How Public Partnerships LLC Has Jeopardized Home Care Workers and Consumers in New York State

Surveys Document Unpaid Wages, Malfunctioning Technologies, and Nonexistent Customer Service, Despite $1 Billion State Contract

Mitra Ebadolahi

An Executive Summary of this analysis is available for download here.

Introduction

In New York State, the consumer-directed personal assistance program (CDPAP) has allowed New Yorkers to hire a person of their choosing, including a loved one, to provide their home care under Medicaid.

In 2025, Governor Kathy Hochul consolidated New York’s CDPAP under a single, for-profit, private equity-backed company: Public Partnerships LLC (PPL). New York agreed to pay PPL $1 billion over four years to serve as CDPAP’s sole fiscal intermediary, despite PPL’s well-documented failures in several other states, including Pennsylvania, New Jersey, and West Virginia. This change impacted 280,000 home care consumers and 425,000 home care workers.

Throughout the rest of 2025, Caring Majority Rising (CMR) administered a series of surveys to home care workers and consumers, documenting the extreme hardships these populations have experienced as a result of PPL’s administration of New York’s CDPAP.

Our analysis of this survey data suggests at least three troubling trends:

PPL’s technologies undermine workers’ pay and consumers’ home care;
PPL repeatedly has failed to timely, correctly, and consistently pay home care workers, jeopardizing home care services and causing significant financial and emotional hardship to vulnerable New Yorkers; and
PPL has not provided timely or adequate customer support services to home care consumers or human resources support to home care workers — and the State of New York has failed to hold PPL accountable for these failures.

This resource highlights just some of the most egregious examples of how PPL is failing New Yorkers, jeopardizing home care workers and consumers alike.

Troubling Trends

#1: PPL’s technologies undermine workers’ pay and consumers’ home care.

It “can take up to 12 tries” before a home care worker can successfully clock in using PPL’s technologies.
CDPAP Consumer from Brooklyn, November 2025

PPL’s CDPAP administration involves three separate technological platforms, which home care workers and consumers must use to get paid and receive care: an app (Time4Care); an online portal (PPL@Home); and a telephonic timekeeping system (Telephony).

CMR’s surveys indicate that each of these platforms repeatedly have failed home care workers and consumers alike:

PPL began administering CDPAP on April 1, 2025. As of April 12, 2025, 45% of care workers responding to a CMR survey reported that they were unable to clock in and out for their shifts with PPL’s technologies. Another 15% of respondents said they were only able to clock in and out “sometimes.” These problems persisted: more than six months later, in November 2025, one CDPAP consumer reported that it “can take up to 12 tries” for their home care worker to clock in.

Home care consumers must likewise use PPL technologies to review and approve care workers’ shifts (even though the consumers, themselves, set their own care schedules in CDPAP). Here, too, technological problems and insufficient customer service support have been major obstacles. Sometimes, a worker’s time does not immediately appear on the PPL dashboard. Sometimes, even after a home care consumer has approved shifts, they inexplicably appear as “under review,” which results in delayed or denied pay for care workers.

For many, PPL tech platforms are inaccessible. As one consumer explained in November 2025: “My hands barely work and I sometimes hit ‘reject’ instead of ‘approve,’ and there is no second step to check that you really do want to reject it, and it can’t be undone once it’s been rejected.” One CDPAP home care worker observed: “The Time4Care app is hard to navigate for low vision elderly people like my consumer. She must approve all of my shifts and has complained that the print is too small for her.” Another consumer reported that they “physically can’t use phone lines,” yet were told to call a PPL hotline for assistance.

Non-English speakers have also reported difficulties understanding and navigating PPL technologies.

“I am frustrated that I approve time, often check online & through the app that the time was approved. But the next shift, it shows up pending approval. This was just a sometime issue, but now it is [an] every week occurrence with one assistant or another. … Saturdays [are the] wors[t], because I approve, & then [I] see waiting for approval after the deadline & then their pay is a week late for that day!”
CDPAP Consumer from Tonawanda, November 2025

Some CDPAP participants lack personal devices sufficiently technologically advanced to access PPL’s platforms.

