With news of a conceptual budget agreement that includes drastic changes to the Consumer Directed Personal Assistance Program, we have serious concerns that potential reforms could lead to negative outcomes for New Yorkers and their families in the disabled and elderly communities that rely on this program. With a move to single fiscal intermediary, the state could single-handedly put small and medium-sized businesses that have been responsibly helping families for years out of business, with no guarantee of a seamless transition for consumers and caregivers by the state’s hand-picked operator. Rather than involve stakeholders in making common-sense reforms that would make the program more efficient and effective, save dollars, and eliminate the bad actors taking advantage of the CDPAP program, the state will seemingly move forward with a radical proposal negotiated in secret without the involvement of the people served by this important program and passed without a plan to ensure continuity of care.