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State issues Guidance to Comply with Preliminary Injunction on April 10th- If PAs not fully registered wiith PPL Consumer can Opt for Payment by Prior FI15 Apr, 2025
All CDPAP CONSUMERS must be enrolled with PPL by May 15, 2025 & their AIDES must Fully Register with PPL by June 6, 2025 (from extension granted by Preliminary Injunction - see below).
Background. The 2024-25 NYS Budget requires all 280,000 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. The deadline for both consumers and PAs to finish registration with PPL was originally March 28, 2025 for . PPL to take over all CDPAP services on April 1, 2025. Under the Preliminary Injuncction issued April 10, 2025, consumers have until May 15th to register. and PAs must fully register by June 6th. PAs may in some cases get paid by their former FI. See more below. This is rapidly changing information - Please check back here for changes and also check the websites here and https://nylag.org/engesser/ for news. STATUS of TRANSITIONApril 14th - State DOH posted a consumer fact sheet and guidance to plans and Local DSS about the Preliminary Injunction:
On Apr. 14, Politico reported that a recent survey of 327 PAs by Caring Majority Rising, a disability advocacy group between Thursday and Saturday found that 70 percent of the workers surveyed didn’t get paid on time, and 72 percent of workers who were paid received the wrong amount in their paycheck. The survey also found that 45 percent of respondents still can’t clock in the hours they worked. (Politico NY Health Newsletter 4/14/25) Here are the survey results:
Consumers and caregivers posted a video reporting difficulties with registering for and using PPL systems. You can skip to any of the following testimonies at these links: Tara Murphy, Albany–area caregiver “I got a pay stub in the mail for $0 for an EVV training…PPL is supposed to save money. And it's severe mismanagement and a gross waste of funds to print pay stubs for $0 and send checks for $0 to how many people? It's absolutely disgusting…. I wasn't paid by PPL this week. I don't know if I'm going to be paid by the PPL…And if I don't make that payment next week, I lose my car.” Dawn Meany, Long Island-area caregiver “I made 19 phone calls with only zero being returned. I had six emails to PPL never returned. I have not received a paycheck….The anxiety it has caused him because he lost three staff members is insane. I have become his 24-7 care person because I couldn't get anybody else approved. I couldn’t even get him approved.” Kim Conway, Long Island-area CDPAP user “Now, this week is a whole different story. None of my overnight aides are being paid for their shifts. They work 12 or 16 hour shifts. Every one of them has been denied…At this point, unfortunately, I chose for my own and my aides' sanity and financially, we chose to have to move over to PCA services. And as of Monday, I'm no longer in the CDPAP program.” Heather Burroughs, Rochester-area CDPAP user “Everybody's paperwork has been in for almost two months at this point. But guess what? Out of nine caregivers, one got paid. One, this pay period….This is quite literally the only program that my daughter qualifies for that can save her life. The only other option is to move her into a nursing home or a group home.” Rebekah MacNeill, Rochester-area caregiver “I love this job so much, truly. I feel like this was my passion. I feel like this is what God put me on the earth to do is to help people. And it's devastating that I might have to walk away from this job just because this is happening….It's sad that this is happening in 2025. We're fighting for civil rights here….it makes me tear up because these are people and we're not treating them like they're people.” Friday April 10- 11, 2025 - NYLAG posted this Frequently Asked Questions about the Preliminary Injunction, which Judge Block signed on Thursday April 10, 2025 - The court injunction can be downloaded here. See press articles here about the injunction. Paper timesheets that can be used through April 26, 2025 for those PAs unable to use the TIme4Care PPL app. Use this paper timesheet or this updated fill-able version. See these PPL instructions. . Fax to 1-844-244-4384 or by email to NYCDPAP_TS@pplfirst.com. (There is also a physical mailing address listed on the form.)