Unable to consistently and accurately clock in and out, or to have time approvals correctly registered in PPL’s system, many CDPAP home care workers have been denied their full pay, earned overtime, and/or authorized work hours. PPL has also failed to safeguard sensitive personal information.

CDPAP was created to give New Yorkers the flexibility to direct their own care, but PPL’s administration of the program has undermined consumer autonomy and consumer choice. CDPAP participants have struggled to satisfy unnecessary and burdensome requirements with glitchy or inaccessible technology and little or no support. This has driven home care workers out of CDPAP, and forced some home care consumers to switch to long-term care or other programs that do not meet their needs as well as CDPAP could.

#2: PPL has repeatedly failed to timely, correctly, and consistently pay home care workers, jeopardizing home care services and causing significant financial and emotional hardship to vulnerable New Yorkers.

The first official CDPAP pay day under PPL’s contract with New York State was April 10, 2025. According to a CMR survey, 70% of respondents reported not being paid by PPL on or around this pay day.

The next official pay day was April 17, 2025. According to a second CMR survey, 57% of respondents reported not being paid by PPL on or around this day. When asked how this missing pay had impacted their finances, 72% of respondent care workers said they had had to buy fewer groceries, and 32% reported they would have to skip a rent payment.

The third official pay day was April 24, 2025. According to a third CMR survey, 49% of respondents reported not being paid by PPL on or around this day; 11% of respondents reported receiving only partial pay. Of those survey respondents who reported receiving no or only partial pay since April 1 , 48% stated that they would not be able to make their rent or mortgage payments.

In its fourth week as New York’s CDPAP fiscal intermediary, PPL paid only 165,000 care workers (out of a total population of 425,000). When asked how this missing pay had impacted their finances, 33% of care workers responding to a fourth CMR survey stated they’d missed a phone payment – which threatened workers’ ability to register or clock time with PPL’s technologies.

Three months later, in August 2025, 55% of home care workers responding to a fifth survey reported they had not received pay for all hours worked to date. Spanish-speaking home care workers seem to be disproportionately impacted: only 18% of these survey respondents reported they’d received pay for all hours worked to date.

By December 2025, 44% of home care workers responding to a sixth survey reported having experienced financial hardship under PPL’s CDPAP administration, and 33% reported having worked more unpaid hours under the PPL regime.

“They are forcing assistants to work hours for free. I could be finishing cleaning up [a] soiled client due to incontinence for example and go over my hours and they WILL NOT pay those hours worked. It’s not like I’m going to leave the client filthy as that’s insensitive and could lead to hospitalization for skin breakdown.”
CDPAP Personal Assistant from Marion, November 2025

CDPAP consumers and workers also have reported widespread and serious accounting and administrative errors, including: inaccurate allotments of authorized home care hours; hourly pay that is below the contractual amount; partial pay without explanation; and missing PTO accruals.

CDPAP participants have reported evidence of rounding errors on PPL platforms. Such errors are particularly inappropriate in the CDPAP context, where consumers and aides are allocated a certain number of hours per week based on consumers’ care needs. These rounding errors result in either the constructive theft of allocated care time from consumers, or theft of wages for hours worked from aides — often several hours per pay period.

#3: PPL has not provided timely or adequate customer support services to home care consumers or human resources support to home care workers — and the State of New York has failed to hold PPL accountable for these failures.

“I have been waiting for almost two months for thousands of dollars that I’m owed retroactively and PPL payroll can’t seem to figure out how to do simple math. I’ve called and emailed multiple times a week for 8 weeks and NEVER get a response. There is no way to contact payroll dept directly and nobody knows how to get my pay corrected.”
CDPAP Personal Assistant from Farmingdale, November 2025

Home care consumers and workers alike have reported countless unanswered phone calls and emails; inconsistent and contradictory responses from PPL representatives (on those rare occasions when one can be reached); and PPL’s persistent failure to timely respond to or correct reported problems. Some survey respondents also reported that registration delays on PPL’s end have deprived them of home care services or pay to which they were entitled.

