Consumer Directed Personal Assistance Association of New York State

Statement from Executive Director Bryan O'Malley on Governor Hochul's 2022 State of the State Address

“Governor Hochul today signaled that she is aware of New York’s “worst in the nation” home care workforce crisis and that she intends to do something about it. While we are thrilled with this acknowledgment, we also know that the devil is in the details and we now eagerly await the Governor’s budget. Aging and disabled New Yorkers have waited for over a decade for action to address the workforce shortages that are preventing access to critically needed services, and every day they are forced to continue to wait, their risk of institutionalization, or worse, rises. We look forward to working with the Executive and the Legislature over the next several months to ensure that Fair Pay for Home Care, and an investment that fully funds a wage of $22.50 per hour for this critical workforce dominated by women of color, are included in this year’s budget.”



Statement from CDPAANYS Executive Director Bryan O'Malley on the increase in the "Upstate" minimum wage


“New York State is the epicenter of a national home care workforce crisis. According to national experts, the state has a shortage of almost 50,000 home care workers, which means tens of thousands of seniors and people with disabilities are going without critically needed healthcare services or are being unnecessarily forced into nursing homes.

While an increase in the minimum wage is necessary, the Consumer Directed Personal Assistance Association of New York State (CDPAANYS) highlights that businesses in the Upstate region who are not reliant on the state for funding, such as Stewart’s Shops, Amazon warehouses, and McDonald’s, are already paying their workers $15 – $17/hour. At this point, increasing the minimum wage will not do anything to address the home care workforce crisis.

For meaningful action, we must enact Fair Pay for Home Care, legislation sponsored by Senator Rachel May (Onondaga, Madison) and Assembly Member Richard Gottfried (New York County), which would set wages for home care workers at 150% of the highest minimum wage in a region, or $22.50/hour. This would solve the home care workforce crisis once and for all.”




New York State Department of Health has put out a new FAQ clarifying that fiscal intermediaries, consumers, and PAs in CDPA will not, in most instances, be required to get the COVID-19 vaccine in order to continue working.

Based on the guidance, there may be limited circumstances where FI staff (those who work in the agency) may be required to get a vaccine, and even more limited circumstances where a consumer or PA may be required to get the vaccine themselves. If you find yourself in this situation and are not willing or able to be vaccinated, explore whether there are options that can prevent the mandate from applying, such as direct deposit or other measures.

This decision is only applicable as it relates to NYS Department of Health requirements. President Biden has also indicated he is putting in place different requirements that we are continuing to pay attention to; but, which are not final.


DOH RESCINDS COVID-19 enrollment, assessment, reassessment waivers

The Department of Health has just issued new guidance that immediately rescinds the Guidance Document from March 18, 2020 regarding assessments, reassessments, authorizations, PA health assessments, and other matters.

The document details exactly what has been rescinded and what proposals remain in place, as well as transition timelines.



Click here to register for the conference!

Register online before September 1, 2021 to receive $50 off the cost of registration

CDPAANYS is offering a virtual conference option for those who cannot or do not wish to attend in person. Please make sure to specify when registering whether your attendance will be in person or virtual.

$250 CDPAANYS Members (discount code required)
$300 Non-Members
$75 Non-Member Consumer
$50 CDPAANYS Member Consumer

For more conference details, including lodging and sponsor information, please visit our conference page.

    Issue Brief: In NYS, Fast Food Wages Will Surpass Home Healthcare Wages on July 1, 2021

    View the brief in its entirety here.

    On July 1, 2021, the fast-food minimum wage will increase to $15 per hour statewide, catching up with New York City where this rate had been in place since December 31, 2018. For non-fast food industries, the current minimum wage outside New York City, and Nassau, Suffolk, and Westchester counties is $12.50/hour.

