Advocates for older and disabled New Yorkers and their caregivers reacted on Friday, April 4, to a same day federal court ruling which has extended a temporary halt to a controversial transition by NYS Department of Health (DOH) of its CDPAP home care program to a new single, statewide financial intermediary (FI), replacing around 600 individual FIs.

 

CDPAP allows members eligible for home care to choose their personal caregivers/assistants, including family members or friends. Program participants (consumers and homecare workers) were due to transition over three months to the newly selected statewide, single FI, Public Partnerships LLC (PPL), by April 1, with the transition having started in early January. However, in addition to other concerns, there is at least some evidence to suggest the transition was not going as smoothly as hoped.

 

Norwood News had received some calls in the last week from concerned residents saying they were finding it difficult to get through to the PPL helpline to get assistance with transitioning their relatives by the required deadline. One resident wrote, “I’m checking to see if you have info on the new state program taking over the family to friends home care program. Do u have the contact information? I’m having a hard time getting them on the line. Do u have [an] alternate number of information!??? Plz advise.”

 

We duly informed both the Office of Gov. Kathy Hochul and the Office of State Sen. Gustavo Rivera (S.D. 33), chair of the State health committee. The senator later shared the attached flier with constituents [which we also shared with readers].

 

The U.S. District Court for the Eastern District of New York extended the temporary stop to the transition on Friday after having issued an initial restraining order against DOH on March 31 before the April 1 deadline, and as advocates gathered for a rally on Friday outside the Brooklyn-based courthouse (which has concurrent jurisdiction over all five city boroughs in some instances).

 

In response to the ruling, IIana Berger, political director for Caring Majority Rising, an advocacy organization for older and disabled New Yorkers, family caregivers, and home care workers, said, “We welcome Judge Block’s decision to extend the pause on this deeply flawed transition, but this short-term extension merely prolongs the pain. Every day this drags on, disabled and older New Yorkers wonder if they’ll have the support they need to bathe and eat, while caregivers can’t pay the rent or feed their families.”

 

She continued, “For the second time this week, a judge has needed to step in to prevent a catastrophe because Gov. Hochul won’t. This piecemeal approach is cruel and callous. It is clear that the administration’s refusal to admit failure is inflicting needless suffering on hundreds of thousands of New Yorkers.”

 

Berger concluded, “Gov. Hochul must acknowledge reality: the CDPAP transition is a spectacular failure that no amount of PR spin can hide. We need a substantial delay, measured in months, not days, to allow for a complete overhaul of this transition plan. The lives and wellbeing of hundreds of thousands of New Yorkers hang in the balance.”

 

Following Friday’s ruling, both parties pledged to file joint language for a preliminary court injunction by midnight Tuesday, April 8, with a tele-conference with the court planned for Wednesday, April 9.

 

On April 1, CDPAP participants had filed a contempt of court order against DOH, charging the Hochul administration with violating the initial temporary restraining order issued March 31 “to punish financial intermediaries (FIs) rather than serving CDPAP consumers.”

 

At Friday’s rally, protestors shared firsthand accounts of not being able to clock in anywhere due to what they said were “PPL’s failed systems.” Some, including some wheelchair users, held signs that read, “We’re in PPL Hell” and “Delay PPL! Before People Die!” Click here and here to hear some of the speakers.

 

They said that despite the court’s intervention on March 31, consumers and workers had continued to “face steep obstacles to enrolling and widespread confusion about the state of the transition, with numerous reports of workers unable to clock in to PPL’s system to report their hours, while CDPAP consumers continued to face struggles enrolling in PPL’s system.” Meanwhile, they said many home care workers were uncertain about how or whether they would be paid  for their work beginning April 1.

 

On March 24, DOH officials had announced a late registration window for CDPAP members who had not completed their registration by April 1 to ensure members could continue to receive care, and so workers who had not yet completed the transition could retroactively receive payments for hours worked in April upon completion of their registration.