“… I had 87 calls unanswered and never returned and dozens of emails never answered still to this day!”
CDPAP Personal Assistant from Gloversville, November 2025

Conclusion

New Yorkers deserve a functioning CDPAP. PPL has failed to deliver, jeopardizing home care consumers’ health and independence, and materially harming home care workers throughout New York.

Two immediate remedies are available.

First, New York should immediately restore consumer choice in CDPAP, re-establishing trusted, community-based fiscal intermediaries (including independent living centers) that served this essential program successfully for many years before Governor Hochul gave PPL sole and total control.

Second, state legislators should pass the Home Care Transparency Act, which would require PPL to submit quarterly reports to the New York Department of Health on key metrics, including: how Medicaid funds are spent; unpaid or late wages; customer service wait times; and how many CDPAP consumers actually receive care (versus how many have been authorized to receive care).

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Upturn Authors

Mitra Ebadolahi

A “fiscal intermediary” (FI) is an entity that has a contract with a social services district or Medicaid Managed Care Organization to process each consumer directed personal assistant’s wages and benefits. FIs establish the amount of each personal assistant’s wages; process all income tax and other required wage withholdings; and must comply with worker’s compensation, disability, and unemployment insurance requirements.

Home care workers in the CDPAP are referred to as “personal assistants.” The terms “home care worker” and “personal assistant” are used interchangeably here.

This document draws from six specific online surveys administered by CMR between April and December 2025: (1) “Survey 1” April 10-12, 2025; 327 respondents (78% of whom were home care workers); (2) “Survey 2” April 17-21, 2025; 477 respondents (81% of whom were home care workers); (3) “Survey 3” April 25-28, 2025; 492 respondents (77% of whom were home care workers; 22% consumers or designated representatives); (4) “Survey 4” May 2-5, 2025; 401 respondents (75% of whom were home care workers; 25% consumers or designated representatives); (5) “Survey 5” May 14-21, 2025; 233 respondents (73% of whom were home care workers; 26% consumers or designated representatives); and (6) “Survey 6” November 17-December 8, 2025; 339 respondents. CMR distributed these surveys via social media, text banking, and emails to CDPAP contacts. CMR also distributed these surveys through outreach to partner organizations with large networks of home care consumers and personal assistants. Given the inherent partiality of any survey data, the primary purpose of this summary is to make legible the personal and collective hardships CDPAP participants have experienced, as reported in survey responses.

“Hours are not recorded. For example one time had to try 9 times to log out. Took 15 minutes which then caused another 1 hour pay. Taking valuable time away from authorized hours.” Survey 2 (4/17/2025 15:53:38), Personal Assistant from Rochester.

Survey 6 (11/20/2025 10:04:08), Consumer from Brooklyn

“They want[] us to share our location all the time, the [home care consumer has] to approve your time sheet through an App and our customers are old people who [do] not [know] how to use[] technology or do[] not have smart phone[s]. You need to have [a] smart phone in order to clock in, they don’t allow you to clock via phone call. The App sometimes does not work properly…” Survey 2 (4/19/2025 9:40:55), Personal Assistant from Utica.

“Last Friday I could not get into [PPL’s system] to verify [my Personal Assistant’s] time. I try to do this every day. Then late Saturday it came back, but everything I verified was marked not completed. When I sign into PPL, 68% of the time it shuts down and I have to sign in again. I have a very high [speed] internet connection. I wonder how others with less connection are able to sign in & stay signed in.” Survey 4 (5/2/2025 17:26:18), Consumer from Tonawanda.

“Also, my consumer often has trouble verifying my time because it sometimes takes hours or days to show up on her dashboard.” Survey 4 (5/2/2025 17:07:46), Personal Assistant from Delhi.

