About 190,000 caregivers in New York's Consumer Directed Personal Assistance Program (CDPAP) would be represented by 1199SEIU United Healthcare Workers East if a union election they have requested passes. The workers filed with the National Labor Relations Board to hold the election, Home Health Care News reported on Sept. 24, 2026.
In CDPAP, people who need care use Medicaid to hire and direct their own aides, often friends or relatives. The union says it collected well over the 30 percent of worker signatures needed to trigger an election. The NLRB will now work with the union and the employer, Public Partnerships LLC (PPL), to set the rules and timing.
Why workers are organizing
PPL became the program's single statewide fiscal intermediary in 2025. According to the union, workers want to organize because of problems since that switch, including insurance disruptions and administrative hurdles. The transition has also brought lawsuits and protests. In July, a federal judge gave preliminary approval to a $162 million class-action settlement for roughly 200,000 CDPAP workers. PPL has said it has saved New York taxpayers more than $1 billion.
Why this matters for providers and DSPs
This would be one of the largest organizing efforts ever among Medicaid-funded home care workers, and other states are watching self-directed programs closely. For agencies and self-directing families, it shows how payroll and administrative problems can turn into workforce unrest. For caregivers, it's a reminder that pay and benefits in these programs mostly come down to state funding decisions.