ALBANY, N.Y. (NEWS10) — Fiscal intermediaries are once again suing New York State Department of Health (DOH) Commissioner Dr. James McDonald over the Consumer Directed Personal Assistance Program (CDPAP). In a lawsuit filed Wednesday, September 18, plaintiffs argued that changing the program would violate their constitutional rights and endanger vulnerable populations.

Take a look at the complaint at the end of this story.

The ongoing conflict involves over 250,000 elderly, sick, or disabled New Yorkers who use CDPAP. This Medicaid program lets them control what health services they get, and customize their care at home.

Hochul does not plan to end the program, but she does want to replace over 600 local fiscal intermediaries (FIs) that administer it with a single state-chosen provider by October 1. New York has more FIs—characterized by detractors as middlemen siphoning tax dollars—than the rest of the country combined. Her office said that the new plan would not change caregiver pay rates, that payments wouldn’t be interrupted, and that participants won’t need to reapply.

According to a spokesperson from Hochul’s office, “Our reforms will strengthen CDPAP, protect home care users, and cut out hundreds of middlemen to ensure taxpayer dollars are effectively serving the people who need them. Our plan does not change CDPAP eligibility for home care users and ensures that caregivers will continue receiving timely payment so they can keep providing the care that CDPAP users need.”

The plaintiffs in the lawsuit are:

• Principle Homecare: Founded in 2015, this minority-owned business serves over 200 CDPAP patients in the Bronx and will be forced out by the amendment due to ineligibility.
• Marton Care: Founded in 2017 and serving 120 consumers in Brooklyn, it would have to close by April 1
• Prompt Home Care: Founded in 2017 and with 700 CDPAP patients in the Bronx and Westchester County, it cannot compete for the new contract
• Care Connect CDPAP: Founded in 2016 and serving 500 CDPAP patients in Brooklyn and Westchester County, it will lose its contracts to the amendment

The lawsuit said the change would destroy the industry, shutter many small and minority-owned businesses, cost thousands of jobs, inflate administrative budgets, and disrupt services for the vulnerable people who need them. The plaintiffs argued that the law disrupts existing relationships, limits bids from experienced providers, and reduces specialized services for rare languages or diverse cultures.

On June 17, DOH released a Request for Proposals to select a single statewide FI. The plaintiffs said the selection process for the new statewide provider could create a monopoly, because DOH never explained how bids would be judged, leaving bidders unclear about the system. An April 1 deadline looms large over the entire process.

The case in the Southern District of New York claims violations of constitutional rights, including the Contracts, Takings, Equal Protection, and Due Process Clauses. Amending CDPAP in this way, according to the lawsuit, breaks existing contracts, disrupts business, and unfairly disenfranchises the plaintiffs. They seek a jury trial, where they want:

1. A declaration that the CDPAP Amendment violates the Constitution
2. A permanent injunction or court order to stop the amendment
3. Fees, costs, and expenses paid

Also on Wednesday, the Consumer Directed Personal Assistance Association of New York State (CDPAANYS) held a conference to “prepare for Gov. Hochul’s plan to outsource the entire program to one company.” At the Renaissance Hotel in Albany, conference attendees talked about likely consequences, which they said include forcing patients into nursing or group homes.

An online petition characterized the changes as “New York’s plan to hand over home care to big business.” It said that amending CDPAP represents “a $40 billion deal without any statewide oversight that will bankrupt hundreds of small businesses, eliminate home care jobs, and force thousands of elderly and disabled New Yorkers into nursing homes.”