Controversial changes to a $9 billion Medicaid home care program in the state could become part of upcoming budget talks, lawmakers said, depending on how an ongoing transition to a new company proceeds in the coming weeks.

Gov. Kathy Hochul's budget proposal estimates the state will save $500 million next year after thousands of New Yorkers who use the Consumer Directed Personal Assistance Program (CDPAP) to choose their home caregiver get enrolled under one company.

"This is a classic example of how not to do something in government and we're paying the price for it," Hochul told reporters Tuesday after the release of her spending plan. "New Yorkers are paying $9 billion, and I don't think they're getting $9 billion of service."

About 700 smaller companies known as fiscal intermediaries will be out of business after the change takes effect April 1, or the start of the state's fiscal year.

The 2024-25 budget projected $200 million in savings in CDPAP for the current fiscal year, even though the transition is not complete. Budget officials Thursday said the state has saved zero dollars to date. 

"These savings are expected to be realized by administrative actions," a spokesperson with the state Budget Division told Spectrum News 1 on Thursday.

Budget officials said they did not know what specific administrative actions were taken to expect $200 million in savings.

"We obviously do not know if we will achieve these savings as the fiscal year is still happening," the budget spokesperson said. "There certainly may have been savings. The fiscal year is still open. We won’t know if or the amount until the fiscal year is closed out."

More than 12,000 people have completed or started the registration process with Public Partnerships LLC — or under 5% of enrolled New Yorkers.

But Hochul and her top aides expressed confidence this week that the transition is on schedule, and the state does not need more time to register about 280,000 disabled and elderly people who use CDPAP with less than 10 weeks to go.

State Budget Director Blake Washington said the state is forging ahead with its current timeline to cut down on program fraud and abuse as soon as possible.

"We're not talking about the consumers that took advantage of it, we're talking about these shadowy corporations that would not exist but for the Medicaid program 100% financed with state taxpayer dollars," Washington said Tuesday.

It remains unclear what will become of program recipients who fail to register with the new company by April 1.

The governor and her top aides vow no person will lose care because of the change, and say they'll adapt the timeline if necessary, but won't say how or when.

"The savings are very, very important, but what's more important is preserving the care relationship — that's paramount," Washington said. "We will adapt as we go."

The company has received more than 30,000 calls since the transition started Jan. 6. 

"This aligns with our forecast and puts us on track given our planned ramp of activities," a spokesperson with PPL said in a statement Thursday. "Ramp up is common with these type of contract transitions. PPL did a soft opening in the first few weeks without broadscale communications. We started our broader outreach activities in the past few days and are seeing high increases in both inbound call volume and registrations. The volume trends are aligned with our planned transition volumes."

The company started limited radio announcements this week, and will launch paid print and social media ads across the state in 10 languages, in addition to calling, emailing and mailing consumers to notify them of the transition and how to register.

"In February, we add commercials on streaming platforms," according to PPL. "We are pleased with the progress and with the service we are delivering. Wait times are under 30 seconds and consumers have commented on the friendly and helpful support they are receiving."

Some state lawmakers want to fight for more transition time in upcoming budget talks, but it's unclear if it will be a battle legislative leaders will want to prioritize during negotiations.

Legislative leaders say they'll monitor how the transition goes in the coming weeks before making a decision.

"I can't say that April 1st is not realistic, because right now the transition is happening," Senate Majority Leader Andrea Stewart-Cousins said last week.

Senate Health Committee chair Gustavo Rivera reintroduced bipartisan legislation this week to delay the transition until later this year and increase program oversight.

Rivera said Thursday he's concerned the number of CDPAP consumers registered with PPL to receive care is so small with less than 10 weeks until the deadline.

“Unless this number increases drastically in the remaining months, this transition will significantly disrupt access to critical long term care services for vulnerable New Yorkers," Rivera said in a statement. "...While there are systems to address someone leaving CDPAP and returning to a traditional agency model of home care delivery, the practical result could be weeks of delay for someone who is dependent on a personal assistant for assistance with daily living activities that keep New Yorkers safe, healthy and residing in their own communities."

The senator said his bill could serve as a framework to accomplish a smoother transition and avoid interrupting care for thousands of vulnerable people.

"I will continue having conversations with all involved stakeholders in order to create momentum for my bill as I strongly believe that it is a solution that will benefit patients and their families as well as workers alike," he said.

But Assembly Speaker Carl Heastie has blamed the program for inflated Medicaid expenses, and blasted for-profit insurance companies for abusing the program.

Assembly Health Committee chair Amy Paulin said it's too soon to know what the Legislature's response should be in each chamber's counter spending plans.

"Regarding the transition, it is still too early to tell, but I am watching it very closely," Paulin said Thursday.

Officials with the Health Department said the state's plan to transition the program is on track to take effect by April 1, and registrations are proceeding as expected.

"Registration will continue to ramp up significantly as the state and PPL work with more than 30 community-based partners – including 11 independent living centers – to proactively engage CDPAP consumers and caregivers across the state," a Health Department spokesperson said.

Agnes McCray has cerebral palsy and has used CDPAP for over 28 years. She's worried about the level of care she'll receive after the change and said the program has kept her out of the hospital or other long-term care.

"I love it because I'm in control of the hours, my health and everything that has to do with me living my American dream and my best life ever," said McCray, of Syracuse.