The Work We Do: Homecare members

April 10, 2024

The Consumer Directed Personal Assistance Program (CDPAP) in New York State has allowed thousands of individuals with disabilities who rely on Medicaid to live independently and with dignity in their own homes, with the support of a caregiver of their choice.

But in 2012, in an effort to streamline services and save money, New York brought its entire Medicaidfunded home care program under the Managed Long-Term Care system [MLTC]. Instead of cutting costs, this program has instead allowed health insurance middlemen to extract billions of dollars in profit out of the homecare system.

In March, four of the largest MLTC insurance companies reported exorbitant profits of more than $18 billion for 2023.

Rather than address the real driver of homecare cost increases—excessive insurer profits and administrative costs—as the 1199 Magazine was going to press, Governor Kathy Hochul was planning to target home care workers and consumers instead. Her budget proposal would cut the wages of CDPAP workers by more than $2.50 an hour—a cruel blow to their livelihoods which would make it even more difficult for home care consumers to hire the help they need.

The Home Care Savings & Reinvestment Act introduced in Albany this year is designed to stop profit-driven insurance companies from ripping off home care consumers and taxpayers. It also opposes cuts to home care worker pay in the state budget. This legislation will generate $3 billion in savings annually. That money could be used to pay for growing home care needs, and ensure continuity of care by funding higher wages for home care workers to help resolve New York’s worstin-the-nation home care worker shortage. The 1199 Magazine caught up with some CDPAP members in Albany as they lobbied their elected representatives to support this legislation and protect their wages.

1199 Mag Homecare members stacked 1.png1. The Moronta family has always been tight-knit. When they moved to New York, Adalgisa Moronta initially stayed in the Dominican Republic to finish her university studies in Computer Science before reuniting with her family in 2011. When her brother Felipe developed diabetes and lost most of his sight, she joined the CDPAP program to look after him.

“She saved my life,” Adalgisa's brother says. “My blood sugar was so low, that I fell out of bed, barely conscious. She heard me fall and gave me juice. I don’t know where I would be without her. We cannot afford any cut in her wages. Rent, electricity, and food are all too expensive as it is.”

2. Elsa Mendoza is an 1199 CDPAP member with the Elara agency in the Bronx. She has been looking after her uncle, who is blind, for seven years. Originally from Ecuador, she is now a U.S. citizen.

“Any decision to reduce our wages is completely illogical at a time when we are facing inflation in our rent, food prices and car costs,” Mendoza says. “The governor has no idea what it is like to live in New York City. At the same time, they are taking money away from us, the insurance companies are banking billions of dollars. It is blatant robbery."

1199 Mag Homecare members stacked 2.png3. Zwinda Flores has been looking after her mother Idalia Bonet for the past 18 months. Flores moved to New York from Puerto Rico in 1983, and was an 1199 home health worker with Cooperative for 24 years. When her mother suffered a stroke in 2018, the family decided she would be better off living in New York, too.


Flores learned about the CDPAP program and realized that she was the best person to look after her mother.

“She feels better with someone from the family taking care of her,” Flores says. "She has a speech problem, but I know what my Mom needs. Before we joined the program, she often called me or my daughter for help.

“I treat caring for her like a job, but I’m not just doing it for the money. If someone from the outside can do it, I can do it. Any cut to my pay will hurt not just me — it will hurt my mother too.”

4. Akira Hope, an 1199 home care worker from Queens has been in the field since 2008. She travelled to Albany to speak at an 1199 press conference about the need for reform of the MLTC payment system.

“I care about people,” she says. “Can you imagine? Last year Molina reported $1 billion in profits…for Centene it was $2.7 billion…and Elevance banked $5.9 billion. This has got to stop.”

Hope called on Governor Hochul to do better for home care workers and consumers by supporting The Home Care Savings & Reinvestment Act.

1199 Mag Homecare members stacked 3.png

5. Caring for her mother for the past six years, Ileana Chinchay, went to Albany to urge state legislators to oppose Governor Hochul’s wage cuts.

“It would hit us really hard,” Chinchay says. “There are five people in our household, and paying for groceries and utilities is already a struggle. I’m paid for 32-hours, but I work 24/7. Governor Hochul should meet with us and see what we deal with on a daily basis. She’s always talking about mental health, and my mother has a mental health diagnosis. It’s hard right now. If [Governor Hochul] cuts our pay, it’s going to be dire. I voted for her. I want her to know that if I support you, I want you to support me back.”

6. CDPAP members are not just in NYC. Chicquita Callaway travelled from Buffalo to Albany to make her voice heard. She began looking after her late mother with the CDPAP program in 2018.

“I have done this work for close to 30 years because people need us — whether they are our family members or not,” Callaway says.

“Despite having had two strokes, I keep showing up no matter what. I’m skipping doctors’ appointments because I cannot always afford the copays. And while I must choose between paying for a doctor’s visit, or making my car note, or paying rent — the State of New York is giving away billions to these greedy insurance corporations.”