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NBC News
2 days ago
- Health
- NBC News
Mother with cerebral palsy struggles to hire aides after private equity takeover
Renee Christian, a single mom with cerebral palsy, lives in Buffalo, New York, with her 12-year-old daughter. Although her condition forced her to spend most of her childhood at a nursing home, she has resided in her own home for years with the help of personal assistants she hires under a New York State Medicaid program. In April, however, Christian's life was upended when the state forced her and her assistants to work with a new company administering the nation's largest consumer-directed personal assistance program, called CDPAP. One by one, she lost nearly half her assistants because they said they did not receive the proper pay for their work, Christian said. She now fears for her future living at home where she needs help getting dressed, doing laundry and cooking meals. 'I'm trying to hire new staff, and I am very good at navigating technology,' Christian, 37, said. 'But it's hard when you have to tell your new hires, 'I can't guarantee you're going to get paid on time or get the appropriate amount of hours.'' Christian is not the only one affected by the state program's recent takeover. NBC News spoke with nineconsumers and personal assistants who described multiple problems since Public Partnerships LLC (PPL) won the $1 billion, five-year contract in 2024, replacing roughly 600 entities that had been administering the program. The issues range from assistants receiving checks for zero dollars to problems arranging for direct deposit, onboarding new workers and clocking hours worked. PPL, which has a staff of 1,400 on the New York program, is owned by two private equity firms. Its takeover as the program's sole administrator triggered an avalanche of complaints from consumers unable to reach anyone to answer questions and assistants unpaid for hours they worked and unhappy with reduced health insurance benefits, according to lawmakers, consumer advocates and the consumers and assistants interviewed by NBC News. Before the transition to PPL, roughly 280,000 consumers were participating in the CDPAP program, according to the New York Department of Health. Since PPL took over, some 80,000 have left the program, the department said. 'A lot of these folks need the services being provided by the program,' Gustavo Rivera, a New York state senator who represents constituents in the Bronx, told NBC News. 'It's likely they dropped out because of difficulties making the program work or they switched to programs that are more expensive.' Rivera has scheduled hearings in August about what he calls the botched transition to PPL. At a cost of $9 billion a year, New York's CDPAP is the largest personal assistance program in the nation. It allows consumers like Christian to directly hire the folks who help them pursue their lives rather than rely on a staffing agency. At-home programs like New York's are less costly than providing institutional care, research shows. In 2024, according to one analysis, a semi-private room in a nursing home cost an average $9,277 a month nationwide. That's 43% more than a home health aide costing on average $6,483 each month. Amanda Lothrop, chief operating officer for New York State's Medicaid program, told NBC News that the transition to PPL aimed to eliminate the former program's administrative inefficiencies while protecting taxpayers. She said fraud and abuse had marred the previous program, but the state has identified very few cases. A 2022 audit by the Office of Medicaid Inspector General in New York, for example, uncovered only $46,000 in overpayments in the program, a 99% accuracy rate. In response to questions from NBC News, PPL and the New York state health department said together they had identified 30 instances of home care workers under the previous system billing consumers who were hospitalized or dead, five cases of workers billing for work with consumers who were out of the country, one worker claiming to work for two people at the same time and another who claimed to be in two places simultaneously. More than 200,000 workers are in the CDPAP program. 'In partnership with PPL,' the department of health said in a statement, it 'is using enhanced data and monitoring tools to protect program integrity, support consumers, and take timely action when issues arise.' Meg Fitzgerald, a PPL spokeswoman, said in a statement that the company's 'systems and centralized control processes would have been able to identify and prevent these violations.' The contract New York State awarded to PPL is a recent example of private equity's increasing involvement in home health care, said Aditi Sen, managing director of research and campaigns at Americans for Financial Reform, a nonprofit nonpartisan organization that advocates for fairness in the U.S. financial system. Last month, Sen published a report detailing the industry's forays into home health care entitled, 'Wall Street on Your Doorstep: Protecting Home Care from Private Equity Abuses.' 'The private equity industry is looking for any streams of steady public funding,' Sen said in an interview. 