Advocates decry changes to long-term home care
Caregivers, recipients gather at Capitol to protest possible cuts to popular Medicaid program
ALBANY — With the final state spending plan overdue by nearly two weeks, home care workers and disability rights advocates clamored Friday for state lawmakers to refuse rollbacks to a popular Medicaid program that allows New Yorkers to choose their own caretakers.
The Consumer Directed Personal Assistance Program allows New York residents to opt for family and friends as caregivers if they have longterm medical needs that require care or assistance at home. Those caregivers are then reimbursed through Medicaid.
The program is popular with many New Yorkers, but state officials have balked over the years at its swelling costs. On Friday, members of the major health care union 1199SEIU and several disability rights advocates protested against changes to the Medicaid program that Gov. Kathy Hochul’s administration has floated, included tweaking the CDPAP program to remove the majority of fiscal intermediaries, or groups that serve as middlemen between residents and the large health insurance plans known as managed long-term care programs.
Budget figures provided by Hochul’s administration have pointed to a 10 percent growth in enrollment in managed long-term care this fiscal year, with spending expected to increase by 20 percent. The administration deemed that growth unsustainable and has also proposed a measure that would remove a supplemental pay benefit for hourly home care aides known as Wage Parity. The move, Hochul’s office said, would save the state up to $200 million “while ensuring services are available for the most vulnerable populations.”
“Governor Hochul’s Executive Budget makes recordsetting investments in New York’s future while ensuring the state remains on a stable long-term fiscal trajectory, and she will work with the Legislature to craft a final budget that achieves these goals,” spokesperson Avi Small said in response to questions about the planned changes.
Instead, health advocates want more changes to the managed long term care plans themselves and have called for the state to crack down on “wasteful administrative spending” instead of changes that could impact caregivers and their patients. The state switched to that system of funding health care for older New Yorkers and those with disabilities in 2012.
Proposed changes could decimate many Independent Living Centers that also function as fiscal intermediaries between managed longterm care plans and New Yorkers with complex and long-term medical needs, said Denise Figueroa, executive director of the Troybased Independent Living Center of the Hudson Valley.
The Independent Living Center she manages, for
example, is able to hire and fire caregivers for consumers with managerial oversight, as well as provide training for consumers on how to use the CDPAP program.
If the state switches to just one fiscal intermediary, Figueroa said she worries how it would capture the best interests of the more than 250,000 people who participate in the program.
“For one entity to have any contact with those people, it’s going to be impossible,” Figueroa said. “There are a lot of supports that are needed … and we know our consumers, because we are the consumers.”