    After July 1, fast food workers upstate will earn $2.50 more per hour than the vast majority of home care workers, nearly all of whom make at or slightly above the minimum wage. Low wages have made it increasingly difficult for self-directing Medicaid consumers and home care agencies to hire workers to provide home and community-based services that empower people with disabilities and seniors to live independently rather than in an institution.

    As fast-food wages have risen, home care wages have stagnated, leading to ‘worst in the nation’ crisis in recruitment and retention where tens of thousands of seniors and disabled are forced to go without services or become institutionalized…

      June 22 Marks the 22nd Anniversary of Olmstead v. L.C. by Zimring


      June 22, 2021

      June 22 Marks the 22nd Anniversary of Olmstead v. L.C. by Zimring

      Landmark Supreme Court Case determined disabled individuals have a right to services within the community over institutionalization

      The Consumer Directed Personal Assistance Association of New York State (CDPAANYS), along with disability advocates across the country, is celebrating the twenty-second anniversary of the Supreme Court’s historic civil rights decision in the case of Olmstead v L.C. (by Zimring). In the intervening years, the decision has begun to fundamentally shift the landscape of how services are provided to physically, mentally, and developmentally disabled individuals. Without it, the horrors of COVID-19 in nursing homes and other institutions would have been even worse.

      Lois Curtis, a Black, disabled woman involuntarily committed to institutions from childhood, will remain in the pantheon of civil rights heroes such as Rosa Parks or Harriet Tubman. Despite being told by medical professionals and State officials that she must be in an institution, she successfully challenged the State of Georgia who had enforced this arrangement. The Court found that Medicaid-funded services for individuals with disabilities must be provided within the community over institutionalization if desired by the recipient. Today, Lois Curtis lives independently and is a successful artist who received the Harriet Tubman Act of Courage Award in 2007 for her efforts in fighting injustice. 

      “While this anniversary is a day of celebration, it is also an important time to reflect on where we go next”, said CDPAANYS Executive Director Bryan O’Malley. “It has been more than two decades since this decision was handed down and here in New York, thousands are being forced into nursing homes despite their desire to be active members of their community.”

      Consumer directed personal assistance (CDPA) is an increasingly popular option for those seeking to stay at home. Because those who need services hire and supervise their workers, the program provides the maximum amount of flexibility and participation in community activities. However, repeated cuts to Medicaid reimbursement rates over the last decade have artificially suppressed worker wages while other sectors, such as fast food and retail, pay more hourly. This has led to New York being home to the largest workforce shortage in the nation, according to Mercer workforce consulting.

      Nikki Reese, a disabled woman from the Bushwick neighborhood in Brooklyn, has been using CDPA for years to allow her to live independently. However, she notes that when she recently had to fill an open spot, it took almost three months to do so, and she counts herself lucky. “My workers are very professional. They work odd shifts and overtime to do what is needed to keep me safe and at home.” When she was finally able to hire new staff, Nikki notes that she was forced to do so without taking steps that she, like most employers, typically would. “I was desperate. I had to skim over what I usually do. I couldn’t check references or take the time to see who might work best with me. I just needed help.”

      Geri Mariano, a disabled woman living in Westchester, said, “Starting in September 2020, while still in the throes of the COVID-19 pandemic, I began having PAs leaving for other jobs. This forced me to put my health at further risk as I interviewed potential workers contrary to medical recommendations and the Governor’s own guidance regarding COVID-19. Several applicants who went as far as taking forms to fill out would cancel appointments to finalize, telling me they were offered other employment for higher pay.  Many would instantly turn me down based on the low pay wage.  Since September I have not had full coverage – even though I was approved for twenty-four hour shifts just a few months ago.  As of today, I have to go as long as twelve hours alone at times.  Because of surgeries gone awry over past 11 years I am mostly bed-bound and definitely stuck in bed when alone since need full assistance to get up into WC.  In 1969, progressive thinking social workers helped make sure I could grow up with a family and not in an institution after being abandoned by biological parents.  Today, if New York is to meet the promise of the Olmstead v. L.C. decision, we must do better and pay home care workers enough so they will want to stay in these jobs and so I can continue to live the life I want to and deserve to live in the community.”