“I am frustrated that I approve time, often check online & through the app that the time was approved. But the next shift, it shows up pending approval. This was just a sometime issue, but now it is [an] every week occurrence with one assistant or another. … Saturdays [are the] wors[t], because I approve, & then [I] see waiting for approval after the deadline & then their pay is a week late for that day!” Survey 6 (11/20/2025 10:31:21), Consumer from Tonawanda.

“worked hours held back for ‘review’” Survey 5 (5/19/2025 14:11:00), Personal Assistant from New York.

Survey 6 (11/20/2025 15:48:10), Consumer from Rochester.

Survey 2 (4/17/2025 12:07:30), Personal Assistant from the Bronx.

Survey 6 (11/20/2025 13:52:42), Consumer from New York.

“For one of my aid[e]s English is her [s]econd language meaning the PPL app is not that easy for her to understand.” Survey 4 (5/2/2025 12:18:30), Consumer from Glen Head.

“My client has a flip phone” Survey 1 (4/10/2025 10:34:02), Personal Assistant from Natural Bridge.

“They lack communication but want disabled and elderly consumers who are not comfortable with technology to download an app on their non smart phone. They also want consumers to have landlines, who has landlines in 2025? My consumer only [has] her little consumer flip cellphone.” Survey 3 (4/25/2025 20:53:31), Personal Assistant from the Bronx.

“I don’t have [a] computer.” Survey 4 (5/5/2025 14:48:58), Personal Assistant from Schenectady.

“Also because of all the sensitive personal information we were required to give we are all subject to fraud and scams. Especially if PPL did not follow rules for training, background checks etc. required for employees who have access[] to this information.” Survey 2 (4/17/2025 15:53:38), Personal Assistant from Rochester.

“This is absolutely the worst system I have ever dealt with and it just continues. I even want to hire another CDPAP worker, but no one wants to get involved with PPL so I can’t even hire someone.” Survey 3 (4/25/2025 9:32:39), Designated Representative from Whitesboro.

“I have been a PA with cdpap for over 11 years and have been forced to take a pay cut of $1.90 PER HOUR. That’s a substantial cut in pay with my experience. I only remain[ed in the program] because I care for [my] adult daughter with autism and have no other option.” Survey 3 (4/25/2025 17:32:17), Personal Assistant from Spencer.

“I already lost 1 PA and now I have 3 that are telling [me] that they’re going to be leaving [CDPAP] if things continue like this they have no money at all.” Survey 4 (5/2/2025 11:02:49), Consumer from New York.

“I am also a lawyer and we have begun to get calls from client[s] who can’t maintain staffing for home care due to PPL not paying aides and they want us to convert their Medicaid to chronic coverage for placement of their loved one in a nursing home.” Survey 4 (5/5/2025 12:09:21), Personal Assistant from Rochester.

“… PPL’s lack of processing me in a reasonable amount of time has resulted in my inability to be authorized to provide services which ultimately resulted in my departure from the consumer as per her request.” Survey 5 (5/19/2025 14:12:20), Personal Assistant from Poughkeepsie.

“Ultimately, I left PPL because I care more about having homecare show up to work happy, than having all the wonderful liberties of the consumer directed plan. I needed to make sure that my aides got their pay or they would’ve left me; thus I gave up many of my benefits that I took for granted with the consumer directed plan, benefits that enabled me to live with more dignity. If things change, meaning if PPL is eliminated, I will definitely go back to the consumer directed plan[.]” Survey 6 (11/20/2025 17:55:59), Consumer from Long Beach.

“I was forced by PPL to leave CDPAP and join traditional homecare which is not the correct program for our needs as no family members can participate in his care [for my 33 year old totally dependent son].” Survey 6 (11/25/2025 14:11:23), Designated Representative from Brooklyn.

“Issues with authorization of hours. PPL bulked hours instead of doing month to month.” Survey 5 (5/20/2025 13:54:34), Personal Assistant from Rochester. * “Not paid all the hours [I] worked my shift overlaps with night shift for 30 minutes for the dual assist my client was awarded[.]”* Survey 5 (5/20/2025 16:11:25), Personal Assistant from Halfmoon.

