State FI Update
On September 30, 2024, Governor Hochul announced that Public Partnerships LLC (PPL) had been awarded the massive contract to serve as the Single Statewide Fiscal Intermediary (FI) in the state’s Consumer Directed Personal Assistance Program (CDPAP). The announcement describes the creation of a “diverse alliance” of more than 30 regional partners that she claims will ensure the delivery of multilingual, culturally sensitive care.
Subject to state approval, the referenced alliance is expected to include four core regional home care partners:
- Chinese American Planning Council, the lead regional partner for New York City, Long Island and Westchester County
- Concepts of Independence, Inc., the lead regional partner for the Hudson Valley region including Rockland, Dutchess, Putnam, and surrounding counties
- Angels In Your Home, the lead regional partner for mid-state areas including Albany, Saratoga, Rochester, Buffalo, Syracuse, and surrounding counties
- Consumer Directed Choices (CDChoices), the lead regional partner for Upstate and Southwestern areas including Allegany, Oswego, Hamilton, Clinton, and surrounding counties
The press release indicates that a list of additional agencies participating in this strategic partnership alliance will be announced soon in addition to these four core partners.
Transition Process
Hochul added in her announcement that the state will begin the transition process to ensure communication and support for the program’s users and caregivers. The transition will take place over the coming months and will “ensure home care users and caregivers are protected before the new statewide partnership takes effect.”
According to the Governor’s notice, the transition will include meetings with beneficiaries and workers and coordination with disability and senior advocacy groups. Additionally, the Governor plans to have an open dialogue with NYS elected officials and an ongoing state review of the process to thoroughly address the needs of CDPAP users and personal assistants before the switch to a statewide single FI.
PPL adds that the new system will include “a robust, multilingual, accessible communications plan” with print, digital, and social media campaigns to add to the understanding of CDPAP users and their families and to “make it easy for home care users to choose the appropriate caregiver for addressing their needs.” FIs have, in the past, been criticized for using advertising to attract workers and to increase program awareness.
The Governor claims that CDPAP users will not experience any service disruptions, but HCP cautions that the transition process is likely to be bumpy, as large-scale restructurings often are. Home care consumers—many of whom are elderly or disabled—are at risk of being caught in bureaucratic delays, leaving them vulnerable to service delays. The statement by PPL regarding users choosing the appropriate caregiver indicates that caregivers may not automatically be assigned to their current cases.
Furthermore, the Governor’s assurance of “timely payments” for caregivers is important, but this promise has been made in the past with mixed results, and questions remain about how this will be enforced under the new structure. PPL has lost or had contracts terminated while managing similar home care programs in New Jersey, Washington, West Virginia, Virginia, and Tennessee. PPL is currently the target of a class-action lawsuit from 20,000 people in Pennsylvania for failure to pay caregivers overtime.
As reported in last week’s HCP Insider, 1199SEIU sent a partnership agreement to PPL and other contract candidates, requesting that it jointly advocate with the union for increased wages and remain neutral to any organizing efforts. The union’s leadership and others quoted in the press release allege unfounded financial malfeasance on the part of New York’s 600 FIs. HCP notes that PPL was found negligent in a lawsuit filed in the Eastern District of Washington for improperly deducting union fees from non-union employees’ checks.
Hundreds of small businesses and nonprofits which help home care workers and those who need services will be shut down, leading to almost 10,000 lost jobs and thousands more home care workers scrambling for support or out of work themselves. PPL’s assertion that it is creating 1,200 jobs with this contract is laughable given the 600 FIs who will close their doors. The 5-year contract, worth a reported $40 billion, will begin on January 1, 2025. PPL intends to relocate its national headquarters to New York.
Advertising to attract consumers and workers, a robust media buy, a headquarters move into New York, and a 5-year contract that is not subject to oversight by the Office of the State Comptroller does not sound like a realistic way to contain programmatic costs. Further, the Department of Health (DOH/the Department) has demonstrated time and again that it cannot successfully implement massive programmatic changes any better than it has managed the program itself.
HCP Support
Stay tuned to HCP channels for updates and next steps as this process unfolds. The announcement of a contract award does not impede any of the lawsuits currently underway to stop the move to a single statewide FI. You can follow the suits on HCP’s Lawsuit Tracker.
The Alliance to Protect Home Care will continue to lead the opposition to the Single Statewide FI. You can watch the latest TV ads, contribute financially, and send a message to your legislators by visiting the Alliance’s website.
**News broke on September 30 that a preliminary injunction was not granted on the single statewide fiscal intermediary Request for Proposals (RFP) lawsuit. Take note this is not the final legal or legislative remedy. Additional information will likely come in the next few days.**