New York State has recently faced its share of challenges, including Gov. Hochul’s 2025 budget and the effort to reduce Medicaid spending, which directly impact the state’s Consumer Directed Personal Assistance Program (CDPAP). It seems the only constant in the state is change.
Home Health Care News recently spoke with Special Touch Home Care CEO Evan Ostrovsky about the company’s 40-year history, serving 150,000 patients, its expansion into New York’s Consumer Directed Personal Assistance Program (CDPAP) as a fiscal intermediary, and how the company expects to grow amid these changes.
Below is that conversation, edited for length and clarity.
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HHCN: Let’s start with some background on yourself and Special Touch Home Care.
Ostrovsky: My father founded Special Touch in 1984. I started working for the company in the summer when I was about 15. When I finished graduate school in 2004, I started working full-time.
My approach was hands-on. I worked in different departments to comprehensively understand the company’s operations. I focused on recruitment and addressing urgent needs. Later, I oversaw all human resources, including recruitment and compliance for home health and personal care aides.
As CEO, my primary goal is to ensure the company’s daily operations run smoothly and efficiently. I am committed to addressing all patient needs and ensuring all departments operate at their best, and I’m constantly seeking ways to enhance and innovate our services. I am always exploring new technologies and processes to keep us at the forefront of home care.
About ten years ago, we began providing services as a fiscal intermediary through the CDPAP program, bringing exciting new things within the company.
We offer services in many languages and tailor our services to different cultures. Because New York City is a highly diverse city, it’s benefited us to serve those groups and make them feel as comfortable doing business with us as possible.
Outside of CDPAP, what service lines do you have? Do you do Medicare-certified home health care, or is it more Medicaid-based home and community services?
Most of our services are Medicaid and long-term care. We see a certain percentage of Medicare patients. Regarding lines of business, we are home care services, home health aides, and private-care attendants, so that’s what we’ve been doing since the company’s inception. We’ve added the CDPAP service, where we’re a fiscal intermediary.
We do some nursing to manage our services, primarily the home care service, but we bill for the home health aide, personal care aide and consumer-directed program.
Is there any private-pay element to the business?
We have a private-pay population, but it’s a small percentage of our overall services. Probably less than 5% of the company is private pay.
What is running a home care business in New York like right now?
Operating in New York is extremely rewarding. We know that we are making a difference in people’s lives. We allow them to stay in their homes instead of going to facilities. To that end, we do it because we love it.
In recent years, the business has faced challenges. A lot of that has to do with wage parity and mandates. We appreciate that, through those mandates, our caregivers are earning more money. Our caregivers have significant benefits, including health insurance and vacation time. When wage mandates kicked in, ensuring we had the reimbursement to cover those was challenging, but those came through.
Regulation changes improve the quality of care, patient safety and other aspects of our work. We appreciate the Department of Health’s efforts to improve the quality of care and the services we provide. After over 40 years of dealing with these issues, we handle new regulatory requirements well.
With CDPAP, you’re optimistic about the program and your involvement. Can you give us a breakdown of what things have been like within that program as a fiscal intermediary, and is it your plan to continue being one in the future?
We started offering fiscal intermediary services about ten years ago. Some patients switched from our home care services to the CDPAP program, so we started investigating and providing those services.
We’re proponents of this program. It allows people who might not otherwise be comfortable with home care services to get the care they need to help them live quality lives. It also gives people greater independence to select their caregiver and oversee their care. You may have situations where a client’s personal assistant can’t work anymore, and they’ll switch from CDPAP to home care service or vice versa. We need to be there for them on both sides. We don’t want patients to go elsewhere for services when we can provide them.
It’s been a fast-growing part of our business. It’s been fast growing in New York, and ever since we started, the Department of Health has implemented specific authorizations or approval programs. Because we are experienced, we were one of the 62 agencies initially approved for the program. Even though things could change at the last minute, we hope that changes will allow us to keep doing this business because we love it.
What do you think New York could do better for home care providers or beneficiaries? What would improve the state of home care in New York right now?
The state does a great job of offering good benefits. New York sees that not only is it highly appreciated by the patients because it helps them live a better life, but it is also a better alternative, even financially, than a nursing home or assisted living facility.
We like to focus on underserved groups who may not know the services exist or cannot find a company that can work with them in their language. Not too long ago, the state gave us some grant money, and we used that money to build up our language abilities. It requires a specific investment when you want to service a different language. You’ve got to translate everything into that language. You need employees to be able to work with the caregivers and patients. Grants for things like that help us serve underserved groups. That grant money also helped us offer bonuses for people who would travel from or to areas where it’s not as easy to get to. That may be a one-time thing, but we want to see things like that ongoing.
