CDPAP Unionization Faces Federal Legal Challenge Over PPL's Employer Status
New York's controversial restructuring of the Consumer Directed Personal Assistance Program (CDPAP) is facing another significant legal challenge, this time involving the effort to unionize approximately 190,000 personal assistants across the state.
On October 14, 2026, the National Right to Work Legal Defense Foundation announced that a Buffalo-area CDPAP caregiver had filed unfair labor practice charges against Public Partnerships LLC (PPL) and 1199SEIU United Healthcare Workers East, along with a motion to intervene in the union's pending representation proceedings before the National Labor Relations Board (NLRB).
The filings raise a fundamental question that Marton Care has previously addressed: Who is actually the employer of a CDPAP personal assistant—the consumer receiving care or the fiscal intermediary processing the caregiver's payroll?
That question is now central to a federal labor dispute with potentially far-reaching consequences for New York's consumer-directed home care program.
The challenge also raises allegations concerning cooperation between PPL and 1199SEIU, the appropriateness of placing approximately 190,000 caregivers into a single bargaining unit, and whether federal labor law permits the proposed statewide arrangement.
These are pending legal challenges, not final findings of wrongdoing. Nevertheless, they raise important questions about how New York's CDPAP program has been reorganized and who ultimately controls the employment relationship between consumers and their chosen caregivers.
A Buffalo Caregiver Challenges the Unionization Effort
According to the National Right to Work Legal Defense Foundation, Elena Rizzo, a personal assistant who provides care to her fiancé through CDPAP, has filed unfair labor practice charges and requested permission to intervene in the NLRB proceedings.
Her legal challenge concerns the unionization petition filed by 1199SEIU on September 22, 2026.
The petition seeks a representation election involving an estimated 190,000 CDPAP personal assistants, with PPL identified as their employer.
Rizzo's attorneys challenge that premise.
They argue that CDPAP personal assistants are employed by the individual Medicaid consumers who select them, rather than by PPL, which performs administrative functions as the state's designated fiscal intermediary.
Her charges further allege that PPL provided unlawful assistance to 1199SEIU in obtaining support for its unionization petition and that the union requested and accepted that assistance.
The motion to intervene seeks to give Rizzo a voice in proceedings that could ultimately determine whether she and thousands of other caregivers become subject to exclusive union representation.
The NLRB will have to evaluate the relevant legal arguments and evidence. The filing of charges does not establish that PPL or 1199SEIU violated federal labor law.
The Employer Question: Something Marton Care Previously Explained
On September 28, 2026, Marton Care published an article titled "New York CDPAP Caregivers Seek a Union Election: What Happens Next?" (https://www.martoncare.com/post/new-york-cdpap-caregivers-seek-a-union-election-what-happens-next).
In that article, we explained an important distinction between the traditional CDPAP model and the employment arrangement adopted by PPL.
Before New York consolidated CDPAP fiscal intermediary services under PPL on April 1, 2025, hundreds of independent fiscal intermediaries operated throughout the state.
Marton Care was one of them.
Marton Care operated as a non-joint-employer fiscal intermediary.
Our responsibilities involved administering the program, including payroll processing and related administrative functions. The consumer or designated representative remained responsible for selecting, training, scheduling, supervising, and directing the personal assistant.
Marton Care did not assume a joint-employer relationship with those caregivers.
Other former fiscal intermediaries may have operated under different employment arrangements. Their legal status depended on their actual responsibilities and circumstances.
When PPL became the statewide fiscal intermediary, its agreement with consumers expressly described PPL as a joint employer of personal assistants.
That distinction is significant.
Under PPL's stated arrangement, the company presents itself as an employer capable of participating in collective bargaining with a union representing CDPAP personal assistants.
Under Marton Care's former non-joint-employer model, the fiscal intermediary did not occupy that same bargaining position.
The legal challenge announced today directly disputes whether PPL's asserted employer status is legally justified.
A contractual declaration of joint employment is relevant, but it does not necessarily settle the question under federal labor law. The actual degree of control over employment terms and the applicable legal standards also matter.
The NLRB must determine whether the proposed bargaining arrangement satisfies the National Labor Relations Act.
This is precisely why the distinction between a fiscal intermediary and an employer cannot be overlooked.
Can 190,000 Caregivers Be Represented Under One Statewide Contract?
The proposed union election would involve one of the largest groups of consumer-directed personal assistants in New York.
According to 1199SEIU's earlier announcement, nearly 70,000 personal assistants signed authorization cards supporting an election involving approximately 190,000 caregivers.
However, support for holding an election is not the same as a vote to unionize.
No statewide union has been certified through this petition, and no collective bargaining agreement has resulted from it.
The legal challenge now asks whether these caregivers can appropriately be grouped into one bargaining unit when they provide services in thousands of individual homes, under the direction of separate consumers and designated representatives.
This creates several important questions.
Who determines the caregiver's schedule?
Who selects the caregiver?
Who provides the necessary training?
Who supervises the caregiver's daily responsibilities?
Who decides whether a caregiver should continue working for a particular consumer?
