Official says they're working to end consumer frustration brought on by the transition of New York state's Medicaid home care program to a single payroll provider.
In September 2024, Governor Kathy Hochul announced what she called a statewide partnership to transition and strengthen CDPAP, the Consumer Direct Personal Assistance Program.
CDPAP enables people with disabilities to hire their own personal caregiver, which could be a family member or friend. As per Hochul, caregivers' workhours and payroll since April 1st are now being handled by Public Partnerships, LLC (known as PPL), a single, state-selected administrator.
State Department of Health Commissioner Dr. James McDonald says it was a transition that had to be made because the existing at-home care program was unsustainable.
"We had over 600 fiscal intermediaries. In other words, 600 different payroll companies," said McDonald. "If that sounds like a lot, it's because it is. We had more than every other state in the country combined, and what started off as a program that was pretty affordable for New York got to be an $11 billion program for New York State last year. And you know, as a point of reference, New York State was spending a lot more on home care than every other state combined.
McDonald says New York accounted for 45% of national spending on home care.
The program got off to a somewhat rocky start. Some CDPAP caregivers complained they were overpaid, underpaid or not paid at all.
Thomas Grimes is a quadriplegic who requires specialized nursing care, attended to by rotating PA's or personal assistants on a daily basis. The Schenectady resident has used CDPAP since 1997.
"The transition has been extremely, extremely difficult for not only me, but for my personal assistants to transition over. There's been continual complications. We're registering with all the information, and trying to get a hold of the single physical intermediate PPL, has been nearly impossible. They don't return phone calls. It's been extremely difficult to get everyone registered and on board. Since I'm high level, I require a lot of hours, so I have numerous PAs, probably more than most people, and that's where the difficulty comes in. I still must be able to register all my PAs. Some of them still have not been paid," Grimes said.
The Legal Aid Society filed a lawsuit this week alleging PPL has failed to properly compensate a substantial number of its home care workers and that PPL’s failures are forcing workers out of the field, threatening a collapse in care for more than 280,000 New Yorkers who rely on these services.
PPL's President Maria Perrin says the company continues to adjust to the new system including working with 45 subcontractor-partners, who are called CDPAP facilitators. They are located throughout the state and have 150 offices between them.
"We currently have more than 200,000 consumers who are fully registered with us, and another 20,000 that are in process of completing their registration, and then close to 200,000 personal assistants who have completed their registration, and another, about 75,000 that are in process," said Perrin. "So we have, again, over 400,000 people who are completely finished with the registration process and or working with us in some form or fashion."
Perrin says PPL offers many self-service tools and has been working double-time to address complaints about PPL's website, app and phone lines.
"We have a daily webinar on how to submit time cards or use the technology, and we answer questions live on those daily webinars. We have a resource page that has videos and screenshots on you know, everything you need to know to interact with our system, and then general information about payments and registrations and other things they may need or want to know, and then just overall, we often hold events in the community as well to help people," Perrin said.
The health department has set up a hotline for anyone experiencing transition issues - 1-833-947-8666
