New York State’s “Consumer-Directed Personal Assistance Program” (CDPAP) allowing patients to hire family members as home caregivers has long been subjected to abuse. Governor Hochu recently bluntly stated that it has turned into a “scam”.
CDPAP allows elderly or disabled patients in need of home care to hire family members as caregivers, with costs covered by Medicaid, making it popular among the public. However, during an interview with Bloomberg News on July 18, Hochu straightforwardly expressed that CDPAP has become “one of the most abused programs in New York State’s history”.
Hochu pointed out that just by browsing TikTok, one can see advertisements where young people boast about sitting at home with their grandmothers, earning $37 per hour, and teaching others how to register and apply. Hochu believes that CDPAP has turned into a form of “scam”.
Since relaxing the eligibility requirements in 2015, the number of “personal assistants” hired through this program – i.e., individuals providing home care – has surged from less than 20,000 in 2016 to nearly 248,000 last year. Medicaid spending on CDPAP has also significantly increased, more than doubling over the past five years, reaching approximately $9.1 billion.
Bloomberg News reported that CDPAP has even been driving most of the job growth in New York City. In the past 12 months leading up to March of this year, nearly all of the city’s new job opportunities have come from the home care industry. Without the employment numbers from the home care industry, private sector employment would show negative growth. The share of home care jobs in the overall economy of New York State and city is also increasing.
The Empire Center for Public Policy estimates that from 2014 to 2024, the proportion of home care jobs in the private sector workforce of the entire city of New York has risen from 6% to 12%.
In February of this year, Hochu proposed amendments to the new fiscal year budget, suggesting reforms to CDPAP and granting the State Health Department greater regulatory authority over the program, but the proposal did not progress further. Hochu has once again convened a committee, planning to put forward reform recommendations by the end of this year. She told Bloomberg News that CDPAP’s “extremely high cost” must be reduced and hopes to make real changes next year.