Unfortunately, myriad barriers to PAs getting paid are happening. see 4/11/2025 News 10 NBC ‘Glitch after glitch’: Families of New Yorkers with disabilities say new CDPAP payment system is a ‘mess’ Wed. April 9, 2025 After intensive negotiations, the parties in Engesser et al v. McDonald submitted a Proposed Preliminary Injunction to Judge Block for his consideration. The Temporary Restraining Order (TRO) and the clarifying April 2, 2025 Order remain in effect through April 14, 2025 unless or until the Court enters a preliminary injunction before April 14, 2025 that replaces the TRO. The Proposed Preliminary Injunction is complicated. See this article for a general summary. : “Proposed preliminary injunction in CDPAP case could create safeguards for PPL transition (WRVO Public Media – NPR News Central NY -April 9, 2025). More will be posted -- stay tuned. Tuesday, April 8, 2025 - Parties are in talks to try to agree to the terms of a Preliminary Injunctions. The Parties will file a status update with the Court by midnight on Tuesday, April 8th. Meantime, DOH's instructions below are in effect issued April 4th. Friday, April 4, 2025 --the Parties appeared in Court for a hearing on a Plaintiffs’ motion for a Preliminary Injunction. Before that hearing began, the Department of Health offered to discuss a potential settlement which would result in a jointly agreed-upon Preliminary Injunction. Negotiations were productive and will continue. Also on April 4th, the NYS Dept. of Health provided instructions for CDPAP Personal Assistants who are unable to report their work hours. This information is now posted at https://nylag.org/engesser/ and copied below. April 4, 2025 Instructions from the State
April 3, 2025 - NYS Dept. of Health issued an "update" that is apparently intended to comply with the TRO as modified on April 2, 2025. From: "health.sm.StatewideFI" <StatewideFI@health.ny.gov> On March 31, 2025, a federal court judge issued a Temporary Restraining Order that was limited in scope applying to changes in the Consumer Directed Personal Assistance Program (CDPAP) Statewide Fiscal Intermediary (FI) transition. The judge clarified that order on April 2, 2025 and a hearing on a preliminary injunction is scheduled for April 4, 2025. Until further notice:
ADVOCACY COMMENT: At least for group 1 in the above April 3rd email, Personal Assistants can use this paper TimeSheet to submit their weekly time records to PPL if they cannot log into the Time4Care app. The TimeSheet, which was apparently created by a facilitator, has an email address and fax number to submit to PPL. The form must be signed by the consumer or designated rep. It is not clear from this guidance how MLTC plans, other managed care plans, and LDSS will carry out this directive and ensure that all PAs get paid on a timely basis. April 2, 2025 - Federal Court Modifies the March 31, 2025 Temporary Restraining Order --After NYLAG and Patterson Beklnap, counsel on the lawsuit, informed the Judge that DOH was violating the March 31st TRO, the Judge modified the TRO: WHEREAS the Court held an emergency telephone conference on April 2, 2025, to clarify its prior temporary restraining order (TRO), entered on March 31, 2025, ECF No. 37 , and to make it explicit that, with respect to the TRO, the State has a responsibility to ensure that all CDPAP consumers and PAs who participated in CDPAP before April 1, 2025, regardless of their individual circumstances and present registration status, shall continue to receive care from their existing PA, who shall be timely paid for their services. Based on the papers and the hearing, and for good cause shown, it is hereby: Ordered by Judge Frederic Block on 4/2/2025. (MI) (Entered: 04/02/2025) ADVOCACY COMMENT: This modified Order implicitly REJECTS the State's interpretation of the original TRO that the Department of Health communicated to MLTC and other managed care plans about the TRO. DOH had interpreted the Order to say that if a consumer has registered with PPL, they cannot receive services paid for by their "old FI" even if each of their PA workers have hit roadblocks in registering with PPL, or even if there are other barriers such as PPL not receiving the "authorization" for their services from the plan or Local DSS/HRA. According to this slide, the PA workers must wait for back pay from PPL. See this FAQ from CDPAANYS on the TRO. Transition Update from CD Choices, one of the Facilitators that help consumers and PAs register with PPL NYS DOH REPORT ON NUMBER TRANSITIONED - 4/14/25 -- NYS Dept. of Health announced in a press release on 4/14/25 that 216,000 of 220,000 CDPAP consumers have "either started or completed the registration process with Public Partnerships LLC (PPL)," of which more than 190,000 have completed registration.
