As previously discussed, New York’s State Budget for fiscal year 2024-2025 includes legislation that significantly changes the state’s Consumer Directed Personal Assistance Program (CDPA Program). The CDPA Program, funded through Medicaid, allows chronically ill and/or disabled individuals to engage and employ personal assistants (from recruitment through termination) to provide home health services for them, while a Fiscal Intermediary performs wage and benefit processing. The Budget states that as of April 1, 2025, there will be a single Statewide Fiscal Intermediary (SFI), defined as “an entity that provides fiscal intermediary services and has a contract for providing such services” with the New York State Department of Health (NY DOH) that “is selected through the procurement process.” On June 17, 2024, the NY DOH issued a Request for Proposals (RFP), seeking competitive proposals from qualified bidders to become the one Fiscal Intermediary to provide SFI services.

In accordance with the legislation enacted through the Budget, the NY DOH specifically stated that it is their “intent to award one (1) contract from this procurement.” Notably, although the Budget granted the NY DOH discretion to expand upon the selection criteria for the SFI and/or its subcontractors, the requirements set forth in the RFP remain largely unchanged from those promulgated through the Budget.

Specifically, the RFP requires each bidder to, among other things, attest that it:

• has demonstrated cultural and language competencies specific to the population of consumers and those of the available workforce;
• has experience serving individuals with disabilities;
• will accept and acknowledge its role as a joint employer, with the CDPA Program Consumer, of the personal assistant.;
• has met and will continue to meet the requirements of section 220(3-a) (a) (iii) of the NY Labor Law;
• will ensure the avoidance of actual or perceived conflicts of interest, including but not limited to, ownership or control by a Licensed Home Care Services Agency (LHCSA) or a Managed Care Organization (MCO) or by an entity that owns or holds the controlling interest in a LHCSA or MCO;
• will comply with all applicable federal and state laws, rules, regulation, and guidance;
• will certify that all physical location(s), at a minimum, satisfy the 2010 Americans with Disabilities Act Standards for Accessible Design and meet all state and municipal building codes; and
• will enroll as a CDPA Program-FI enrolled Medicaid provider.

Although bidders are not mandated to identify all subcontracting arrangements in their applications, the RFP reiterates that subcontractors must have a proven record of delivering services to individuals with disabilities and the senior population and have been providing FI services since January 1, 2012, or earlier, and that subcontractors are restricted from directly performing many of the tasks that FIs currently perform.

The SFI will be reimbursed for administrative costs, on a per-member, per-month basis, and direct care service costs.

The RFP sets forth the following deadlines, although the NY DOH may extend the dates:

• Submission of Written Questions – July 2, 2024 by 4:00 p.m. ET;
• Responses to Written Questions Posted by DOH – on or about July 19, 2024;
• Submission of Proposals – on or before August 2, 2024 by 4:00 p.m. ET; and
• Anticipated Contract Start Date for Awarded Statewide Fiscal Intermediary – October 1, 2024.

We will provide additional information as we analyze the details within the RFP and as more information is released, including Responses to Written Questions posted by DOH.