It is unclear how many recipients of a popular home care program have lost services after 30,000 people failed to complete paperwork with a new administrator by the statutory deadline.
Roughly 190,000 out of an estimated 220,000 elderly and disabled residents in the state’s consumer directed personal assistance program have re-enrolled after a controversial overhaul of the over $11 billion Medicaid program, according to the state Department of Health. But the department has been mum on how many have lost services or switched to other home care programs after missing the mandatory April 1 deadline.
As recently as January, the state estimated 280,000 people were receiving services under the program, which allows individuals to hire and manage their home care worker, leaving room for customers to employ their family and acquaintances.
Until April 1, payroll for the workers was administered by a small sector of hundreds of brokers, known as fiscal intermediaries, who funneled Medicaid dollars from insurance plans to aides. Last year, Gov. Kathy Hochul and state lawmakers passed a law to abolish the fiscal intermediary system and replace it with a single broker to cut down on what Hochul has said is widespread fraud.
Since the move to the new vendor, Georgia-based Public Partnership LLC, an estimated 60,000 have left the program altogether in favor of agency-run home care services that are more expensive and heavily regulated, according to the Health Department. Of the remaining users who failed to re-register, it is unclear how many were able to retain services without gaps, or altogether, under their previous fiscal intermediaries after a federal judge temporarily allowed them to stay in business while the transition unfolds.
Customers, fiscal intermediaries and 1199SEIU, the state’s powerful health care workers union, which backed the transition, warned that the state was on target to miss the deadline. On March 26, New York Legal Assistance Group, a public-interest law firm, sued to ensure people wouldn’t be left without care after the deadline leading to a temporary restraining order followed by a preliminary injunction.
Among the unknowns is how many recipients had a fiscal intermediary to return to after hundreds of companies were told they would have to close down shop by April, just one day after the judge issued an initial pause on March 31. Many of them are small companies that likely shuttered altogether or lack the bandwidth to flip the switch back on, said Michael Kinnucan, senior health policy advisor at the Fiscal Policy Institute.
“Most of them are clearly not receiving paid services and are presumably depending on either not getting treatment and in serious trouble, or depending on the charity of their loved ones,” he said.
The ones who haven’t moved over are likely those with the greatest barriers to information about the transition, either because of a lack of internet or cell phone, or due to language barriers, he added.
The Department of Health would not say how many of the unregistered recipients fell through the cracks.
On Friday, the court ordered the Health Department to provide weekly data to New York Legal Assistance Group. Though the judge didn’t specify what data should be shared, a spokesperson for the group confirmed the lawyers had not received any information as of Monday afternoon.
