan-colored news studio with an image of downtown Buffalo behind me. My interpreter, Joan, is a middle-aged white woman with short gray hair, gold-rimmed glasses, wearing black clothing, and she has an image of Toronto behind her.
Maria, could you please describe yourself?
Maria Perrin: Yes, I am a white woman with red shoulder-length hair. I wear gold-rimmed aviator glasses. I'm wearing a dark teal shirt and I'm sitting in a white room with a teal sofa and a plant behind me.
Emyle Watkins: Thank you. Dozens of people from consumers, personal assistants, designated representatives, facilitators, and concerned New Yorkers submitted questions directly to us to ask. For transparency, Maria was provided a list of topics in advance, but not the questions. This will be her first time hearing them. And Maria, again, I'd like to give you the chance to share why you do personally care about this program.
Maria Perrin: Yeah. So about 20 years ago, my child was diagnosed as autistic and especially 20 years ago there's no roadmap or playbook for it then. So my family was thrown into this journey of how do we get help? What is the type of help we need? How can we best support our child and make sure that he could live the most fulfilling life possible? So we did get help with home care. We had a lot of home therapy and worked through state programs, and I will say that that set me personally on my own journey. I soon became an advocate for other families, helping families who recently got diagnoses of their child having a disability and directing them on where they should go, and I made a decision that that's how I wanted to spend all my time. So I started working for companies who specifically supported Medicaid programs. So that's why I do what I do personally.
Emyle Watkins: Thank you for sharing. And again, CDPAP allows people to hire, train and self-direct their own personal care workers and families like yours, it might be a parent being a designated representative for the child. Can you talk a little bit about how CDPAP operates and some of the values of the program?
Maria Perrin: Sure. So CDPAP, like many self-direction programs around the country, allows people who need personal care services in their home. So things such as getting dressed or meal preparation, or maybe they need transportation to medical appointments or other services that are home-based, it allows that individual to recruit and direct the services of their caregivers. So they're basically managing their own caregivers. This is an alternative to either going through an agency who selects and trains the caregivers for you or living within a facility. So the self-direction programs benefit people who really want to take on this role and have more independence and choice in terms of their caregivers and how their caregivers operate.
The CDPAP program in general is available to first Medicaid qualified recipients. Those who are interested in receiving CDPAP services should speak with their Medicaid health plan. Or if you don't have a Medicaid health plan, your local department of social services and they can help you get evaluated for services and help you with a care plan so that you can get started.
Emyle Watkins: Give us your elevator pitch. Why should people trust PPL? Why should people trust you? Because right now it does seem that there's a fair amount of distrust.
Maria Perrin: Yeah. So PPL started 25 years ago. We were part of a pilot program on self-direction, and that pilot program with the Robert Wood Johnson Foundation was very successful and it became the framework for different self-direction programs around the country. That was the birth of PPL. And ever since then, for 25 years, our mission has been to expand access to self-direction programs and to make them work better for the people who need them and want them.
Many of the people who work at PPL specifically have experience with self-direction programs. In fact, 21% of our employees identify as disabled themselves and 44% of our employees have an immediate family member who is disabled and who they've helped in a self-direction program. So that's how we attract people to come work for PPL and it's that lens that we do our work, understanding, having been in the situation ourselves to try to get services in the home and have to navigate what you need to do that, that's the framework that we come to work to do.
So after 25 years, we've been doing this for 50 different programs across 20 different states. We now have about 4,000 people that work for us and more than 2000 in New York State alone, and we're here to help. The changeover from a transition is always hard, but I guarantee it'll get smoother. And as I said, we want your feedback and every day we're evaluating what do we do that's better to enhance the program so that we can live our mission, which is make these programs more accessible and work better.
Emyle Watkins: Yeah, that brings me to a topic I've heard brought up repeatedly and it's PPL's work in other states. A Spectrum News article from September pointed out that PPL has lost or had contracts terminated, managing similar home care programs in New Jersey, Washington, West Virginia, Virginia, and Tennessee.
Larissa Martin, a 35-year-old consumer from Wallkill, New York, wrote in saying, "Your company has a history of failures in other states, how can you be certain that's not going to happen here?" I'm wondering, what assurance can you offer consumers that they problems won't repeat in New York and what accountability measures do you have in place?
