If you are participating in the NY Consumer Directed Personal Assistance (CDPAP) program as a consumer or home care aide, you should be aware of recent changes in the program. Due to these changes, New York State CDPAP participants and their Personal Assistants (PAs) will need to act by March 28, 2025 to prevent a lapse in home care services.
What has changed for 2025 in NY’s CDPAP program?
The NY CDPAP program now restricts Medicaid-eligible home care consumers and their providers to a single Fiscal Intermediary (FI). This means current CDPAP consumers, and their Personal Assistants, will need to register with the designated Public Partnerships, LLC (PPL) by March 28, 2025.
Previously, there was an option of choosing from 600+ Intermediaries (companies) in New York. But New York State is now moving the administrative arm of CDPAP to one Fiscal Intermediary to handle worker Medicaid payments and benefits, and maintain records. As a result, current caregivers and their home care aides will need to be registered with PPL by the deadline.
What is PPL (Fiscal Intermediary) and what does it do?
To be clear, a Fiscal Intermediary is a program administrator who pays the wages and benefits of a CDPAP aide or Personal Assistant (PA) based on the designated care plan. The aide or PA is an independent contractor and therefore does not work as a home care employee.
The Fiscal Intermediary is contracted by the county, state or managed care plan and provides authorized CDPAP services. Here is what PPL does:
- Assist with processing PA/aide’s payments.
- Assist with the processing of PA/aide’s income tax and withholdings.
- Maintain PA/aide required employment records.
Who is affected by these changes?
CDPAP consumers and their PAs will be affected by the changes. In order to avoid a lapse in your current home care services, you must transition to the single Fiscal Intermediary, Public Partnerships, LLC (PPL).
Although you will transition to PPL, there will not be changes to your CDPAP covered services and you can keep your home care aide as long as they are registered by the deadline.
What action will need to be taken?
Don’t let your home health care services stop! If you are a CDPAP home health care consumer, you are now required to register your Personal Assistant or home care aide with the Public Partnerships, LLC (PPL), which is the selected Statewide Fiscal Intermediary by March 28, 2025. Under the NY CDPAP program, PPL is the company chosen to handle onboarding and payments of those providing home health care services.
Your transition to PPL must take place by the deadline in order to avoid a lapse in your home care services as mandated by the State Budget for 2024-2025. This mandate requires that all recipients switch their home care services from their current Fiscal Intermediary to the single, statewide PPL to administer the program. This PPL replaces the option of choosing from hundreds of Fiscal Intermediaries (private insurance companies) that were previously part of the CDPAP program.
If you are new to the CDPAP program, recipients or their personal assistants will be able to register with PPL beginning March 1st, 2025.
How do I make the transition?
Whether you are a recipient of Medicaid home care services or a personal assistant, you can begin the registration process via one of these options:
- Call the PPL Support Center at 1-833-247-5346 or TTY: 1-833-204-9042.
- Go to the NY PPL website at pplfirst.com/cdpap for personal assistance and to access PPL@Home.
- Start the registration process online or check out CDPAP’s resources and events page.
- Work with a NY CDPAP-approved facilitator from the approved list at CDPAP Facilitators. These facilitators are available through the state of New York to help with transitioning to the single PPL.
CDPAP transition timeline challenge.
Although considered by some as a viable solution to the runaway Medicaid costs, the transition to a single, statewide Fiscal Intermediary does not come without issues. For example, several NY lawmakers have stated that “April 1 does not work” for the start of this newly designated PPL. As a result, they are asking for more time to transition the massive “$9 billion Medicaid home care program.”
Currently there are over 280,000 New York CDPAP consumers who will need to transition and register by the March deadline. To meet the deadline nearly 5,000 CDPAP consumers will need to make the transition daily.
However, Dr. James McDonald, New York State Health Commissioner, testified before in a joint legislative budget hearing on February 11, 2025 indicating that April 1st is the PPL’s start date and that’s what he “is planning on doing.” This is in spite of some New York officials suggesting that this type of mass overhaul of the home care program may not happen by the deadline.
McDonald also expressed concerns over the challenges of misinformation and people being told not to sign up. McDonald stated that PPL calls were being answered and that after reviewing the data said there were no wait times at the call center.
NY CDPAP changes come with controversy and opposition.
