The following letter (PDF available here) was sent to NYS Department of Health Commissioner James McDonald as another attempt to get the State to delay the dangerous transition of the CDPAP to a single statewide fiscal intermediary:
We urge you to delay the transition of the Consumer Directed Personal Assistance Program to a single statewide fiscal intermediary immediately.
On January 8th, you were copied on our letter to Governor Hochul urging a delay in the CDPAP transition to a single statewide fiscal intermediary. The rushed and flawed nature by which this process is taking place will inevitably lead to large numbers of people currently in CDPAP losing vital home care services. With the deadline fast approaching, we are deeply concerned about the status of the transition and strongly urge the Department of Health (DOH) to delay the transition until there is ample time to ensure that access to care will not be interrupted.
Even at this late date, DOH has not articulated a plan for what will happen on April 1st to CDPAP consumers who have not finished enrolling with the new fiscal intermediary. DOH has cast blame on individual consumers and soon-to-be-defunct fiscal intermediaries, claiming that anyone who wants to be signed up by April 1st can do so. But the reality of the situation is found in the voluminous individual accounts of CDPAP consumers and workers who are having trouble enrolling in the system. Even technologically savvy consumers are reporting difficulties understanding the system and completing enrollment. We have heard numerous reports of phone delays, language access issues, systems problems, and problems getting aides enrolled in the system. The fiscal intermediary’s website and portal are solely in English. There was simply not enough time allotted for a transition on this scale, resulting in these failures.
Consumers have not been given meaningful notice of the impact on their access to CDPAP if they cannot get through the enrollment process by March 28th . None of the model notices that fiscal intermediaries are directed to send to consumers explain what will happen if the consumer fails to enroll in the new system by the deadline. Failure to inform consumers of the consequences of failing to enroll cannot be considered meaningful notice. Moreover, the fiscal intermediary notices were not sent in the language of the consumer or their designated representative – only in English and Spanish. Furthermore, while DOH staff indicated notice was sent by the managed care organization (MCO) or local district to the consumer to alert them of this change and advise them of the requirement to switch to the new fiscal intermediary, the template for this notice is not online and we have not seen it. Even if such a letter was sent, it is simply not enough to convey the urgency that the consumer act immediately and the consequence for not doing so.
The narrative by DOH that anyone who “wants to” will be able to sign up on time is concerning, as it implies that anyone who is not signed up on time did not want to be. This narrative fails to recognize CDPAP serves 280,000 people with disabilities and older adults. While those who are not self-directing have someone to direct their care, we doubt notices were sent to all these designated representatives (DR). Even if they were, not every DR has sophisticated abilities to navigate the new portal, which is confusing and has frequent glitches, requiring calls to the fiscal intermediary that take hours, days, or even weeks to resolve. We have heard from many consumers, DRs, and personal attendants who have submitted everything they believe is required to register but are waiting for days or weeks for a response. In addition, attendants have not been informed about how they can get trained on using the fiscal intermediary’s electronic visit verification app.
Additionally, we have learned personal assistants will face a gap of at least a month and likely three to four months before they have health insurance. This gap in coverage will deter many attendants from registering in the new system, which in turn jeopardizes continuity of care for consumers.
We contend the rights of individuals currently in CDPAP must be upheld. The state must provide a transition that comports with due process, giving notice and opportunity to request a hearing with aid-continuing and continuity of care rights.
We remain available to discuss this transition. We look forward to your response.