In late April, New York Gov. Kathy Hochul and state legislature approved a $233 billion budget for the upcoming fiscal year. One item in its 144-page official summary has raised concerns among disability advocates: significant changes to a critical home healthcare program that may force more people into nursing homes.
A quarter of a million New Yorkers currently use CDPAP (Consumer Directed Personal Assistance Program.) CDPAP was created nearly 30 years ago. The program allows people to hire a family member or friend to assist them with daily tasks such as bathing, dressing, and eating. The program is largely funded through Medicaid.
Governor Kathy Hochul believes that the program has been exploited and “become a racket” according to a recent Bloomberg article. The program “has become one of the most abused programs in the entire history of the state of New York,” Hochul said last month in an interview.
State data seems to contradict Hochul’s claims. The state’s Medicaid Inspector General, conducted audits of $37 million in claims in 2022. They found that 99% of claims were accurate. Of the $46,000 in documented overpayments, $41,000 was collected.
Disability advocates argue that they had little say in the matter. “This was a backroom deal that happened days before the budget was finalized, it was never discussed with disabled communities” Kendra Scalia told Mother Jones. Scalia is the president of the board for The Consumer Directed Personal Assistance Association of New York State which serves both CDPAP providers and recipients.
It can be very difficult to receive care through the CDPAP program. When Laura Mauldin, a graduate student, applied in 2010, it took nine months—and an initial rejection—to have her partner, who had been sick with cancer for four years, approved for assistance. Mauldin could leave the apartment they shared knowing her partner was well cared for. Ultimately, her partner benefitted from the program for three months before passing away.
Lacey Tompkins, who works in advertising in New York City, says that CDPAP allows her to continue a hybrid career as a disabled employee. She is able to have someone take her to work, despite hours that can vary from week to week.
Hochul doesn’t like the idea of people being able to hire family members. “I’m telling you right now, when you look on TikTok and you see ads of young people saying, ‘Guess what, you can make $37 an hour by sitting home with your Grandma. You know, here’s how you sign up,’ — it has become a racket,” she told Bloomberg last month.
Kendra Scalia hired family members as part of the CDPAP program, when she started college. “I felt really vulnerable to hiring strangers or welcoming strangers into my dorm room where there’s no oversight,” Scalia said. Her sister worked for her when she was in college. Her brother has worked for her since 2014.
Some caregivers believe they have been left in the dark about how Hochul’s changes will affect them. Tara Murphy, who previously worked as a certified nurse assistant in a nursing facility, has been a home care provider through CDPAP for the past 25 years. Murphy believed that as a home healthcare worker she would be better equipped to serve others.
“I saw all the horrendous things and lack of care and neglect that were happening,” said Murphy, who is based in Troy, New York. “I knew I couldn’t change it, and I didn’t want to be part of the medical mafia.”
Murphy is now terrified about the upcoming changes to the program that would help her find work. She is unsure whether she will be hired due to the monopolization of the program or if her pay will be reduced. She worries about affording food and housing.
While the CDPAP program isn’t cheap, neither is nursing home care. In New York City, for example, the average annual cost of nursing home care is $171,276. If someone lives in a New York City nursing home for a decade, it will cost taxpayers more than a million dollars.
The CDPAP program also provides people with more independence. Many people would be unable to live independently without programs such as CDPAP. Employees must be paid a living wage for the critical care they provide.
Sources:
“Estimated Average New York State Nursing Home Rates.” New York State Partnership for Long-Term Care, New York State Partnership for Long-Term Care, nyspltc.health.ny.gov/rates.htm. Accessed 14 August 2024.
Métraux, Julia. “Disability Advocates Fear New York Will Gut a Key Home Care Program.” Mother Jones, Mother Jones, 13 Aug. 2024, http://www.motherjones.com/politics/2024/08/disability-advocates-new-york-cdpap-hochul-home-care-fi/.
Nahmias, Laura. “NY’s CDPAP Home Health Aide Job Program Has Become a ‘Racket’: Hochul.” Bloomberg.com, Bloomberg, 22 July 2024, http://www.bloomberg.com/news/articles/2024-07-22/ny-s-cdpap-home-health-aide-job-program-has-become-a-racket-hochul?leadSource=uverify+wall.