NYLAG files Lawsuit to delay PPL/ Grace Period gives to April 3oth for complete Registration of CDPAP consumer and Worker with Back Pay after April 1st

All CDPAP CONSUMERS & their AIDES must TRANSFER TO PPL from their CURRENT FISCAL INTERMEDIARY ("FI") by MARCH 28, 2025

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 is March 28, 2025. PPL takes over all CDPAP services on April 1, 2025.  

This is rapidly changing information - Please check back here for changes and also check the websites here for news.   

STATUS of TRANSITION - WEEKLY UPDATES FROM STATE DEPT. of HEALTH

NYLAG and Patterson Belknap filed a class action lawsuit 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.  NYLAG is seeking a TRO and Preliminary Injunction to enjoin the state from implementing the April 1, 2025 date to move to a single fiscal intermediary for the State.  The case is Engesser et al v McDonald, and you can read the complaint here:  Engesser-et-al-v-McDonald-complaint-25-CV-1689-EDNY.pdf   The case is scheduled for oral argument in front of Judge Block in the federal court for the Eastern District of NY  on Monday, March 31 at 3pm, but that date and time could theoretically change.

Status 3/28/25 -- Please note that no court order has been issued yet and CDPAP services as provided by the 600 current FI's will terminate April 1st, unless delayed by the court.  Those who are fully registered with PPL (have completed the training on their Electronic Verification app, etc.) should start keeping time on that app April 1st and be  paid.  However, hundreds of thousands of PAs and consumers are NOT fully registered.  DOH did grant an extension for consumers and PAs to enroll until April 30th, but the PAs will only be paid back pay - and tONLY if they are fully registered by April 30th.  As acknowledged by the State in soliciting volunteers to assist PPL with enrollment - and as a PPL whistleblower reported -- the one-month extension is nowhere near enough time. 

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)

DOH reports that 165,000 consumers and 170,000 personal assistants have "either started or completed the registration process with Public Partnerships LLC (PPL)."  They are still not saying how many have completed the process -- workers who started the process in February are just getting approved now, with PPL very backed up in processing and approving registrations, and with frequent systems failures.   See more here about the compressed time period for this transition.   

LATEST PRESS 

Click here to see Latest Advocacy

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 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. 

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 Receive

View 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.  There have been a number of lawsuits, but no court order is  in effect that extends the April 1st cut-off of CDPAP services for those not fully enrolled along with their PA's. 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.  

Should a Consumer Switch from CDPAP to Traditional Personal Care in order to avoid having to switch to PPL?

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:

  1. Personal Care is considered a different "service" - requiring a new "authorization" to be issued by the MLTC plan, managed care plan or local DSS for Personal Care.. See DOH Chart "Understanding the Differences between CDPAP and Personal Care,"  and FACT SHEET -- both posted around Feb. 20, 2025.   This may cause delay.  The plan or DSS, not the LHCSA must approve the switch.

  2. Does the consumer have "skilled needs?" 

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

    1. is not residing in the patient's home; or
    2.  is residing in the patient's home because the amount of care required by the patient makes his presence necessary.”

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? - 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  


28 Mar, 2025
NYLAG files Lawsuit to delay PPL/ Grace Period gives to April 3oth for complete Registration of CDPAP consumer and Worker with Back Pay after April 1st
http://health.wnylc.com/health/news/97/