Maria Perrin: Yeah, first I'd like to maybe correct the record a bit on some of what was published. First of all, we've been working in New York jersey since 2016 and we continue to work in New Jersey where we have a very high satisfaction rating. In the other states we continue to work in Tennessee, Pennsylvania, and actually all the other states you mentioned except for Washington where we were awarded the contract but chose not to continue with the contract because of other organization priorities. So just so that the folks on the line have the true information because sometimes there is a bit of a spin out in the media.
But in terms of how we'll approach CDPAP, again, this is a big change for many people, we understand that. As we hear from the community on what else they need for support, we're going to add it. We're going to do what we can, whatever it takes to make sure people can continue to receive care and to give care under this program if they want to remain on the program.
Emyle Watkins: Thank you for sharing that. You mentioned as well that many employees within this program are disabled themselves. We had several people write in with concerns about accessibility of your Time4Care app and your web portal, especially for blind consumers and personal assistants.
Julie Phillipson wrote into us saying, "Thank you for taking my question. There are many blind people who need this program and get assistance from family or friends or other assistants, and the application that must be used is not accessible to us. It does not work with voiceover on the phone. This must be fixed soon if we're able to take part in this program. This is an urgent problem that must be fixed. This has been very frustrating and unnecessary."
We also had another New Yorker write in saying, "My consumer and I are both blind. The Time4Care app is not totally accessible to us. I cannot add past shifts at all. I also found out yesterday that PPL customer service people cannot officially support Time4Care problems. The tech support number I was given was not good because they told me they do not support New York. I'm wondering, was the Time4Care app and your website tested for accessibility before launch, and how did you test accessibility?"
Maria Perrin: We did test for accessibility and it is operational in 13 other states and being used successfully. But I will mention just for some of the specific questions besides entering time in Time4Care, did we do have a telephony, an IVR system, to enter time. So you don't necessarily have to use the mobile app or computer app to enter time, you can call and enter time. So that's another option for people, especially if they are more comfortable with an auditory option.
I also want to mention that we have partners who are called CDPAP facilitators. They are in community organizations that can help with registration, timekeeping questions or any type of customer service needs. And many of them specialize in helping people who need certain aid such as braille documents, people who are visually impaired, hearing impaired. Those facilitators are also available to assist people if they have certain specific needs and I'm happy to get that information to you on the specific facilitators who might be able to help that particular listener.
Emyle Watkins: I appreciate that. But I do want to go back to the question of the Time4Care app specifically. If blind users are having this issue, what is PPL doing to remedy it?
Maria Perrin: So I really need to understand what their specific issue is. If I can get that person's information, I'm happy to call them with someone, a Time4Care specialist and find out exactly what's happening. But you can enter past shifts on Time4Care, and so that is active for them. So if there's something else that is happening, I'd love to talk to that individual person and get their needs met.
Emyle Watkins: Absolutely. And we'll make sure to publish PPL's contact information on our website following this interview.
Maria Perrin: Perfect.
Emyle Watkins: I'm glad you mentioned facilitators. We received a lot of questions about the registration process and we actually had one facilitator anonymously fill out our form. They asked, "Why are facilitators not allowed to add individuals who need assistance without having to call PPL? This is taking weeks to get a consumer added and provide the help they need. They are still unable to get in touch with PPL. And so many are still without services because they cannot register."
Can you talk more about the relationship between PPL and those facilitators? And I have heard from facilitators that an issue is that the rosters of consumers they had previously were not automatically transferred to them to help them and they're having to call PPL and add, as this facilitator describes, each consumer one by one to their roster. So can you talk about why that is?
Maria Perrin: So that isn't, first of all, facilitators who came on board with us, whatever consumers that they were already serving, they were designated to that facilitator.
Secondly, facilitators have a whole team of facilitator account support. They can be reached immediately if they have any questions or need to tag a particular consumer to that facilitator. So that's in place, it has been from day one.
And then your other question is why can't facilitators just assign a consumer to them directly? It's because what we don't want to happen is for a facilitator to take a consumer who's already assigned to another facilitator and just randomly switch them over because the consumer may have already chosen that other facilitator and there has to be some checks and balances. So how we do that is we make this account team available to facilitators. If they need anything to be flipped over, then we verify it and then we do that for them. But we want to be fair to the consumer and don't want them randomly assigned, and we also want to be fair to each facilitator.
