Budget Cuts May Threaten Consumer-Directed Care Program

NEW YORK – A cut in state funding will severely impact a program that helps people with disabilities remain in their homes. That’s the message advocates for people with disabilities want Gov. Andrew Cuomo to hear. 

The Consumer Directed Personal Assistance Program allows people who need home care to hire those who provide that help, including friends or family members. The program helps more than 70,000 New Yorkers get paid assistance from people they already know and trust instead of relying on agencies to send strangers into their homes. 

The state budget cut the funding for the fiscal intermediaries who administer the program by $150 million. According to Heidi Siegfried, director of health policy with the Center for Independence of the Disabled New York, that will effectively end availability of the program for many participants.

“Fiscal intermediaries are saying they’re just not going to be able to manage this,” Siegfried said. “And having hundreds close their doors means there’s going to be no other fiscal intermediary that the worker and the consumer can turn to to continue to provide the service.”


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The state’s budget office said the cut will not reduce the number of people enrolled in the program or the hours of care they receive.

The Cuomo administration said from 2012 to 2018, the number of fiscal intermediaries rose from 58 to more than 600 with little quality control. But Siegfried pointed out the state has only analyzed cost reporting from about 10% of those intermediaries.

“The Department of Health should be getting cost reports from every fiscal intermediary, and they should really do an analysis of what it costs to run the program so that it wouldn’t go under,” she said.

Siegfried said the size of the funding cut was predetermined, not based on the actual cost to administer the program.

She noted that if the fiscal intermediaries who administer the program close, many people will be forced to get their assistance through home health-care agencies or to go into nursing homes. 

“In low-income communities in particular, where you’re not going to get an unpaid caregiver to care for you, it’s really important to be able to not have an agency worker but be able to pay a worker that you know and trust,” Siegfried said.

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