Critical updates are coming to New York’s Consumer Directed Personal Assistance program!

These long overdue reforms will ensure consumer directed caregiving can continue by reining in out of control administrative costs of the program.  

The Consumer Directed Personal Assistance Program, or CDPAP, started as a grassroots led program created by people with disabilities to allow them to come home from institutions.

Today, thousands of people across New York State depend on consumer directed care (CDPAP), many getting the support needed from a trusted family member or long-term caregiver in the comfort of their own home.

New York wants to ensure consumers continue to receive this care - that's why the NY Department of Health is cutting down on the 700 unregulated middlemen fiscal intermediaries (FIs) administering CDPAP funds, many of which are exploiting taxpayers and caregivers to fund lavish executive salaries.

This streamlining of CDPAP will save an estimated $1 billion in taxpayer dollars, redirecting resources to consumers and caregivers. Eligibility and ability to hire the personal assistant of your choice will not change.

Over a dozen states including Washington, Pennsylvania and Massachusetts have implemented similar systems to ensure better management of consumer directed programs, while protecting services. We’re ready for New York to do the same, in order to secure the future of this critical community health program.

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  • “We are thrilled to be part of the team of FIs that will carry CDPAP forward for years to come. PPL and the strategic partner alliance of FIs understand the importance of this program for our most vulnerable citizens, and we are determined to make the transition seamless.”

    CEO Anthony Caputo
    Concepts of Independence

  • “CAPC is one of the longest standing FI’s in NY and will be part of an essential partnership to ensure Asian Americans can receive choice in their home care. CAPC will join PPL and their Strategic Partnership Alliance of FIs across NY to ensure continuity and culturally competent care for diverse communities.”

    Wayne Ho
    President Chinese American Planning Council (CAPC)

  • “The network of NY-based FI’s who have proven their integrity and dedication to promoting core values of consumer-direction will administer a program that aims to preserve service levels while creating a sustainable program for years to come.”

    Chris Graber
    CEO for Consumer Directed Choices (CDChoices)

  • “This diverse new alliance will safeguard the commitment and ongoing work of New York State to provide multilingual, culturally sensitive home care that is readily accessible for those who rely on it today, and who will need it in the future.”

    Dr. James McDonald
    State Health Commissioner

a nurse standing with a young patient in a wheelchair

Why Now?

Since 2018, spending on CDPAP has gone up 23% each year under managed care, drawing increased scrutiny. In 2019, the Legislature passed reform to require FIs to contract with the state, and significantly limit the numbers of FIs to bring these out of control costs down, but it was never fully implemented after fierce industry opposition.

This year, the NY Legislature enacted a new law in the FY2025 budget approval process.

Rather than cutting services or caregiver wages to keep the program going, the reform is going after exploitative agencies/FIs and out of control administrative costs, implementing a streamlined CDPAP program similar to a dozen other states like Washington and Pennsylvania. The long overdue changes to consumer directed care will bring accountability, efficiency, and better quality care to the NY home care industry.

What Will Be The Impact?

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Ensures The Future of Consumer Directed Care

Allows spending from excess administrative costs and profit to be redirected consumer services and wages.

Easier to administer for government

Supports program sustainability for the long term

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Higher Quality Care

Easier for Consumers to Find Specialized Caregivers (skills, language, location)

More Hours of Care

Voluntary Training/Certification opportunities for caregivers

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Increases Efficiency

Easier to Match Consumers with Caregivers

Faster Approvals for Caregivers

Faster Payments

Easier to Implement Improvements

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Stronger Oversight

Reduced wage theft and other violations of caregivers’ rights

Easier to advocate for improvements to system

Easier for caregivers to resolve issues with pay

Wage, overtime, workers’ compensation support

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Medicaid Dollars Re-directed Towards Consumer Care

End to Exorbitant Executive Salaries

Reduced admin costs by ending use of 700 unregulated middleman agencies