How the state’s Medicaid changes will affect disabled residents

State Sen. Simcha Felder

New Medicaid provisions enacted statewide in February could interrupt the care of many disabled residents who are currently allowed to choose their own caregivers this November. 

New York State Senator Simcha Felder is trying to protect his legislation that allows Fiscal Intermediaries (FI) for patients who need personal assistance, such as the elderly and disabled, to help patients with a range of tasks—including choosing and paying the caregiver of their choice. 

Parts of the legislation are in jeopardy because of new provisions from the Department of Health in the state’s budget, all of which went into effect on Nov. 8.

“The original intent of the legislation that myself and then-Assemblyman [Joe] Morelle (now Congressmember) enacted was to ensure that CDPAP [Consumer Directed Personal Assistance Program] patients are afforded increased flexibility and opportunity to hire the caregiver of their choice,” Felder wrote in a letter to Governor Kathy Hochul in early November. 

Limiting the CDPAP, Felder says, would force 80% of the participants to choose a new Fiscal Intermediary.

“Denying New Yorkers who participate in CDPAP the ability to continue with the trusted FI provider of their choice is not only bad policy, it’s also, quite frankly, cold-hearted,” Felder continued. 

There have been recent questions from the public on if CDPAP is closing down, especially as COVID-19 has put those with more medical needs in danger. 

According to their site, “The CDPAP program is a big success. It serves about 74,000 chronically ill or disabled people, allowing them to choose their caregivers and remain in their homes. The Department of Health is implementing some changes to make CDPAP more cost-effective, but the program is not closing down.” 

NY Health Access reported that some changes will be delayed, but not all. Those who need home assistance would have been required to need help with three daily tasks to qualify for CDPAP, and the person who helps them would have to be approved by an independent assessor. Those two facets are delayed but a new date has not been announced.

 Patients with dementia or Alzheimer’s have fewer hoops to jump through, but everyone in CDPAP would need help with at least two daily tasks in order to qualify for assistance through this Medicaid program.

Here’s what’s already in place: Some CDPAP providers will no longer be allowed in the program, and after a 90 day, 120 day or full-year transition period, there may be a reduction in services. 

In a public hearing about the budget proposal that initiated these changes, NY State Medicaid Director Donna Frescatore said that FI that wasn’t able to make it into the program can be debriefed on why they didn’t make the cut. “We’re committed to having an open process for those that weren’t awarded.  We extended debriefing rights in the initial letters,” Frescatore said in February. 

Transitioning to a new caregiver, or being denied one entirely once all of the provisions are in place, can be a huge disruption to the life of someone living with disabilities. 

“So many of the organizations, the not-for-profits that have provided this crucial service to many of our most vulnerable, some of our largest organizations, some of our organizations who deal with refugees and new Americans, who speak the language of those who have come here were not rewarded,” said Assemblymember Pam Hunter.

The state allowed 68 organizations to remain in the program during that process. “All of this adds to the urgency of protecting and preserving the CDPAP program,” Felder says in his letter, adding that stability in the healthcare system has never been more crucial. 

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