CDPAP HEADACHE: When Julie Farrar saw Hochul would make a public appearance at a suburban Albany mall Tuesday, she quickly concocted a plan. The 56-year-old drove 20 minutes to confront the governor — in front of a bank of news cameras — about a change to a Medicaid service for people with disabilities. What followed was a rare upending of the governor’s carefully choreographed public event to highlight her anti-inflation plans. Hochul found herself defending a cost-cutting phaseout of some 700 companies that provide payment services in the program. “I’m a loudmouth broad,” Farrar told Playbook a day after the brief confrontation. “I’m representing up to 280,000 New Yorkers who don’t get out there and do that and don’t know enough about the system. Somebody has to do that.” Farrar is worried the highly tailored individual services offered in the Consumer Directed Personal Assistance Program are at risk as a result of the move to eliminate the payment services middle men and hand a contract to one company, Public Partnerships LLC. So Farrar confronted the state’s most powerful official, ahead of the April 1 scheduled policy change. “I don’t want to hear sound bites anymore,” Farrar told Hochul in their exchange. “You won’t hear a sound bite,” the governor responded. “You’re being lied to.” Farrar, a longtime activist and health care policy analyst, was not satisfied. “It was condescending,” Farrar later said of Hochul’s response. “She’s acting as if I’m being manipulated.” Farrar is happy with the attention being given to an otherwise wonky Medicaid issue, and she’s triggered a full-blown political and public relations headache for the governor. Video of the confrontation was picked up by the governor’s rivals, Republican Rep. Mike Lawler and Democratic Rep. Ritchie Torres. House Republicans have applied pressure over a lucrative contract awarded to Public Partnerships LLC to replace the billing firms. The Empire Center, a fiscally conservative think tank in Albany, has sued for more information on the home care program’s reorganization. And controversy over the contract has drawn in the powerful health care workers union 1199SEIU. Advocates for people with disabilities believe the issue has resonated in a state with an aging population. “Home care doesn’t get the credit it deserves for being an issue that impacts a vast number of New Yorkers,” said Ilana Berger, the New York political director of the non-profit organization Caring Majority Rising. Berger wants changes to the program, but said many of the middle men play “a crucial role in peoples’ care” like language services. The Hochul administration proposed the change to reduce costs in the state’s Medicaid program, the costliest portion of the $239 billion budget. State officials have argued that hundreds of billing providers — known as fiscal intermediaries — have created an unnecessary expense. And those entities are pushing back with $4.6 million on TV ads, lobbying and PR between May and October from The Alliance to Protect Home Care — an organization funded in part by the payment providers. Hochul’s office has slammed the “massive abuse” of the program. “It's heartbreaking that unethical business groups like the Alliance to Protect Home Care are spreading lies about the status quo to protect their own profits,” said Hochul spokesperson Sam Spokony. “We know many New Yorkers are hearing this misinformation, and it's critical to correct the record.” He added Hochul has taken “significant steps to make New York a more welcoming state for people with disabilities, and she continues to believe CDPAP home care users deserve the best quality care.” The state will move forward with the plan to make the program “better, stronger” for people who receive services, Spokony said. The Alliance to Protect Home Care, in turn, accused the Hochul administration of avoiding disclosure. "Rather than heeding repeated calls for transparency in light of serious bid rigging allegations, Kathy Hochul continues to try to mask the truth about PPL's disastrous record and the concerns of this New Yorker,” Executive Director Bryan O’Malley said. “Here are the facts: PPL has a failed track record across multiple states including missed payments to home care workers, wage theft allegations, and letting thousands of consumers and workers fall through the cracks." A spokesperson for Public Partnerships LLC did not return a message seeking comment. But Farrar is concerned the state’s change will make people with disabilities like her just another number on a spreadsheet. “It’s commodification — that’s what I’m worried about,” she said. “How can we squeeze as much profit as possible from this population?” — Nick Reisman | 
