Senate Bill S7954

                                 
BILL NUMBER: S7954

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the social services law, in relation to fiscal interme-
diaries under the consumer directed personal assistance program; and to
repeal certain provisions of such law relating thereto

 
PURPOSE:

This bill would I ensure that consumers of the Consumer Directed
Personal Assistance Program (CDPAP) program continue to have a choice of
Fiscal Intermediary (Fl) which would increase the quality of the program
and create a safety net for the program consumers.

 
SUMMARY OF PROVISIONS:

Section 1 of this bill amends subparagraphs (i) and (ii) of paragraph
(a) of subdivision (4-a) of the social services law and subparagraph (i)
as amended and subparagraph (ii-a) as added by section 1 of part HH of
chapter 57 of the laws of 2024 to define terms.
              

Section 2 repeals subparagraphs (ii-b) and (ii-c) of paragraph (a) and
paragraphs (b) and (c) of subdivision 4-a of section 365-f of the social
services law.

Section 3 amends subdivision 4(a)(1) of section 365-f of the social
services law to conform with the definition changes in section 1.

Section 4 provides the effective date.

 
JUSTIFICATION:

This bill would create a new class of Fls beyond the current State-wide
Fiscal Intermediary (SFI). This new class of Fls would operate as the
current SFl in conjunction with entities that are (1) independent living
centers that have been operating as a fiscal intermediary since January
1, 2024, or at the discretion of the Commissioner of Health; or (2) an
entity selected as a subcontractor under the Single Fiscal Intermediary
law as of April 1, 2025.

Under this legislation these Fls would be required to have a contract
with New York State Department of Health (NYSDOH), have the same legal
status as the SFI, and would be required to provide Fl services with
cultural and linguistic competency specific to the population of consum-
ers and those of the available workforce.

These FIs would be established to provide consumers with a choice of FI
services and would be permitted to expand their services into areas of
the State lacking choice with NYSDOH approval.

The Governor has promised that any statutory restructuring of the CDPAP
program would result in a more efficient and higher quality program.
While some reforms to CDPAP were needed, it was never intended to erase
the providers that created the CDPAP program over 30 years ago,operating
by all accounts at a high level of quality service and accountability.
The selection process implemented by DOH resulted in an out of State
for-profit corporation, Public Partnerships LLC (PPL First), being
selected as the single SFI. Since transitioning to PPL, there have been
several major operational and logistical problems associated with this
selection. This bill would provide a safety net for consumers, personal
assistants, and providers and would promote consumer choice; which would
raise the quality and efficiency of the CDPAP program. We have already
seen many negative consequences associated with a lack of choice of Fl
provider in the planning and execution of the SFI. Thousands of CDPAP
consumers immediately left CDPAP and chose another program to get their
long-term care home care rather than receiving their home care from the
single SFI. This has disrupted both CDPAP consumers and the personal
assistant work force that worked to deliver the necessary home care
services they require to remain independent.

In addition, the SFI chosen in the RFP has operated more as an exclusive
franchise of the State rather than a service option available to CDPAP
consumers. They have begun to view all New York CDPAP consumers as their
property, so that any consumer that had even begun to register with PPL
under DOH guidance could not return to any other service option. With
court intervention, this has been stopped for now.

PPL's enrollment systems are antiquated and complicated to use. Their
services have been frequently offline at critical times, and service
calls and questions to PPL by consumers or their advocates in frus-
tration are often unreturned. Many workers are unsure whether they will
ever get paid for services rendered, in apparent violation of State
labor laws which require payment within a week.  Additionally, promised
employee benefits, especially health insurance, are subpar.

Reasonable legislative and advocacy calls to delay implementation of the
SFI so that all the consumer and worker problems could be worked out
before there was any harm have been rejected. Litigation has helped
delay some of the pain and suffering, however changes to state law are
needed.

This bill would guarantee consumer choice and help 'stop the hemorrhag-
ing of consumers to other programs because they have no alternative to
the SFI. This bill would deliver on the Governor's promise of a better
CDPAP program, and it can all be accomplished within existing funding
levels.

 
FISCAL IMPACT TO THE STATE:

None. Any costs associated with this legislation are already anticipated
in existing appropriation authority to DOH.

 
LEGISLATIVE HISTORY:

New bill.

 
EFFECTIVE DATE:
Effectively immediately.