And most importantly, who has sufficient authority over the employment relationship to bargain collectively over its terms?
Under CDPAP, consumers retain substantial responsibility for choosing and directing their personal assistants.
PPL, meanwhile, administers payroll and other program requirements and asserts a joint-employer role.
The question is whether that combination supports the statewide bargaining unit requested by 1199SEIU.
A union election cannot resolve every underlying legal issue merely by taking a vote. The NLRB must first address the employer and bargaining-unit questions presented in the representation proceeding.
Allegations of Cooperation Between PPL and 1199SEIU
Another important aspect of today's development involves the relationship between PPL and 1199SEIU.
The National Right to Work Foundation alleges that the two organizations cooperated through an organizing agreement connected to the transition of CDPAP fiscal intermediary services.
According to the Foundation, this relationship raises questions about whether PPL improperly assisted the union in obtaining support for its representation petition.
The Foundation has also argued that because PPL and 1199SEIU are not necessarily adversarial in the representation proceeding, caregivers who oppose the proposed arrangement should have an opportunity to present their own arguments.
This is a particularly important distinction.
Normally, an employer and a union may have different positions concerning a representation petition, bargaining-unit composition, or employment status.
When the employer named in a petition supports the unionization process, questions can arise about whether the interests of workers who oppose representation are adequately presented.
That does not mean cooperation between an employer and a union is automatically unlawful. Federal labor law permits certain forms of employer neutrality and lawful cooperation.
The relevant legal issue is whether the conduct alleged in the charges crossed the line into prohibited employer assistance or interference.
Those allegations must be evaluated through the NLRB's established procedures.
The Larger Controversy Surrounding PPL's Statewide CDPAP Contract
Today's development does not occur in isolation.
It comes after New York fundamentally changed the administration of CDPAP, replacing a system involving hundreds of fiscal intermediaries with a single statewide fiscal intermediary.
PPL assumed that role on April 1, 2025.
The transition eliminated the ability of hundreds of former fiscal intermediaries, including Marton Care, to continue serving consumers under their previous arrangements.
The state's decision has generated extensive debate over consumer choice, administrative efficiency, caregiver payments, access to services, and the concentration of administrative responsibility within one company.
The federal government has also challenged aspects of PPL's selection.
In June 2026, the U.S. Department of Justice filed a lawsuit alleging fraud connected to the process through which PPL obtained the statewide fiscal intermediary contract.
Those allegations remain subject to litigation and should not be treated as established findings.
The National Right to Work Foundation has cited the federal lawsuit in its arguments that the NLRB should carefully examine the proposed unionization arrangement.
It previously asked the NLRB to pause the representation proceedings, permit additional legal briefing, and consult with the U.S. Departments of Justice and Health and Human Services.
The Foundation argues that the employment and unionization questions may intersect with federal Medicaid requirements and the legal responsibilities of consumer-directed programs.
These are separate legal proceedings, but together they demonstrate the continuing controversy surrounding New York's CDPAP restructuring.
What Happens to Consumer Choice?
At the center of CDPAP is a principle that should not be lost in the legal arguments: the consumer directs their own care.
CDPAP was designed to allow people who need assistance with daily living to choose individuals they know and trust.
Those caregivers are frequently family members, friends, or other individuals with an established relationship with the consumer.
This is not always comparable to a traditional workplace where employees report to a common supervisor at a single business location.
Care takes place inside private homes.
Consumers may require assistance with bathing, dressing, eating, mobility, medication-related tasks permitted by the program, and other highly personal activities.
For many consumers, the relationship with their caregiver is essential to their independence, dignity, and safety.
That is why Marton Care has consistently emphasized that consumer direction must remain central to the program.
Union representation does not automatically eliminate consumer choice or the consumer's legal responsibilities under CDPAP.
However, a statewide collective bargaining agreement could introduce negotiated employment terms that interact with the existing consumer-directed structure.
The exact effects would depend on the legal authority of the bargaining parties, the terms of any future agreement, and the consumer protections that remain in force.
Those questions deserve careful consideration before a statewide bargaining arrangement is implemented.
What Could Unionization Mean for Caregiver Wages and Dues?
1199SEIU has identified improved wages, health benefits, paid time off, education opportunities, and stronger worker representation as objectives of its organizing campaign.
Those are legitimate issues for caregivers to consider.
Personal assistants deserve fair compensation, reliable payroll administration, and respect for the important services they provide.
However, union certification would not automatically produce higher wages or additional benefits.
If 1199SEIU were certified, collective bargaining would generally follow, and any resulting changes would depend on negotiations and applicable law.
There is also the question of union dues.
New York does not have a right-to-work law prohibiting union-security agreements in employment relationships covered by the National Labor Relations Act.
Depending on the applicable legal framework and any future collective bargaining agreement, certain financial obligations could potentially become a condition of employment.
That possibility does not mean that union dues would automatically become mandatory upon certification, or that every caregiver would necessarily be required to join the union.
The distinction matters, particularly because CDPAP personal assistants are paid through a Medicaid-funded program.
