Author: MainStaff

Yesterday, Governor Kathy Hochul identified 24 fiscal intermediaries that will “join the new statewide partnership” to provide services under the State’s new single statewide fiscal intermediary (“SFI”) consumer direct program. As the rest of the Governor’s announcement makes clear, these 24 entities were selected to be PPL’s subcontractors. The State will continue to announce additional “partners” to PPL in the coming weeks. According to the Governor’s website, this “statewide partnership is expected to begin in January and take full effect by April 1.” Here, we describe the Governor’s announcement in greater detail.

The Governor announced on her WEBSITE that the State Department of Health (“DOH”) has “conditionally approved the [24] additional partners for New York’s statewide CDPAP partnership.” It is not clear on what basis the DOH selected these 24 entities, or where the DOH derives its authority to do so. The SFI law is relatively clear that PPL selects subcontractors, not the DOH.

The Governor’s website indicates that the “partners” (they are not referred to as subcontractors in the announcement) “collectively operate nearly 100 offices with service to all 62 counties throughout the State and have experience providing home care to New Yorkers who speak dozens of different languages… Additionally, these partners have specialized home care experience, including focuses on seniors and children with intellectual, physical and developmental disabilities.” There is no indication if any of these partners have been in business since at least January 1, 2012, as required by the SFI law for an entity to be a subcontractor.

The “State Department of Health has granted its conditional approval of these partners pending successful resolution of any potential conflicts of interest.” As many providers know, the DOH has taken the position in the RFP FAQs that there cannot be a conflict between the FI and any LHCSA that may be a subcontractor to the SFI. The definition of a conflict, however, has not been established clearly by the DOH (and, to be clear, the prohibition of this conflict and any definition of conflict is not in any regulation).

The Governor’s announcement further states that the selected 24 agencies will “work in partnership with PPL” and that additional partners will be selected, but with DOH approval. The involvement of DOH in the selection of subcontractors for PPL has not previously been clearly defined and remains unclear.
Lastly, the Governor highlighted that State officials will undertake the following process to transition consumers to the SFI system:
• Direct in-person and virtual meetings with home care users and caregivers throughout the State.
• Coordination with disability and older adult advocacy groups.
• Open dialogue with elected officials across the State.
• Ongoing review by State officials to ensure the needs of home care users and caregivers are thoroughly addressed before the new statewide partnership takes effect.

The anticipated January 1, 2025 date is around the corner, however, we are dubious about the State’s ability to effectuate any consumer transfers or contracts with any potential subcontractors by January 1. Therefore, while PPL may complete its negotiations and contracting with New York State by January 1, it is unlikely that the subcontractors will be fully “onboarded” and working on transition of consumers from the non-subcontracting entities by January 1. Further, there are a number of current and incoming litigations that may impact this timeline.
Please let us know if you have any questions about this important development in the ongoing CDPAP FI saga.

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