“[N]ow they are telling me [I] can’t work overtime. Patient approved for 56 hours for over a couple of years.” Survey 6 (12/6/2025 14:03:55), Personal Assistant from Delmar.

“They are not following the amount per [their] wage offer letter.” Survey 4 (5/2/2025 11:39:58), Designated Representative and Personal Assistant from Berne.

“[Operative contract said] my aides were t[o] get [$]20.55 [an hour] Monday through Friday. And [$]21.10 [S]at[urday] and Sunday. They [are only] getting [$]20.10 even on weekends.” Survey 5 (5/20/2025 13:55:35), Consumer from Arverne.

“Wife worked 32.5hrs and got paid for 4.45hrs. When trying to call no one picked up the phone. Very hard to speak to someone regarding problems. Very frustrating.” Survey 2 (4/18/2025 16:26:20), Personal Assistant from New York.

“I worked 19 hours they paid me for 16[] hours.” Survey 5 (5/19/2025 10:02:25), Personal Assistant from the Bronx.

“[E]very week I was partially paid for Saturday 16 hrs, 9am to 1am, [I’ve] tried different methods, I now clock out at 11:59 and clock back in at 2400, then out at 1am, but [I] have still not been paid correctly for the spread of hours, I work 3 shifts over 10 hours, and only get part of the pay.” Survey 5 (5/20/2025 10:12:59), Personal Assistant from NYC.

“I think how they are doing the pay makes no sense. My aide[] works the same hours everyday. Only 2 times in a month it’s 5 less hours and his pay changes.” Survey 5 (5/20/2025 13:55:35), Consumer from Arverne.

“They are forcing assistants to work hours for free. I could be finishing cleaning up [a] soiled client due to incontinence for example and go over my hours and they WILL NOT pay those hours worked. It’s not like I’m going to leave the client filthy as that’s insensitive and could lead to hospitalization for skin breakdown.” Survey 6 (11/20/2025 15:06:59), Personal Assistant from Marion.

“I have lost 100 hours of Paid Time Off because I was forced to switch to PPL as my FI [fiscal intermediary]. No other reason!” Survey 1 (4/10/2025 11:00:45), Personal Assistant from Rensselaer.

“Due to the transition I’ve lost my 52hrs of pto.” Survey 2 (4/18/2025 17:55:32), Personal Assistant from Amsterdam.

“We also still have no way of claiming PTO, and no response from PPL.” Survey 3 (4/26/2025 15:52:57), Personal Assistant from Clyde.

“Due to the transition I’ve lost my 52hrs of pto.” Survey 2 (4/18/2025 17:55:32), Personal Assistant from Amsterdam.

“We also still have no way of claiming PTO, and no response from PPL.” Survey 3 (4/26/2025 15:52:57), Personal Assistant from Clyde.

“The Time4Care app takes so long to log into that I went over by 1 minute on 2 occasions. Then PPL paid me 15 minutes for each 1 minute over, isn’t this Medicaid Fraud? I can only work 28 hours, yet they paid me for 28.5[.]” Survey 2 (4/18/2025 15:26:19), Personal Assistant from Huntington.

“I am being overpaid. Anytime my punches are even 1 minute past a full hour or half hour, they round up to the next full hour. Example: punched in at 4:59 and out at 9:01 - I was paid for 5 hours. Are they billing Medicaid for 5 hours, not 4? Both weeks, my paystubs show 16 hours; the auth[orization] for my [CDPAP] participant is for 14 [hours.]” Survey 3 (4/25/2025 10:19:56), Personal Assistant from Corfu.

“Sign in [and] out has to be to the second or consumer [loses] 15 minutes or 1 unit so not fair[.]” Survey 3 (4/26/2025 14:04:01), Personal Assistant from Morrisonville.

