NY CDPAP Fiscal Intermediaries and Elderly Support

Explore the role of NY CDPAP fiscal intermediaries in elderly care, from compliance to confidentiality.

steven zauderer
Steven Zauderer
March 26, 2024
9 min read
min read

Understanding the Role of Fiscal Intermediaries

In the realm of elderly care and the Consumer Directed Personal Assistance Program (CDPAP), Fiscal Intermediaries play a significant role. Understanding the definition and duties of these intermediaries can assist in navigating the complexities of the NY CDPAP program.

Definition of a Fiscal Intermediary

A Fiscal Intermediary (FI) is a crucial component in the CDPAP landscape. They are tasked with handling a myriad of administrative tasks for program participants. Rather than burdening individuals with the complexities of payroll, taxation, and workers' compensation, FIs take these tasks on, allowing individuals to focus on their care needs.

FIs work on behalf of the consumer, providing an essential service for those who choose to hire personal assistants through the CDPAP. Their role is to smooth the process and ensure program participants can focus on their health and well-being without the administrative burden.

Duties of a Fiscal Intermediary

The duties of a Fiscal Intermediary in the NY CDPAP are multi-pronged. Among their primary responsibilities is the provision of payroll services. This includes not only paying the personal assistant but also handling taxes, and workers' compensation.

FIs also need to be reliable and possess robust systems to ensure seamless payment of personal assistants and compliance with state regulations. Part of this reliability is ensuring that personal assistants receive their pay on time and face no payment delays or issues.

Moreover, FIs are involved in the minutiae of administrative tasks. They assist with submitting timesheets, managing taxes, and addressing any concerns or issues related to payroll for personal assistants in the CDPAP program.

Through their crucial role, FIs provide an essential service that enables the smooth functioning of the CDPAP, offering a lifeline for both the elderly and their caregivers. Understanding their role can significantly enhance the benefits one derives from the CDPAP program.

Selecting a Fiscal Intermediary for CDPAP

Selecting the right fiscal intermediary for the Consumer Directed Personal Assistance Services (CDPAS) program is essential for effective management of care. Participants are given the freedom to choose their fiscal intermediary, which further emphasizes the need for a careful selection process. This selection should consider factors such as licensing, services offered, and reputation of the fiscal intermediary to ensure a smooth and beneficial experience with the NY CDPAP program.

Importance of Licensing and Accreditation

One of the key factors to consider when choosing a fiscal intermediary for the NY CDPAP is their licensing and accreditation. These intermediaries must be authorized by the New York State Department of Health to provide services under the program, ensuring they meet required standards and regulations set by the state [3].

The inclusion of Consumer Directed Personal Assistance Services (CDPAS) into the Medicaid Managed Care and Managed Long Term Care (MCO) benefit package occurred on November 1, 2012, as stated in the guidelines provided by the New York State Department of Health. Therefore, an authorized fiscal intermediary would have the necessary licensing to operate within these guidelines.

The licensing and accreditation of the fiscal intermediary ensure they adhere to specific guidelines and standards to maintain the quality and legality of the program. This offers assurance to participants that the intermediary is fully compliant with state requirements, thus ensuring the reliable delivery of services.

Evaluating Reputation and Experience

In addition to licensing and accreditation, the reputation and experience of a fiscal intermediary play a significant role in the selection process. These aspects can provide valuable insights into the reliability and service quality of the intermediary.

When evaluating the reputation of a fiscal intermediary, it's beneficial to research their track record and seek out reviews and testimonials from other individuals. This can provide a clearer picture of their capabilities and the level of satisfaction among previous participants.

An experienced fiscal intermediary will likely have a streamlined process in place and a well-trained staff to manage the various aspects of the program. They would also be well-versed in managing the complexities of the program, ensuring that participants receive the personalized care they need.

In conclusion, selecting a fiscal intermediary for the NY CDPAP is an essential step in managing personal care. By considering the licensing, accreditation, reputation, and experience of the intermediary, participants can ensure they are making a well-informed decision that caters to their specific needs.

Operational Expectations from Fiscal Intermediaries

NY CDPAP fiscal intermediaries are expected to meet certain operational standards to ensure the smooth running of the program and the provision of quality services to the elderly and their caregivers.

