New York’s 2025 state budget was passed last month. It will bring sweeping changes to home care stakeholders and recipients in the state.
The budget makes significant changes to New York’s Consumer Directed Personal Assistance Program (CDPAP).
Under New York’s CDPAP, individuals seeking care are permitted to hire a caregiver of their choice. These are often informal carers. These caregivers are paid for their services through the program.
The most notable change the budget makes to CDPAP is that it assigns a statewide financial intermediary to oversee the program.
Some of New York’s home care providers – AccentCare is one example – act as financial intermediaries (FIs).
“Our providers really feel like the state is trying to dig a hole with a grenade,” Kevin Wade, vice president at Sandata, told Home Health Care News. “The state believes there is significant fraud, waste and abuse within CDPAP. They believe they can save $200 million by switching to a single financial institution. A change like this adds an additional layer of complexity to an already complex system.”
Sandata is a technology company and provider of electronic visit verification. It works with states, home care providers and MCOs.
Wade pointed out that the state probably could have taken other steps to reduce fraud, waste and abuse that wouldn’t have upended the current system.
“There are ways to monitor and oversee programs without necessarily changing or transforming the way health care is delivered,” he said.
Wade says there are also many questions about how a statewide FI would work in practice.
“There is still a lot to be clarified when it comes to the question of how many subcontractors will be permitted within a given area for a single financial institution,” he said. “We know there will be at least one subcontractor per tariff region, so in New York State there are four. But beyond that it is not known. We don’t know who that financial intermediary would be.”
Wade also noted that moving from hundreds of FIs to a single one could impact care, as many of the providers taking on this role are deeply embedded in the communities in which they operate.
Aside from changes to the CDPAP, the budget included an increase in the minimum wage for home health aides and increases in Medicaid rates for hospitals, nursing homes and assisted living communities.