'As advocates have secured more funding for home and community-based services, that has resulted in the private equity encroachment.' She said the next step for researchers is to analyze the quality of home care after private equity gets involved. Founded in 1999, PPL calls itself an industry leader 'in financial management services for consumer direction, serving consumers throughout the U.S.' As for the difficulties in the New York program, the PPL spokeswoman said in a statement: 'The transition to a single fiscal intermediary required a significant element of education and, in some cases, a change in practices for submitting and approving time. We have been committed to providing various methods of extensive education and resources to all stakeholders. Ultimately, we strive to provide the accountability this program deserves.' Three CEOs in five years Private equity firms have taken over wide swaths of the health care industry in recent years and ill effects on care have been well-documented in independent academic research. The firms typically acquire companies or doctors' practices using debt and hope to sell them within five to seven years at a profit. This requires the firms to improve the financial results of the companies they buy, often firing employees or cutting services to slash costs. The private equity firms bought PPL three years ago. Studies on hospitals and nursing homes have found significant deterioration in patient outcomes after private equity takes them over. Other research has found that prices rise significantly after private equity acquires a practice or operation. According to Sen, private equity firms have rolled up hundreds of small home health and home care chains into large companies like Comfort Keepers, Help at Home and Accentcare. Combined, private equity-owned companies offering home and community-based care services are second only in size to chains owned by insurers Humana and UnitedHealthcare, Sen found. Many acquisitions by private equity-owned chains have been in companies offering home and community-based services for people with physical, intellectual and developmental disabilities, Sen determined. Pediatric home care for children with disabilities is another area of interest as is the consumer self-directed care industry, PPL's focus. Private equity acquisitions are not always easy to track. PPL's website does not identify its owners, but a recent court ruling disclosed the two private equity firms that control it — DW Healthcare Partners of Toronto and Park City, UT, and Linden Capital Partners of Chicago. Although both the firms' websites list other companies they have invested in, neither lists PPL as an investment. After winning the New York State contract, PPL tried to keep its ownership secret. In a lawsuit filed last year against New York's Department of Health by a home care company over the transition to PPL, the company's private equity owners were identified in a document that PPL requested the judge keep under seal. If the information were made public, the company argued, it 'may put individuals in danger and/or allow them to become targets of violence.' Public disclosure would also increase the risk of 'unwanted attention and harassment,' PPL said. The company lost that battle and the document became public. Fitzgerald, PPL's spokeswoman, declined to elaborate on the company's desire for secrecy in its ownership. Neither DW Healthcare nor Linden Capital Partners responded to emails seeking comment for this story. PPL also objected to a 2024 Medicare rule affecting home care organizations. The rule mandated that at least 80% of Medicaid payments go to compensation for direct care workers, such as personal assistants, not a company's 'administrative overhead or profit.' Fitzgerald said the company's objections were not about worker compensation. Rather, she said, the company believed the rule would 'make it more difficult for states to initiate new self-directed programs and to maintain small self-directed programs.' Participants in the CDPAP program aren't the only ones experiencing upheaval in the transition to PPL. Recently, Vince Coppola, PPL's former chief executive, and Maria Perrin, its former president, departed unexpectedly. PPL has had three CEOs over the past five years, Fitzgerald said. Filling out forms for hours Tara Murphy said she enjoyed working as a personal assistant in the CDPAP program for 25 years. But when she tried to switch to PPL, she encountered multiple difficulties, she said. 'Their technology is so hard to navigate, it took me four and a half hours to fill out their forms,' she recalled. 'I uploaded them nine times before they were finally accepted in their system.' Murphy's hourly pay with PPL was 2% less than she had previously earned, she said, and she never received the correct pay under the new program. 'I ended up having to quit my job and leave my consumer,' she said. Rivera, the New York state senator, said he hopes to gain some answers from state officials on the PPL transition at the Aug. 21 hearings in New York City he co-sponsored with state Sen. James Skoufis. 'Last year, when it was pushed upon us in the budget process I said back then that I thought it was a bad idea,' Rivera said of the switch to PPL. 'Unfortunately, what I heard from my constituents is the transition was indeed bungled.' Meanwhile, Christian, the Buffalo mom who has lost five personal assistants since PPL took over, is especially worried about how it might impact her daughter. 'My daughter is 12 years old, she needs me here for her,' Christian told NBC News. 'If I have to go into a facility because I can't get care in my home, where is she going to go?'