Temporary Restraining Order issued on March 31, 2025 in Lawsuit Filed by NYLAG and Patterson Belknap On March 31, 2025, Judge Frederick Block issued a Temporary Restraining Order [TRO] in Engesser et al v McDonald (E.D.N.Y.), a lawsuit filed by the New York Legal Assistance Group and Patterson Belknap Webb & Tyler LLP, which seeks to enjoin the state from implementing the April 1, 2025 date to move to a single Fiscal Intermediary for CDPAP. The lawsuit was filed on March 26, 2025, seeking to vindicate CDPAP recipients’ right to timely and adequate notice and an opportunity to be heard with aid continuing prior to the termination of their CDPAP services. The TRO, which can be downloaded here, orders that the State Department of Health -- "... be immediately and temporarily restrained from implementing those sections of Part HH of Chapter 57 of the New York Session Laws of 2024 .... [that amended the NYS law to mandate transition to a single Fiscal Intermediary on April 1, 2025] Importantly, this Order does not prevent the Statewide Fiscal Intermediary (“PPL”) from operating, processing applications, servicing and paying CDPAP participants who have already registered with PPL. Rather, this Order restrains Defendant from disallowing other Fiscal Intermediaries from servicing those CDPAP participants who have not yet registered with PPL;.." The case is scheduled for a hearing on the request for a preliminary injunction in front of Judge Block in the federal court for the Eastern District of NY on Friday April 4, 2025 at 11 AM,
3/27/25 Albany Times-Union State workers asked to volunteer to assist with CDPAP transition NY's Department of Health asked for employee help, even as the agency has signed a multimillion-dollar contract with a private vendor for the same work. Comment: By recruiting so-called volunteers, the state is acknowledging that its timeline was impossible to meet and that PPL cannot meet it. Spokesperson says, "Team will be reviewing CDPAP worker paperwork, running key information through federal process checks, and documenting the results,” the directive reads, adding that employees who volunteer would be given virtual training." 3/25/25 - DOH posted the policy implementing the grace period -- see CDPAP SFI Late Registration Payment Policy for April 2025 - (PDF) 3/24/25 - State Department of Health Announces Plan to Extend Deadline to April 30th for Consumers and Personal Assistants to Complete Registration with PPL - Gives a grace period of an extra month to start and complete registering. However, for those who are not fully registered for PAs to start working April 1st -- the PAs will not get paid until later -- when they are fully registered and receive back pay. They will be paid by their current soon to be former FI for work done through March 31st. THe former FIs may not pay them for work done starting April 1st. They will use some sort of paper timesheets to track time - details still not known. This one month "grace period was announced by Politico on March 23rd - "Hochul Administration Gives CDPAP Participants One-Month Grace Period to Enroll" -(paywall) LATEST PRESS (some is behind paywall)Click here to see Latest Advocacy April 17, 2025 Albany Times-Union Commentary: For independent living centers, CDPAP is about care, not money By Lindsay Miller, Executive Director of the New York Association on Independent Living. April 16, 2025 WXXI News NPR Disabilities Beat: Court sets new deadlines, changes for CDPAP transition (interview with Elizabeth Jois, NYLAG attorney that was conducted prior to preliminary injunction) Apr. 14, 2025 Politico - Recent survey of 327 PAs by Caring Majority Rising, a disability advocacy group between Thursday and Saturday found that 70 percent of the workers surveyed didn’t get paid on time, and 72 percent of workers who were paid received the wrong amount in their paycheck. The survey also found that 45 percent of respondents still can’t clock in the hours they worked. (Politico NY Health Newsletter 4/14/25) 4/11/2025 News 10 NBC ‘Glitch after glitch’: Families of New Yorkers with disabilities say new CDPAP payment system is a ‘mess’ 4/11/2025 Crain's Health Pulse State agrees to delay deadline for contentious home care consolidation (behind paywall) 4/10/25 Gothamist NY officials agree to delay $9B home care overhaul amid consumer complaints 4/10/25 New York Law