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CDPAP consumers and Their Personal Assistants Must Switch to "PPL" as their Fiscal Intermediary by March 28, 2025 - or Lose CDPAP Services21 Feb, 2025
Under a change enacted in the 2024-25 NYS Budget, NYS Is requiring all 240,000 Medicaid recipients who have CDPAP services to switch their "Fiscal Intermediary" (FI") -- the agency that manages payroll and benefits for their Personal Assistants ("PA")-- to a new "single FI" called Public Partnerships LLC or "PPL." This includes members of MLTC plans, mainstream managed care plans, and those receiving CDPAP from their local county Dept. of Social Services (HRA in NYC). As the "single FI," PPL will replace the more than 600 FIs that currently handle payroll and benefits for all PAs in CDPAP. This is rapidly changing information - Please check back here for changes and also check the websites here for news. NEW - 2/20/25 - DOH just posted this chart and Fact Sheet explaining differences between CDPAP and Personal Care services, noting that switching from CDPAP to traditional Personal Care would require a new authorization from the MLTC, Managed care plan or DSS. See more about differences between CDPAP and personal care here. IN THIS ARTICLE
What is a Fiscal Intermediary or FI?FIs are the agencies that pay the CDPAP Personal Assistant, monitor their hours and attendance and administer benefits. They have a contract with the MLTC or managed care plan, or the local DSS, which authorizes the hours and pays the FI for the authorized hours, which in turn pays the PA. The FI's process the tax documents, check immigration and vaccine status, and sometimes help the consumer find and train a PA. The FI's contract with and are paid by the MLTC plans, mainstream managed care plans, and local Dept. of Social Services (DSS) which authorize the CDPAP services. What Must CDPAP Consumers and their Personal Assistants (PA) Do by March 28, 2025?The NYS Dept. of Health is requiring all 240,000 CDPAP consumers and all of the more than 500,000 Personal Assistants to sign up with PPL. The NYS CDPAP website and the PPL-NY website explain the FOUR ways that a consumer and their PA may make the transition -- by phone, online, with a "facilitator," or at an in-person registration session. The transition does not happen instantly and may take several contacts over a period of time -- therefore consumers should not wait until the last minute to begin the process. Also, a consumer's transition will not be complete unless all of their PAs also register with PPL, which can involve uploading extensive paperwork. The consumer is being tasked with responsibility for making sure their PAs register. Who are the "Facilitators" who can help consumers transition to PPL?PPL has subcontracted with 31 CDPAP Facilitators around NYS. These are all current FIs that will continue as subcontractors to PPL -- but they will NO LONGER serve as FI's. Instead, they will help consumers and PA's transition to the new FI PPL. People who now receive CDPAP from one of the 31 CDPAP Facilitators must still transition to PPL.
Steps Involved in Transition and Notices that Consumers will Receive
What happens on April 1, 2025?By April 1, 2025, all FIs other than PPL must stop operating. This means CDPAP services will stop for anyone not registered with PPL on that date. The State has not announced that consumers will receive any further notice of the discontinuance prior to April 1, 2025. The lack of notice is concerning as a matter of due process. Is there Enough Time for all 240,000 Consumers and their PA's to Register with PPL before March 28, 2025?Advocates are very concerned that there is not enough time to transition all 240,000 consumers. PPL's hotline only opened on January 6, 2025. In the month since then, about 20,000 consumers have reportedly completed the transition. This does not leave enough time to transition the rest -- even if PPL has the capacity to handle the deluge of requests and all systems run perfectly -- which is not likely. In a news report on January 23, 2025 PPL said the number of consumers who “completed or started” enrollment was 12,000 over 18 days. Another news article calculated "That’s about 660 per day, and not all fully enrolled. Simple math says that if registrations continue at this rate, fewer than one in four consumers will be enrolled by the April 1 deadline." Though it does not appear to be feasible to move everyone to PPL in such a short time, the Governor has not delayed the April 1st cut-off date. So - the advice must be to register sooner rather than later to allow enough time. Advocates as well as MLTC and managed care plans have raised alarm bells about disruption in care that is likely:
Isn't there a Court Order Stopping This Transition from Moving Forward? NO. There have been a number of lawsuits, and one Temporary Restraining Order is still in effect. A group of about 50 FI's obtained a Temporary Restraining Order saying they cannot be penalized for not turning over consumers' data to PPL because of HIPPA protections. However, this court order does not say that these FI's may continue to provide CDPAP services after April 1, 2025, so it does not protect services for consumers. Many consumers and PA's are being told they should switch to traditional Personal Care agencies (called Licensed Home Care Services Agencies or "LHCSA"). Many FI's are operated by companies that also operate LHCSAs - so if the consumer and PA switch to the LHCSA this is a way for that company to keep the business. Consumers are NOT required to switch in order to maintain services. Consumers should keep several factors in mind before making this switch:
a. Administration of medications -- a PCA may not directly put a pill in the consumer's mouth, or put in eyedrops, or inject insulin. She may bring these medications to the consumer to self-administer. Family -- not the PCA - must pre-pour the weekly medication box for a consumer who is not self-directing. However, even if the consumer is not self-directing, the personal care aide may remind the consumer that it's time to take a medication, and bring the medication that was pre-poured in a medication box with water to the consumer, put it in her hand, and remind or cue her to take it. b. Suctioning a tracheostomy or administering tube feeding are skilled tasks. c. Using a hoyer lift is NOT a skilled task and can be done by a personal care aide. same for incontinent care, assistance with walkers and wheelchairs, turning & positioning, transfer and other daily tasks. d. See "Q-Tips" (also in Spanish) chart comparing the scope of tasks of Personal Care Aides (PCAs) to that of CHHA Home Health Aides (HHA) at pages - see pp. 5-7. 3. Is the LHCSA (personal care vendor agency) in the plan's or DSS network? For MLTC and mainstream managed care plans, the LHCSA must be in the plan's network. If the consumer is receiving CDPAP services through their local county Medicaid agency (HRA in NYC), then the LHCSA must be under contract with that DSS. 4. Some family members will be prohibited from becoming PCAs under state regulation. While the consumer's son or daughter, son-in-law or daughter-in-law, or parent (if the consumer is an adult) may be a CDPAP PA, these relatives may NOT be a PCA. Other relatives may become the PCA for a family member if she
18 NYCRR 505.14(h)(2)(posted at this link). 5. All PCA’s must go through a 2-week training to get certification. Some LHCSA’s offer this training. 6. The PA will now be an employee of the LHCSA personal care agency - and will not only work for the consumer. They might be reassigned to another case. Where are other FAQ's and Information About This Huge Change?
Where Does Consumer Go if They have Problems with Transition?
TTY Relay Service: 711 Website: icannys.org ican@cssny.org
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