      Advocates also point to recent policy shifts apart from funding that have jeopardized New York’s compliance with the mandate established in Olmstead v L.C. Policies that encourage institutional placement for those who receive a high level of services would mandate nursing home placement despite a lack of clinical evidence indicating that hours of care can provide a basis for decision-making on one’s ability to live independently. Additionally, changes in how assessments are conducted and the legal appeal rights of seniors and disabled folks in need of services also pose a significant risk. 

      T.K. Small, an attorney in Brooklyn who uses CDPA today, spent 9 1/2 years in a rehabilitation hospital for kids, summed it up this way, “I had to fight to get out and build a life for myself. I won’t go back to living in an institution. I will give everything I have to make sure New York lives up to the mandate of Olmstead v L.C., because my independence, and the independence of all disabled New Yorkers, demands it.”


        Fireside Chat on Liability Exposures of Joint Employment

        Paul Essner, CFP®, CLU, ChFC, Risk Strategies
        Bryan Pendrick, CFP® , CLU, Risk Strategies
        Joe Levy, Senior Vice President, Risk Strategies

        Friday, May 21 at 10:00 AM

        SIGN UP TODAY!

        For the final installment in CDPAANYS’ Spring Learning Series, we are excited to welcome back insurance & financial experts from Risk Strategies for a Fireside Chat on Liability Exposures of Joint Employment. This session, targeted toward fiscal intermediaries in all regions of New York State, will focus on a host of issues relating to joint employment. 
        Topics covered include:

        • Satisfying Affordable Care Act requirements without Minimum Essential Coverage (MEC) plans;
        • How FIs can utilize Individual Coverage Health Reimbursement Accounts (IHCRA);
        • Ongoing discussion of Joint Employment as relating to the RFO; 
        • Much more!


        CDPAANYS and the New York State Association on Independent Living will be holding a virtual rally starting at 9:00 AM on Monday, February 8 to kick off Advocacy Week. 

         Join us and show your support for the campaign to #FairPay4HomeCare and lift up disability priorities in the New York State budget!



        Thank you to Governor Andrew Cuomo and the NYSDOH – New York State Health Department for recognizing the importance of making sure that personal assistants are vaccinated early!

        According to the vaccination plan, home care workers, including those in consumer directed personal assistance, will be eligible for the vaccine beginning on January 11.

        CDPAANYS fought hard to make sure that this specific mention of PAs was made in the vaccination plan, and that any uncertainty regarding whether or not PAs were included in home care was eliminated. CDPAANYS is absolutely thrilled that the community’s voice was heard.

        This is a big win for the 100,000+ workers and the consumers they work for.



        As part of CDPAANYS’ work identifying and bringing light to disparities and gaps in services related to COVID19, we issued a survey to collect data on the impact of the pandemic on consumers and workers.

        It was widely acknowledged that many health conditions that require long-term care increase the rate of mortality from COVID-19, but the conditions for people using community based services like CDPA did not receive nearly as much attention. CDPAANYS wanted to know how the pandemic was affecting consumers and their access to services, and sent a survey to members in April asking about changes in staffing and access to personal protective equipment (PPE), among other disruptions. We used the results to create a report that we shared with lawmakers and journalists in order to bring attention to the growing long-term care crisis and advocate for legislative solutions.

        You can read the final report from the survey, “The Impact of COVID19 on Consumer Direction in New York State,” by clicking here.

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        Advocacy & News Updates

        Report: The High Cost of Low Wages (2020 version)

        The Consumer Directed Personal Assistance Association of New York State (CDPAANYS) has released a new report, entitled The High Cost of Low Wages. The report is based on the results of a survey of consumers within Consumer Directed Personal Assistance (CDPA), updating...