The state’s biggest health care workers union, perhaps the most powerful supporter of a plan to overhaul a popular home care program outside Gov. Kathy Hochul and the legislative leaders who negotiated it last year, is calling for its postponement.
1199SEIU is urging Gov. Kathy Hochul to delay the transition of New York’s consumer directed personal assistance program, a Medicaid program that allows enrollees to hire and manage their own aides, to a single broker via executive order. In a letter to the Department of Health and state lawmakers, the union argued there was not enough time to move more than 100,000 current home care workers to the new system by the April 1 statutory deadline, leaving workers at risk of losing employment and tens of thousands of users at risk of losing services.
The letter comes nine days before the program, which currently has more than 200,000 enrollees and many more workers, a new administrator takes over payroll and benefits for aides currently paid through a network of hundreds of so-called fiscal intermediaries. Hochul pushed for the transition in last year’s legislative session as a way to reduce fraud in the program, which reached an estimated $11.2 billion in 2024, but many of the program’s current brokers and a growing chorus of state lawmakers have called for the plan to be revisited.
The union, which represents 300,000 healthcare workers across the state and stands to gain hundreds of thousands of new members when the home care workers join the new system, has been the single-most avid proponent of the change. Its call for a delay is a major weight on the scale in the final days before action may be necessary.
The Hochul administration and Public Partnerships LLC, the Georgia-based company selected to administer the new system, have insisted the state is on track to transition all current customers, despite a relatively slow pace of signing up enrollees. Since January 6, 150,000 participants and 160,000 workers have begun or completed the registration process, the Health Department announced on Thursday, out of an estimated 280,000, according to state Medicaid director Amir Bassiri at a state budget hearing in February.
The union has previously said the transition could take as long as 18 months to complete and in its letter echoed the administration’s argument that the slow rollout can be blamed in part on some fiscal intermediaries who have misled their customers about the restructuring. But it also said PPL and the administration have issued confusing messaging and needed to revise their approach to more urgently reach the highest-need clients.
“Language that is meant to reassure consumers that their eligibility for services has not changed may inadvertently be sending the message that no action is necessary,” the recommendation states.
But the union does not want to open the door for lawmakers to revisit the statute that created the overhaul. By seeking a postponement through executive order, it is trying to thread the needle of providing continuity for workers and customers without inviting changes to the agreement sought by fiscal intermediaries and some lawmakers who also want a delay. The chair of the state Senate’s health committee, Sen. Gustavo Rivera, has been pushing legislation to delay the move and restructure it to preserve more of the existing fiscal intermediaries. The fate of that campaign is tied to the nebulous and opaque negotiations currently taking place over the governor’s $252 billion budget proposal, which in recent years have missed the same April 1 start of the state fiscal year.
“Frankly, they made an agreement last year. This is about how to implement that agreement,” said Helen Schaub, the union’s interim political director.
In the meantime, the union is asking the Department of Health to make a more concerted effort to re-enroll members with the greatest health needs, along with the geographic areas and language groups with the lowest numbers of unreached consumers. Zip codes in Queens, the Bronx and Brooklyn with large numbers of Asian, Latino, Orthodox Jewish and Russian residents have the lowest rates of re-enrollment, the recommendations point out.
The union also included a plug for standardizing wages and benefits across the system until, “if and when,” workers unionize, when they will negotiate contracts through collective bargaining. Currently, New York City workers are entitled to an additional “wage parity supplement” on top of minimum wage, which can be paid either through salary or benefits with little consistency in how it is currently provided.
