Settlement Win Protects In-Home Care For 280,000 NYers

By Marco Poggio | August 13, 2025, 5:45 PM EDT ·

The New York State Health Department has resolved a class action filed by a group of chronically ill Medicaid recipients who accused the state of violating their due process rights by failing to provide enough time to register their home care workers through a new system, attorneys said on Wednesday.

Under the Consumer Directed Personal Assistance Program, or CDPAP, New York Medicaid recipients hire, train and supervise their own home care workers — known as personal assistants, or PAs — including certain friends and family members without nursing licenses.

For years, patients have been able to utilize a network of more than 600 private fiscal intermediary agencies, funded by Medicaid, to handle payroll and compliance. But that changed on April 20, 2024, when lawmakers passed a law mandating that, beginning April 1 this year, New York would replace all existing fiscal intermediaries with a single, statewide entity.

In January, the Health Department told Medicaid patients and their assistants that they had to re-register with the new intermediary, called Public Partnerships LLC, by March 28 or risk losing services and pay. The deadline meant that roughly 280,000 consumers and 300,000 PAs had about two months to complete the process.

In a complaint filed in late March by New York Legal Assistance Group and Patterson Belknap Webb & Tyler LLP attorneys working pro bono, named plaintiffs Liza Engesser, Marisol Getchius, Geetanjali Seepersaud, Maria Jaime, Y.P.S. and C.P. accused the Health Department of not giving them and their PAs adequate notice of the transition — resulting in them losing critical care.

The plaintiffs in the case, Engesser et al. v. McDonald, specifically challenged the Health Department's failure to provide CDPAP consumers with written notice and an opportunity for a fair hearing before they lost services.

In addition, the plaintiffs alleged the transition process itself was riddled with technical issues: Public Partnerships' registration system was slow and confusing, its phone lines were hard to reach, and its representatives took weeks to return voicemails. In some cases, the names of patients and their personal assistants were switched or Medicaid numbers had been entered incorrectly, issues the plaintiffs said were due to Public Partnerships' inability to handle the large number of consumers.

"Defendant's failure to provide sufficient time to surmount these barriers, as well as notice and an opportunity to be heard before any loss of services, violates plaintiffs' statutory and constitutional rights," the plaintiffs said in the complaint.

On June 27, while negotiations on the settlement played out, U.S. District Judge Frederic Block for the Eastern District of New York approved a preliminary injunction ordering extensive outreach to class members throughout July.

According to the NYLAG, that outreach was successful: A majority of class members either began to use Public Partnerships as their fiscal intermediary or had switched to a different type of home care service by an Aug. 1 deadline.

Then, in early July, the parties reached a settlement. On Tuesday, U.S. District Judge Frederic Block for the Eastern District of New York signed off on it. Under the terms of the deal, which takes effect on Oct. 3, the Health Department has agreed to continue its outreach to consumers who did not take steps to secure their home care by the August deadline.

The department will send notices explaining CDPAP consumers' rights to request fair hearings and provide additional opportunities for pre-hearing resolution to any class member who requests a hearing.

"Instead of those benefits coming after many months of protracted litigation, they are coming now," Patterson Belknap partner Lisa E. Cleary said in a statement. "We are very proud to have partnered with the New York Legal Assistance Group to secure this settlement for the class."

In a statement, Elizabeth Jois, a supervising attorney in the NYLAG's Special Litigation Unit, praised Judge Block's work guiding the parties through negotiations.

"Our ultimate goals in bringing this litigation were to ensure that CDPAP consumers had adequate time and assistance to switch to the new statewide fiscal intermediary, and that any consumer who was unable to get through that process received written notice explaining what steps they had missed and that they had the ability to present their issues in a fair hearing," Jois said.

"We know that there are class members who continue to face hurdles in accessing CDPAP services and that they deserve to have the relief we've worked hard to successfully negotiate on their behalf sooner rather than later," she added.

--Editing by Philip Shea.