 

DOH officials said the window was available to all current CDPAP consumers and workers, including those who had not yet started the registration process, as long as they completed their registration by April 30. State Health Commissioner Dr. James McDonald said, “I want this to be a seamless transition for everyone who would like to remain in the CDPAP program, so for those who have not finished their registration by April 1, don’t worry if it takes a little longer to wrap up.”

 

He continued, “You can still receive continuation of your care and your caregivers will still be paid for your care, as long as you and they complete the registration in April. If you’d like to continue with CDPAP services, join the hundreds of thousands of home care users and workers who have already taken action as part of this transition.”

 

DOH officials said under the late registration window, members who had not completed their registration as of April 1, but wished to remain in the CDPAP program, were advised to continue trying to register as soon as possible. They explained that the transition to PPL preserved the CDPAP program, while “reducing wasteful administrative spending by transitioning from 600 middlemen to the single [financial] intermediary.”

 

They added that since Jan. 6, around 165,000 consumers had either started or completed the registration process with PPL, and nearly 55,000 were in the process of transitioning from CDPAP to Personal Care Services (PCS), a State program available through Medicaid which provides services like housekeeping, meal preparation, bathing, toileting, and grooming.

 

Additionally, DOH officials said nearly 170,000 CDPAP personal assistants (PAs) had either started or completed the registration process, and home care users who chose to switch to the PCS program retained the option to register with PPL in the future if they decided to return to CDPAP.

 

PPL President Maria Perrin said, “We are committed, above all, to the consumers and caregivers who rely on CDPAP. The late registration window is one important measure of many to ensure all New Yorkers who wish to continue in CDPAP can do so seamlessly and without interruption. PPL is here to support you.”

DOH officials also said [on March 24] the transition remained on track as DOH continued “to combat misinformation spread by companies seeking to disrupt the legislatively mandated transition.” They added that DOH sent a letter to the Alliance to Protect Home Care, Inc (“Alliance”), urging them to take action to publicly call on New York FIs to stop “spreading false, deceptive or coercive information regarding the transition,” and to publicly commit to working with all stakeholders to ensure New York consumers and PAs had accurate information regarding the transition.

 

An extract from the Alliance website reads, “Gov. Hochul Plans to Hand Over New York’s Entire Home Care Program to PPL, an Out-of-State Company Backed by Private Equity. HERE’S WHY THAT’S A HUGE MISTAKE.”

 

It continues, “Over 250,000 older and disabled New Yorkers rely on life-saving services provided by local home care agencies. This network of caregivers and small businesses keeps our loved ones at home, safe, and surrounded by family and familiar faces. But Gov. Hochul wants to give control of our home care system to an out-of-state company called PPL, backed by private equity. PPL has a failing track record – we can’t [let] PPL take over our home care.”

 

DOH officials said Cease and Desist letters were issued to FIs and Licensed Home Care Service Agencies (LHCSAs) alleged to have provided “false, deceptive or coercive information about CDPAP and PCS options to consumers and workers.” They said at least two organizations cited in complaints had made financial contributions to the Alliance, which DOH said purports to be committed to protecting the integrity of home care services.

 

DOH officials added that LHCSAs and FIs had been directed to immediately cease and desist from making the following statements or taking the following actions:

1. Providing false information to consumers about the requirements of the transition.
2. Charging a fee to potential personal care workers for the minimum 40-hour training and assessment to become a personal care assistant.
3. Falsely telling PAs that they can provide personal care services (PCS) to their family member currently participating in CDPAP, in violation of 18 NYCRR 505.14.
4. Falsely telling PAs that they can provide PCS without meeting PCS requirements, including training and other assessments, registrations, and background checks.
5. Falsely telling consumers that as of April 1, they no longer qualify for CDPAP services, or that their PA will no longer qualify to provide PA services.
6. Falsely telling PAs or consumers that a personal care worker in a LHCSA can provide the same services as a PA under the CDPAP, in violation of scope of practice regulations.

