City Limits: Opinion: Fixing New York’s Home Care Chaos
“What we need is a return to the original intent of CDPAP. Run by responsible non-profits, with input from disabled people themselves.”
Gov. Kathy Hochul at a healthcare-related press conference in 2023. (Mike Groll/Office of Governor Kathy Hochul)
Read full Opinion piece at City Limits
By Gabriela Amari
July 17, 2026
Nearly 30 years ago, I was seriously injured by an ex-boyfriend. He pushed me off a chair and I fell hard, with permanent damage to my spinal cord that turned me into a disabled person.
Suddenly, I had to navigate a different world. Here I was, in my 30s, and I couldn’t do my nursing job anymore, nor could I pursue my dream of a singing career. But, with some help, I reinvented my life, eventually doing part-time work as an advocate for people with disabilities.
At first, I got help via a home care agency. Then I learned about a state Medicaid option called the Consumer Directed Personal Assistance Program (CDPAP). I’ve been in CDPAP since 2004 and, until recently, it’s been a godsend.
But in 2025, Gov. Kathy Hochul handed CDPAP over to a private equity-backed company called PPL. In short, it’s been a disaster. In fact, it’s so bad that on June 16, the U.S. Department of Justice sued PPL and two top executives who work for Hochul. The charges outline fraud, bid-rigging, wage theft and more. Sadly, for those of us who have had to deal with this disastrous transition, none of this comes as a surprise.
For many years, I was served by Concepts of Independence—a nonprofit here in Brooklyn—to help manage my state-approved, 49 hours a week of home care. I even found my current, big-hearted caregiver, Carron, through Concepts. It wasn’t perfect, but Concepts was an utter vacation compared to PPL.
Dealing with PPL has been a chaotic, stress-filled mess. They lose paperwork repeatedly. They don’t get back to you. Their technology is loaded with glitches. Carron has had to squeak by, waiting for pay that only arrives because we are such bulldogs about it. There are workers I know who still haven’t been paid by PPL. (In fact, PPL just settled a wage-theft lawsuit brought by The Legal Aid Society here, handing over $162 million to workers.) No wonder tens of thousands of CDPAP consumers and workers have been hounded out of the program.
Yet this sorry state of affairs was entirely predictable. PPL has left a trail of destruction in other states due to their incompetence and greed in running home care. They’ve even been kicked out of six states.
In New York, PPL replaced hundreds of smaller outfits, with the supposed goal of saving taxpayer money. The governor touts over a billion dollars in CDPAP savings. Of course, those savings are only because people have fled, to go to more expensive state options like home care agencies and nursing homes, or to burden their families with unpaid care.
Which brings me back to the DOJ lawsuit. On the surface, it is justified. But the dark worry is what it may bring. Will it simply be used as a political weapon? With the Trump administration already targeting Medicaid, will they use it as a way to justify even more cuts? If Kathy Hochul loses re-election, she’ll lick her wounds in a mansion in Buffalo. If PPL loses their contract, its private equity investors will simply move on to suckers in other states.
But what happens to people with disabilities?
There should be no place in our healthcare system for profit over care. And no place for corrupt politicians making backroom deals with people’s lives and well-being at stake. What we need is a return to the original intent of CDPAP. Run by responsible non-profits, with input from disabled people themselves.
Nothing about us, without us.
Gabriela Amari works part-time as a supervisor of the Open Doors Peer Program for the Brooklyn Center for Independence of the Disabled. She is a Leader at NY Caring Majority.