Emyle Watkins: Thank you for explaining that. And one of the most frequent topics we had people write in to us about was your health insurance. Diane Furey, a designated representative, wrote in asking, "PPL has indicated that health insurance would be offered, but why is there not any information on what health plan will be offered, how much the premium would be and when the personal assistants can enroll or how to un-enroll? Why is there a lapse of coverage?"
And I want to point out it's very common for employers or their brokers to provide information sessions about health insurance. Can you start by answering how PPL is communicating health insurance information to upstate New Yorkers who have this optional plan?
Maria Perrin: Yeah, so we have actually a whole benefits team. If you're on Facebook, I assume you have access to the internet. So if you go to our CDPAP webpage, the resources page, there is all information on our benefits program and also direct contact numbers to our benefits team. So you can have a direct conversation with them and they will be able to answer all your questions specifically.
Emyle Watkins: Thank you. And I had a chance to look at the elective plan you're offering and we had a lot of questions about why you're offering this specific plan. This elective plan that you offer has a deductible of $6,350. Several preventative services are offered prior to the deductible. But many have criticized that dozens of services are not covered until you hit the deductible, including primary care, specialty care, hospice, outpatient mental health services, autism related services, chemotherapy, dialysis, and more. Furthermore, according to the Department of Health's resources on the transition, the offer of this health plan could also impact a personal assistant eligibility for the essential plan and marketplace health insurance. I'm wondering, does PPL feel this plan provides reasonable coverage for the average New Yorker and why did you choose to go with this plan specifically?
Maria Perrin: Yeah, so when we were looking at plans for the personal assistant population, we wanted to make sure that we could at least for full-time PAs offer basic coverage because we understood that many FIs were not offering any type of coverage. So this was a way to get a what is equivalent to a bronze plan available to PAs who didn't have any coverage before.
Now there are other options. Many of the personal assistants my understanding have care through Medicaid. And so the state will basically help you decide is the PPL plan a better option for you or is Medicaid a better option for you? And the state will help to offset any costs of the PPL plan if the PPL plan is a better option for you. What I would recommend for all PAs is to call New York State of Health and I could provide the number for that and they can walk you through the options, whether it's the PPL plan, medicaid or another state option, and they'll help walk you through that information. And then you can also call our benefits team and they'll also offer help. But may I give the phone number for New York State of Health?
Emyle Watkins: You can. And we'll make sure to include on our website as well.
Maria Perrin: It's 1-855-355-5777.
Emyle Watkins: And I just want to mention if you're joining us now, this is Disabilities Beat Live from Buffalo Toronto Public Media and I'm your host Emyle Watkins. I'm joined by Maria Perrin, the president of Public Partnerships LLC, or PPL, the new sole fiscal intermediary for the Consumer Directed Personal Assistance Program.
I am of the understanding that some of our initial questions may have gotten missed by some viewers due to some technical difficulties and we do apologize. If it is all right, Maria, I do want to go back to those questions and make sure people can hear them, but if it's all right with you, I'd like to wait to the end because I want to make sure we can get a few more questions answered first. Is that all right with you?
Maria Perrin: Yes, of course.
Emyle Watkins: Okay. Thank you so much. Looking downstate, we received a lot of questions about the mandatory insurance that personal assistants are automatically enrolled in. One loved one of a consumer wrote to us saying, "Why are personal assistants in the downstate area being forced to enroll in your MEC insurance plan, which then becomes their primary insurance? This coverage should be offered as an option, not mandated. Workers should have the ability to make their own health care decisions, especially if they already have existing coverage. Additionally, please explain why PPL is treating downstate personal assistance differently. This policy appears to be discriminatory and unfairly targets a specific group of workers. We appreciate transparency around this decision and a clear explanation as to why this requirement is being enforced in such a selective matter."
So I want to ask you, what does make downstate different? Is it state or federal laws? Is it the wage parity?
Maria Perrin: It is the wage parity and the SecureHealth Plan, which is a Wellness Plan, doesn't interact with their comprehensive benefit plan. There is no cost to the personal assistant. It covers certain preventative care, it covers certain things like preventative medications, screenings and things of that nature. So it should not interact with your full comprehensive coverage. It also has a flex benefit card. So per hour worked there accrues money towards a flex benefit card and you can use that for things such as transportation, covering childcare, covering other medical expenses, prescription drugs, et cetera.
