New York State lawmakers introduced a new bill this past week hoping to reverse recent structural changes to theConsumer Directed Personal Assistance Program (CDPAP)by allowing multiplelicensed Fiscal Intermediaries (FIs)to operate alongside the newly selectedsingle statewide FI (SFI). The proposed legislation, Senate Bill 7954 (S7954), attempts to address widespread concerns about service breakdowns, loss of workforce and consumer dissatisfaction since the SFI model went into effect on April 1, 2025.
Background
CDPAP allows New York State Medicaid beneficiaries with chronic illnesses or physical disabilities to self-direct their home care by choosing their own caregivers. Historically, CDPAP relied on a network of FIs to manage administrative functions, such as payroll, benefits and training of such caregivers.
Pursuant to legislation passed in last year's budget, the state shifted the program to single FI, selecting Public Partnerships LLC —a for-profit, out-of-state vendor —through a competitive procurement process. This decision sparked litigation, and the change has resulted in many operational issues, such as lost paychecks and benefits and, worst of all, leaving many elderly and disabled New Yorkers without access to care.
Key Provisions of S7954
The new law would create a new class of FIs with the same legal status as the SFI. Specifically, the new FIs would have to contract with the New York Department of Health (DOH) and work with independent living centers that have operated as FIs since Jan. 1, 2024, or earlier, but only at DOH's discretion, or be one of the previously selected subcontractors of the SFI.
The bill repeals statutory language that requires managed long-term care plans and local social services districts to contract exclusively with the statewide FI. Qualified FIs will be permitted to contract directly with such plans and other programs offering CDPAP services. Finally, the new FIs would be permitted to expand into areas of the state lacking FI availability. DOH is authorized to review and approve such expansions through an expedited process.
S7954 represents a significant legislative push to preserve consumer autonomy, rebuild trust in CDPAP and ensure service continuity. Though reforms to streamline the program are welcomed by many, this bill highlights a growing consensus that choice and competition are critical to delivering effective, person-centered care in New York's long-term care system.
According to the bill's policy justification, the current SFI functions less as a service option and more like a state-sanctioned monopoly, viewing "all New York CDPAP consumers as their property." The bill seeks to end this dynamic and align CDPAP operations with consumer-directed care principles.
The bill is currently with the Senate Health Committee. Holland & Knight attorneys will continue to monitor developments on S7954 and other legislation impacting CDPAP.
For additional background on the current legal landscape, see previous blog posts: "New York Court Strikes Down CDPAP Reimbursement Changes," "CDPAP Legal Storm Continues: New Lawsuit Targets DOH's RFP Implementation, Single FI Structure," and "Fiscal Intermediaries Sue NYDOH Over CDPAP Reimbursement Changes."
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