New York CDPAP Caregivers Seek a Union Election: What Happens Next?
New York’s Consumer Directed Personal Assistance Program (CDPAP) may be heading toward a statewide union election. According to 1199SEIU, nearly 70,000 personal assistants signed authorization cards supporting an election that could cover approximately 190,000 caregivers. The union has filed an election petition with the National Labor Relations Board (NLRB). No vote has taken place, and no new statewide union contract is in effect.
The proposed election brings attention to an important feature of CDPAP: the division of responsibilities between the person receiving care and the organization administering the program. It also highlights a significant difference between how Marton Care operated as a former fiscal intermediary and how the current statewide fiscal intermediary, Public Partnerships LLC (PPL), describes its role.
How does CDPAP work?
CDPAP allows eligible New York Medicaid members to choose their own personal assistants. The member, or a designated representative, recruits, trains, schedules, and supervises the caregiver. The program gives people receiving care a direct role in deciding who assists them and how that assistance is provided.
A fiscal intermediary (FI) handles administrative functions associated with the program. Before April 2025, hundreds of separate FIs operated in New York. Marton Care was one of them. Since April 1, 2025, PPL has been the state’s single statewide CDPAP FI.
How did Marton Care operate under the former system?
Marton Care operated as a non-joint-employer fiscal intermediary. In that model, Marton Care performed FI administrative duties while the CDPAP member or designated representative selected and directed the personal assistant. Marton Care did not take on a joint employer role with the consumer.
Marton Care was among hundreds of FIs in the former system, but those organizations did not necessarily have identical employment arrangements. Whether a particular FI acted as a joint employer depended on its own role and the applicable facts. It would be inaccurate to classify every former FI as either a joint employer or a non-joint employer simply because it participated in CDPAP.
That distinction mattered for union organizing. A union needs an employer with whom it can bargain over the workers’ terms and conditions of employment. A non-joint-employer FI performing administrative services would not occupy the same bargaining role as an FI that acted as a joint employer. The former system did include CDPAP workers who joined unions; for example, 1199SEIU announced in 2021 that nearly 6,000 personal assistants associated with Concepts of Independence had joined.
What is different about PPL?
PPL’s agreement with CDPAP consumers expressly states that PPL serves as a “joint employer” of their personal assistants. PPL also says that, if a union is certified to represent CDPAP personal assistants, it would bargain with that union over wages, hours, and other employment conditions.
PPL’s stated role differs from the non-joint-employer model Marton Care used. Combined with PPL’s position as the single statewide FI, it provides a common bargaining counterpart for the large group of caregivers covered by the proposed election. Consumers and designated representatives still retain their CDPAP responsibilities for choosing, training, scheduling, and directing their personal assistants.
What happens next in the union election process?
The NLRB must address the election arrangements, including which workers are eligible to vote. Filing a petition starts this process; it does not certify the union. If an election is held, representation is decided by a majority of the votes cast.
If workers vote for representation and the union is certified, collective bargaining with PPL would follow. Certification would not automatically create a contract or change wages and benefits. Those terms would have to be negotiated.
1199SEIU says it wants to pursue better wages, health benefits, paid time off, education opportunities, and a stronger voice for caregivers. These are the union’s stated goals, not changes that have already taken effect.
What does this mean for CDPAP families today?
The election filing itself does not change a member’s caregiver, authorized hours, or care plan. Members and designated representatives should continue following their current care arrangements. Personal assistants should continue using the required registration and timekeeping processes.
For questions about CDPAP administration or payment, the New York State Department of Health directs members and caregivers to PPL at 1-833-247-5346. Workers should look for official information about any election date, voting method, and eligibility.
Marton Care served CDPAP families as a non-joint-employer FI before New York’s statewide transition in April 2025. We understand the importance of preserving a member’s ability to choose trusted care and of ensuring that caregivers are paid accurately and on time. We will continue to follow the proposed election and report confirmed developments that affect CDPAP members and workers.