Emyle Watkins: And we've heard from many families who say the pay rates their personal assistance were promised are now lower than expected, particularly in regions like Long Island, which as we both know are impacted by the wage parity. Can you please address what the wage parity is in more detail and how you're using it versus how previous FIs used it?
Maria Perrin: Yeah, so in terms of Long Island, we have moved to basic wage for all CDPAP personal assistants based on the area they work in. On Long Island, as well as in Westchester County, the basic wage is $19.50, in New York City it's $20.10 and in the rest of state, the upstate areas it's $18.10.
Emyle Watkins: But how are you dividing up the wage parity and using it? My understanding is some previous FIs used the entirety of the wage parity to increase wages for workers and now some of those workers are confused because they're seeing a lower wage but they are getting this MEC plan.
Maria Perrin: So we have put a portion of the wage parity dollars into the basic wage. So instead of a minimum of, for example, in New York City, the minimum is 19.10, we took a dollar and made the minimum 20.10. And then the rest of that goes into other benefits such as the flex card and the other plan benefits.
Emyle Watkins: And one of the interesting criticisms I've read about your MEC plan, which for people who aren't familiar stands for minimal essential coverage preventative, plan. Michael Kinnucan a senior health policy advisor at the Albany-based Fiscal Policy Institute, he wrote that the "skinny plan loophole," which allows large employers to offer almost purely preventative care plans to avoid the most severe Affordable Care Act employer mandate penalties for not offering health insurance. So essentially he's saying that PPL may be offering this plan, which is almost purely preventative to avoid receiving fines for certain mandates of the Affordable Care Act. And again, he's arguing that PPL may be using the wage parity to instead cover this MEC plan. Can you respond to this criticism?
Maria Perrin: Yeah. So I think the two are getting confused. For full-time workers, SecureHealth Plan is the comprehensive plan. And so anyone who's working 130 hours a month or more is offered the secure, more comprehensive health plan and that's the one that's connected with the federal laws for large employers to offer health insurance. It's not related to the preventative plan.
Emyle Watkins: So you're saying that the MEC plan has no influence on whether PPL will pay ACA penalties?
Maria Perrin: No, it's not related to that. Our obligation as an employer is to provide for full-time workers a more comprehensive plan, and that's our SecureHealth Plan. It's not the Wellness Plan.
Emyle Watkins: So why offer the Wellness Plan?
Maria Perrin: The wellness, it's another more options for people in terms of covering preventative care. It has the benefit of the flex card that they can use. It can use that for co-payments or pharmacy cost and even things like childcare and transportation. So it's offering more comprehensive benefits to the population.
Emyle Watkins: Many people also wrote into us to ask if PPL has any sort of opt-out for this downstate benefits plan or if PPL will consider adding an opt-out so they instead can take the wage parity as a wage increase and purchase health insurance on their own. Can you speak to that?
Maria Perrin: Yeah, so the Wellness Plan does not keep you from getting any other benefits such as Medicaid or other government healthcare programs except for Medicare. It becomes a primary, so you can opt out of the Wellness Plan if you have Medicare.
Emyle Watkins: But I think people are asking that because they'd like, instead of their money from their wage going to these benefits, they would instead just like to receive that money as part of their wage.
Maria Perrin: We'll definitely consider it. I can't give you an answer today because all of these were designed for providing a comprehensive and professional package to people, which also includes things like personal time off and holiday pay and things of that nature. So it was developed to really professionalize the personal assistant compensation package. But certainly we'll be happy to take it back and consider the options.
Emyle Watkins: Thank you. I really appreciate that. I know it's saying we got several, several questions about. I also know we received many questions about the rollout's impact on rural consumers and personal assistance. How has PPL adapted to consumers and PAs in areas that have no or limited internet access?
Maria Perrin: So as mentioned earlier for things like timekeeping you can use our telephony system and so you can call in to put in your shifts, consumers can approve shifts through telephony, they don't need to have internet access. In terms of other things that they may need such as registration support or customer service questions, we do have a call center open six days a week from 8:00 AM to 8:00 PM. We do have offices in community where people can come into our offices for support. And then we have over 40 facilitators who both have telephone support as well as 150 offices across the state to support consumers and their PAs in rural areas.
