Host:  Welcome to Independent Perspective, a public affairs presentation of Western New York Independent Living (WNYIL). Our guest today is Todd Vaarwerk, Chief Policy Officer of WNYIL, and your host is yours truly Ernie Churchwell. Welcome to the program, Todd.

Guest:  Always good to be here.

Host:  And I believe since you always have your finger on the pulse of everything in the political sphere, you have some information on what's happening with Consumer Directed Personal Assistance.

Guest:  Well, for those people out there that might not necessarily know what the program is, Consumer Directed Personal Assistance Services (CDPAS) are a way for you to hire, if you're Medicaid eligible, you to hire the people that do the home health care in your home. Agencies in the community act as employers of record. So, they make sure that we've dotted all the i's and crossed all the t's on the paperwork, but you become the day to day supervisor of the person who provides services in your home. It's a very popular program, there's a lot of cost savings that go with the program and the program is currently under attack.

Host:  Would you say that consumer directed makes a big difference compared to the traditional way, just involving the nursing organization?

Guest:  Absolutely, with the traditional system, the person that comes to your house doesn't work for you, they work for the agency that has your case. So, if you've got a complaint about something that happens with that person, you've got to complain to the agency, and whether or not they do anything about it, is a completely different story. So, what we have happening right now is the fact that the government wants to move the way fiscal intermediaries are paid to do the work they do. Now these are the people that not only handle all the financial end but handle the paperwork and with Department Health, do all the Medicaid oversight and the fraud waste and abuse pieces that come with the Medicaid program, as well as training and support for supervisors to make sure that the aides do what it is that they're supposed to do. When you move to a capitated payment system, the fiscal intermediaries are at risk because they can't continue to employ the people that actually help them run the program

Host:  For the benefit of our listeners when you say a capitated program does that place limits that currently aren't there?

Guest:  Right, well instead of paying a percentage of the hourly rate, and then it's basically indexed by the amount of hours somebody has per week. The state has wanted to move to what's called a per member per month system which is, no matter how many hours a week you get, you're going to the agency that provides services to you is going to get paid $64. You can't run a program on essentially $64 a head.

Host:  Hmm. So, what is the state's suggestion for how fiscal intermediaries can function with this cut?

Guest:  No, the state doesn't have a suggestion. However, at this point, the reason why I'm on the show is because I want consumers of the program to know that there is something that they can actually do about it that's really simple. Record a message with your phone, talk about how important your aides are to you. Talk about how important the fiscal intermediary you work with is for you and send that stuff to our Facebook page at WNYIL or to our Twitter feed at @WNYILinc, because we're going to take those things and put them together with some other folks statewide, and send that stuff to the governor and to the Department of Health, so that they know that consumers are paying attention to this issue.

Host:  When they talk about direct consumer input into the system in their own best self-interest that's independent living at its peak.

Guest:  Yes, it is.

Host:  And I'm sure that people are going to have a lot of questions on just how this all will work, how can they contact you to find out more?

Guest:  You can always call me 716-836-0822 extension, 101, or send a message to the Facebook page and tell them you want to talk to me, they'll let me know.

Host:  Is there a particular deadline that people should do this by?

Guest:  I would do it as soon as possible because they're looking at making the change on September the first. I don't think that the battle will be over exactly on September the first but the more stories of this nature we have, the better off we are.

Host:  Thanks for being with us, Todd.

Guest:  Always a pleasure.

Host:  You've been listening to Independent Perspective, a public affairs presentation of WNYIL. Our guest today was Todd Vaarwerk, Chief Policy Officer of WNYIL and your host was yours truly, Ernie Churchwell.