The state’s transition of a popular Medicaid-funded home care program remains in limbo as a legal challenge aiming to extend the deadline continues to play out in court.
Gov. Kathy Hochul has held tight to the April 1 deadline to overhaul the consumer directed personal assistance program, which allows home care users to hire family and friends as caregivers. The consolidation, which started in January, sent the Department of Health scrambling to move approximately 280,000 home care users into a new system to pay their workers. The state planned to make a single firm, Georgia-based Public Partnerships LLC, responsible for all worker payments by April 1, shuttering roughly 600 third-party businesses called fiscal intermediaries that used to do that job; but not all users and caregivers moved to the new system by that date.
Amid lagging enrollment earlier this week, Judge Frederic Block, who presides over a federal court in Brooklyn, issued a temporary restraining order banning the state from shutting down all of the fiscal intermediaries that previously paid workers. That order remains in place while the state negotiates a new deadline to complete the transition, allowing home care users who haven’t signed up with the new system to continue working with their old agency as a stopgap to ensure their workers get paid and they can still receive services.
The judge’s order does not apply to home care users who have started their registration with PPL. As of Friday, roughly 205,000 consumers have started or completed registration with the company and 60,000 have moved to an alternative home care program, leaving an estimated 15,000 people who have yet to start registering, according to the Department of Health.
Additionally, 235,000 personal assistants have started or completed registration with PPL, and 195,000 were able to clock in with the company as of Friday, according to Erin Clary, a spokeswoman for the Health Department.
“This order is the latest positive development that allows the state’s CDPAP transition to continue, preserving care for those who need it and eliminating unnecessary bureaucratic spending,” said Sam Spokony, a spokesman for the governor. The order does not impact the 93% of consumers who have already registered, he said.
Consolidation of the home care program, which cost an estimated $11.2 billion last year, is an effort by the governor to cut its skyrocketing costs. For months, the state Department of Health maintained that it was “on track” to complete the overhaul by the April 1 deadline, but days before that date, tens of thousands of consumers had not started registering with the new system. State Health Commissioner James McDonald announced a one-month registration “grace period” a week before the deadline, giving home care users and caregivers until April 30 to sign up.
As a part of its extension, the state promised to retroactively pay home care workers once they enrolled – a solution that advocates said was not an option for caregivers who are low-income and live paycheck-to-paycheck. The move raised concerns that caregivers would leave their jobs in search of other work to pay the bills, leaving consumers, some of whom have physical disabilities that require round-the-clock care, without services.
The state has blamed lagging registrations on misinformation spewed by companies that were set to go out of business. But some consumers said that the slow sign-ups were perpetuated by technical issues, alleging in the federal lawsuit that directions to register with PPL were not available in multiple languages, they faced long wait times to talk to a company representative and it took weeks to complete their paperwork.
Jose Hernandez, a home care user who lives in the Bronx, said that he started registering with PPL in February, but didn’t get all of his paperwork approved until April 3. Hernandez, who uses a wheelchair and receives services from five caregivers, said that one of his personal assistants still has not received clearance from PPL and cannot be paid through the system.
Attorneys for the state said in court on Friday that PPL has agreed to implement a team to expedite registrations and help consumers complete their paperwork. The company has also agreed to allow caregivers who cannot clock in to the company’s app to submit their timesheets on paper in the short term.
Lawyers for the state and the plaintiffs, who are represented by the New York Legal Assistance Group, are aiming to reach an agreement by Tuesday, the attorneys said.
