In 1973, a group of individuals with severe disabilities, joined together to find a solution to the way they were receiving care. At that time, these individuals had no suitable alternatives available other then the traditional approaches of institutionalization, such as a nursing home or hospital. Others could go home with no support from government, with the help of a family member willing to care for them.

From this group of disabled individuals a model for what is now referred to as the Consumer Directed Personnel Assistance Program (CDPAP) was developed. It would be the cornerstone of a program that recognizes that disabled individuals have the ability to choose their own caregivers and to direct their own home care services.

Since inception, the Board of Directors have insisted that the dignity of the human spirit and personal choice be the core component of the Concepts program. Concepts has become a symbol of hope and strength to people with disabilities around the United States and in other countries.

In order to satisfy the concerns of Medicaid regulators related to payroll and benefit administration, Concepts created a corporate structure that would receive Medicaid funds on behalf of qualified Medical Assistance recipient, who voluntarily agreed to manage their own home care responsibilities. Concepts would then pay out those same funds to the caregivers in the form of wages, wage differentials and fringe benefits.

In 1980, Concepts began providing service to four (4) consumers with the understanding that the program would have to grow. During that first year, Concepts successfully passed the initial test by enrolling more than one hundred (100) consumers and continued to grow slowly, serving only self-directed consumers requiring personal care from 1980 to 1992.

After this time period, two major policy events spurred even more growth in the program. During the period 1992 to 1995, Concepts was involved in the evolution of the Consumer Directed Personal Assistance Program in New York State. Concepts’ Consumers were active proponents in movements that resulted in the:

• Modification to the New York State Nurse Practice Act, this enabled Concepts to provide services to people with higher service needs, such as: tracheal suctioning, ventilator support, catheter care, and injections. Changes to the Act permitted consumers to manage the responsibility of overseeing their own high level services.
• Creation of the new Section 367-p of the New York State, Social Services Law, which states that “…each local district shall ensure access to a Consumer Directed Personal Assistance Program operated pursuant to section 365-f of this title is available in this district to allow persons receiving home care pursuant to this title to directly arrange and pay for such care.”

Concepts demonstrated that the Consumer Directed Personal Assistance Program, which Concepts exclusively administered, was saving the New York State Medicaid program millions of dollars.

In addition, the State added a new category of consumer, thus permitting the program to begin to serve non-self-directing consumers with surrogates.

Today New York State Medicaid funds Concepts through a contract with the City of New York, Human Resources Administration. We presently serve over 1,200 Consumers, who employ over 3,000 Personal Assistants.

Concepts has been able to use its growth to help the program attract better benefits for the Personal Assistants and provide more effective recruitment and retention supports for consumers, with negligible increases in per hour cost.