Exploring NY CDPAP Fiscal Intermediaries

Understanding CDPAP Fiscal Intermediaries

CDPAP fiscal intermediaries play a crucial role in the Consumer Directed Personal Assistance Program (CDPAP), ensuring the smooth operation of the program and providing support to participants and caregivers. In this section, we will explore the role of fiscal intermediaries and the administrative services they offer.

Role of Fiscal Intermediaries

Fiscal intermediaries are entities that have contracts with social services districts to provide various services within the CDPAP. Their primary responsibility is to handle the wage and benefit processing for consumer-directed personal assistants. They assist participants in navigating the administrative aspects of the program, allowing them to focus on managing their own care.

Fiscal intermediaries ensure compliance with the necessary laws and regulations that CDPAP caregivers must follow. They assist with contracts, employment paperwork, and interactions with agencies if caregivers were hired through one. By providing these services, fiscal intermediaries help streamline the process and make it easier for participants to access the care they need.

Administrative Services Structure

The administrative services provided by fiscal intermediaries can vary, but they generally encompass a range of tasks to support participants in the CDPAP. These services may include:

• Payroll and Tax Processing: Fiscal intermediaries handle payroll processing for personal assistants, ensuring accurate and timely payment. They also manage tax withholding and reporting, relieving participants of the administrative burden.
• Benefits Administration: Fiscal intermediaries assist participants in understanding and accessing benefits available to them through the CDPAP. This may include health insurance, workers' compensation coverage, and other benefits that caregivers may be eligible for.
• Administrative Paperwork: The paperwork involved in the CDPAP can be significant and overwhelming due to the program's government funding requirements. Fiscal intermediaries can assist participants in completing administrative paperwork, ensuring compliance with regulations and reducing the administrative burden.
• Recruitment Assistance: Some fiscal intermediaries offer full-service support, assisting participants in recruiting qualified and vetted candidates for personal assistants if they do not have anyone in mind. They may also facilitate the transition of an existing aide to a CDPAP personal assistant.

By providing comprehensive administrative services, fiscal intermediaries play a vital role in supporting participants and caregivers in the CDPAP. They ensure compliance with regulations, handle payroll and tax processing, and assist with administrative paperwork, ultimately making it easier for participants to manage their care and access the necessary resources.

Reimbursement and Enhancement

When it comes to the reimbursement of administrative services provided by Fiscal Intermediaries (FIs) under the Consumer Directed Personal Assistance Program (CDPAP), New York State operates based on a three-tier Per Member Per Month rate structure. This structure ensures that FIs are fairly compensated for their services. As of April 1, 2021, FIs have been reimbursed based on this three-tier structure, with a one percent enhancement that came into effect on April 1, 2022.

Three-Tier Rate Structure

The three-tier rate structure for the reimbursement of administrative services under the CDPAP provides different levels of compensation based on the complexity of the services provided by the FIs. The rates are as follows:

Please note that these rates are subject to change and it's important to refer to the official sources for the most up-to-date information.

One Percent Enhancement Details

Effective April 1, 2022, a one percent enhancement was introduced to the reimbursement rates for administrative services provided by FIs under the CDPAP. This enhancement aims to provide additional support to the FIs and recognize the valuable services they offer. It is important to note that the enhancement applies to the rates established in the three-tier structure mentioned earlier.

The Department of Health pays FIs that are enrolled as Medicaid providers and have contracts with social services districts for the provision of CDPAP services at rates established by the Department and approved by the Director of the Division of the Budget.

By utilizing this three-tier rate structure and introducing the one percent enhancement, the State of New York aims to ensure fair reimbursement for FIs and support the provision of high-quality administrative services under the CDPAP.

Responsibilities of Fiscal Intermediaries

Fiscal intermediaries play a crucial role in the Consumer Directed Personal Assistance Program (CDPAP) by assisting both caregivers and consumers with various administrative tasks. Two key responsibilities of fiscal intermediaries include payroll and tax processing, as well as benefits administration.

