Thread by @GreggBeratan

A number have people have reached to ask about @NYGovCuomo's attack on #CDPA services and what it will mean for disabled New Yorkers. I'll try and cover it in the thread that follows. #CripTheVote …

#CDPA or Consumer Directed Personal Assistance began in New York and was quickly copied across the country. It was designed by disabled people for disabled people to give us more control over or lives and the supports we used to live in the community. #CripTheVote

#CDPA makes disabled people the employer of the attendants who provide us services. It gives us control over hiring & firing as well as how and when it is provided. It lets us control who touches our bodies, who assists us with our most intimate needs and who doesn't #CripTheVote

Disabled people started #CDPA because under traditional home care we were often at the mercy of whoever an agency sent us, with not choices. We had to get up lat and go to bed early because that was when Home care could be there. #CripTheVote

#CDPA gives us control over how & when our attendants work and who they will be. This control is made possible by the assistance of a group of organizations known as fiscal intermediaries (FIs). FIs provide disabled people with assistance in managing our services. #CripTheVote

The assistance FIs provide ranges from payroll processing, recruitment assistance, training, advice, & other supports for consumer-supervisors. These services are often the difference between a person thriving in the community and being forced into an institution. #CripTheVote

.@NYGovCuomo has 3 #CDPA proposals
1. He proposes awarding a no-bid contract for a statewide FI.
The criteria for this are unspecified & in other states where this has happened big multi-state corps like @PCGPPL have come in and made a hash of it. #CripTheVote

.@NYGovCuomo's 2nd proposal is:
2. limit FIs to either Independent Living Centers or orgs contracted to county depts. of soc. services since 2012 and any other criteria DoH may develop. There are a number of problems with this... #CripTheVote

The state is concerned with bad actors offering traditional homecare and calling it #CDPA to get around marketing bans and expand their business. @NYGovCuomo is addressing this by using a sledgehammer to perform a task requiring a scalpel... #CripTheVote

What makes this more appalling is @NYGovCuomo has a scalpel at his disposal. #NY began an FI authorization process last year that allows the governor to wipe out bad actors easily. Leaving only FIs that are providing valuable services that support community living. #CripTheVote

3. changes FI reimbursement to a per member per month flat rate. Ignores the reality the services FI’s provide. Even if FI’s only provided payroll services. Payroll processing for someone receiving 12 hours a week is not the same as for someone getting 168 hours. #CripTheVote

It ignores the fact that FI admin cannot be fixed at any rate if it includes non fixed items like Workman’s comp. There is no way to limit workman’s comp claims so a flat fee is almost certain to put FIs in the Red #CripTheVote

All of this is contingent on ‘adequate’ federal funding. The budget does not say what is adequate & leaves it to the commissioner’s discretion. A sweeping new power for an unelected official, if he is not satisfied w/ the funding he can wipe out the program entirely! #CripTheVote

Even if you discount the threat of the commissioner wiping out the program entirely (which you shouldn’t), these proposals will encourage FIs to serve only individuals without complex support needs whose services can fit under the per member per month fee #CripTheVote

Even if the fee were actuarially sound across FIs it might not be not be across a single FI. It makes serving people with complex support needs unappealing because of the risk that it could put an FI in the RED. #CripTheVote

Looking at this proposal, it is hard not to see it forcing more people into institutions either because the services they need to stay in the community are no longer available or because FIs won’t take them. Either way Disabled people lose their freedom. #CripThevote