Yahoo
03-04-2025
- Health
- Yahoo
CDPAP transition 'a nightmare' for Southern Tier agencies. What to know
New York's shakeup of a Medicaid-funded home caregiver program has left Binghamton-area residents and lawmakers confused and concerned about access to its services. On Sept. 30, 2024, New York Gov. Kathy Hochul announced a single private Georgia-based company, Public Partnerships LLC would replace hundreds to handle the administrative and financial affairs for the Consumer Directed Personal Assistance program beginning in April. All New Yorkers currently enrolled in CDPAP will keep their services under the new format, and there will be no changes to eligibility, but users are required to register with PPL for home care workers to continue to be paid. Hochul recently extended the registration deadline from April 1 to April 30, but even with the extension, New York State Senator Lea Webb criticized the rollout of the transition, and said it requires more "transparency and accountability." Webb and Assemblywoman Donna Lupardo joined representatives from Finger Lakes Independence Center, Access to Independence, Cortland County Community Action program and the Southern Tier Independence Center on Monday, March 31 to address concerns of residents and caregivers. "We are at a critical point," Webb said, "because there are a lot of challenges." Statewide, about 220,000 CDPAP consumers had taken action in advance of the April 1 transition deadline, or about 78% of the total number of consumers who have relied on the program previously, according to state health officials. That figure included about 165,000 New Yorkers who have either started or completed the registration process. Another 55,000 New Yorkers are in the process of transitioning from CDPAP to Personal Care Services program, which includes other caregiver models within Medicaid, as well as some programs covered by health plans or private payment. Home care users who switch to Personal Care Services have the option to return to CDPAP in the future, health officials said. About 280,000 New Yorkers had been relying upon CDPAP prior to the overhaul efforts, suggesting as many as 60,000 could have lost care due to their inability to meet the April 1 deadline. The exact amount of people enrolling in the program going forward will remain unclear until the new April 30 deadline. The state underestimated and downplayed the volume of people and the overall transition process which "lacked coordination from the beginning," Lupardo said, adding the CDPAP program is "far too important to be put at risk with this rushed rollout." More: Bethanie Dougherty went missing 17 years ago in Broome County: What to know Local agencies assisting clients in the transition say they have encountered hurdles. PPL has set up call centers and registration information sessions to assist in the transition process, but Jan Lynch, the executive director of the Finger Lakes Independence Center, said the system is flawed. "We have hired extra staff to help people sign up and it is still a nightmare," said Lynch, who referenced system crashes, unanswered calls and differing advice depending on who picks up the phone. The Southern Tier Independence Center has acted as a middleman facilitator for over 25 years for the CDPAP program. Jennifer Watson, executive director for STIC, said most workers are earning minimum wage and living paycheck to paycheck. Home care workers will retroactively receive payments for hours worked in April, provided the April 30 registration deadline is met. If CDPAP clients are not able to meet the registration deadline, workers are left facing a decision, Watson said, "continue to work without pay and support their consumers or find work elsewhere and leave the workforce." "That is going to leave people with disabilities high and dry, they are going to end up in emergency rooms, hospitalized, institutionalized or honestly worst." A federal judge issued a temporary restraining order on Monday, March 31, allowing other financial agencies to continue to serve CDPAP clients who have not yet registered with PPL — the order did not impact the transition already underway for those who have registered. The case was scheduled to be revisited in court on Friday, April 4. Kalyn Grant reports on public service issues for the Press & Sun-Bulletin, focusing on schools and community impact. Have a story to share? Follow her on Instagram @KalynCarmen and on Facebook under Kalyn Kearney. Get in touch at kcgrant@ This article originally appeared on Binghamton Press & Sun-Bulletin: CDPAP transition 'a nightmare' for Medicaid-funded program users
Yahoo
25-03-2025
- Health
- Yahoo
Hochul admin offers ‘grace period' for NY home care switch — but still denies any issues in chaotic rollout