Managing Volume Changes

The ability to manage significant volume changes is a critical requirement for NY CDPAP fiscal intermediaries. These companies must be prepared to handle an anticipated minimum of 300 consumers per month, with the potential for growth up to 75,000 consumers per month by year five [5]. This requires a robust infrastructure and a well-trained, scalable workforce to manage the increased workload effectively.

Year Expected Number of Consumers
1 300
2 15,000
3 30,000
4 50,000
5 75,000

Ensuring 24/7 Access to Services

Another important operational expectation from NY CDPAP fiscal intermediaries is the provision of round-the-clock service. They are expected to provide access to services 24 hours a day, 7 days a week, including the provision of after-hours services and during disasters or emergencies [5]. This 24/7 availability ensures that consumers and caregivers can receive assistance or guidance at any time, contributing to the continuity of care and the overall well-being of the program's beneficiaries.

The ability to meet these operational expectations is a crucial factor in determining the effectiveness of a fiscal intermediary in the NY CDPAP program. Intermediaries that can manage volume changes effectively and provide uninterrupted service are more likely to offer reliable support and contribute to the program's success. Therefore, it's crucial for those involved in the CDPAP program to choose a fiscal intermediary that can meet these expectations, ensuring the best possible care for the elderly.

Compliance Requirements for Fiscal Intermediaries

A crucial aspect of the operations of NY CDPAP fiscal intermediaries is compliance with regulatory requirements. These include conducting criminal background checks and maintaining a quality improvement program.

Conducting Criminal Background Checks

One of the key responsibilities of fiscal intermediaries under the CDPAP program is to ensure that all personal assistants undergo criminal background checks. This is in accordance with the New York State Department of Health (DOH) requirements [5].

This requirement is crucial for safeguarding the safety and well-being of consumers under the program. By conducting thorough background checks, fiscal intermediaries can ensure that they hire only trustworthy and capable individuals as personal assistants. This, in turn, enhances the quality of care provided to the elderly and other beneficiaries of the program.

Maintaining a Quality Improvement Program

In addition to conducting background checks, fiscal intermediaries for the CDPAP program are required to maintain a comprehensive quality improvement program. This program should include annual, semi-annual, and quarterly program evaluations to ensure compliance with the program's standards and guidelines.

The quality improvement program is designed to regularly assess and enhance the quality of services provided under the CDPAP program. By conducting regular evaluations, fiscal intermediaries can identify areas of improvement and implement necessary changes. This continuous process of evaluation and improvement ensures that consumers receive the highest quality of care.

In summary, compliance with regulatory requirements is a fundamental aspect of the operations of NY CDPAP fiscal intermediaries. By adhering to these requirements, fiscal intermediaries can ensure the provision of safe, high-quality care to consumers. They can also contribute to the overall success and credibility of the CDPAP program, thereby enhancing its value and effectiveness in supporting the elderly and other individuals in need of care.

The Impact of Fiscal Intermediaries on Caregivers

Fiscal intermediaries (FIs) under the NY CDPAP program have a significant impact on caregivers, particularly in areas such as payroll management, taxation, and recruitment and training responsibilities. These entities handle crucial administrative tasks on behalf of the consumer, allowing caregivers to focus more on providing care.

Payroll Management and Taxation

One of the principal functions of NY CDPAP fiscal intermediaries is payroll management. They are responsible for paying the personal assistants, handling taxes, and managing workers' compensation [1]. This encompasses activities such as submitting timesheets, managing taxes, and addressing any concerns or issues related to payroll.

FIs need to be reliable and have robust systems in place to ensure seamless payment of personal assistants and compliance with state regulations [2]. One of their key responsibilities is to ensure that personal assistants get paid on time and do not face any payment delays or issues.

By taking over these administrative duties, FIs alleviate the burden off caregivers, enabling them to concentrate on their primary duty of providing care to the consumers.

Recruitment and Training Responsibilities

In addition to payroll management and taxation, fiscal intermediaries also have a role to play in the recruitment and training of personal assistants. Although the participants in the CDPAP program have the freedom to hire caregivers of their choice, FIs can provide valuable assistance in the recruitment process.

