Big changes are likely coming to the structure of New York’s Medicaid program and the impacts would be detrimental to the hundreds of thousands of home-care recipients supported through the Consumer Directed Personal Assistance Program (CDPAP). With Governor Hochul’s office choosing to defend their decision and standing firm with their “reforms” to CDPAP, individuals with disabilities and the elderly who access in-home care through CDPAP will have funding reduced and their ability to choose who provides their care stripped away. 

Understanding the Proposed Changes to CDPAP in New York

New York State is known for fighting to protect its most vulnerable citizens and that is being tested more than ever. Governor Hochul’s proposed Medicaid cuts stand to greatly restrict the Consumer Directed Personal Assistance Program (CDPAP), which was established to promote choice, autonomy, independence and empowerment for seniors and people with chronic illnesses or disabilities. The CDPAP system as it is currently structured allows individuals to choose caregivers and manage care according to their specific needs, allowing them to shape and have control in their healthcare journey.

The current state proposal threatens to dismantle CDPAP by including significant amendments, shifting away from the extensive network of local fiscal intermediaries currently in place. Fiscal intermediaries are experts in delivering tailored, community-based care through CDPAP and play a crucial role in ensuring that funds are appropriately disbursed, claims are processed efficiently, and program regulations are followed. 

Governor Hochul is pushing for a drastic consolidation, replacing all local fiscal intermediaries with a single entity. Not only would hundreds of fiscal intermediaries be reduced to one, that agency may even be from out of state and therefore lack essential knowledge and commitment New Yorkers deserve. And it doesn’t stop there – the chosen entity could be a FOR-PROFIT provider, risking a decline in the quality of care and reducing legal protections for those most at-risk in New York.

The Consequences

This intended change of transitioning to a single fiscal intermediary is devastating. Under the new structure, estimates suggest the loss of tens of thousands of jobs, disproportionately impacting the rural regions where fiscal intermediaries are often major employers. The potential impacts on quality of care and job stability are very real for those providing care under the current system. Even worse, those currently receiving care and support via CDPAP, an estimated 250,000 New Yorkers, have serious concerns about the disruption of care, loss of benefits and lack of control in their previously self-directed care. 

What You Can Do

There is still time to come together and take action to prevent the drastic restructuring that will limit access and disrupt care to those in need. If you think you are helpless in this situation, you are not. This vital program is too important to give up on and we are joining the community and urging the Governor and Legislature members to recognize the stakes involved and to put the current proposal on hold so a proper review and investigation into the planned restructuring can take place, preserving the system that respects the dignity and autonomy of all New Yorkers.

If we all come together, CDPAP participants, caregivers, and advocates, in solidarity and collectively voice our concerns, we may be able to shift the outcome. A first step is to directly contact our elected officials to implore the New York State Legislature to listen to their constituents, emphasizing the importance of preserving your right to choose a fiscal intermediary under CDPAP. Below you will find the contact information for our elected officials and a link to a petition backed by State Senator Andrew J. Lanza.

Let’s stand together to protect CDPAP and ensure that New York’s healthcare system remains supportive, inclusive, and empowering for all.

Contact info:

 Governor Kathy Hochul: 518-474-8390

 Senate Majority Leader Andrea Stewart-Cousins: 518-455-2585

 Assembly Speaker Carl Heastie: 518-455-3791

Petition – https://www.nysenate.gov/petitions/andrew-j-lanza/save-choice-home-care