More than 600 companies that administer New York’s consumer-directed home care program can continue to operate until Tuesday at midnight under a temporary restraining order, a federal judge ruled on Friday.
The ruling from the U.S. District Court for the Eastern District of New York temporarily halted the state Department of Health’s plans to cease work with companies that process payments and handle administrative matters for personal assistants in the state’s Consumer Directed Personal Assistance Program, or CDPAP.
About 250,000 disabled people are enrolled in the program.
The decision extends a previous restraining order issued against the health department by Judge Frederic Block on Monday that was to last until Friday. Representatives from the department and groups of consumers, who filed as plaintiffs, are expected to submit a letter to the court on Tuesday and agree to terms of a preliminary injunction while the case proceeds. A preliminary injunction may allow CDPAP providers to continue operating until the case is heard.
Block praised the parties for expressing willingness to find a solution.
“We all know what we're trying to do,” he said.
The ruling is the latest setback for Gov. Kathy Hochul’s administration, which has been attempting to switch the administration of CDPAP to a single fiscal intermediary, Public Partnerships LLC, or PPL. Through CDPAP, disabled people can hire, train and direct their own personal assistants, who are paid and provided benefits through a fiscal intermediary using Medicaid funds.
“Our warnings about the impending disaster of forcing hundreds of thousands of people to transition to a single company with only a three month timeline were ignored,” Nina Bakoyiannis, a consumer from Brooklyn, said outside the courthouse Friday. “Yet here we are. We hate to be right.”
Assemblymember Amy Paulin, a Democrat from Westchester County who chairs the Assembly Standing Committee on Health, supported the order.
“Today’s court ruling allows the State and PPL more time to fix this transition, which has caused major hardships for thousands of New Yorkers,” she wrote in a statement.
While state Sen. Gustavo Rivera, D-Bronx, who chairs the Senate Health Committee, also backed the decision, he said the order still leaves questions unanswered over how payments will be processed.
“That’s the bottom line: people are going without care, workers are going without pay, and they might not get paid in the future,” Rivera told the New York Public News Network. “The state is messing this up.”
The transition began in January, and the state had set a deadline of April 1 to have disabled people and their personal care workers moved from those 600 plus businesses to PPL. The previous intermediaries were supposed to stop providing services on that date. Bakyonnis emphasized that many consumers feel the rushed transition has threatened disabled peoples’ lives.
“Paperwork not processed in time, attendance, not getting paid, not coming to work, and we disabled consumers left trapped,” Bakoyiannis said. “Can't get out of bed, can't take a shower, can't use the bathroom. Families in crisis, caregivers not given the pay they need to make their ends meet. We haven't heard the stories, we've lived them.”
Rivera called on the judge to have the state delay the transition.
“This is not neglect,” he said. “This is active harm to people because of some hardheadedness, that ‘We’re gonna go through with the transition, regardless of what anybody says.’ It is nonsense. It is B-S.”
Hochul and top state health officials decided last year to cut out the agencies as a cost-saving measure and to provide better oversight of the program.
“This order is the latest positive development that allows the State’s CDPAP transition to continue, preserving care for those who need it and eliminating unnecessary bureaucratic spending,” Sam Spokony, a spokesperson for Gov. Hochul wrote in a statement Friday. “Our much-needed reforms will strengthen CDPAP for home care users who need it and protect all New York taxpayers by putting an end to years of runaway administrative costs.”
But the transition to PPL has been riddled with logistical jams, leaving tens of thousands still unenrolled in PPL’s system.
Consumers have also criticized the health department, saying the transition takes away their right to choose which fiscal intermediary to work with. They also note many fiscal intermediaries were either disabled-led agencies or were focused on specific cultural or language needs of communities.
Two of the plaintiffs of this federal case, Brooklyn Center for Independence of the Disabled and Regional Center for Independent Living, are independent living centers (ILCs). ILCs, required by law to be run by at least 51 percent people with disabilities, had a hand in the creation of the consumer-directed system. Many ILCs have been fiscal intermediaries for CDPAP.
Consumers who went through ILCs, including Western New Yorker Renee Christian, say they just want to go back to their original fiscal intermediary while this gets sorted out.
“I understand why the Governor wanted to do what she wanted to do, but reinstate some of the FIs that we know are good FIs, like the independent living centers,” Christian said. “Pause the transition until we figure it out. Figure out a better, different way, because this is not the answer.”
Christian has used CDPAP for over a decade, and is one of the nearly 180,000 disabled people who the Department of Health highlights as having already fully transitioned to PPL. However, she is down to four workers and not all of them have been approved to work by PPL yet. At least three of her workers have quit because of the transition.
“Most of [them leaving] was because of the transition, the insecurity of knowing whether or not they're going to get paid on time, that kind of thing,” Christian said.
The Department of Health has reported about 60,000 consumers have left CDPAP for other personal care services, and about 40,000 have still not fully transitioned to PPL.
While the temporary restraining order covered CDPAP consumers who had not registered with PPL, consumers like Christian are holding out hope the final preliminary injunction will include language to include consumers like her that transitioned, but are still left without some services due to delays and issues.
“My calendar was full of at least two to three shifts a day with all those staff last month, and for the month of April, I have approximately somewhere between 27 and 30 shifts not full, not covered,” Christian, who receives nearly 24-hour care, said.
