For hundreds of thousands of New Yorkers with disabilities, chronic illnesses or other long-term health conditions, the Consumer Directed Personal Assistance Program is a lifeline. It allows them to maintain dignity and autonomy by enabling them to employ trusted loved ones as personal assistants, or PAs, to provide at-home care. But up until this year, this crucial program was incredibly fraught.

CDPAP was previously overseen by more than 600 fiscal intermediaries, or FIs, across the state. These are the entities that ensure PAs get paid for the critical care they provide. And while some FIs did this well, others did not. Quality standards were inconsistent across FIs and often did not meet the level that consumers and caregivers deserve.

Of course, no transition at this scale and on

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