State lawmakers introduced a new bill this week to expand the companies that oversee a $9 billion Medicaid program that enables disabled or elderly New Yorkers to choose their home caregiver.

State Senate Health Committee Chair Gustavo Rivera and Assembly Health Committee Chair Amy Paulin introduced legislation they said would help address persistent issues in the Consumer Directed Personal Assistance Program (CDPAP), which management company Public Partnerships LLC took over April 1.

The bill would create a new class of smaller companies, known as fiscal intermediaries, to give CDPAP users a choice about what organization they want to work with. 

"I decided to sponsor this bill because it is necessary to consider every option to address the ongoing chaos created by the failed transition to a single FI," Rivera told Spectrum News 1 in a statement Thursday. "One month after the transition occurred, 99,000 workers had not received a single paycheck and saw their health benefits basically erased while countless of disabled and older New Yorkers have been left without care. People are hitting a breaking point — we've even heard of workers who are planning on sleeping in their cars because they cannot pay their rent."

The separate class of FIs would work be required to have a contract with the state Health Department and operate at the health commissioner's discretion, or must work with independent living centers that have operated as a program fiscal intermediary since Jan. 1, 2024.

The health chairs said earlier this month they planned to pursue legislative action after the budget as they continue to hear from program users who have lost care during the transition. Many personal assistants have found other work after weeks of pay delays, or a change in health care benefits or lower wages.

"We must hold this administration accountable for their irresponsible actions that caused so much harm to both workers and patients," Rivera said. "I urge the executive to come to the table and engage in a good-faith discussion on how to resolve these ongoing issues. They owe it to these New Yorkers and we are working to make sure it happens."

A spokesperson with PPL said the company paid about 191,000 personal assistants in the sixth week of statewide payroll, which represents more than 99% of all CDAPAP workers who have registered with the company and submitted timesheets by the weekly deadline. 

PPL has issued more than $619 million to 198,000 individual personal assistants since April 1, according to the company. 

A spokesperson with Gov. Kathy Hochul's office said the legislative proposal does not make sense, and the change to one statewide fiscal intermediary adopted in last year's budget will cut program waste, fraud and abuse.

“Under the old CDPAP system, administrative waste among hundreds of FIs sparked a fiscal crisis that put home care at risk – and this legislative proposal would try to send us back to the old system, which makes no sense," Hochul's spokesperson Sam Spokony said in a statement Thursday. “The new structure will protect CDPAP consumers and ensure the program is fiscally sustainable, and the data shows that it's already being well managed.

“The state Department of Health is continuing to closely monitor the transition as part of this administration’s ongoing commitment to protecting home care, supporting workers and ensuring any questions or issues regarding the payroll process are addressed," Spokony added.

Lawmakers argue creating another level of fiscal intermediaries would expand services for CDPAP consumers across the state and provide a higher quality of care. 

The proposal has bipartisan support with about a month remaining of scheduled session days in Albany.

"It is encouraging to see my colleagues moving forward with introduction to help address some of the issues surrounding the transition to a statewide FI," said Assemblyman Josh Jensen, the ranking Republican on the Health Committee. "I hope to see further discussion on this legislation and on the process as a whole to ensure that we are engaging all stakeholders as well as making certain that we are taking into account all issues that have arisen before and after April 1 while achieving efficiency and effectiveness in the program, and that guaranteeing that CDPAP is serving those New Yorkers who need it."

The Senate will conclude for the year June 12. The Assembly will finish session June 17.