The clock is ticking for New York to begin its overhaul of a popular Medicaid-funded home care program. But legal battles aiming to thwart the changes stand in the way of the state’s plans.
Gov. Kathy Hochul is pushing to complete a consolidation of the Consumer Directed Personal Assistance Program — a more than $9 billion program that allows New Yorkers to hire friends and family members as home health aides — by April 1 of next year. The state handed over a contract to Georgia-based company Public Partnerships LLC in September to become the sole administrator of the program, putting almost all of the roughly 700 middlemen companies that currently manage payroll and other administrative tasks at risk of shuttering.
Despite outrage from middlemen companies and home care advocates, the governor’s office has maintained that it will complete the consolidation by the April 1 deadline, transitioning at least 240,000 older New Yorkers and people with disabilities to a new home care system. The transition will begin in the early days of the new year, and the Department of Health has directed health plans to start informing consumers on Jan. 6 that they will receive services through the state’s chosen home care agency.
But ongoing legal cases could hinder those plans; existing home care companies have filed at least six lawsuits in state and federal courts to block the state’s overhaul. It’s unclear whether any of those cases will be successful. But the challenges stand to draw out a transition that’s almost a year in the making, leaving consumers in limbo about the status of their home care services come January.
Hochul’s decision to transition the home care program to a single administrator was politically fraught from the start. The plan emerged in the final weeks of budget negotiations as the governor and lawmakers grasped for ways to cut spending in the state’s bloated Medicaid budget, but many raised questions about the last-minute proposal and whether it was a ploy by labor giant 1199SEIU to organize a large swath of the state’s home care workers. Home care advocates fear that it will upend services for New Yorkers who rely on the program, and agencies who administer services currently are bracing to shut down.
Despite the critiques, the state has remained steadfast on the transition, which it believes will save the Medicaid program at least $500 million each year.
In the interim, legal cases from companies that stand to go out of business have continued to pile up. The bulk of the lawsuits have targeted the state’s bidding process for the new home care administrator, alleging that it unlawfully blocked most of the existing businesses in the state from having a shot to stay afloat. A case filed by the state’s largest home care agency accused the state of creating a “sham bidding process” that selected PPL to take over the program before the procurement process started, and another has accused the governor of rigging the process.
Allegations that the contract to PPL was fixed have led local lawmakers to target Hochul’s home care plan. Bronx Congressman Ritchie Torres sent a letter to state and federal regulators earlier this month, asking them to probe what he called a rigged bidding process.
“The pre-selection of PPL was the worst kept secret in Albany,” Torres, who is planning to run for governor in 2026, said in the letter. He described the competitive bidding process that ensued as a “dog and pony show with a predetermined outcome.”
It remains to be seen whether judges will issue rulings that delay the state’s home care transition. But elected officials who want to preserve the program say there’s another option on the table. Sen. Gustavo Rivera introduced a bill in September that would repeal the language in the law governing the home care changes and institute a new licensing process to keep a number of currently operating fiscal intermediaries in business. The legislation would extend the runway time for program changes to April 1, 2026.
