Some lawmakers have come up with a proposal to help reduce the administrative costs of a home care program that wracked up a roughly $9 billion tab for the state last year.
During recent budget discussions, the Assembly put forth a proposal to reduce administrative costs related to the consumer-directed personal assistance program, which allows older New Yorkers and people with disabilities to hire their own caregivers to help with activities such as personal hygiene and cooking. Such caregivers could be family members as opposed to home health aides, for example. Caregivers get paid by administrative agencies that contract with the state.
The plan would appoint a single entity to manage payroll and home care hours for the state’s entire personal care aide workforce. That job currently falls on roughly 600 to 700 nonprofits and businesses — a fact that home care advocates say will put more than 7,000 administrative workers out of a job.
The proposal is the latest attempt by state officials to reduce costs in the program. Gov. Kathy Hochul proposed restrictions on it in her executive budget proposal in an attempt to curtail costs of the program, which state officials say have skyrocketed 1,200% over the last decade. The Assembly and the state Senate rejected the bulk of Hochul’s proposed restrictions in their one-house budget proposals, but cuts are still on the table. The personal-assistance program has proved popular with New Yorkers, with 250,000 enrolling last year – up from the roughly 1,000 that enrolled when it launched in the 1990s.
“We have to deal with the explosion of the program,” said Assemblywoman Amy Paulin, who represents parts of Westchester and serves as chair of the health committee. She added that it’s still not certain if the suggested plan will be included in the final budget.
Lawmakers are grappling with the impacts this proposal could have on small agencies that provide consumer-directed care – the bulk of which could go out of business if it goes through, Paulin said. She added that there are discussions about support for independent living centers that serve New Yorkers with disabilities, many of which manage payroll for personal care aides.
It’s not clear how the state would execute the plan. After the Assembly proposed to cut back to a single fiscal intermediary, the governor’s office put forth language offering a no-bid contract to Alpharetta, Georgia-based financial services firm Public Partnerships, according to a source familiar with the discussions.
But Paulin said the current discussions have suggested a bidding process to select the right vendor.
A spokesperson from the governor’s office did not respond to a request for comment on Hochul’s stance on the proposal, nor whether a no-bid contract was on the table.
Not all lawmakers are backing the proposal. Sen. Gustavo Rivera, who represents parts of the Bronx and also chairs the health committee, said he is wary about awarding a contract to a single entity, as New York doesn’t have a good track record of doling out sole-source contracts to big companies to run big parts of the health care system. “I’m not a fan.”
The deadline for the final state budget, which was supposed to be final by April 1, has been extended to April 15.
Amanda D'Ambrosio , 2024-04-12 11:33:03
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