Emyle Watkins: Thank you. I know that's a huge challenge because while people think of New York and think of New York City and some of our larger cities, even like Buffalo, we do have the Adirondacks, we have the Catskills, which are very, very rural areas and I know you've contracted with occupational health provider, Mobile Health to help provide medical examinations and they have several locations in most cities in New York. But we did receive concerns that for PAs in rural areas, it would be a significant drive to get their medical exam covered through Mobile Health. For example, people living around Long Lake in the Adirondacks would likely have to drive two to three hours to go to Watertown for an exam. I'm wondering how did PPL decide to contract with Mobile Health and are you working on any exam alternatives for rural workers who maybe can't make that two to three hour drive?
Maria Perrin: Yeah, so we selected Mobile Health because they are the largest provider of these such health assessment services. So they had the most coverage of all of the providers who we looked at any providers serving the state of New York, they currently had been serving CDPAP PAs. So they were a good fit from that standpoint in terms of they have the most locations, they were the largest and they have experience with the population, so that's how we chose them.
Secondly, happy to go back and look at are there any points where they should have more coverage and talking with Mobile Health to offer some options for people so that the hours that they need to drive, the time they need to drive is shortened for when they do their health assessment.
And then lastly I would say is in case people don't know if you are already a personal assistant in the program and you have done your health assessment in the past year, you don't need to get another one until your health assessment becomes due again. So I just want to make sure people have that information as well.
Emyle Watkins: Thank you so much. And one topic I want to make sure we touch on is pay. I know that a lot of workers have expressed or spoken out on social media about issues getting their paychecks. I know that a lot of people didn't know their first few paychecks may be mailed to them. I'm wondering if you can touch on where payment stands right now and how PPL is continuing to make sure that people get paid and get their back pay as well.
Maria Perrin: Yeah. So right now people are getting paid and if they got a paper check, it was because of one of two reasons. Either they gave us their direct deposit information and it couldn't be verified. So there is either a problem, maybe a digit was wrong or when our payroll test checked it couldn't go through. And I think we've all been through that where we give our checking account and there's a dollar test or a penny test. So that would have been the reason that the test couldn't go through or we didn't have the correct direct deposit account information. You can correct that on our system at PPL at Home in your profile or you can call us and we'll help you get that corrected if that happens.
And then in terms of pay, I think it's important for everyone to understand how payroll works so that their expectation and they know what to do to make sure they get paid every Thursday. So the payroll period starts on Sunday at 12:00 AM to Saturday night at 11:59. So for payment the next Thursday, please get your time cards in by Saturday at 11:59 PM that'll enable you to be in the next Thursday paycheck.
In terms of people who may have submitted time and didn't get paid right away, almost exclusively the reason is because they didn't complete their registration and specifically they didn't fill out their I-9 documentation or provide us with their I-9 documentation that is required not only by the program but by state and federal law. So that is the lion's share if someone didn't get paid right away. And what we do in that case is we do a reach out to them. We have a team that calls them by phone. If we have their email address, we'll send an email. If we are able to send texts to them, we'll send a text that says, please submit this documentation right away. So you'll either hear from one of our agents calling you, you'll get an email, you'll get a text that say, please submit right away so that we can release the pay that it says you're legal to work not only for the program but for the state and country. And those get released right away.
If you need help with submitting documents, you can call our call center, you can come to our offices, the team will walk you through that. And if you haven't access to the internet on our resources page, there are videos that show you step by step, here's how you do that.
Emyle Watkins: Great. And I wonder if part of that confusion as well about receiving payment also comes from the fact that many PAs had bank cards from some of their FIs. So some of the larger FIs, I believe including FreedomCare had provided debit cards essentially to PAs who were unbanked. And it's not uncommon for someone to be without a bank. And so I guess I'm wondering, and this is a question we receive several times, is does PPL have any plans to provide a bank card or some sort of option for unbanked people?
Maria Perrin: We do. So we have heard from certain PAs that they want a bank card and we are working on that option now and it will be available within the next 60 days.
