In the last few weeks, new information has come to light regarding New York State’s Consumer Directed Personal Assistance Program, as many consumers continue their advocacy against the company running the program. CDPAP allows disabled people to hire and manage their own home care workers, paid by a fiscal intermediary using Medicaid funds.
Last week, protesters in Downtown Buffalo continued to criticize Public Partnerships LLC (PPL), the current single fiscal intermediary, or FI. New York State selected PPL to replace over 600 companies previously running the program after adding language to the state budget limiting the number of FIs.
At a rally at the Buffalo and Erie County Public Library, CDPAP consumer Janine Hunt-Jackson said the new system has caused issues that did not exist before the switch and worries the changes will force people out of the program.
Caring Majority, which held the rally, is calling on lawmakers to end the contract with PPL.
Coincidentally, this was just days after the Empire Center released an email showing PPL and the state communicated about the switch to one FI before it was added to the budget.
The state contends that the switch was made to save money and improve oversight. However, BTPM NPR was unable to get specific numbers from the state on savings so far. Department of Health officials told BTPM NPR they expect to save $1 billion in administrative costs this year.
Empire Center Senior Fellow Bill Hammond, who obtained the email and has been tracking the change, says it is hard to get information about the state's spending on the program. Hammond also says despite concerns over the changes, including questions about whether PPL influenced the decision to move to one fiscal intermediary, he is not sure a legal line was crossed.
TRANSCRIPT:
Emyle Watkins: Hi, I'm Emyle Watkins, and this is the Disabilities Beat. Last Thursday, activists in Buffalo held a rally in the downtown library, speaking out against, quietly chanting and booing the company in charge of the state's self-directed home care program.
Protestors: We need care, not corruption. We need care, not corruption.
Emyle Watkins: Public Partnerships LLC, or PPL, was selected by the state to be its fiscal intermediary, which pays home care workers under the Medicaid-funded Consumer Directed Personal Assistance Program, or CDPAP. CDPAP allows disabled people to hire, train, and self-direct their own home care workers. PPL replaced over 600 nonprofit and for-profit organizations earlier this year.
Janine Hunt-Jackson: Now my aide struggles with constant administrative hurdles that never existed in the previous system. It's like they want to drive us out of the program and lose our care. Without proper home care, I would have no help at all and would probably end up in a nursing home.
Emyle Watkins: Janine Hunt-Jackson, a retired social worker and consumer who uses a power wheelchair, was among those speaking out at the rally.
Janine Hunt-Jackson: We need our governor and our state legislature to listen to us.
Emyle Watkins: The consumers, workers, and advocates involved in Thursday's rally are part of Caring Majority, an organization calling on legislators to address concerns around private equity leading the system and to end one company running the program. The rally came just days after the Empire Center published an email obtained through a Freedom of Information Act request showing that PPL was speaking with the state about the move to a single fiscal intermediary. Prior to the change being added to a previous state budget, the state has contended the move was designed to save taxpayer money and that no part of the process was improperly done.
Bill Hammond: It's kind of hard to keep track.
Emyle Watkins: Bill Hammond is a senior fellow at the Empire Center, a think tank, that uncovered the email. Hammond has been studying changes to Medicaid in New York and says even before the move to a single fiscal intermediary, there was limited information about program enrollment, workers, and spending.
Bill Hammond: And frankly, the state doesn't do a great job of disclosing this in real time. Periodically, in the context of a budget fight, it will say, “It went up this percent in this time period,” but they don't routinely tell us, “Okay, this is what we spent on CDPAP.”
Emyle Watkins: Now, it's hard to know exactly how much the state is saving with the switch. Despite repeated email requests from BTPM NPR asking for a breakdown of savings or a year-to-year comparison of program spending, a State Department of Health spokesperson said they were on track to have “administrative savings of one billion this year.” They added that these savings are the result of transitioning to a single statewide fiscal intermediary, as the per-member-per-month rate was reduced from a range between $150 to over $1,000 under previous fiscal intermediaries to around $68 under PPL.
Hammond says despite concerns over the changes, including questions about whether PPL influenced the decision to move to one fiscal intermediary, he is not sure a legal line was crossed.
Bill Hammond: They created a custom-built bidding process just for this one contract. The health department said it would post a request for proposals, review those proposals, and pick the one it deemed the best value without defining what best value means. Technically, the department followed that process. Even though it cut off most communication with bidders during the process, it didn’t have to do that. Meeting with PPL in early April did not violate any part of the process. The term “bid rigging” is getting thrown around, and I understand why, but I’m not sure it crossed any legal lines.
Emyle Watkins: You can listen to the Disabilities Beat segment on demand and view transcripts and plain-language descriptions for every episode on our website at btpm.org. I'm Emyle Watkins. Thanks for listening.
