Dear Cuomo, you're killing us.
At the beginning of 2019, news was going around that New York State was trying to drastically slash the funding for it's CDPA (consumer-directed personal assistant) program. This is the very program that I, as well as thousands of other disabled and elderly New Yorkers are on. It didn't happen, but now, nearly six months later, we're back at square one.
Before I get into the nitty-gritty of this blog post, let me give you a little background information on how this program works. CDPAP is a state-run, medicaid funded program, which allows individuals who need assistance the opportunity to direct their own care. Under this program, we are responsible for finding, hiring, training, and if it comes to it, firing, all of our own aides, or as I like to call them, PAs (aides makes me cringe...ew.) Luckily, we are not responsible for all the paperwork or payroll, which is where agencies, or financial intermediaries (FIs) come into play.
Medicaid pays FIs -> FIs pay PAs
This program is fundamentally the reason we are able to live independently at home, in our own communities, and be an active participant in society.
In February, after weeks of protests and lobbying, we were able to stop legislation from passing that would have slashed the funding for this program, basically dismantling the entire thing. Last week, it was announced that Gov. Cuomo is working directly with the Department of Health on "restructuring" the CDPA program and how the FIs recieve their reimbursements. At the moment, medicaid uses a model that reimburses the FIs a certain amount per hour per consumer. This money is used to pay for the administrative tasks like the paperwork and payroll. A small part of it also contributes to wages. On July 1st, a policy guidance was released stating that, effective September 1st, 2019, FIs will start getting reimbursed on a PMPM (per month per member) basis. This means that instead of the FIs getting reimbursed per hour, it is going to be a flat rate for each consumer, each month. There will be three tiers of reimbursements. Every consumer will fit into one of these tiers depending on how many monthly hours they are approved for.
If this happens, who knows what it would lead to? There is a good chance that many of the FIs will be forced to shut down because they cant afford the costs of day-to-day operations, forcing their consumers to switch to a different FI. With the closure of the FIs, and influx of consumers to the few remaining ones, quality of care and services are very likely to suffer. There is also a possibility that some consumers won't be able to recieve the proper care, and will be forced to live in institutions! That means no freedom, no autonomy, no independence. People will d i e.
It's a scary time to be disabled. We already have a hard enough time finding the right people to work for us. Now, this is just another thing we have to worry about.
I am wondering why Gov. Cuomo and the DOH is pushing this policy so hard. It makes no sense. I understand they are trying to save money. But, if this policy gets enacted, and people end up in nursing homes (which btw, ends up costing MORE), how is that helping? Do they actually care about their constituents, or is someone in their pockets? Is there a deal on the table? Sure seems it.
STOP ATTACKING DISABLED PEOPLE. WE ARE NOT THE PROBLEM.
Here is the full policy guidance:
There is still time to fight this. I urge you all to GET INVOLVED. Disabled or not.