Emyle Watkins: That is fantastic to hear. I'm glad you could provide that announcement here. And speaking of the phone lines, another question we received repeatedly was about the fact that when people call into the phone lines, they may be waiting for about 10 to 15 minutes and then they get an option to have a callback or the line drops. And when people call in, it's not kind of from my understanding sorted based on the issue they're having. I'm wondering, are you doing anything to improve your phone line system and how many people do you have working on the phone lines at a given time?
Maria Perrin: Yeah, so we're always looking at ways where we can segment out by people's needs. So right now the segmentation is based on language, so we have nine different language lines. There are segmentation based on health plan-related issues, facilitator-related issues and a few other things. We're looking at adding some other type of segmentation now that many people are through with their registration, we're looking at do we need a payroll option and some other things. So in the future we will be adding some of those options.
The other thing that I would say besides making that available is if you're looking for other support that I would encourage you if you live in a vicinity of one of our offices on our website, you can see our offices and you can make an appointment so you don't have to wait. That's also a good way. If you have the time and the ability to get to an office, that's a great way to really make sure that you understand the full breadth of what you need for the program as well. So I want to offer that other option. And then the last option I'll give to this audience because I know you're on social media, so I'm assuming you can get on webinars. We do offer daily webinars as well that have live Q and As and it's all about time tracking and other things that you need to know how to use our systems and other important things for your daily interactions with us.
Emyle Watkins: I know that you were just able to provide some sort of timeline on the bank cards. Are you able to provide any sort of timeline on an update to the phone system?
Maria Perrin: On the phone system, I'm not able to give you a definitive date today, but it is forthcoming. I would also say that we had kind of a mad rush to the phone lines in early April and a couple of things drove that it was many people had waited to do their registration and that was because of information they were getting maybe from some people who didn't want the transition to PPL to happen, so they advised people just to wait until early April.
But I think it was also due to the fact that there was a court order issued at that time that extended the transition timeline and many people called in with questions about the court order. The phone lines had jumped from receiving about 60,000 calls a day to 150,000 calls per day. And many of them were questions on what does this mean? Should I submit time to PPL? Should I go through my former FI? I'm not sure what to do. So there was a lot of confusion when that court order came out.
Now the phone lines, there's not a lot of wait time, so if you try again now, I think you'll see that it's much easier to get through and much easier if you choose the callback to get a callback or if you are comfortable with email, you can also email us at newyorkCDPAP@PPLfirst.com and those are now like same day responses.
Emyle Watkins: I appreciate that. And I do want to say I can imagine as a large company taking on a very large transition like this and then having that confusion in place was probably a major challenge. But I would be remiss if I didn't bring up the fact that a lot of people with disabilities were very upset about the way that the State Department of Health and even the Governor's Office sometimes referred to consumers and PAs. There was a lot of language around being misinformed and most of us have seen the video of activist Julie Farrar being patted on the shoulder by the Governor and being told she was "being lied to."
I want to give you a chance to address, has PPL worked with the Department of Health on messaging around this program? And if so, do you have any concerns about the ways your customers have been talked about or too? Because for a lot of people with disabilities, I've heard this language, they found it to be infantilizing.
Maria Perrin: Yeah, no, I mean as you know, this is all we do at PPL. We work for 50 different self-direction programs across the state. Our community, half of the people we serve are disabled, half the people we serve are seniors and these are hundreds of thousands of people around the country. And as I said earlier, this is also us, these are our family members. The people who come to work at PPL, it's us, it's our family members. So people who deserve to be treated with respect and taking their concerns seriously.
So we do work with the department, especially our communications. Many of them have been reviewed by their chief disability officer and other communication specialists and people who work with the community in New York. Of course, we also have people in-house who, as I said, they do identify as disabled themselves and we have them review our communications as well. So I hope that the community, your listeners and beyond feel that PPL's communications have been respectful. And if there are ways to improve, please let us know. Let me know and I'm happy to address them.
Emyle Watkins: Thank you, Maria. I do really appreciate. I know these are very tough questions, but these are the exact kind of questions we've been getting in and I know people appreciate the chance to hear from you directly. I do want to remind people if you're just joining us that this is Disabilities Beat Live from Buffalo Toronto Public Media. And I'm your host disability reporter, Emyle Watkins. I'm joined by Maria Perrin, the president of Public Partnerships LLC, or PPL, the new sole fiscal intermediary for the Consumer Directed Personal Assistance Program, or CDPAP.