There are hundreds of companies who currently oversee CDPAP. After April 1, these intermediaries will need to cease operations as the program is then taken over by approximately 30 subcontractors.
In a letter to New York’s Attorney General and Ethics Committee, NY Governor Hochul’s administration highlighted that these smaller companies would prefer to keep the status quo and not lose the benefit of “hundreds of millions of annual administrative expenses.” The Hochul Administration letter was written to begin an investigation into who was behind a $10 million ad campaign against the CDPAP transition and Hochul’s overhaul plans.
PPL challenges in New York State.
The transition also doesn’t come without court challenges including one state Supreme Court judge issuing a temporary restraining order in Livingston County. The order would block a company from sending CDPAP patients personal data to a third party for reasons including the violation of federal HIPAA laws, freedom of speech, and others.
A PPL spokesperson, however, said “PPL has been a trusted steward of consumer data for more than 25 years.” Such a ruling could hamper the transition.
Issues with Public Partnerships, LLC (PPL) in other states.
Issues have surfaced with PPL in other states such as Pennsylvania, New Jersey, and Colorado. In addition, several lawsuits have been filed against the PPL alleging a failure of overtime payments to caregivers as well as abruptly dropping consumers.
Other changes for 2025.
Other budget changes for 2025 include an increase in minimum wage for home care workers, and Medicaid rates increase for nursing homes, assisted living communities, and hospitals.
Will my CDPAP eligibility be affected?
According to Dr. James McDonald, New York State Health Commissioner, your eligibility and services will remain unchanged. If you are currently enrolled in the CDPAP program, your home care services will continue after the transition, which must take place by March 28, 2025.
However, rules will be stricter in 2025 for new CDPAP or personal care applicants. New applicants will need help with “three (3) Activities of Daily Living (ADL), or supervisory assistance with 2 ADLs if the person has dementia or Alzheimer’s disease.” Learn more about these coming changes, which were delayed from the public emergency, here.
Do I have to change my PA/home aide?
No, McDonald has stated that you are allowed to keep your current Personal Assistant/aide and reminds CDPAP consumers that their personal assistants will be required to register with PPL. The transition to PPL by your personal assistants and caregivers will help ensure they receive timely payments.
Can my spouse be my caregiver or personal assistant under CDPAP?
No, your spouse cannot be chosen as your personal assistant or caregiver according to CDPAP regulations. Designated representatives and the parent of a CDPAP consumer under 21 years old are also not allowed to service as PAs or caregivers.
How will this transition affect my personal assistant or caregiver?
According to PPL’s President Maria Perrin, the statewide PPL will provide a “comprehensive support system,” not only for the transition, but to benefit PAs by giving them access to “health benefits, paid time off, 401K plans, and bonus payments.”
I am new to Medicaid, is CDPAP for me?
Individuals who are physically or chronically ill and are in medical need of skilled nursing services and/or daily activities are the primary consumers under the Consumer Directed Personal Assistance Program (CDPAP).
The CDPAP program allows Medicaid-eligible recipients to choose, hire, and train their own personal assistance or aide to stay independent while receiving care at home. Under this program, home care services can be provided by family members who serve as Personal Assistants and home health aides as opposed to seeking a home care agency. These home care aides are paid for their services from Medicaid through a designated Fiscal Intermediary.
Other CDPAP services can be provided by a personal assistant such as a nurse, home health aide, or a personal care aide or home attendant.
What are the eligibility requirements for CDPAP Services?
For an individual to be eligible for CDPAP services, the following is required:
- Be a New York resident;
- Be at least 18 years of age;
- Be eligible for NY State Medicaid;
- Be eligible for personal care, private duty nursing, certified home health care, or AIDS or other waiver program
- Have a stable medical condition;
- Be determined to need home care services and require assistance such as skilled care or help with daily activities;
- Be able to self-direct your care or have a designated representative.
What are the CDPAP Program requirements?
The following list is what the CDPAP program recipient (or designated representative) is responsible for:
- Recruit, hire, supervise, train, and terminate personal assistants;
- Arrange coverage when back-up assistance is needed;
- Coordinate and arrange other services;
- Keep payroll records for personal assistants; and
- Work with CDPAP Fiscal Intermediary in the processing of payroll for the services received.