Payroll and Tax Processing

One of the primary responsibilities of fiscal intermediaries in the CDPAP program is to handle payroll and tax processing for caregivers. This ensures that caregivers are paid correctly and in a timely manner, while also ensuring that federal and state taxes are deducted from their paychecks. By taking care of these financial aspects, fiscal intermediaries alleviate the burden of payroll management for both caregivers and consumers.

Benefits Administration

In addition to payroll and tax processing, fiscal intermediaries also manage benefits administration for caregivers in the CDPAP program. This includes offering a range of benefits to caregivers, such as paid time off, sick leave, increased pay on holidays, health insurance, dental insurance, life insurance, 401(k) options, and more. By providing these benefits, fiscal intermediaries ensure that caregivers receive all the entitled benefits and support their overall well-being.

By overseeing payroll, tax processing, and benefits administration, fiscal intermediaries relieve caregivers and consumers of the administrative burden associated with these tasks. This allows caregivers to focus on providing quality care to consumers while ensuring compliance with the necessary laws and regulations that govern the CDPAP program. Additionally, fiscal intermediaries can assist participants in navigating the complex administrative paperwork required for the program, offering guidance and support throughout the process.

Overall, fiscal intermediaries play a crucial role in the CDPAP program by managing payroll, tax processing, benefits administration, and ensuring compliance with laws and regulations. Their support and expertise contribute to the smooth functioning of the program, benefiting both caregivers and consumers alike.

Qualifications and Selection

When considering the selection of a fiscal intermediary for the NY CDPAP program, it is essential to look for certain qualifications and qualities that can guide the decision-making process. Choosing the right intermediary can have a significant impact on the overall experience and success of the program.

Qualities to Look For

To ensure a positive experience with a fiscal intermediary, there are several qualities to consider:

1. Nonprofit Structure: It is important to look for a fiscal intermediary with a nonprofit structure. This indicates a commitment to serving the needs of the program participants and caregivers, rather than prioritizing profit margins. A nonprofit structure demonstrates a dedication to providing quality services and support.
2. Fiduciary Service for Consumers and Care Providers: A reputable fiscal intermediary should act as a fiduciary, meaning they have a legal and ethical obligation to act in the best interest of the program participants and care providers. This includes managing funds responsibly and transparently, providing accurate and timely payroll processing, and ensuring compliance with tax regulations.
3. Accreditation: Look for a fiscal intermediary that has obtained accreditation from recognized accrediting bodies. Accreditation confirms that the intermediary meets certain standards of quality and service. It provides assurance that the intermediary has undergone a rigorous evaluation process and is committed to maintaining high standards in their operations.

Choosing the Right Intermediary

Selecting the right fiscal intermediary is a crucial step in the NY CDPAP program. To make an informed decision, consider the following factors:

1. Experience and Expertise: Assess the fiscal intermediary's experience in the field. Look for those with a proven track record and established expertise in managing fiscal responsibilities within the CDPAP program. A well-established intermediary is more likely to have the necessary knowledge and resources to navigate the program successfully.
2. Services and Support: Consider the range of services and support offered by the fiscal intermediary. A full-service intermediary can provide valuable assistance in recruiting qualified personal assistants if participants do not have anyone in mind. They can also facilitate the transition of an existing aide to a CDPAP personal assistant, ensuring a smooth process for all parties involved.
3. Participant Feedback and Reviews: Research feedback and reviews from current or previous program participants who have worked with the fiscal intermediary. Their experiences can provide valuable insights into the quality of service, responsiveness, and overall satisfaction with the intermediary.

By carefully considering these qualifications and qualities, individuals can make an informed decision when selecting a fiscal intermediary for the NY CDPAP program. Remember, finding the right intermediary ensures that the program runs smoothly, participants receive the necessary support, and caregivers are properly compensated for their services.

