Department of Health and PPL: CDPAP transition issues are not our fault

After weeks of insisting that New York was on track to hit an April 1 deadline for the Consumer Directed Personal Assistance Program transition, state Health Commissioner James McDonald all but admitted on Monday that those assertions were bunk. He announced a 30-day “grace period” – which he emphasized is not technically a delay or extension – to allow workers to receive retroactive pay for the month of April if they need more time to finish registering with the single new middleman authorized to handle payments for the program. And according to both McDonald and that company – Public Partnerships LLC, or PPL – the blame for issues with the transition lay with everyone but them.

As part of the state budget last year, lawmakers and the governor agreed to transition the program from hundreds of fiscal intermediaries – middlemen who handle payments to home care workers through the CDPAP Medicaid program – to a single company. It was meant to save the state money by cutting down on alleged fraud. The transition officially kicked off on January 6, giving upwards of 280,000 consumers and an estimated 400,000 personal assistants only about three months to either register with PPL or make the decision to switch to an alternate form of care. 

On Monday, McDonald acknowledged for the first time that not everyone would make the April 1 deadline, when all fiscal intermediaries in the state other than PPL and its handful of subcontractors are legally required to cease operations. Most fiscal intermediaries in the state will still shutter on April 1, but the grace period gives workers and consumers until April 30th to complete registration with PPL, permitting workers to receive retroactive pay while continuing to care for patients. “This is not a delay, nor is it an extension,” McDonald said repeatedly, noting that an actual delay would require a statutory change.

What caused the issues that require this extra grace period and additional time to complete registration? It’s not the Department of Health or PPL, according to McDonald and PPL President Maria Perrin. Nor is it the unheard of three-month time period to transition hundreds of thousands of people. It’s just everyone else pushing misinformation. “The misinformation for this has been like nothing I've ever seen in my career,” McDonald said. He said multiple times that he doesn’t blame consumers or workers for being “misled” and therefore causing hiccups in registering on time. “That's why there is this late registration window,” McDonald said. 

Never before has a state that transitioned to a single or smaller number of fiscal intermediaries attempted to complete that shift in as short a timeframe as New York. Massachusetts, for example, took 19 months to make a similar transition with a much smaller population and far fewer companies to consolidate. But according to McDonald, people had “quite a bit of time” to sign up. He blamed uncooperative fiscal intermediaries for  the situation that the state has now found itself in. “What the other fiscal intermediaries could have done was simply given the names of the patients and the workers to PPL,” McDonald said. “In other words, they should have helped us with this law, but they chose not to.”

Perrin, the PPL president, said it was a well-funded opposition campaign, not the short timeline for the transition, that made New York different from other states that have completed a similar transition. “No one expected a tens of million dollar opposition campaign on this,” Perrin said. “This just doesn't happen in other states.” And she also tacitly blamed the press, adding that there “has not been a lot of coverage on what all this disinformation has been doing to affect the consumer and the (personal assistant).” 

What about all those reports of glitches in the PPL system and problems that people ran into while trying to contact the company in order to complete their registration? Or the recent whistleblower report from the New York Post that described the rollout as “a shit show?” All lies, according to Perrin. “I think that is false information,” she said. Perrin denied that the website ever crashed, despite numerous reports that PPL website was down due to the number of people trying to access it. “System never crashed, was never down,” Perrin insisted, explaining that the system had only experienced a slowdown on a single day, which affected just 10% of people. A screenshot shared with City & State shows the PPL registration site crashed on March 17.

State Sen. Gustavo Rivera, chair of the state Senate Health Committee, was livid at the insinuations made at the press conference. He said that constituents have been telling him about the problems they have faced with PPL even as they try their best to complete the registration. “You're giving misinformation, commissioner,” Rivera told City & State. “You're the one that's saying that the folks that are calling my office… you're telling me that they're liars.” He added that the 30-day grace period does nothing to solve the problems that constituents have raised to him and advocates have described, nor does it help workers who may be living paycheck-to-paycheck and can’t afford a month's lag in compensation.

Lawmakers, advocates, PPL facilitators and even the influential health care union 1199SEIU  – which stands to gain from the transition by unionizing home care workers – have all called on Gov. Kathy Hochul to offer more time. Rivera said that Hochul should use her executive authority to postpone or delay the deadline, but the governor has refused to even consider that. “We are not changing that deadline for the companies,” Hochul told reporters at an unrelated press conference on Monday when asked about the CDPAP changes. “They don't deserve it because they are the reason we're in this situation… I’m not letting them off the hook, hell no.”