Lawmakers, advocates and contractors beg Hochul to delay April 1 CDPAP deadline

The clock is ticking for hundreds of thousands of home care recipients and their personal aides to make the switch to a single new payment processor. The state Department of Health has insisted that the transition is on track to be completed by the April 1 deadline, but home care advocates, lawmakers and a powerful health care workers union warn that tens of thousands of people stand to temporarily lose their care if the state is wrong – and they’re making a final appeal to Gov. Kathy Hochul to extend the deadline before it’s too late.

As part of the state budget last year, lawmakers approved a major change to the Consumer Directed Personal Assistance Program, which Hochul pitched as a cost-saving measure and a way to cut down on what she has called rampant fraud in the program. The Medicaid program covers home care for those who qualify and permits friends and families to serve as aides. Currently, hundreds of different fiscal intermediaries process these payments to aides in the state. But starting in a week and a half, a single company – Public Partnerships LLC, or PPL – will be the only fiscal intermediary allowed to operate in the state.

About 280,000 consumers use CDPAP, and about 400,000 home aides provide services through the program. According to the state Department of Health, as of Thursday, nearly 150,000 consumers and 160,000 aides have started or completed the registration with PPL since the transition began at the start of January. An additional 45,000 consumers have switched to a different program called Personal Care Services rather than continue under CDPAP. The Department of Health said the transition is “proceeding on track” to meet the deadline.

Advocates, lawmakers and even subcontractors for PPL, however, disagree. “Governor, once again, for the love of all that is holy in heaven and earth, delay the goddamn date,” state Sen. Gustavo Rivera said at a rally on Wednesday at the state Capitol. As chair of the Senate Health Committee, he has been a vocal proponent of pushing back the deadline and has generally been critical of the transition process so far. But Rivera said that “this is not about stopping, this is not about ruining.” The Department of Health and Hochul have claimed that advocates pushing for a delay are just fearmongering bad actors pushing false information in an attempt to prevent the transition from taking place. “As companies continue to work to disrupt this transition by pushing a misinformation campaign, the dedicated DOH staff, PPL and its facilitators will continue to deliver the facts so home care users can make the best choice for themselves and their families,” state Health Commissioner James McDonald said in a statement.

But some of those facilitators are the ones raising the alarm, like independent living centers contracted with the state who serve CDPAP consumers and are helping with the transition. “If they don’t delay it, people will go without care,” Susan McCormack, executive director of the Long Island Center for Independent Living, told City & State. While some home care advocates have criticized PPL and questioned the company’s ability to deliver, McCormack placed the blame for issues that have arisen squarely on the three-month period provided to complete the transition. “It's just unheard of,” she said. “That's the problem, the timeframe. I can't blame it on PPL.”

The New York Association for Independent Living, which represents independent living centers including those contracted with the state, sent a letter to Hochul’s deputy secretary for health on March 13, asking for a delay. The letter followed a meeting the centers had with Hochul’s staff the day before. “Yesterday you stated that a delay ‘is not an option on the table,’ and your Counsel closed the meeting by saying that a delay ‘is not nor will ever be considered,’” the letter reads. “The Administration’s response to our request to extend the implementation time frame is deeply concerning.”

The letter also laid out in detail the various issues that the short timeframe has caused. PPL’s online-only registration has been glitchy and posed a problem for consumers who don’t have smartphones or computers. The letter also mentions long wait times to speak with a PPL representative and the insecure way in which the company stores data. All of those issues are placing stress on the facilitators meant to help with the transition. “We're experiencing call volumes of, like, 1200 calls a week just for this, just for this program,” McCormack said. “That's not something we normally deal with.”

After this story was published, 1199SEIU added its voice to those calling for a delay. The powerful union specifically said that Hochul should use an executive order to extend the deadline for fiscal intermediaries who were not chosen as facilitators, but limit the benefit to those companies that have been fully cooperating with the transition. “The transition has been hampered by misinformation spread by certain FIs and others who are attempting to disrupt care for vulnerable consumers to serve their own financial interests,” said George Greshamn, president of 1199. “With over 100,000 workers who still need to start their registration process, there must be immediate and urgent action to mitigate disruption for consumers and the workers.”

In a press release, 1199 said that it had sent letters to the Department of Health and legislators with a series of recommendations on how to make the transition smoother, with a new deadline in September. The Thursday afternoon move by the union is particularly notable because of the health care union’s political clout and its plans to unionize home care aides following the transition.

State Sen. Leroy Comrie sent his own letter to Hochul on March 13, which was signed by eight of his colleagues. “It has become clear that these folks are putting forth a good faith effort to fully transition, and even those with excellent internet technology skills are experiencing major challenges,” the letter reads. It also calls for the state Senate to take steps to remedy the issue rather than wait until after the completion of the state budget, which is due on April 1 – the same day that the CDPAP transition is supposed to be complete. In the lower chamber, Assembly Member Chris Eachus is currently circulating a similar letter among Assembly members to send to the governor. And just this week, AARP added its voice to the growing calls for a delay in its own letter to the governor.

But Hochul has continued to stand by her decision not to extend the deadline. “Hundreds of thousands of CDPAP consumers and workers have already taken action as part of the State’s transition, which remains on track for April 1,” spokesperson Sam Spokony said in a statement. “Our much-needed CDPAP reforms will protect home care users who rely on this important program, while also protecting all New York taxpayers by putting an end to years of runaway administrative costs.” 

Legislative leaders have given no indication that they will push for a delay. Neither chamber included any changes to the CDPAP transition as part of their one-house budget proposals, and Assembly Speaker Carl Heastie told reporters on Thursday that a potential delay has not come up during high-level budget talks. “At least between myself and the other leaders, there's been no talk of a delay,” Heastie said.