Hardships Caused by PPL's Administration of New York's CDPAP

Introduction

In New York State, the consumer-directed personal assistance program (CDPAP) has allowed New Yorkers to hire a person of their choosing, including a loved one, to provide their home care under Medicaid.

In 2025, Governor Kathy Hochul consolidated New York’s CDPAP under a single, for-profit, private equity-backed company: Public Partnerships LLC (PPL). New York agreed to pay PPL $1 billion over four years to serve as CDPAP’s sole fiscal intermediary, despite PPL’s well-documented failures in several other states, including Pennsylvania, New Jersey, and West Virginia. This change impacted 280,000 home care consumers and 425,000 home care workers.

Throughout the rest of 2025, Caring Majority Rising (CMR) administered a series of surveys to home care workers and consumers, documenting the extreme hardships these populations have experienced as a result of PPL’s administration of New York’s CDPAP.

Our analysis of this survey data suggests at least three troubling trends.

Troubling Trends

#1: PPL’s technologies undermine workers’ pay and consumers’ home care.

PPL’s CDPAP administration involves three separate technological platforms, which home care workers and consumers must use to get paid and receive care: an app (Time4Care); an online portal (PPL@Home); and a telephonic timekeeping system (Telephony). 

CMR’s surveys indicate that each of these platforms repeatedly have failed home care workers and consumers alike:

PPL began administering CDPAP on April 1, 2025. As of April 12, 2025, 45% of care workers responding to a CMR survey reported that they were unable to clock in and out for their shifts with PPL’s technologies. Another 15% of respondents said they were only able to clock in and out “sometimes.” These problems persisted: more than six months later, in November 2025, one CDPAP consumer reported that it “can take up to 12 tries” for their home care worker to clock in.

Home care consumers must likewise use PPL technologies to review and approve care workers’ shifts (even though the consumers, themselves, set their own care schedules in CDPAP). Here, too, technological problems and insufficient customer service support have been major obstacles. Sometimes, a worker’s time does not immediately appear on the PPL dashboard. Sometimes, even after a home care consumer has approved shifts, they inexplicably appear as “under review,” which results in delayed or denied pay for care workers. 

For many, PPL tech platforms are inaccessible. As one consumer explained in November 2025: “My hands barely work and I sometimes hit ‘reject’ instead of ‘approve,’ and there is no second step to check that you really do want to reject it, and it can’t be undone once it’s been rejected.” One CDPAP home care worker observed: “The Time4Care app is hard to navigate for low vision elderly people like my consumer. She must approve all of my shifts and has complained that the print is too small for her.” Another consumer reported that they “physically can’t use phone lines,” yet were told to call a PPL hotline for assistance.

Non-English speakers have also reported difficulties understanding and navigating PPL technologies.

Some CDPAP participants lack personal devices sufficiently technologically advanced to access PPL’s platforms.

“My client has a flip phone”

Survey 1 (4/10/2025 10:34:02), Personal Assistant from Natural Bridge

“They lack communication but want disabled and elderly consumers who are not comfortable with technology to download an app on their non smart phone. They also want consumers to have landlines, who has landlines in 2025? My consumer only [has] her little consumer flip cellphone.”

Survey 3 (4/25/2025 20:53:31), Personal Assistant from the Bronx

“I don’t have [a] computer.”

Survey 4 (5/5/2025 14:48:58), Personal Assistant from Schenectady

Unable to consistently and accurately clock in and out, or to have time approvals correctly registered in PPL’s system, many CDPAP home care workers have been denied their full pay, earned overtime, and/or authorized work hours. PPL has also failed to safeguard sensitive personal information.

CDPAP was created to give New Yorkers the flexibility to direct their own care, but PPL’s administration of the program has undermined consumer autonomy and consumer choice. CDPAP participants have struggled to satisfy unnecessary and burdensome requirements with glitchy or inaccessible technology and little or no support. This has driven home care workers out of CDPAP, and forced some home care consumers to switch to long-term care or other programs that do not meet their needs as well as CDPAP could.

#2: PPL has repeatedly failed to timely, correctly, and consistently pay home care workers, jeopardizing home care services and causing significant financial and emotional hardship to vulnerable New Yorkers.

The first official CDPAP pay day under PPL’s contract with New York State was April 10, 2025. According to a CMR survey, 70% of respondents reported not being paid by PPL on or around this pay day.

The next official pay day was April 17, 2025. According to a second CMR survey, 57% of respondents reported not being paid by PPL on or around this day. When asked how this missing pay had impacted their finances, 72% of respondent care workers said they had had to buy fewer groceries, and 32% reported they would have to skip a rent payment.

The third official pay day was April 24, 2025. According to a third CMR survey, 49% of respondents reported not being paid by PPL on or around this day; 11% of respondents reported receiving only partial pay. Of those survey respondents who reported receiving no or only partial pay since April 1 , 48% stated that they would not be able to make their rent or mortgage payments.

In its fourth week as New York’s CDPAP fiscal intermediary, PPL paid only 165,000 care workers (out of a total population of 425,000). When asked how this missing pay had impacted their finances, 33% of care workers responding to a fourth CMR survey stated they’d missed a phone payment – which threatened workers’ ability to register or clock time with PPL’s technologies.

Three months later, in August 2025, 55% of home care workers responding to a fifth survey reported they had not received pay for all hours worked to date. Spanish-speaking home care workers seem to be disproportionately impacted: only 18% of these survey respondents reported they’d received pay for all hours worked to date.

By December 2025, 44% of home care workers responding to a sixth survey reported having experienced financial hardship under PPL’s CDPAP administration, and 33% reported having worked more unpaid hours under the PPL regime.

CDPAP consumers and workers also have reported widespread and serious accounting and administrative errors, including: inaccurate allotments of authorized home care hours; hourly pay that is below the contractual amount; partial pay without explanation; and missing PTO accruals.

CDPAP participants have reported evidence of rounding errors on PPL platforms. Such errors are particularly inappropriate in the CDPAP context, where consumers and aides are allocated a certain number of hours per week based on consumers’ care needs. These rounding errors result in either the constructive theft of allocated care time from consumers, or theft of wages for hours worked from aides — often several hours per pay period.

#3: PPL has not provided timely or adequate customer support services to home care consumers or human resources support to home care workers — and the State of New York has failed to hold PPL accountable for these failures.

Home care consumers and workers alike have reported countless unanswered phone calls and emails; inconsistent and contradictory responses from PPL representatives (on those rare occasions when one can be reached); and PPL’s persistent failure to timely respond to or correct reported problems. Some survey respondents also reported that registration delays on PPL’s end have deprived them of home care services or pay to which they were entitled.

Conclusion

New Yorkers deserve a functioning CDPAP. PPL has failed to deliver, jeopardizing home care consumers’ health and independence, and materially harming home care workers throughout New York.

Two immediate remedies are available.

First, New York should immediately restore consumer choice in CDPAP, re-establishing trusted, community-based fiscal intermediaries (including independent living centers) that served this essential program successfully for many years before Governor Hochul gave PPL sole and total control.

Second, state legislators should pass the Home Care Transparency Act, which would require PPL to submit quarterly reports to the New York Department of Health on key metrics, including: how Medicaid funds are spent; unpaid or late wages; customer service wait times; and how many CDPAP consumers actually receive care (versus how many have been authorized to receive care).