 

They had stressed that participants had to register with PPL, adding that completing registration guaranteed caregivers could continue to be paid for providing vital services. They said eligibility for CDPAP would NOT change and those enrolled would retain their services. They said CDPAP consumers could keep their trusted caregiver, and reminded those impacted once again that PAs were required to transition to PPL.

 

They said the transition saved taxpayers $1 billion a year and was “a commonsense effort that protects services for CDPAP consumers while reducing wasteful administrative spending going to middlemen and Medicaid fraud.”

 

DOH officials said PPL was continuing its direct outreach with participants, and was offering PAs competitive wages and a robust benefits package that includes paid time off, holiday pay, overtime, participation in a health benefits plan and 401(k) plan, paid professional development training, paid family leave, and more.

 

They said PAs whose consumers live in New York City’s five boroughs and in Nassau, Suffolk, and Westchester counties also receive a flex card with funds to use on medical and dental expenses, medications, transportation and other health related expenses.

 

DOH officials said it expected registration to accelerate in advance of the deadline, and that PPL had conducted more than 115,000 outreach calls to support consumers and PAs through various channels of support, in different languages, as well as via 42 facilitators (community based organizations) supporting the transition. 

 

They said consumers and PAs had to complete their registration as soon as possible through one of the following options:

Option 1: Call PPL’s support center at 1-833-247-5346 or TTY: 1-833-204-9042 and a PPL team member will help you complete the process.

Option 2: Access PPL@Home by going to PPL’s website at http://pplfirst.com/cdpap.

Option 3: Work with PPL or another approved CDPAP facilitator who can guide you through the process. A list of approved CDPAP facilitators can be found here: CDPAP Facilitators | PPL First.

 

DOH referred participants to its CDPAP transition webpage, and said PPL had widely promoted transition information via radio ads, print ads in 24 publications across 12 languages, and via thousands of fliers delivered to community and senior centers, and at in-person community registration sessions.

 

They said complete information about the transition and registration could also be found on PPL’s website, including Frequently Asked Questions. They said the program reforms address “the runaway costs of the program and root out fraud and abuse, including a recently discovered $68 million fraud scheme and hundreds of millions more lost to administrative middlemen.”

 

In a Dec. 2, 2024 letter sent to Lucy Lang, inspector general of New York, and Christi Grimm, inspector general of the federal health department, Bronx Democrat, Rep. Ritchie Torres (NY-15), alleged, among other things, that PPL had been selected as the CDPAP provider before any formal Request for Proposal (bidding) process began, and despite having an alleged “questionable track record.” Read the full letter here.

 

Norwood News asked the governor for comment at the time and a spokesperson replied, saying, “It looks like Ritchie Torres is trying to derail much-needed reforms and protect the status quo of runaway spending and fraud that has hurt New York taxpayers and made CDPAP unsustainable for home care users who need it. That doesn’t seem like a great use of time, and his letter is full of false claims anyway – so we’ll stay focused on delivering a stronger and more effective CDPAP as part of the transition that will take effect by April 2025.”

 

Officials from the governor’s office refuted in detail the allegations set out in the letter, saying the standard procurement process was followed by DOH with no advance knowledge by state officials of who would be selected ahead of time. They said PPL scored highest and was selected. They said the Office of the Chief Disability Officer (CDO) did not draft the RFP nor evaluate the responses.

 

They said it was not true the governor had removed the state comptroller’s oversight of the procurement process and that it was carried out in line with a specific statute, and the State comptroller could review and report on it at any point once the contract was finalized. They said total CDPAP spending nearly quadrupled in the last five years from $2.5 billion in 2018 to more than $9 billion in 2023.

 

In citing examples of CDPAP fraud, they said in October 2023, federal prosecutors announced an indictment against one CDPAP FI for an alleged $68 million scheme to defraud Medicaid. They added that community based partners across the State would facilitate the State’s oversight of CDPAP in the future.

Norwood News has reached out to the governor’s office and NYS DOH for comment on the latest court ruling and will share any updates we receive.