Journal Preliminary Accord Reached in Litigation Over NY Medicaid Program Transition 4/9/25 NYStateofPolitics.com State Health Dept. agrees to court order to extend home care transition deadline 4/9/25 WRVO Public Media – NPR News Central NY: “Proposed preliminary injunction in CDPAP case could create safeguards for PPL transition 4/9/25 WBFO-FM (NY Public Radio) - Buffalo, NY: “Disabilities Beat: CDPAP preliminary injunction expected Wednesday” 4/9/25 WRGB CBS 6 – Albany, NY: “CDPAP payments to start Thursday amid ongoing PPL transition confusion “ 4/8/2025 WTEN (ABC News 10) - Albany, NY: “News10 at 5:30” 4/7/2025 Hell Gate (NYC): “Is Governor Hochul Fixing Home Care, or Using a 'DOGE Maneuver' to Destroy It? “ 4/7/2025 Politico Federal judge slated to issue preliminary injunction on CDPAP transition 4/7/205 Crain's Health Pulse State's home care overhaul deadline in flux amid legal battle (Behind paywall)(excerpt -- ...As a part of its extension, the state promised to retroactively pay home care workers once they enrolled – a solution that advocates said was not an option for caregivers who are low-income and live paycheck-to-paycheck. The move raised concerns that caregivers would leave their jobs in search of other work to pay the bills, leaving consumers, some of whom have physical disabilities that require round-the-clock care, without services. The state has blamed lagging registrations on misinformation spewed by companies that were set to go out of business. But some consumers said that the slow sign-ups were perpetuated by technical issues, alleging in the federal lawsuit that directions to register with PPL were not available in multiple languages, they faced long wait times to talk to a company representative and it took weeks to complete their paperwork. Jose Hernandez, a home care user who lives in the Bronx, said that he started registering with PPL in February, but didn’t get all of his paperwork approved until April 3. Hernandez, who uses a wheelchair and receives services from five caregivers, said that one of his personal assistants still has not received clearance from PPL and cannot be paid through the system. After the publication of this story, the governor's office reached out to Crain's and said that the state addressed outstanding issues related to Hernandez's enrollment with PPL. Hernandez confirmed the fix. Attorneys for the state said in court on Friday that PPL has agreed to implement a team to expedite registrations and help consumers complete their paperwork. The company has also agreed to allow caregivers who cannot clock in to the company’s app to submit their timesheets on paper in the short term.... 4/6/25 Spectrum News 1: “DOH negotiating partial block of N.Y. home care transition” 4/6/25 News 12 Long Island: “Long Island caregivers frustrated over registration process for CDPAP“ 4/4/2025 Spectrum News 1: “DOH negotiating partial block of N.Y. home care transition” [video clip] 4/4/2025 Politico Pro Grim picture of CDPAP registration emerges amid tumultuous transition -- The new consolidated Medicaid program launched Tuesday, but thousands are still working through a fraught transition. 4/4/2025 Politico Pro State negotiates preliminary injunction for CDPAP transition -- The state is working with plaintiffs to hash out terms of a preliminary injunction, which is due Tuesday evening. 4/4/2025 Albany Times Union Editorial: A careless approach to care -- The home care program transition isn’t going well, and the state seems unable to admit it. 4/4/2025 WNYW-NY (FOX 5) - New York, NY “THE 5 O'CLOCK NEWS“ 4/3/2025 Binghamton Press & Sun-Bulletin: “CDPAP transition 'a nightmare' for Southern Tier agencies. What to know” 4/2/25 CBS 6 NEWS NY’s home care payroll shift leaves aides struggling to log hours amidst app rollout VIDEO segment here 4/1/2025 New York Law Journal/Law.com: “Federal Judge Issues TRO, Pausing New York's Transition of Medicaid Procedures “ 4/1/25 Politico Pro New York forges ahead with CDPAP transition despite TRO The state Health Department is barred from cutting ties with fiscal intermediaries until a federal judge decides Friday on an extension. 