Moreover, FIs can provide training resources and support to ensure the caregivers are equipped with the necessary skills and knowledge to provide the best possible care to the consumers. By offering these services, FIs help to enhance the quality of care provided under the CDPAP program and ensure a better outcome for the consumers.

In summary, the role of fiscal intermediaries in the NY CDPAP program extends beyond mere administrative tasks. They play a crucial role in ensuring that caregivers can focus on their primary responsibility of providing care, while also helping to enhance the quality of care through their recruitment and training support.

Legal Guidelines for Fiscal Intermediaries

Fiscal Intermediaries (FIs) operating under the Consumer Directed Personal Assistance Program (CDPAP) in New York must adhere to specific legal guidelines set by the state. These rules are designed to ensure the highest level of care and service for program participants.

Meeting Medicaid Provider Enrollment Criteria

Effective April 1, 2021, all FIs providing services under the CDPAP must be enrolled as a New York State Medicaid provider. To meet the specific qualifications, FIs must be able to perform all responsibilities listed under the Medicaid fiscal intermediary authority with a contract or sub-agreement under the CDPAP.

More specifically, FIs must be capable of providing fiscal management services for participants in the program. These services include wage and tax processing, benefits payments, state and federal withholding, and providing the flexibility to manage CDPAP services tailored to the needs of the participants [6].

Adherence to Deduction Regulations

FIs under the CDPAP must adhere to strict regulations regarding withholding from the assistants' paychecks. There are limitations on deductions that can be made, and explicit participant consent is required for any authorized deductions made from the assistants' payments.

In addition, FIs must meet stringent requirements from the New York State Department of Health, including conducting up-to-date background checks for all employees, ensuring assistants are properly trained and supervised, and following strict guidelines when hiring individuals with criminal histories.

FIs under the CDPAP are also required to maintain participant records confidentially and with precision to ensure compliance with Medicaid regulations and provide transparency in the management of services and financial transactions related to the program.

In conclusion, NY CDPAP fiscal intermediaries must operate within the confines of these legal guidelines to ensure the safety, quality, and effectiveness of the care provided to the elderly and other participants in the program.

Confidentiality and Record-Keeping

As part of NY CDPAP fiscal intermediaries' responsibilities, maintaining confidentiality and precision in record-keeping are paramount. These aspects are critical to ensure compliance with Medicaid regulations and to support transparent management of services and financial transactions pertaining to the program.

Importance of Confidentiality

Under the CDPAP, fiscal intermediaries are required to uphold strict confidentiality regarding participant records. This obligation stems from the need to protect personal information of the elderly and caregivers involved in the program.

The importance of confidentiality extends beyond just protecting participants' information. It's also crucial for establishing trust between the participants and the fiscal intermediaries. By safeguarding personal data, fiscal intermediaries help ensure that the elderly and their caregivers can confidently engage with the program, knowing that their information is being handled with the utmost discretion and respect.

Furthermore, maintaining confidentiality also aligns with the legal requirements laid out by the Medicaid program. Any breach of confidentiality can lead to serious consequences, including potential legal action and loss of accreditation.

Precision in Record-Keeping

In conjunction with maintaining confidentiality, fiscal intermediaries are also tasked with ensuring precision in record-keeping. This involves keeping accurate and up-to-date records pertaining to the services rendered and financial transactions made under the program.

Precision in record-keeping is not just about maintaining a log of transactions. It also involves managing payroll services, such as paying personal assistants, managing taxes, and overseeing workers' compensation.

Key Record-Keeping Tasks Description
Timesheet Submission Fiscal intermediaries are responsible for submitting timesheets accurately and promptly.
Tax Management They are tasked with handling all tax-related matters, ensuring compliance with state and federal regulations.
Payroll Management They should ensure that personal assistants are paid on time, without any delays or issues.

By maintaining precise records, fiscal intermediaries can ensure seamless payment operations and adherence to state regulations. This not only promotes transparency but also contributes to the efficiency and effectiveness of the CDPAP program.








steven zauderer

CEO of CrossRiverTherapy - a national ABA therapy company based in the USA.

Table of Contents