The Hochul administration announced Monday a 'grace period' for consumers caught in the middle of its turbulent overhaul of the state's $9 billion home care system – but continued to deflect blame for the chaos. The Department of Health said participants in the consumer directed personal assistance program, or CDPAP, can be reimbursed once their paperwork is processed by Public Partnerships LLC, the company handpicked by Gov. Kathy Hochul's team to consolidate payroll services. But State Health Commissioner Jim McDonald blamed a massive backlog on processing and other issues on misinformation from the hundreds of former intermediaries being replaced by PPL. 'It's deeply troubling to me that the past information that has been out there has been so misleading to everybody,' McDonald said at a news conference. The grace period marks a massive turnaround after months of the administration claiming the transition was on track to be completed by April 1, while only occasionally sharing actual numbers of how many people have transitioned. 'I don't view it as secrecy,' McDonald said, when asked why his department often refuses to provide precise data and other information about the transition. The commissioner touted sending 18 cease and desist letters to fiscal intermediaries accused of spreading misinformation. There are more than 600 such firms being part of the transition overall. At Monday's news conference, PPL CEO Maria Perrin said around 140,000 consumers have completed the transition process. The DOH said last week that around another 55,000 have left CDPAP altogether and moved to the more expensive, personal care services program. That still doesn't account for another roughly 85,000 consumers. State Medicaid Director Amir Bassiri said Monday he expected PPL will have completed signing up the 220,000 consumers by April 1. A health department spokesperson later walked back the figure saying Bassiri 'misspoke', but refused to provide an accurate estimate. Despite the one month 'grace period,' critics are still pointing out that thousands of personal assistants will be left without pay for weeks as they hope and pray PPL will process their paperwork, after which they can get paid. 'The Department of Health continues to blame everyone except themselves and PPL for this disaster of a transition,' said Bryan O'Malley, executive director of the Alliance to Protect Home Care, one of the groups representing fiscal intermediaries. 'Now, they are creating more chaos and confusion by asking home care workers to work without pay and without even the most basic protections,' O'Malley continued. 'An I.O.U doesn't pay for rent or groceries and it doesn't cover late fees and overdraft fees.' As of Monday evening, PPL's website makes no mention of anything about the 'grace period' and still says consumers and personal assistants must transition by March 28. DOH Medicaid Chief Operating Officer Amanda Lothrop said PAs who take advantage of the grace period should continue to fill out timesheets as they do now, even though their current fiscal intermediaries will be effectively defunct. 'You still keep track of your time the same way that you have,' Lothrop said.
Yahoo
18-03-2025
- Health
- Yahoo
CDPAP changes put caregivers' health insurance at risk
BUFFALO, N.Y. (WIVB) — New Yorkers with disabilities and the people who support them are rushing to apply for continued benefits under a revamped $9 billion Medicaid home care program as the April 1 deadline looms. The Consumer Directed Personal Assistance Program (CDPAP) enables New Yorkers with disabilities to hire family members or friends as paid caregivers. Although the service will remain in place, Gov. Kathy Hochul recently announced a major overhaul in how caregivers are paid, with payments now being managed through a single facilitator, Georgia-based Public Partnerships LLC. 'This is not an easy switch, and whoever thought of it should have thought a little bit more about it,' said caregiver Stephanie Finch. Finch and Nancy Brown, caregivers with a combined 16 years of experience, shared that they first learned about the CDPAP changes through a commercial, only receiving formal letters from the Department of Health last month. 'Immediately we went out and tried registering and that just was so difficult and frustrating. The website that they have is very confusing. There are several tabs and depending on who you talk to, whether it's a facilitator or whether it's PPL, you'll get two different answers,' said Brown. These unanswered questions have led PPL to announce on Monday that they have 'received over 770,000 customer calls and made 100,000 outgoing calls.' 'I wrote down every time I talked to somebody with a date and their name, and I think I have over 30 phone calls,' said Brown. 'I started the process on Feb. 12 and it took me until March 4th to finish,' said Finch. More than 700,000 New Yorkers use CDPAP. In a statement on Monday, the Department of Health (DOH) reported that nearly 140,000 individuals and 150,000 personal assistants have started or completed their registration. This means that 58% of current users must complete their registration within the next 15 days or risk losing both care and employment. 'Good luck to them if they're just starting now,' said Finch. State Health Commissioner Dr. James McDonald emphasized on Monday that anyone who hasn't started the process yet should do so immediately. Brown and Finch added that they are now registered, but this raises even more questions — such as the requirement for PPL training. 