Consumer Directed Personal Assistance Program

The Consumer Directed Personal Assistance Program (CDPAP) is a Medicaid program in New York State that provides individuals with the freedom to choose their own caregivers and direct their own care. Initially introduced as the Patient Managed Home Care Program (PMHCP) in 1995, the program was later elevated to program status and renamed CDPAP. Its purpose is to offer flexibility and choice in obtaining home care services for chronically ill and physically disabled individuals receiving home care under the medical assistance program in New York State.

Evolution and Purpose

Originally established as a demonstration program, the CDPAP was designed to address the needs of individuals requiring home care services. It allows participants to choose, train, and supervise their own caregivers, who can be family members, friends, or individuals of their choosing . By giving individuals the ability to select their caregivers, the program aims to enhance the quality of life and promote independence for participants.

Scope of Authorized Services

Under the CDPAP, individuals have the authority to direct their own care, including setting their own schedule of hours and duties for their caregivers. The program operates as a Medicaid State Plan service in New York State and complies with applicable assessment and authorization processes outlined in 18 NYCRR § 505.28. The scope of services that may be authorized under CDPAP includes tasks that can be provided by a Personal Care Aide, Home Health Aide, Licensed Practical Nurse, or Registered Professional Nurse.

The CDPAP allows eligible individuals to receive the necessary care and support while remaining in the comfort of their own homes. By authorizing a range of services provided by qualified caregivers, the program aims to meet the unique needs of each participant, promoting their overall well-being and independence.

Understanding the evolution, purpose, and scope of authorized services within the Consumer Directed Personal Assistance Program is crucial for individuals seeking personalized home care services in New York State. By participating in the CDPAP, individuals have the opportunity to exercise choice and control over their care, ensuring their specific needs are met while allowing them to maintain their independence and quality of life.

Compliance and Regulations

When it comes to the Consumer Directed Personal Assistance Program (CDPAP) in New York State, both legal frameworks and compliance requirements play significant roles. It is essential for both districts and fiscal intermediaries to adhere to these regulations to ensure the smooth operation of the program.

Legal Framework

The authority for the provision of the CDPAP can be found in Social Services Law 365-f, while the regulatory authority is located at 18 NYCRR § 505.28. These regulations outline various aspects of the program, including program description, eligibility requirements, assessment and reassessment processes, guidelines for determining applicant eligibility, and the roles and responsibilities of program participants, districts, and fiscal intermediaries. It is crucial for all parties involved to understand and follow these regulations to ensure compliance.

District and Intermediary Compliance

Social services districts in New York State are required to administer the CDPAP in compliance with 18 NYCRR § 505.28. This ensures statewide consistency when authorizing or reauthorizing CDPAP services. Districts must follow all applicable CDPAP assessment and authorization processes and policies outlined in the regulations.

Fiscal intermediaries, on the other hand, are entities that have contracts with social services districts to provide various services, including wage and benefit processing for consumer-directed personal assistants. These intermediaries act as the employer of record on behalf of the consumer, handling financial and administrative tasks related to the CDPAP. It is crucial for fiscal intermediaries to comply with the regulations and contractual obligations to ensure proper compensation and benefits for caregivers and the smooth operation of the program.

By adhering to the legal framework and complying with the regulations set forth by the state, both districts and fiscal intermediaries contribute to the effective implementation of the CDPAP. This ensures that eligible individuals receive the authorized services they need while maintaining consistency and accountability throughout the program.

References

• ‍https://www.health.ny.gov/health_care/medicaid/publications/adm/11adm6.htm
• ‍https://friendsfamilyhomecare.com/cdpap-new-york/what-is-a-cdpap-fiscal-intermediary/
• ‍https://www.cdchoices.org/2022/11/09/consumer-assistance-program/
• ‍https://www.health.ny.gov/facilities/longtermcare/reimbursement/cdpap/fiscalint3tieredfee_schedule.htm
• ‍https://friendsfamilyhomecare.com/cdpap-new-york/ny-cdpap-guide-how-it-works-eligibility-pay-rate/
• ‍https://www.cdchoices.org/2022/06/28/what-is-a-fiscal-intermediary/