4/1/25 Albany Times-Union Judge partially blocks NY health department's CDPAP transition 4/1/25 Crains Health Pulse Judge postpones Hochul's home care transition (behind paywall) 4/1/25 CBS News 10 Albany Judge says intermediaries can continue CDPAP for now 3/31/25 RochesterFirst.com: “CDPAP deadlines nears, Rochester organization joins class action,” by Isabel Garcia, March 31, 2025 3/25/25 RochesterFirst.com: April 1 CDPAP transition deadline remains, 30-day grace period announced Last week, Assemblymember Josh Jensen, who represents the 134th district and is the ranking Republican on the Health Committee, alongside Senator Patrick Gallivan, introduced a bill (S.6689) amplifying calls for the deadline to be pushed back. PPL President Maria Perrin said there is about a 70% call-back rate for those calling the company seeking answers 3/24/25 City and State Department of Health and PPL: CDPAP transition issues are not our fault - report from press conference in which DOH announced the "grace period" of one month 3/24/25 - Spectrum News - Interview with DOH COmmissioner McDonald - denies having seen the New York Focus expose about Leading Edge, which runs the sham health insurance plans offered by PPL. See more on the health insurance scam exposed by the Fiscal Policy Institute. Yet he says "This is people's health care, vulnerable New Yorkers' health care.... I think healthcare really is one of the most important things." 3/24/25 WNYT NBC Albany: NY Health Dept. Announces Late Registration For CDPAP Transition 3/24/25 CBS6 Albany NY offers 30-day grace period as CDPAP users protest April 1 transition deadline 3/24/25 Politico Officials defend contentious CDPAP transition -- State Health Commissioner James McDonald and Public Partnerships President Maria Perrin announced a month-long grace period, but said this is not a delay. (behind paywall) DOH Commissioner McDonald said they decided to create a grace period to ensure consumers and their workers are not burdened when PPL takes over the program's administrative system. He insisted the move does not constitute a delay, since FIs are still expected to cease their operations on April 1, as planned. “The misinformation that I've seen is unlike anything I've seen in my life,” McDonald told reporters Monday. “So we could have worked like crazy in the last week to try to get everybody into (the new system). I don't want anyone left behind though, it's too important a group. So that's why we did the late registration window.” McDonald was joined by PPL President Maria Perrin, who refuted claims of problems with the program's online portal. She said workers and consumers should be able to register with the online system within roughly one hour. Additionally, when asked about calls by 1199SEIU and workers to reconsider the company's benefits package, Perrin said the new plan affords most workers greater benefits. Hochul told reporters Monday that “the truth is on our side,” when referring to a campaign of alleged misinformation from fiscal intermediaries who are expected to cease operations on April 1, when PPL takes over. “We are not changing that deadline for companies, they don't deserve it because they are the reason we are in this situation,” Hochul said of the fiscal intermediaries that currently run the program. “They have been digging their heels in, refusing to turn over legally obligated information about who the patients are and who the caregivers are. I'm not letting them off the hook. Hell no.” 3/24/25 NY Post Hochul admin offers ‘grace period’ for NY home care switch — but still denies any issues in chaotic rollout 3/24/25 Spectrum News Questions loom as New York state gives 30-day grace period for Medicaid home care transition 3/24/25 Albany Times Union Deadline for NY home care program transition delayed a month PPL is expecting— between 5,000 to 10,000 per day — to enroll with PPL by April 1. Its spokesperson Maria Perrin did not clarify how many people would be expected to enroll in the program during the one-month grace period, but from state data it appears about 65,000 have not yet begun to register and perhaps another 100,000 have started but not completed registration. "But the confidence from officials has contrasted sharply with the testimony from individual patients who say they have faced logistical and technical difficulties trying to switch their information over to PPL, which has been hampered by large call volumes and long wait times." 