'Where do we go for this training? How do we find the training? There's just no answers to that. They say that's forthcoming, just wait and we'll either get an email or a text message,' said Finch. Brown, a full-time caregiver, claims that her 280 accrued PTO hours and health insurance have been 'thrown out the window' with this change, posing a risk to both her and the individuals with disabilities she cares for. 'I would have to work for one month at least 130 hours for people before I qualify for their, what they call minimum value plan, out of Florida. But I don't know what that is,' said Brown. Between now and March 28, PPL will continue its outreach but consumers and personal assistants can start their registration now through one of the following options: Call the PPL Support Center at 1-833-247-5346 or TTY: 1-833-204-9042. Go to the NY PPL website at for personal assistance and to access PPL@Home. Start the registration process online or check out CDPAP's resources and events page. Work with a NY CDPAP-approved facilitator from the approved list at CDPAP Facilitators. These facilitators are available through the state of New York to help with transitioning to the single PPL. Dillon Morello is a reporter from Pittsburgh who has been part of the News 4 team since September of 2023. See more of his work here and follow him on Twitter. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
17-03-2025
- Business
- Yahoo
Local residents sound alarm as CDPAP changes loom
BUFFALO, N.Y. (WIVB) — New Yorkers with disabilities and the people who support them are on the clock as the April 1 deadline to apply for continued benefits under a revamped $9 billion Medicaid home care program arrives soon. The Consumer Direct Personal Assistance Program (CDPAP) allows New Yorkers to hire family or friends as paid caregivers for those with disabilities. While the service isn't going away, Gov. Kathy Hochul's recently announced overhaul on how caregivers get paid is causing concern from residents who say this could leave their disabled loved ones without service. 'We're at a crisis situation right now that can be prevented,' said the mother of a disabled child who uses a CDPAP caregiver. This change, stemming from last year's budget, now uses a single statewide facilitator of payroll to handle worker Medicaid payments, benefits, and maintain records. This is a major shift from over 600 plus intermediaries have raised concerns about this new facilitator, Georgia-based 'Public Partnerships LLC' — a company that has been accused of wage theft in a class-action lawsuit, and has also been accused of delaying homecare worker pay in other told CBS in a statement: 'The allegations are mischaracterizing a lawsuit that is addressing who should pay overtime in a sole employer consumer direction model.' 'I believe CMS (Centers for Medicare and Medicaid Services) could act in a way that kind of stops things and lets people reevaluate the whole picture, keep the services in place. Let's review what's going on,' said the mother. The state says the change is due to massive fraud and waste that added millions in Medicaid costs, and that this plan will now be saving millions of taxpayer dollars. Hochul said the overhaul won't change eligibility or timely payments. The mother said the process to enroll in this new system is cumbersome. 'She's not been able to get the training that they said or the app that is required to sign in and out. And we do not know of anybody who's made it this far who's received any training,' said the mother. She's worried her son could be forced into nursing homes or emergency rooms if left without help after the deadline. 'Just imagine the days I'm sick, or I'm not able to do it as fast as I should be able to do it, and you are just watching your loved ones suffer. It's brutal,' said the mother. Over 700,000 consumers and workers are in CDPAP. The state says over 115,000 consumers and 115,000 workers had either started or completed registration as of March 10 — which leaves 67% of current users in need to register in the next 16 days or risk losing care and employment. 'It also risks putting a lot of these caregivers in our unemployment system. It also risks flooding our hospitals with people who are being cared for at home and I don't think our hospitals are aware of this potential crisis unfolding,' said the mother. Lawmakers across the state have called for the April 1 due date to be pushed back; nothing has come from the request as of yet. Between now and March 28, PPL will continue its outreach, but consumers and personal assistants can start their registration now through one of the following options: Call the PPL Support Center at 1-833-247-5346 or TTY: 1-833-204-9042. Go to the NY PPL website at for personal assistance and to access PPL@Home. Start the registration process online or check out CDPAP's resources and events page. Work with a NY CDPAP-approved facilitator from the approved list at CDPAP Facilitators. These facilitators are available through the state of New York to help with transitioning to the single PPL. Dillon Morello is a reporter from Pittsburgh who has been part of the News 4 team since September of 2023. See more of his work here and follow him on Twitter. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
