CDPAP Overhaul in NY: What the Changes Mean for Home Care Workers and Social Services

Last Updated: May 12, 2025

New York's Consumer Directed Personal Assistance Program (CDPAP) is undergoing a dramatic transformation that affects nearly 250,000 disabled and elderly New Yorkers and over 400,000 home care workers. The move to a single FI for the state will replace several hundred FIs currently in operation. This sweeping change, mandated by the state budget in April 2024, has sparked multiple lawsuits, widespread protests, and heated debates about the future of home care in New York.

What is CDPAP and Why Does It Matter?

CDPAP provides services to chronically ill or physically disabled individuals who have a medical need for help with daily activities or who require skilled nursing services. CDPAP offers recipients the flexibility and freedom in choosing their caregivers. Program participants can hire family members, friends, or trusted neighbors as personal assistants (PAs), giving them control over their care while maintaining cultural and linguistic preferences.

The Major Transition: From 600+ Fiscal Intermediaries to One

Governor Hochul announced that the State has selected Public Partnerships LLC (PPL) to serve as the Statewide Fiscal Intermediary (FI) for the Consumer Directed Personal Assistance Program (CDPAP). Hochul has been adamant the transition is necessary because New York was spending about $3.2 billion on CDPAP in 2018, which has skyrocketed to $11.2 billion last year because of mismanagement by the hundreds of smaller companies.

Legal Challenges and Service Disruptions

The transition has faced significant legal resistance. In an emergency petition filed Nov. 25, 2024, by the state's largest fiscal intermediary (FI), Freedom Center LLC (FCL) alleges that the Department of Health's (DOH) FI bidding process was a "sham" that resulted in a multibillion-dollar contract being awarded to Public Partnerships LLC (PPL), a Georgia-based company "with no relevant prior experience in New York" and an "abysmal record in other states."

More concerning for workers are the recent payment issues. The Legal Aid Society and Katz Banks Kumin LLP have filed a lawsuit on behalf of an individual plaintiff and tens of thousands of home care workers against Public Partnerships, LLC (PPL), the newly contracted statewide intermediary for New York's Consumer Directed Personal Assistance Program (CDPAP). This litigation seeks to hold PPL accountable for its widespread failure to pay personal care assistants accurately, on time — or at all — since assuming its new role.

Impact on Workers and Training Concerns

"We had to teach ourselves," said one former PPL customer service representative, who requested anonymity. "It was self-learning — watching videos to figure out PPL's system." In addition, they felt the system itself was not designed to adequately accommodate CDPAP consumers and their disabilities. These training deficiencies have directly impacted the ability of workers to receive timely payments.

Advocacy Groups Demand Delays

Multiple advocacy organizations have called for delays to the transition. Medicaid Matters wrote to Governor Hochul: "We are CDPAP consumers, their families and advocates, asking you to slow down the transition to a single Fiscal Intermediary (FI). Whether through executive action or the upcoming state budget process, the March 31, 2025 deadline for about 250,000 consumers and 400,000 personal assistants (PAs) to transition is unrealistic and must be extended."

In response to a previously published Times Union opinion piece, NYLAG's Valerie Bogart and Rebecca Wallach wrote a letter to the editor dispelling misinformation about Medicaid's Consumer-Directed Personal Assistance Program (CDPAP). The Legal Aid Society argues that the rushed transition will devastate consumers and workers without delivering the promised savings.

Government Response and Misinformation Concerns

State officials maintain that the transition is necessary and on track. According to the Department of Health, "The Department is also highlighting wins over legal challenges levied against the transition to a single statewide fiscal intermediary. To date, the court rulings on the challenges to the CDPAP amendment, the Department's Request for Proposal, and the selection of PPL as the single Fiscal Intermediary have been resolved in the Department's favor and have had no impact on the timing of the transition."

The Department of Health has also issued cease and desist letters to organizations allegedly spreading misinformation. Additionally, Cease and Desist letters were issued to Fiscal Intermediaries (FIs) and Licensed Home Care Service Agencies (LHCSAs) who are alleged to be providing false, deceptive or coercive information about CDPAP and PCS options to consumers and workers.

What This Means for Social Services Training

For training providers and educational organizations in the social services sector, these changes present both challenges and opportunities:

Looking Ahead: What's Next?

The CDPAP transition remains in flux with several key developments to watch:

"No caregiver should ever have to choose between caring for a loved one and being able to afford rent or groceries." - Michael Diller, attorney with Legal Aid's Employment Law Unit

Resources for Workers and Consumers

For those affected by the CDPAP transition, several resources are available:

Conclusion

The CDPAP overhaul represents one of the most significant changes to New York's home care system in decades. While state officials tout potential savings and reduced fraud, workers and consumers face uncertainty during this massive transition. For social service professionals and training providers, understanding these changes is essential to supporting clients and preparing the workforce for New York's evolving home care landscape.

As the situation continues to develop, staying informed and prepared is crucial. Whether you're a home care worker, consumer, or training provider, the CDPAP transition will likely impact your work in the months and years ahead.