In the latest development in the overhaul of New York’s Consumer Directed Personal Assistance Program (CDPAP), the New York State Association of Health Care Providers penned a letter to Gov. Kathy Hochul and members of the state legislature.
Broadly, the letter urges lawmakers to make significant investments in home-based care and pass legislation that will improve reimbursement rates for home care services, in light of the increased utilization of licensed home care services agencies (LHCSAs) that resulted from the rocky CDPAP transition period.
CDPAP is a state Medicaid program that allows individuals in need of home-based care to hire the caregiver of their choice. The caregiver can be a friend or family member who can receive compensation through the program.
The program once used roughly 700 fiscal intermediaries, including some home care providers. In late 2024, the New York Department of Health awarded a single organization, Public Partnerships LLC (PPL), the fiscal intermediary contract, requiring consumers and personal assistants to register with the company.
In the association’s letter, the organization explains that recent changes to CDPAP have created a “ripple effect,” causing more individuals to switch from the Medicaid-funded home care program to LHCSAs.
Further compounding matters, these LHCSAs are now seeing increased demand at a time when these providers have less state investment, the letter said.
“LHCSAs are grappling with Medicaid reimbursement rate cuts – implemented this week – exacerbating financial strains and hindering their ability to recruit and retain essential home care workers,” the New York State Association of Health Care Providers wrote in the letter. “Despite increases in the home care worker minimum wage, these agencies face
skyrocketing operational costs – including workers’ compensation, utilities, and other business expenses – that far outpace reimbursements. Consequently, many agencies are operating at a loss, unable to offer competitive wages necessary to attract and retain staff.”
The New York State Association of Health Care Providers outlines three solutions that they state will address these issues. They ask lawmakers to allot a $150 million investment in home and community-based care from the Managed Care Organization tax.
Additionally, the organization suggests that lawmakers pass bills to set a regional minimum base rate for home care services to improve reimbursement.
“Failure to ensure access to home- and community-based long-term services in this year’s budget will threaten the rights, dignity, and lives of hundreds of thousands of New Yorkers,” the organization wrote. “We call on you to prioritize these urgent needs as you finalize the state budget.”
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