Caregivers deserve accurate information about potential dues obligations, how any deductions would be authorized, and what rights they would retain.
Marton Care's Previous Position: Why We Urged Caregivers to Vote No
On September 28, 2026, Marton Care also published an opinion article titled "Why Marton Care Urges a No Vote in the Proposed CDPAP Union Election" (https://www.martoncare.com/post/why-marton-care-urges-a-no-vote-in-the-proposed-cdpap-union-election).
Our position was based on the importance of preserving consumer-directed care.
We acknowledged that unions have helped many workers obtain better wages, benefits, and working conditions.
We also emphasized that the CDPAP model is different from traditional agency employment.
The consumer, not an outside organization, should remain at the center of decisions about personal care.
We raised concerns about a bargaining arrangement in which large organizations negotiate employment conditions affecting hundreds of thousands of individual caregiving relationships.
We also expressed concern about the possibility of service interruptions and the consequences they could have for vulnerable consumers.
Those concerns do not mean that unionization necessarily results in service interruptions or the loss of consumer authority.
They mean that the consequences of statewide collective bargaining deserve careful examination.
Today's legal challenge reinforces why we believe caregivers should understand the proposed employment structure before voting.
Our position remains that consumer direction, caregiver rights, and reliable access to care must be protected.
What Happens Next at the NLRB?
The NLRB must now address the pending representation proceeding and the legal issues raised by the new filings.
The motion to intervene asks that Elena Rizzo be permitted to participate in the case and present arguments challenging the proposed arrangement.
The unfair labor practice charges raise separate allegations about the conduct of PPL and 1199SEIU.
The NLRB's handling of those matters will determine what procedural steps follow.
Possible developments include additional hearings, legal briefing, rulings concerning the proposed bargaining unit, or further proceedings involving the unfair labor practice allegations.
The new filings do not themselves cancel the election petition, establish unlawful conduct, or invalidate PPL's contractual claim to joint-employer status.
Any election schedule or procedural changes should be confirmed through official NLRB records.
The underlying representation proceeding can be followed through "NLRB Case No. 03-RC-395461" (https://www.nlrb.gov/case/03-RC-395461).
What Should CDPAP Caregivers and Consumers Know Today?
For now, the legal filings do not change existing CDPAP care arrangements.
Consumers and designated representatives continue to have their established responsibilities under the program.
Caregivers should continue following applicable registration, payroll, and timekeeping requirements.
Those interested in the unionization proceeding should follow official NLRB updates, review information from the parties involved, and understand their rights before making decisions.
Caregivers who oppose the proposed unionization effort can also review the "National Right to Work Foundation's special legal notice for New York CDPAP personal assistants" (https://www.nrtw.org/nycare/).
The Foundation offers legal assistance to qualifying caregivers challenging compulsory union representation.
Our Perspective: CDPAP Must Remain Consumer Directed
Marton Care served thousands of CDPAP consumers and caregivers before New York eliminated the former fiscal intermediary structure.
We understand firsthand the responsibilities involved in administering consumer-directed services and the importance of maintaining dependable relationships between consumers and caregivers.
The current dispute highlights a concern we have raised before: administrative responsibility should not be confused with the consumer's authority to direct care.
The distinction between a fiscal intermediary and an employer is not merely a technical legal issue.
It affects who has the authority to negotiate employment conditions, how caregivers are represented, and how consumer direction is preserved.
PPL's contractual claim to joint-employer status and the legal challenge to that status deserve careful, independent review.
The NLRB must apply federal labor law to the facts, rather than assume that a statewide administrative arrangement automatically creates an appropriate statewide bargaining unit.
New York's CDPAP program exists to serve people who need care.
Its administrative structure, employment relationships, and collective bargaining arrangements should ultimately support that purpose.
Caregivers deserve fair compensation and meaningful rights. Consumers deserve the ability to direct their own care. Neither principle should be sacrificed in the name of administrative consolidation.
Marton Care will continue following these proceedings and reporting developments affecting New York's CDPAP consumers and personal assistants.
Sources and Further Reading
- "National Right to Work Foundation — October 14, 2026: NY Home Care Provider Files Unfair Labor Practice Charges and Motion to Intervene" (https://www.nrtw.org/news/new-york-caregiver-files-motion-seiu-ppl-10142026/)
- "National Right to Work Foundation — Special Legal Notice for CDPAP Personal Assistants" (https://www.nrtw.org/nycare/)
- "National Labor Relations Board — PPL Representation Case 03-RC-395461" (https://www.nlrb.gov/case/03-RC-395461)
- "Marton Care — New York CDPAP Caregivers Seek a Union Election: What Happens Next?" (https://www.martoncare.com/post/new-york-cdpap-caregivers-seek-a-union-election-what-happens-next)
- "Marton Care — Why Marton Care Urges a No Vote in the Proposed CDPAP Union Election" (https://www.martoncare.com/post/why-marton-care-urges-a-no-vote-in-the-proposed-cdpap-union-election)
- "New York State Department of Health — CDPAP Overview" (https://www.health.ny.gov/health_care/medicaid/program/longterm/cdpap/)
