State lawmakers are making an end-of-session push to walk back Gov. Kathy Hochul’s consolidation of a popular Medicaid-funded home care program.
Health chairs Sen. Gustavo Rivera and Assemblywoman Amy Paulin introduced a bill this week to undo some of the state’s changes to the consumer-directed personal assistance program, an estimated $11 billion home care program that allows New Yorkers to hire family members as caregivers who are paid by the state. The governor hired a single company, Public Partnerships LLC or PPL, to administer payroll to all home care workers starting on April 1, a job previously held by roughly 600 third-party businesses known as fiscal intermediaries.
Though the transition was set to be completed by April 1, the state ran into challenges enrolling more than 280,000 home care users and workers say their paychecks have been delayed. Lawmakers’ new proposal seeks to address those challenges by allowing companies other than PPL to continue processing payroll, giving consumers the choice of which entity handles their home care services.
“I decided to sponsor this bill because it is necessary to consider every option to address the ongoing chaos created by the failed transition to a single [fiscal intermediary],” Rivera said in a statement to Crain’s. One month after the transition, 99,000 workers went without a single paycheck and saw their health benefits “basically erased” while people who use the home care program went without care, he said.
Sam Spokony, a spokesman for the governor, said that the legislative proposal “makes no sense.”
“Under the old CDPAP system, administrative waste among hundreds of [fiscal intermediaries] sparked a fiscal crisis that put home care at risk,” Spokony said. “The new structure will protect CDPAP consumers and ensure the program is fiscally sustainable,” he added, noting that the new system is working. PPL issued paychecks to 99% of workers who were fully registered and submitted their timesheets before the most recent pay period, he said.
The bill marks the latest hiccup for Hochul’s home care transition, which is supposed to save the state up to $1 billion per year. Though the state has maintained that the consolidation was necessary to reduce Medicaid spending and crack down on fraud, home care users and the industry opposed the transition stating that it would erode access to care for older New Yorkers and people with disabilities.
Last month, the state agreed to delay the deadline to complete the home care transition from April 1 to June 6 after home care users filed a lawsuit alleging disruptions to care. The state is still working to register all home care users and workers within its new payment system, but workers continue to report challenges.
PPL has issued paychecks to more 191,000 home care workers since the start of the transition, the company said Friday. At least 237,000 workers serve the home care users already signed up with PPL, Spokony said. PPL said in a press release that not all previously counted workers in the program are reflected in its payroll count, as caregivers have the option to be paid by their previous fiscal intermediary under the court order.
