In this article…
- Overview of the CDPAP Program
- What Is Changing in 2025?
- Concerns from Home Care Agencies
- How These Changes Could Affect Patients
- Impact on Home Care Agencies and Providers
- Final Thoughts
Overview of the CDPAP Program
The Consumer Directed Personal Assistance Program (CDPAP) is a Medicaid initiative that allows consumers to hire family members or trusted individuals to provide home care services. It’s a vital option for thousands of New Yorkers who prefer to receive care from someone they know and trust rather than from a traditional agency caregiver.
What Is Changing in 2025?
The New York State Department of Health has announced that it will consolidate the administration of CDPAP from approximately 700 fiscal intermediaries (FIs) to a single statewide vendor: Public Partnerships LLC (PPL).
According to the state, this transition is expected to save $500 million annually. However, this move has drawn strong opposition from home care companies, advocates, and patients alike.
Concerns from Home Care Agencies
As a licensed home care provider on Long Island, Care Connection Home Care, LLC is deeply concerned about the rapid implementation of this plan and the risks it poses to both consumers and workers.
Unrealistic Transition Timeline
The plan requires the transition of 250,000 consumers and 400,000 personal assistants to PPL by March 31, 2025. As of early March, over 145,000 consumers had not even begun the registration process, creating widespread fear of disruption in care services.
Source: Times Union
Legal Challenges and Bid Controversy
Several lawsuits have been filed, alleging that the bidding process was flawed or even rigged. Accusations include collusion between state officials and a powerful union to favor PPL, the winning vendor.
Sources:
How These Changes Could Affect Patients
Service Disruption
With the majority of patients not yet registered with PPL, the risk of interrupted care is very real. Patients who depend on consistent, in-home support may find themselves without assistance if they’re not transitioned in time.
Loss of Trusted Caregivers
Many patients choose CDPAP because it allows them to be cared for by a familiar face — often a family member. The administrative changes may make it difficult for patients to retain these relationships, leading to emotional distress and gaps in care continuity.
Impact on Home Care Agencies and Providers
Job and Business Losses
With a single vendor taking over, hundreds of small- to mid-sized fiscal intermediaries — many of them locally owned and operated — face closure. This threatens jobs and limits patient choice in favor of a centralized model.
Reduced Reimbursements
Agencies fear that the new system could also result in lower reimbursement rates, reducing their ability to provide quality services and invest in caregiver training or technology upgrades.
Strain from Legal and Administrative Hurdles
Instead of focusing on care, many agencies have been forced to divert resources to legal challenges and compliance with unclear transition guidelines.
Final Thoughts
Care Connection Home Care, LLC urges lawmakers and the Department of Health to reconsider the scope and speed of this transition. A program as important as CDPAP should not be rushed through without the input of the patients and providers it serves.
We stand with our fellow home care companies, caregivers, and — most importantly — the patients and families who count on this program every day.
We will continue to update our patients and partners as the situation develops. If you or a loved one are affected by these changes, please reach out to us directly for support and guidance.
Frequently Asked Questions about Changes to New York’s CDPAP Program
1. What is CDPAP and why is it important?
CDPAP (Consumer Directed Personal Assistance Program) is a New York State Medicaid program that allows patients to hire family members or people they trust to provide home care. This model promotes independence, dignity, and continuity of care for seniors and people with disabilities.
➡️ Learn more from Medicaid Matters NY
2. What changes are being made to the CDPAP program in 2025?
The State of New York is reducing the number of fiscal intermediaries (FIs) from approximately 700 to one statewide provider, Public Partnerships LLC (PPL). The goal is to streamline operations and cut costs by an estimated $500 million annually.
➡️ Source: Spectrum News
3. Why are home care agencies and advocates opposing the change?
Agencies are concerned about:
- Unrealistic transition timelines
- Service disruptions
- Loss of patient choice
- Alleged unfair contracting practices
- Financial instability for local providers
➡️ Source: Times Union
4. What is the timeline for this transition?
The transition to PPL is scheduled to be completed by March 31, 2025. As of early March, over 145,000 consumers had not registered, increasing the risk of care interruptions.
➡️ Read more: Medicaid Matters NY
5. Could patients lose their caregivers?
Yes. Because of administrative hurdles, patients may not be able to retain the family members or trusted aides who currently provide their care. This threatens the continuity and quality of care.
➡️ Source: Times Union
6. What happens if a patient doesn’t register with PPL in time?
If consumers don’t register before the deadline, they may temporarily or permanently lose access to personal care services, putting them at risk of hospitalization or institutionalization.
➡️ More details at: Times Union
7. What are the allegations of bid rigging and favoritism?
Several lawsuits have been filed alleging that the state rigged the bidding process in favor of PPL, influenced by political connections and union involvement.
➡️ Source: New York Post
8. How will this affect local home care agencies?
Many local FIs may be forced to shut down due to the loss of contracts. This threatens jobs, limits patient choice, and reduces competition in the market.
➡️ Read more from McKnight’s Home Care
9. Will caregivers be paid less under the new system?
There is concern that PPL may offer lower reimbursement rates than current intermediaries, potentially lowering pay for caregivers and impacting the quality of services.
➡️ Analysis from HealthAide.org and Medicaid Matters NY
10. What are advocates asking the State to do?
Advocates are urging New York State to:
- Delay the transition
- Increase transparency in the contracting process
- Preserve patient choice and continuity of care
- Consider a multi-vendor model instead of a single FI
➡️ Advocacy updates from Medicaid Matters NY
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