Maria, I want to ask, consumers have a constitutional right to not have their Medicaid benefits reduced or ended without notice or due process. Consumers that may live in areas with limited internet access may not have meaningful access to information provided electronically or for other reasons they have not known about or fully engaged with this process still have those Medicaid rights. I'm wondering how has PPL and the Department of Health worked together to ensure consumers' constitutional right to due process is respected?
Maria Perrin: Yeah. So in terms of reaching people who may not have access to all of the communications that many of us do on forums like this, we worked closely with all of the health plans in the state, the Medicaid health plans in the state, with the local departments of social services, the LDSS offices and with the Department of Health to make sure that there were physical notices sent, multiple physical notices sent to all Medicaid recipients who were receiving CDPAP services, that the care managers at the health plans as well as at the LDSS offices were calling and contacting these particular Medicaid recipients to make sure they understood what their rights are, but also what they needed to do to transition in the CDPAP program and what their options were, whether they wanted to remain on CDPAP or whether they wanted to choose a different path.
Emyle Watkins: Thank you so much. And to be fair, while we are asking you a lot about PPL's role in this rollout, New York state and their Department of Health also have responsibilities in making sure the transition happens properly. I'm wondering how has the state of New York been helpful to you in the rollout and how could they have done better?
Maria Perrin: So they have been helpful in coordinating the effort between PPL, the health plans and the local departments of social services. So we have daily meetings with the health plans. We have three times a week group meetings with the LDSS offices and then individual meetings daily with those. And many of that came through a coordination with the Department of Health, which we found very helpful because these are a lot of entities between the LDSS offices and the health plans, there's over 100 different entities. They helped us organize to get data from these entities that we needed to make sure that there was proper reporting, that there was focus on people who needed help, as per your last question, people who may be in rural areas or people who may not have access to all the communications that many of us do.
So they've been helpful in really coordinating with us and these other entities on how do we make sure we reach people to get the information they need and that they're being supported appropriately.
Emyle Watkins: And consumers are also meant to be co-supervisors with the FI and the administration of their care. We had one consumer ask how PPL will collect consumer supervisor feedback, and do you plan to create an advisory council of consumers?
Maria Perrin: We do. So we are starting to work on that and we will have a consumer advisory for New York. We do have a national consumer advisory and I'm sure some of the people who participate in New York will want to or we hope they will want to join our national advisory with consumers from many other states. But we will be working on that and we'll have that up and running this summer.
Emyle Watkins: That's great to hear. And I do want to ask, with the issues with accessibility that have been brought up post-launch, that also points to a larger concern people have. How is PPL going to engage in constant improvement and do you have a team focused solely on improving these services?
Maria Perrin: Yeah, so we have a few different teams. We have a community liaison team. As far as I know, we were the only, at least a national fiscal intermediary, who deploys community liaison. And these are people who specifically are out there talking with consumers, working with advocacy groups to find out what are the needs of the community and then taking it back to PPL and whether it's improving technology, whether it's improving process or other types of accessibility needs, making sure that those get implemented and there's a voice from consumers and NPAs who need it. So we do have a team of community liaisons now. They have met with dozens of advocacy groups. They've been out in the community and they will continue to play a role as well as playing a role in administering and facilitating our advisory council, which will be made up of consumers of course.
Emyle Watkins: What are some of those advocacy groups that you're working with?
Maria Perrin: So we've talked with the ARC, we've talked with AARP, we've talked with many of the community groups that help with people who are new Americans or non-English Americans. Of course, we work with different disability rights groups. So right now, as I said, I think we've met with more than 50 advocacy groups. I'm happy to provide the list to you and maybe if people, your listeners are connected with them, we can even organize an event with those particular groups. We have done events with success in YMCAs and senior centers and other types of community centers as well. So if it's helpful for your listeners and for the broader CDPAP consumer groups, we're happy to do that with our community liaison folks.
Emyle Watkins: I will absolutely reach out for a list because I think for consumers and PAs, it's helpful to know which community organizations to reach out to and I know that your facilitators are quite busy with the transition itself.