We also would like grant money to help with educational programs to offer to our employees to better care for our patients. The state has provided grant money to help us train caregivers to improve their skills, ability to care for people, cultural competency, etc. We would like to see more of that because it really does help. It makes caregivers feel more valued, helps them develop their skills and helps them better serve our patients.
You recently reached 150,000 patients cared for since the company’s founding. How do you plan to continue growing?
We’ve always put the patient first in our business, focusing on services and the diverse population of New York City. That’s what got us to where we are, and we want to continue that.
As far as what we’re looking to do going forward, we see that this is an aging population, and you have different people, maybe decision-makers for patients, looking in other places than they used to for care. We have put a lot of time and effort into our website to educate those people. We also created a new site for the CDPAP program that offers information to help them decide if it’s right for them and to help them reach out to us when they’re ready to do that.
We’ve placed information on social media channels for people looking for care for themselves, a family member or a friend. If they’re in the CDPAP program, they can get information there and reach out to us when they need assistance.
Internally, we’ve always focused on our hiring practices. My brother and I hire most of the office staff because it’s crucial to ensure we get the right people in place and continue to provide outstanding service.
In addition, we’re exploring expanding our geographic reach. We primarily offer in-home care services in New York City and Westchester, but we think it’s time to offer services throughout New York State. That requires licensing and adding new services such as therapy and nursing. We’re also looking to explore areas to add to our product offering to help us grow as a company.
Regarding geographic expansion and organic growth within your current markets, what do you see as the largest barriers?
When it comes to growing in different geographic areas, it’s always been essential for us to offer our services correctly. We don’t want to provide a service that is not as good as what we’re doing in New York City.
We’ve had a training program in New York City for a long time, which has helped us ensure that we have caregivers ready. When we moved to Staten Island, we started training and certifying caregivers there. By doing that, we quickly became one of the largest home care agencies in Staten Island.
Our goal of reaching new language groups and cultures is challenging, especially when it starts small. You need to devote resources, and that’s always challenging, but it’s a welcome challenge.
Do you feel as though your staffing situation has improved? If so, why do you think that is? Is it due to external factors, internal initiatives or both?
Interestingly, staffing was relatively easy for us in 2004 when I started recruitment without much advertising. Word of mouth, historically, has been almost all we’ve ever needed. Our only advertising was for hardship service areas and certain language groups.
COVID-19 made it more difficult. A lot of people were scared to go into a patient’s home, and staffing became challenging during that period. But as that ended, we’re back to where people walk into our offices throughout New York City looking to work for us. So, we’re back to where the only areas we might need to focus on are the challenging service areas and languages. Offering training programs is an advantage for us.
Do you feel like one of the untapped areas of opportunity you’ve been going after remains that language piece, where you are willing to go into these neighborhoods where there may be language barriers and train caregivers to service those clients?
We’ve been doing English, Russian, Spanish, and Chinese and have translated everything into those languages for a long time. There are still a lot of groups out there that have a hard time finding providers that can work with them in their languages. We do see that as an area of growth. If you become the agency that provides services to those people, that’s a great opportunity. We do that with our home care agency and also with CDPAP.
Is there a particular technology you feel you need to unlock in the future or a technology you have adopted recently that will soon become table stakes for providers?
I firmly believe we need to adopt the latest technology. Regarding reimbursement, there’s not a lot of extra money for overhead, so you want to do as much as you can with as little as you can and use technology to improve the experience of your patients and consumers.
We all jumped into online education during the COVID-19 pandemic. Now, we’ve improved our phone system with a voiceover IP system for more accessible communication between caregivers and patients in the company, and that is critically important as fewer people are showing up to the offices. Right now, we’re converting from paper to digital charts. That comes with the nurses having a direct connection to the office, which helps us react to any issues they might see quicker and complete paperwork more efficiently.
From my perspective, I’m looking for something that can automate our processes so we can focus on tasks that require a human touch, such as talking to patients and helping when issues arise. We see technology as a way to be more efficient and spend more time dealing with people.
What excites you most about Special Touch Home Care’s future?
I am proud of what we do to make a difference in people’s lives. This kind of senior care will only become a more significant issue as we look to the future. I’m excited to see what happens as the population ages and how we can better use our services to care for them. Our goal is to help patients live their best lives.
We’re looking forward to seeing the changes in the health system over time and how patient outcomes are improving. We’re also looking forward to devoting more time and effort to expanding our reach and the scope of our services.
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