Proposed CDPAP Changes In Home Care

The landscape for CDPAP or Consumer Directed Personal Assistance Programs are changing, we’ll share: 

• What is CDPAP
• What is changing?
• How it impacts your business

What is CDPAP? 

According to Angelo Spinola, Home Health, Home Care & Hospice Chair at Polsinelli, Consumer-Directed Personal Assistance Programs or CDPAP “can vary. These programs generally provide state funding for some or all of the care provided to a qualifying care recipient who may receive care from a friend or family member who will get paid for the care they provide,” he shared. 

“In other consumer-directed programs, the state may provide a roster of caregivers to choose from, engage an agency or registry to supply the caregivers, or serve as a fiscal intermediary to assist with the administrative aspects of the relationship, such as paying the caregivers. These programs are mostly funded by Medicaid,” Spinola added.

To learn more about CDPAP and other home care business models, view our webinar recording on: Breaking Down the Different Methods of Home Care Delivery: Agencies, Registries, Virtual Marketplaces and Consumer-Directed Models.

What may change?

Many states are considering changes to their CDPAP programs. Most of the proposed changes are designed to lower the cost of these programs. One proposed by Governor Holchul of New York is the “number of hours those employed can work, that her administration estimates will save the state $100 million.” 

Many programs often fall short of providing coverage for the appropriate amount of care that recipients need. Not the other way around. 

Additionally, the main concern that prompted changes to the program was its likelihood of being linked to fraud, waste, and abuse or (FWA). The 21st Century Cures Act implemented a system called electronic visit verification (EVV) for each state, and all Medicaid personal care programs utilize it. This system has curbed millions in abuse, and has the ability to stay on that trajectory, provided that the program is adequately funded and administered. 

Critics of the program cite: 

• Lax eligibility requirements
• Lack of oversight
• Abuse
• Caregivers that are chosen don’t need a healthcare background

How these changes could impact your business

One of the proposed changes to the program would limit the amount of fiscal intermediaries that can facilitate the program. The New York Post shares, the Department of Health would have “broad regulatory authority to reign in fiscal middlemen trying to game the system, by setting a limit on the number of financial intermediaries that can operate in the state.”

If you are a CDPAP program intermediary, be sure to ensure that all of your client and caregiver records for the program are accurate, filed on time, and more. 

In terms of regulations, prepare for more close and zoomed-in regulations. We aren’t sure what the changes could look like, but they could be enhanced monitoring of caregivers during their shifts, heavier vetting of EVV and claims data for CDPAP clients, and more.

On the caregiver side, Hochul’s budget proposal included the idea of “cutting an additional $1.55 per hour boost that CDPAP home care workers in New York City as well Nassau, Suffolk, and Westchester counties receive on top of a minimum wage.” The New York State minimum wage is $15 per hour but increased to $16 per hour in certain areas. 

Additionally, you can comment on these issues. Make calls to Governor Hochul’s office and to other influential people to make your voice known. There are many benefits to the CDPAP program and you’re likely more intimately familiar with the success stories than the state. And you’re also more familiar with family’s inability to afford to pay for care out-of-pocket, and it’s through third-party payers like Medicaid and the VA, that clients in need are able to access care.

Use a software system that supports CDPAP and more.

The proposed changes are one reminder of the need for proper care planning, utilization of electronic visit verification, and record-keeping. If you’re in New York, be sure to make sure that you and your team are taking proper care of the data that comes in and out of your systems and take action as needed. 

Using a home care software built with CDPAP care and other models in mind is important. If your system is hard to navigate or hard to integrate with the systems that you need to connect with, consider switching to CareTime today.