And one question we received was from Robert A. from New York, New York, and he wrote a very direct question, I want to read it for you. He said, "The transition has not gone according to plan. According to PPL, who is responsible for this? Please explain." I want to give you a chance to answer this towards the end of this interview because I think a lot of people share this sentiment or idea that the transition has not gone according to plan. And I want to give you a chance to address that. And I want to ask, do you agree with this sentiment and who does bear responsibility if the transition has not gone to plan?
Maria Perrin: So I don't know who at PPL said that or what he's referring to. But what I will say is how this transition was different from the transitions we've done in other states. And we've done many, right? So 25 years doing this. We have done transitions where we're the outgoing fiscal intermediary and we're the incoming fiscal intermediary. And one that was very different here is there was not this shared cooperation in the transition. So one thing we always do when we're transitioning out is we provide the consumer and the caregivers' data to the incoming fiscal intermediary. We provide their contact information, everything we know. Because at the end of the day, we want to make sure that people are getting the care they need, there's no gap in care and that people can get paid when they need to get paid.
We didn't always have that for this particular transition. In fact, many of the outgoing fiscal intermediaries refused to give us data, refused to tell us how to get in touch with the PAs and who the PAs were. So this was a different transition from that standpoint because in every other transition at the end of the day, the fiscal intermediaries, they worked together for the good of the community. So that was a little different.
Emyle Watkins: And just to clarify, Robert had asked, according to PPL, who is responsible for this? And it wasn't anyone from PPL that submitted that question. But just to be clear, are you saying that the previous FIs are at fault for the way this transition happened?
Maria Perrin: I don't know that there is fault. There's over 200,000 consumers who are fully registered, over 200,000 PAs who are fully registered. I understand that there is a group of consumers who have chosen to go to [inaudible 00:53:56], an agency model. So most consumers have chosen their path. And we're doing the transition where there's a weekly payroll. There's a call center with over 2,000 people supporting customer service needs. There's over 40 facilitators also supporting. So I don't know that I'm in agreement that there is a flawed implementation. I would say every implementation contains a lot of change. And that's hard. We have to acknowledge it's hard for consumers, it's hard for PAs, it's hard for all the organizations involved, but the processes are in place now. And if there are individual cases where we could do better for an individual consumer or PA, please let us know because we want to do better.
Emyle Watkins: Absolutely. And again, we'll put that information on our website so people can contact you. I know that was a difficult question, but I know it's something we've heard a lot on social media and want to make sure we give you a chance to address.
I do want to ask, again, we've seen a lot of rumors and questions on social media and as we talk about PPL's relationship with New York State, I want to give you a chance to directly address a specific rumor and concern. Did PPL or your investors have any relationship, communications with or lobbying to New York State or anyone in state government prior to both the budget announcement and the bidding process?
Maria Perrin: No, we participated in the procurement just as everybody else did. We put in a bid, once the procurement was released we put in a bid, like my understanding is over 100 other bidders and we were selected. When you think about our experience and the fact that we serve so many self-direction programs, it's not hard to rationalize why we were selected. So this was a fair procurement, it was, our information as we followed it, to the letter of the law by the state and by the procurement rules and we were selected. I think we offered a fair value in terms of fee, but also our experience went a long way in terms of being able to serve the community.
Emyle Watkins: And I do want to say I appreciate that this conversation has been full of tough questions and that you've taken the time to answer them. And before we wrap up, I do want to ask, is there any message you want to make sure people hear or take away from this conversation? Is there anything you want to say directly to people using or working through this program?
Maria Perrin: Yeah, I would say again that know every change is hard, especially a big transition of an essential program that you, your family or the person you care for is going through. If you need help, please reach out to us again and let us know what you need because we want to be the best we can for you. I'll repeat that many of the people who work at PPL do so specifically because of our mission, like myself. Having a family member who is disabled and needed care from programs and from a lot of caregivers to be successful, I know how important this is. So you're dealing with people like myself at PPL who know what these programs mean and know how essential they are to your daily lives. So if the transition has not been perfect for you or what you expected, give us a chance, let us know what you need and we'll work on it.
Emyle Watkins: Well, thank you so much, Maria, for joining us on Disabilities Beat Live from Buffalo Toronto Public Media. If you missed part of this conversation, we'll have a recording and transcript up on our website shortly, and we will continue to cover the concerns and questions you have with CDPAP as the transition continues. You can feel free to reach out to us at any time at disabilitiesbeat@BTPM.org. Thank you and have a great day.