“The other confusion is with the app being in units and having to clock in at exactly the right time. I put in more hours than my consumer is approved for. With [my prior fiscal intermediary] Freedomcare’s system I would clock in and out when I arrived and when I left. Freedomcare only paid for the approved hours and that was helpful because I could lose track of the time. I’m confused about these ‘units’ and what happens if I am supposed to work for 5 hou[rs] but stay [] for 8 and then clock out.” Survey 4 (5/2/2025 12:08:36), Personal Assistant from Huntington.

“PPL is rounding Medicaid Increments to full hours! My personal example… I worked a shift of 11.12 hours, 44 billable units… PPL paid me for 12 hours and claimed 48 billable units. This is Medicaid Fraud, Waste and Abuse!!! They are overcharging Medicaid for services delivered!” Survey 4 (5/2/2025 21:33:01), Personal Assistant from Rochester.

“I am in the system as an hourly worker and I am concerned about being even a minute over clocking out in case they round up to a full hour like they did the first week I worked. I believe they are committing Medicaid and payroll fraud.” Survey 4 (5/5/2025 14:28:01), Personal Assistant from Sodus Point.

“Also it appears that even though we are watching clock ppl is shaving time on 2 days. Ppl said they pay every 15 min that’s why. That [is] illegal.” Survey 5 (5/20/2025 13:55:35), Consumer from Arverne.

“I was overpaid due to the way [PPL] round[s] up their hours[.]” Survey 5 (5/17/2025 11:34:01), Personal Assistant from Remsen.

“It seem[s] they are rounding down the hours to the closest hour, cutting off 20-30 min if punched in 20-30 before the hour. Generally cutting paycheck by 1 to 2 hours.” Survey 5 (5/19/2026 13:26:25), Personal Assistant from Saugerties.

“There’s no oversight. There’s no recourse. Phone numbers, emails are all dead ends.” Survey 3 (4/25/2025 19:51:33), Designated Representative from Millbrook.

“I have been waiting for almost two months for thousands of dollars that I’m owed retroactively and PPL payroll can’t seem to figure out how to do simple math. I’ve called and emailed multiple times a week for 8 weeks and NEVER get a response. There is no way to contact payroll dept directly and nobody knows how to get my pay corrected.” Survey 6 (11/20/2025 22:58:10), Personal Assistant from Farmingdale.

“… I had 87 calls unanswered and never returned and dozens of emails never answered still to this day!” Survey 6 (11/21/2025 7:31:52), Personal Assistant from Gloversville.

“I used to be able to call or text my FI [fiscal intermediary]. They knew me and made sure our caregivers were paid on time and treated with respect. Now when issues arise, like onboarding a new caregiver (which had taken over 2 months) I have to go to my legislator and ask for their liaison to assist. That is crazy and should be needed for everyday routine FI duties.” Survey 6 (12/1/2025 12:11:59), Designated Representative from Hilton.

“Inconsistent policy depending on which rep I happen to get on the phone. PPL’s HR & Payroll contradict each other often.” Survey 6 (11/20/2025 16:37:36), Personal Assistant from Brooklyn.

“Everyone you speak to…if you can…has a different answer.” Survey 6 (12/2/2025 18:36:11), Personal Assistant from Rochester.

“Trying to speak with [PPL] representatives has been very difficult. You never receive callbacks for problems. I was told by one particular representative that I would have to figure out a problem by myself. They are unable to re-issue a check that was lost in the mail. They said they don’t have a payroll department and they don’t have supervisory staff. They have no number for payroll to correct any problems. This problem dates back to my very first check[.]” Survey 3 (4/25/2025 13:27:11), Personal Assistant from Hicksville.

“The stress it has caused the consumer and myself as we tried to navigate their system and were told an IT rep would call us back and never did for 2 months!” Survey 4 (5/2/2025 13:10:11), Personal Assistant from St. James.

“My aide is still not able to register. So I am stuck with no services. … No one [at PPL] answers the phone or calls [my aide] back.” Survey 1 (4/9/2025 18:25:30), Consumer from Buffalo.

“I went 3 and a half months without pay and was unauthorized on PPL while I still had to take care of [my consumer].” Year 6 (12/2/2025 17:57:44), Personal Assistant from Sherburne.