NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A8355
SPONSOR: Paulin TITLE OF BILL:
An act to amend the social services law, in relation to fiscal interme-
diaries under the consumer directed personal assistance program; and to
repeal certain provisions of such law relating thereto
PURPOSE:
This bill will ensure that CDPAP consumers continue to have a choice of
fiscal intermediary which will thereby increase the quality of the
program while simultaneously creating a safety net for the program
participants.
SUMMARY OF PROVISIONS:
Section one of this bill amends subparagraphs (i) and (ii) of paragraph
(a) of subdivision (4-a) of the social services law and subparagraph (i)
as amended and subparagraph (ii-a) as added by section 1 of part HH of
chapter 57 of the laws of 2024 to define terms.
Section 2 repeals subparagraphs (ii-b) and (ii-c) of paragraph (a) and
paragraphs (b) and (c) of subdivision 4-a of section 365-f of the social
services law.
Section 3 amends subdivision 4(a)(1) of section 365-f of the social
services law to conform with the definition changes in section 1.
Section 4 provides the effective date.
JUSTIFICATION:
This bill creates a new class of fiscal intermediaries beyond the State-
wide fiscal intermediary (SFI) Fiscal intermediaries (FIs) will be the
current Statewide fiscal intermediary as well as entities that are (1)
an independent living center that has been operating as a fiscal inter-
mediary since 1/1/24; or at the discretion of the Commissioner of Health
, (2) an entity selected as a subcontractor under the single fiscal
intermediary law as of 4/1/25.
The fiscal intermediaries shall be required to have a contract with NYS
Department of Health, shall have the same legal stature as the statewide
fiscal intermediary, and shall be required to provide fiscal interme-
diary services with cultural and linguistic competency specific to the
population of consumers and those of the available workforce.
The fiscal intermediaries are specifically established to provide
consumer choice of fiscal intermediary services and are permitted to
expand their services into areas of the State lacking choice with NYS
DOH approval.
The Governor has promised that any statutory restructuring of the CDPAP
program would result in a higher quality program and bring with it effi-
ciencies. While some reforms to CDPAP were needed, it was never intended
that the reforms would erase all the providers that had essentially
created the CDPAP program over 30 years ago and had been operating by
all accounts at a high level of quality service and accountability.
The selection process undertaken by the Department of Health resulted in
an out of State for-profit corporation, Public Partnerships LLC (PPL
First), being selected as the SFI. There have been major operational and
logistical problems associated with this selection. This bill provides
a safety net for consumers and personal assistants and provides consumer
choice which will raise the quality in the CDPAP program. The Governor's
promise of delivering a higher quality CDPAP program is not occurring.
We have seen already in the planning and execution of the SFI many nega-
tive consequences when there is a lack of choice of FI provider. Thou-
sands of CDPAP consumers immediately left CDPAP and chose another
program to get their long-term care home care rather than receiving
their home care from the single statewide FI. This has disrupted both
CDPAP consumers and the personal assistant work force that worked at
their direction to deliver the necessary home care services they require
to remain independent.
In addition, the SFI chosen in the RFP has operated more as an exclusive
franchise of the State rather than a service option available to CDPAP
consumers. They have begun to view all New York CDPAP consumers as their
property, so that any consumer that had even begun to register with PPL
under DOH guidance could not return to any other service option. With
court intervention, this has been stopped for now.
PPL's enrollment systems are antiquated and complicated to use, have
been frequently offline at critical times, and service calls and ques-
tions to PPL by consumers or their advocates in frustration are often
unreturned. Many workers are unsure whether they will ever get paid for
services rendered, in apparent violation of State labor laws which
require payment within a week. Additionally, promised employee benefits,
especially health insurance, are subpar.
Reasonable legislative and advocacy calls to delay implementation of the
SFI so that all the consumer and worker problems could be worked out
before there was any harm have been rejected. Litigation has helped
delay some of the pain and suffering, however changes to state law are
needed.
This bill will guarantee consumer choice. It will help stop the hemor-
rhaging of consumers to other programs because they have no alternative
of to the SFI. This bill will deliver on the Governor's promise of a
better CDPAP program, and it can all be accomplished within exiting
funding levels.
FISCAL IMPACT TO THE STATE;:
NONE. ANY COSTS ARE ALREADY ANTICIPATED IN EXISTING APPROPRIATION
AUTHORITY TO DOH.
LEGISLATIVE HISTORY:
New bill.
EFFECTIVE DATE:
Immediately
