Save the CDPAP Program

The Consumer Directed Personal Assistance Program (CDPAP) is an invaluable resource for thousands of New Yorkers. It allows them to choose their own caregivers and manage their care in a way that best meets their individual needs.

The state of New York recently passed legislation that will drastically reduce the number of fiscal intermediaries administering the CDPAP program from 800 to just one for the entire state when budget changes go into effect on April 1, 2025. This change will have significant ramifications for the people enrolled in CDPAP.

With Medicaid reimbursements being cut and the number of fiscal intermediaries drastically reduced, the future of CDPAP is uncertain—as is the well-being of countless patients and caregivers who rely on this program.

Why the CDPAP Program Is So Important

CDPAP empowers patients. It gives them control over their care and the flexibility to choose who will provide it. Whether they select a family member, a close friend, or a professional aide, CDPAP puts patients in the driver’s seat, allowing them to manage their care on their own terms. For people living with disabilities, chronic conditions, or other health challenges, this level of control can make all the difference.

The program also offers significant cost savings. CDPAP makes it possible for patients to remain in their homes and avoid institutional care, which saves the state money while providing better outcomes for patients. It’s a win-win solution that benefits both patients and the state.

The Role of Fiscal Intermediaries in CDPAP

Currently, CDPAP operates with the help of approximately 800 fiscal intermediaries (FIs). These intermediaries are the crucial link between managed care plans and the patients who use CDPAP services. FIs manage the administrative side of the program, including facilitating payments to caregivers, ensuring that caregivers are compensated on time, and handling other logistical tasks such as documentation and compliance.

How Cutting Down to One Fiscal Intermediary Will Affect CDPAP

Reducing the number of fiscal intermediaries to just one will not only remove patients’ current control over the program but also create a bottleneck in service. With only one intermediary managing the entire state, there’s a risk that payments could be delayed, services could become less personalized, and the overall efficiency of the program could suffer.

The Impact on Patients

Many patients may also lose the trusted relationships they have built with their current FIs. For families navigating complex medical conditions, switching to a new FI can add unnecessary stress and confusion to an already difficult situation. The change could also mean that patients have fewer choices about how their care is managed, ultimately taking away the autonomy that CDPAP was designed to provide.

The Impact on Caregivers

These changes won’t just affect patients—caregivers will feel the impact as well. Many caregivers rely on CDPAP as their primary source of income. If Medicaid continues to cut reimbursements for CDPAP, these caregivers will see their rates drop, making it harder to provide for themselves and their families. This could lead to a decrease in the number of available caregivers, making it even more difficult for patients to receive the care they need.

In some cases, the caregivers in CDPAP are family members or friends of the patient. The ability to provide care for a loved one while being compensated fairly has allowed many families to remain together and maintain a better quality of life. By cutting rates and consolidating the program, New York State risks weakening this vital support system.

Concerns and Theories for the Future of CDPAP

Several factors have fueled concerns about the future of CDPAP in New York. These speculations include:

• Financial Strain: The cost of delivering care through CDPAP has placed pressure on the state’s budget. With limited resources and competing demands for funding across various programs, questions have been raised about whether CDPAP can continue in its current form.
• Program Misuse and Fraud: Instances of abuse and fraud within CDPAP have prompted investigations and calls for stricter oversight. These issues highlight the need for better monitoring to ensure that the program remains effective and serves its intended purpose.
• Policy Shifts: Changes in federal and state policies could impact CDPAP’s future. Adjustments to Medicaid funding and evolving regulations may lead to alterations in the program’s structure, eligibility criteria, or funding levels.

While these factors have sparked concerns about the future of CDPAP, it’s important to note that the program is still active and will function as normal until the budget changes kick in next year and reduce the number of CDPAP FIs. Any potential changes or closures would have far-reaching consequences for the many individuals who depend on it for essential care.

Patients, caregivers, and families must stay informed about ongoing developments, understand the impact of any amendments made to state legislation, and understand the available alternatives. By remaining proactive, they can better navigate any potential changes and make informed choices about their care options.

This is a pivotal moment for the CDPAP program, and it’s crucial that patients, caregivers, and advocates speak out to protect it. If we want to continue providing patient-centered care that empowers individuals and their families, we must ensure that CDPAP remains fully funded and accessible to everyone who needs it.