In recent years, many states across the country have revamped their consumer direct care system to ensure consumers get the care they need, caregivers are respected, and taxpayer dollars are spent efficiently.  

Lessons have been learned and the effectiveness of changes affirmed with the examples of Pennsylvania, Washington, Massachusetts and more - the transition in New York will be seamless to ensure critical care is not interrupted. New York is positioned to adopt the best practices of other states who use single FIs to administer their consumer directed home care services.

a nurse crouching beside a young patient in a wheelchair
illustration of Washington state

Washington

  • 55,000 Consumer Directed caregivers in Washington State are represented by SEIU Local 775. The union has the power to bargain for improvements in their wages and benefits under a single collective bargaining agreement.

  • A collaboration between SEIU 775, the state’s Department of Social and Health Services, and the State’s single FI has enabled the creation of a robust care matching website, Carina.org. Consumers can search the free, user-friendly website to identify individual providers who meet their needs. They can message, chat with, and interview potential providers to hire on the Carina website. Once they have chosen a preferred provider, the hiring process is facilitated by the single FI.

illustration of Pennsylvania

Pennsylvania

  • Every newly hired direct care worker is referred by the state’s FI to Frontline, the state’s provider of participant-directed care worker orientations. These Pre-Service Orientations help new caregivers navigate the hiring process with:

• Assistance completing employment paperwork

• Introduction to the self-directed model

• Training on the use of Electronic Visit Verification

• Providing other mandated trainings including sexual harassment prevention

• Ensuring that new caregivers can begin working with their consumer as fast as possible

  • The Single FI’s contract with Frontline also includes safety, foundational skills and specialty track training for direct care workers.

illustration of Massachusetts

Massachusetts

  • The 58,000 Consumer Directed home care workers are represented by 1199SEIU, and in their most recent contract negotiations won a pathway to $25 an hour.

  • Massachusetts provides a list of all personal care attendants paid through the MassHealth PCA Program. This registry creates a referral directory for consumers,  and is also a tool for consumers and PCAs to identify training opportunities

  • Personal Care Aides are required to attend an orientation providing them with employment-related information about wages, benefits, fraud, abuse, neglect, infection control and worker rights. The FI notifies the consumer-employer about the orientation requirement, and the Personal Care Aides are paid for their time through the FI by MassHealth