3/25/25 The Buffalo News: Caregivers, patients now have until April 30 to register for state program (behind paywall) In a news conference Monday where he was joined by PPL President Maria Perrin, McDonald noted that people had “quite a bit of time” to register for PPL, then moments later said he did not fault patients nor caregivers for not signing up. 3/24/25 Capitol Confidential: CDPAP registration deadline extended through April 30 (behind paywall) - article notes they didn’t provide answers to several questions, including how much workers are being paid, if their insurance benefits will lapse, and why they decided to delay the deadline now 3/23/25 - NY Post Hochul admin caves on rollout of pro-union NY home care overhaul as whistleblower describes chaos: ‘S–t show’ 3/23/25 - Politico Pro NY HealthCare "Hochul Administration Gives CDPAP Participants One-Month Grace Period to Enroll" - (Behind paywall) - details to be announced in Press Conference on Mon. March 24th at 1 PM in Albany. At least some consumer's workers will get back pay if consumer & PAs registration is not complete by April 1st -- but unclear if this includes all consumers or only those who started registration by April 1st. March 22, 2025 Albany Times Union Calls to delay home care transition grow as thousands remain in limbo March 21, 2025 The City Hochul Digs in on Home Care Switch, Despite Labor Ally’s Call for Delay March 21, 2025 Politico Pro NY Health Care - 1199SEIU urges Hochul to delay CDPAP transition via executive order - (behind paywall) - see union recommendations here . Politico article states in part -- “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 who care for them,” 1199SEIU President George Gresham said in a statement. The union is urging Gov. Kathy Hochul to sign an executive order extending the deadline, allowing at least some fiscal intermediaries besides PPL to continue operating. That would buy time to focus on engaging consumers with high needs and in certain ZIP codes with high numbers of unreached consumers, such as Flushing and Elmhurst in Queens, the union wrote in a letter Thursday to the health department. The union also asked that PPL delay enrollment in employer-sponsored health insurance to ensure that CDPAP workers will have access to high quality and affordable benefits — seemingly alluding to an analysis by the Fiscal Policy Institute that found many personal assistants would lose their existing health insurance and have to enroll in a plan that does not cover basic services. March 20, 2025 NY Focus Fraudster-Linked Company Set to Begin Massive Insurance Contract for Home Health Workers - more on the health insurance scam exposed by the Fiscal Policy Institute March 19, 2025 NYStateofPolitics.com As CDPAP deadline nears, calls for an extension grow (also on Spectrum News 1 with video - with Sen.. Gustavo Rivera, Sen. Leroy Comrie and Fiscal Policy Institute Health Policy Director Michale Kinnucan) March 19, 2025 - QNS.com Sen. John Liu urges extension of April 1 CDPAP transition deadline to prevent care disruptions March 18, 2025 - Fox 5 New York NYC caregiver program faces major overhaul March 19, 2025 Crains NY Business State’s home care overhaul could upend insurance coverage for aides (behind paywall - apologies) covering 3/17/25 Fiscal Policy Institute report below. March 18, 2025 - News 10 Fiscal Policy Institute warns CDPAP plan could force New Yorkers off of better insurance - reporting on this report:
March 14, 2025 NYS Association on Independent Living sent this letter to Gov. Hochul's office urging postponement of the April 1st cut-off of CDPAP, citing the delays and obstacles faced by consumers and Independent Living Centers who have been helping them transition to NYAIL. Eleven (11) Independent Living Centers are among the 40 facilitators appointed by the State to assist consumers. Read the full letter here March 14, 2025 LOHUD.com (Lower Hudson Valley) New Yorkers with disabilities to Hochul: overhaul to key caregiver program would hurt us March 14, 2025 Center for Disability Rights in Rochester issued this call for a postponement of the April 1st cut-off March 13, 2025 Medicaid Matters NY again calls on the Commissioner of the NYS Dept. of Health to delay April 1st cut-off of CDPAP for those who have not yet transitioned - to prevent over 100,000 vulnerable New Yorkers from losing services that keep them safe and out of hospitals and nursing homes. March 11, 2025 - Albany Times Union, Home care patients, workers fear ‘major disruption’ on April 1 - features an individual consumer who is paralyzed and, though he has 10 years of experience as an advocate, has not succeeded in registering himself or his aides with PPL. Many quotes of experts saying the deadline is impossible to meet. March 11, 2025 - Politico - The Hochul administration issued 17 cease-and-desist letters to fiscal intermediaries that it accused of misinforming consumers about the CDPAP switchover, (behind paywall) On March 10, 2025 the Albany Times-Union in an editorial warned of a "looming disaster" because "it’s hard to imagine that the state and PPL can process in a few weeks half again as many people as it took two months to enroll... But this uncertainty is no way to treat either the vulnerable clients who depend on this program for their daily needs — for some, even their survival — or the aides who rely on the work for income. The Hochul administration needs to lay out its plan to get full registration, and its backup plan if it fails to achieve it. Because one thing is certain: It will own either the success, or the failure." Editorial: CDPAP transition is a looming care crisis; What will happen if thousands of people who depend on home care aides miss an imminent deadline? The state has yet to say. Albany Times Union, March 10, 2025 - view here . SEE MORE PRESS HERE CBS6 News Albany March 10, 2025 Protesters arrested as New York's home care transition deadline looms Albany Times Union - March 10, 2025 - Letter to Editor from NYLAG Evelyn Frank Legal Resource Program Rebecca Wallach & Valerie Bogart - responding to 2/7/25 op ed piece by Ken Raske of GNYHA -- Commentary: CDPAP changes are needed to get runaway costs under control. Click here for earlier press. 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 Do by May 15, 2025? - and PAs do by June 6, 2025 (extended dates under Preliminary Injunction)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. ADVOCACY SEEKING DELAY TO PREVENT DISRUPTION OF SERVICES
LATEST PRESS ABOUT TRANSITION TO SINGLE FI
Who are the "Facilitators" who can help consumers transition to PPL?PPL has subcontracted with 40 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 CDPAP Facilitators must still transition to PPL.
Steps Involved in Transition and Notices that Consumers will ReceiveView recording of webinar given by Valerie Bogart, NYLAG on March 10, 2025 and download NYLAG PowerPoint about the Single FI Transition - dated March 10, 2025, here. NEW PPL Brochure On HOw to Transition - with Screen Shots NOTIFYING CONSUMERS THAT THEY MUST REGISTER WITH PPL
CONSUMERS REGISTER WITH PPL:
Personal Assistant (PA) Registration
Ask a FACILITATOR to help troubleshoot problems. What happens on April 1, 2025?By April 1, 2025, all FIs other than PPL must stop operating. 3/25/25 - DOH posted the policy implementing a one-month grace period -- see CDPAP SFI Late Registration Payment Policy for April 2025 - (PDF) 3/24/25 - State Department of Health Announces Plan to Extend Deadline to April 30th for Consumers and Personal Assistants to Complete Registration with PPL - Gives a grace period of an extra month to start and complete registering. However, for those who are not fully registered for PAs to start working April 1st -- the PAs will not get paid until later -- when they are fully registered and receive back pay. They will be paid by their current soon-to-be-former FI for work done through March 31st. THe former FIs may not pay them for work done starting April 1st. They will use some sort of paper timesheets to track time. See DOH Policy (PDF). 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. Isn't there a Court Order Stopping This Transition from Moving Forward? NO. See above about the Preliminary Injunction issued in NYLAG's lawsuit, Engesser v McDonald. It allows the transition to go forward but also allows some consumers to request that their MLTC plan or local DSS temporarily authorize their PAs to be paid by the former FI. 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. WEBSITES with FAQ's and Guidance about CDPAP SIngle FI - and Link to View Recording of NYLAG Webinar of March 10th
Where Does Consumer Go if They have Problems with Transition?
TTY Relay Service: 711 Website: icannys.org ican@cssny.org
ARCHIVE: EARLIER PRESS ABOUT TRANSITION TO CDPAP SINGLE FI
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