While it's getting hotter outside, pressure on New York State to fix its troubled home care transition is also heating up.
If you’re just catching up - New York has been switching from hundreds of nonprofits and companies from running its Consumer Directed Personal Assistance Program, or CDPAP, to only one.
That company is Public Partnerships LLC, or PPL. They’re known as the fiscal intermediary, or FI. Disabled people, known as consumers in the program, hire, train and self-direct their own personal assistants, and the fiscal intermediary pays the assistants using Medicaid dollars. Some organizations, including independent living centers, were moved from being FIs to being “facilitators” under PPL as part of this transition process. But two coincidental movements this week focus on facilitators’ role in this transition - and how big it should be.
UPDATE: On Tuesday, the judge in the federal case mentioned in this story decided to extend the deadline for personal assistants to transition to PPL to June 20. When BTPM NPR spoke with Elizabeth Jois, an attorney representing users of CDPAP in the federal lawsuit earlier this week, her team was expecting that the judge may allow them to submit a proposal for an extension on Tuesday. Instead, the judge provided a short extension to allow Jois’ team and the state to negotiate a longer extension or additional guardrails. In a statement to BTPM NPR immediately after the ruling, Jois said "We need the State to use all its resources to fix these issues." Attorneys will have to submit their agreed upon briefing schedule with the court by next Tuesday.
TRANSCRIPT:
Emyle Watkins: Hi, I’m Emyle Watkins and this is the Disabilities Beat
While it's getting hotter outside, pressure on New York State to fix its troubled home care transition is also heating up.
If you’re just catching up - New York has been switching from hundreds of nonprofits and companies from running its Consumer Directed Personal Assistance Program, or CDPAP, to only one.
That company is Public Partnerships LLC, or PPL. They’re known as the fiscal intermediary, or FI. Disabled people, known as consumers in the program, hire, train and self-direct their own personal assistants, and the fiscal intermediary pays the assistants using Medicaid dollars. Some organizations, including independent living centers, were moved from being FIs to being “facilitators” under PPL as part of this transition process. But two coincidental movements this week focus on facilitators’ role in this transition - and how big it should be.
Elizabeth Jois: Unfortunately, I think despite everyone's best efforts, we're still seeing some people who are just left in limbo at the moment.
Emyle Watkins: Elizabeth Jois is a supervising attorney at the New York Legal Assistance Group. She’s representing consumers and organizations in a federal lawsuit that alleges the state’s transition to a single FI has violated Medicaid due process rights when someone is at risk of losing services. Consumers have reported issues with their assistants getting paid, on time or at all, and some have lost them during the transition.
Elizabeth Jois: We're going on seven weeks of this now. And you know, increasingly when I talked to consumers, I'm hearing from people whose personal assistants have actually stopped coming because they needed to go find another job that was going to pay them.
Emyle Watkins: Earlier this spring, the judge in the case issued a preliminary injunction, essentially laying out how things will operate while the case is heard. To address the challenges facing consumers and personal assistants in getting moved to PPL, the parties agreed to guardrails to help the transition move more smoothly. They also established new deadlines – the last of which is coming up on June 6. But Jois and her clients have now asked the judge to reconsider that deadline and the role of facilitators.
Elizabeth Jois: That they be, first, sort of permitted to take more direct actions on behalf of consumers and PAs. Instead of kind of working as a go between, between the consumer and PPL, that they be able to take more direct actions in PPL systems, and that also that they just be assigned all the people who can be identified as as as not having received the proper services.
Emyle Watkins: They want to see the deadline moved to August 15th. But some advocates believe this isn’t enough.
Ilana Berger: It doesn't get at the bigger systemic issue of PPL’s inability to pay all of the PAs accurately and on time.”
Emyle Watkins: Ilana Berger is the political director of Caring Majority Rising, which represents some consumers and assistants. Coincidentally, as NYLAG asks the court to bump up the position of facilitators this week, Caring Majority is making their own push with members of the legislature: let the independent living centers that are now facilitators transition back to fiscal intermediaries.
Ilana Berger: So we are happy to see the injunction, you know, moving forward, and hope that they extend it, and we still... it's not going to ultimately solve the problem. We need the legislation.
Emyle Watkins: Assembly Bill A8355 and Senate Bill S7954 would alter state law to undo the single-statewide fiscal intermediary clause that was created last year. Instead, independent living centers would be written into the law as fiscal intermediaries, since they helped start and have long administered the program. And other currently approved facilitators could be considered for reinstatement as FIs. There’s currently just over 40 state approved facilitators.
Ilana Berger: Also, the entire point of the consumer directed program was consumer choice. So the really good thing about this legislation is that it will allow trusted fiscal intermediaries to reopen, so that there actually will be entities in place in New York State that have the capacity and infrastructure to pay workers correctly for every hour that they work, which will ensure that people will continue to get the home care they need.
Emyle Watkins: Both bills already have the support of several co-sponsors. Jois makes it clear though - the request in their federal lawsuit has no connection or correlation with the legislative push. It’s only based on what they’re hearing from consumers.
Elizabeth Jois: And so honestly, whatever is happening legislatively, it's like, I didn't even have time to pay attention to that. The timing is entirely coincidental.
Emyle Watkins: You've been listening to the Disabilities Beat from Buffalo Toronto Public Media. You can listen to the Disabilities Beat segment on demand, view a transcript and plain language description for every episode on our website at BTPM.org. I'm Emyle Watkins. Thanks for listening.
