New York’s controversial Consumer-Directed Personal Assistance Program transition is off to a rocky start, say immigrant caregivers and consumers who note the new program’s fiscal administrator, Public Partnerships LLC (PPL), has been plagued with missed payments and language access issues.
First established in 1995, the Consumer-Directed Personal Assistance Program (CDPAP) was designed to allow disabled individuals on Medicaid to choose their own personal home caregiver, such as a family member. CDPAP currently provides home care to 280,000 New Yorkers and employs as many as 400,000 workers.
Iris Jimenez, 65, who has suffered from debilitating post-polio syndrome since she was in junior high, said that she’s afraid of losing her personal healthcare worker of 25 years because of missed payments.
“All [my caregiver’s] bills are late,” she said. “So she’s going to have to quit. This is a person I really trust. She’s my backbone of support.”
Jimenez’s caretaker, Amarili Celedonio, a 59-year-old immigrant from the Dominican Republic, says that she would typically work 48 hours a week and earn roughly $1,200 every two weeks, but she claims that when she received her paycheck last week, she only received $168 for a even though she worked a full 48 hours.
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“Ever since I’ve been with PPL, they haven’t been paying me properly,” she said. “I work 48 hours a week and they pay me an equivalent of 9 hours a week.”
As the program’s budget nearly quadrupled from $2.5 billion in 2019 to over $9 billion in 2024, the state consolidated CDPAP under the umbrella of a single statewide fiscal intermediary, PPL, to administer the program beginning on April 1. For those struggling to adapt to the new system, the New York State Department of Health (DOH) issued a late transition window deadline of April 30.
But according to a survey of 477 home care workers, 70% of CDPAP home care workers were left unpaid on their first pay cycle with PPL. The survey was conducted by the Caring Majority Rising, an advocacy group representing people with disabilities, older adults, family caregivers, and home care workers.
Caring Majority Rising also found that at the end of the second pay cycle, more than half of the home care workers surveyed, 57%, were still failing to receive checks. And another 58% of workers who did get paid received incorrect amounts.
Of the 477 respondents, a majority said they were struggling to afford groceries, with 72% saying they had to buy fewer groceries. Nearly half, 47%, said they had to delay paying utility bills, and 32% said they had missed rent payments.
“My bills are late,” said Celedonio. “I’ve been working this job since 1998, and I’ve never had trouble in the past, but now I might not be able to keep working.”
Data from the DOH already shows that approximately 60,000 of the 280,000 consumers authorized for CDPAP have abandoned the program for more expensive and less flexible agency-based care, undermining Hochul’s goal to cut costs with the transition. Only 195,000 of the estimated 425,000 CDPAP employees statewide have been able to fully register with PPL.
“For the last two weeks, I’ve cried twice a day because I don’t know what I’m going to do without my support,” Jimenez said at the prospect of losing her long-term caregiver. “I feel that pain in your stomach when you’re nervous. I can’t sleep. If I keep going this way, I’m going to be sick.”
PPL, which is owned by two private equity firms, DW Healthcare Partners and Linden Capital Partners, has faced multiple allegations of wage theft and mismanagement in the past. After PPL took over home care payroll services for the Pennsylvania Department of Public Welfare in 2013, an auditor general report found that the company’s chronic mismanagement cost the state an extra $7 million a year.
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In 2017, direct care workers in Pennsylvania filed a class action lawsuit against PPL, alleging that the company violated federal law and Pennsylvania state law by failing to pay or underpaying overtime wages. The case is currently under appeal.
Just this year, on April 22, homecare workers in New York filed a class action lawsuit in federal court against PPL, alleging that PPL failed to pay them minimum wages and overtime wages.
“Three weeks into the transition to a single fiscal intermediary, it is clear that neither PPL nor the Department of Health was prepared,” said State Senator Shelley B. Mayer in a statement last week. “It is shameful that thousands of caregivers, who are already underpaid and providing lifesaving work, have continued to work without compensation.”
Senator Shelley also called on Gov. Kathy Hochul to take immediate action to ensure the workers are paid in full.
Lacey Hautzinger, senior director of marketing and communications at PPL, told Documented in a statement last week that the company has issued payments to 155,000 CDPAP caregivers in the third week of statewide payroll, and said that workers have been educated on how to fill out their timesheets.
“Many of the caregivers who have claimed not to have been paid or paid incorrectly have received education on the payroll schedule and timesheet requirements,” she said. “PPL continues to ensure that all timesheets and payments are completed in accordance with CDPAP consumer service authorizations and program rules, as per State and Federal Medicaid guidelines.”
Ilana Berger, political director for Caring Majority Rising, took issue with PPL’s assertion that the home care workers’ lack of education is the result of many of the payment issues.
Immigrant home care consumers and workers navigate complex paperwork every day. It’s insulting for PPL to blame them for enrollment problems,” she told Documented. “In reality, PPL’s language services are inadequate, their systems regularly fail, and they’ve faced similar complaints in other states. If PPL and Governor Hochul won’t acknowledge these failures, the legislature must step in to protect New York’s most vulnerable residents.”
Zaman Khairuzzaman, 27, who worked at Bangla CDPAP in Queens before the CDPAP transition, says that it’s not just missed paychecks that burden home care workers, but that language access is also a challenge for workers whose English is a second language. PPL’s apps and online portal do not have Bengali translations, making it difficult for Bengali home care workers to enroll with PPL, he said.
“So many people are not familiar with English in my Bengali community, and the registration process portal is only in English,” he said. “They are asking questions in English, so how can someone answer those questions if they don’t understand English?”
When he tried to contact someone at PPL directly for help, he could not find anyone who spoke his language. “The main difficulty is that there is no helping hand,” he said. “It’s rare to find a Bengali agent for help.”
However, when asked about language accessibility for non-English speaking caregivers, Hautzinger stated that PPL provides language interpretation for a multitude of languages.
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“PPL offers multiple language lines to support the NY CDPAP program, including Arabic, Bangla, French, Haitian Creole, Italian, Mandarin, Spanish, and Urdu,” said Hautzinger. “We also have multilingual agents and dedicated translators available for 300 languages. Additionally, our network of 45 facilitator partners provides culturally competent and localized support to the many New Yorkers who rely on CDPAP.”
When asked about payment issues workers were having with PPL, Marissa Crary, public information officer for the New York State Department of Health, stated the DOH was monitoring the situation but did not comment further.
“The Department continues to closely monitor this transition as part of its ongoing commitment to protecting access to care and supporting caregivers,” she said in a statement. “The Department encourages any caregivers or consumers with questions to reach out to PPL, their managed care plan, the Local Department of Social Services, or the Department of Health directly for assistance.”
