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  • April 26, 2024
  • Alerts

NY Upends CDPAP Fiscal Intermediary Framework

The recently enacted New York State (NYS) budget for fiscal year 2025 significantly changed who can be a Fiscal Intermediary (FI) under the state’s Consumer Directed Personal Assistance Program (CDPAP). This change was made by amendment to Social Services Law (SSL) § 365-f by eliminating the CDPAP request for offers (RFO) process that was in place for designating FIs (RFO #20039). That procurement process, which started in 2019 and had a list of numerous awardees that were awaiting finalized contracts, has been replaced by a new procurement process pursuant to which there will be a single statewide FI (Statewide FI) selected by the NYS Commissioner of Health.

The criteria for selection of the Statewide FI will include, at a minimum, that the contractor is capable of performing statewide FI services with demonstrated cultural and language competencies specific to the population of consumers and available workforce and has experience serving individuals with disabilities. In addition, as of April 1, 2024, the entity must be providing services as an FI on a statewide basis with at least one other state. This criteria will significantly narrow the number of entities eligible to compete for a contract with DOH to be the Statewide FI.

To facilitate the delivery of FI services, the Statewide FI must subcontract with an entity that is a service center for independent living under Education Law § 1121 and has been providing FI services since January 1, 2024 or earlier. Service centers for independent living are community based non-residential programs designated to promote independent living for individuals with disabilities. They must be not-for-profit corporations and meet a number of requirements set forth in the Education Law. The Statewide FI must also contract with at least one entity per rate setting region that has a proven record of delivering services to individuals with disabilities and the senior population and has been providing FI services since January 1, 2012.  In selecting its subcontractors, the Statewide FI must consider prospective contractors’ demonstrated compliance with all applicable federal and state laws and regulations including, but not limited to, marketing and labor practices, cost reporting, and electronic visit verification requirements. 

The services the Statewide FI delegates to its subcontractors shall include the historic FI services listed in SSL § 365-f(4-a)(a)(ii) such as wage and benefit processing, maintaining personnel records, etc. Delegated FI services may also include assisting consumers with navigating the CDPAP program by providing individual consumer assistance and support, consumer peer support, and education and training to consumers on their duties under the program. All subcontractors of the Statewide FI must register with DOH within thirty (30) days of being selected as a subcontractor. Except for the Statewide FI and its subcontractors, as of April 1, 2025, no entity can provide fiscal intermediary services directly or through contract.

This change in law will likely have a significant impact on the business operations and plans of many entities currently operating as FIs. This is especially the case for current FIs that are not eligible to compete to be the Statewide FI or to be considered for selection as a subcontractor of the Statewide FI because they do not meet the statutory criteria outlined above.

Next Steps

Understanding this new legislation, and following developments on its implementation, is important for current FIs and others to make business decisions going forward.

Should you have any questions regarding the above, please contact the author, the Garfunkel Wild attorney with whom you regularly work, or contact us at info@garfunkelwild.com.