What the Consumer Directed Personal Assistance Program in New York Is
The New York State Department of Health CDPAP guidance describes CDPAP as a Medicaid program. A plain-language overview from the New York Legal Assistance Group explains the same consumer-directed model. It is for people who already qualify for home care and want to hire their own personal assistant. The assistant can help with daily activities. In some cases, the assistant can also do tasks that a home health aide or nurse would usually do. The consumer, or a designated representative, has to train them for that work.
Consumer direction is the difference from agency-arranged care. In a typical agency model, the agency assigns the aide, sets the schedule within the approved hours, and supervises the work. In CDPAP, the consumer, or someone they choose to speak for them, recruits the assistant, trains that person, and supervises the day-to-day care. The required assessment evaluates functional need, and the managed care plan or local social services district applies program rules when authorizing services and hours.
CDPAP is also different from OPWDD self-direction. Self-direction is a pathway inside services for people with developmental disabilities. CDPAP is a Medicaid personal-assistance program. A family can be looking at both, but they are not the same application, the same budget, or the same set of rules. If a child or adult may need developmental-disability services, start with Amelia's OPWDD and special needs home care page, then ask which program actually fits.
Nothing on this page is legal, medical, or benefits advice. Program rules change, and a local district or managed care plan makes the individual decision.
Who May Qualify, and Who Decides
The Department of Health says a person seeking CDPAP must be eligible for New York Medicaid and have a stable medical condition. A state-approved assessment must also find a need for home care. The person must be able to direct their own care, or have a designated representative who can make those decisions. Being a New York resident, or having Medicaid, is not enough by itself.
For people age 21 and older, the Minimum Needs Requirements apply to initial Personal Care Services or CDPAP assessments on or after September 1, 2025 and to later reassessments. State guidance says the person must need at least limited assistance with physical maneuvering for more than two activities of daily living. If the person has a dementia or Alzheimer's diagnosis, the standard is at least supervision with more than one activity of daily living. People who were authorized or receiving Personal Care Services or CDPAP, or continuously enrolled in managed long-term care, as of that date may remain under legacy criteria when the applicable continuity requirements are met.
Activities of daily living are everyday tasks such as bathing, dressing, toileting, walking, or eating. "Limited assistance with physical maneuvering" is an assessment term. It means the person needs hands-on help to move through the task, not only a reminder. A nurse, a plan, or the New York Independent Assessor looks at the person's actual day. A family cannot score this at the kitchen table and treat the result as final.
Children and waiver programs follow different paths. State guidance notes that NHTD, TBI, and OPWDD comprehensive waiver services do not use that same independent assessment to decide waiver eligibility. If a referral is for a senior who may need Medicaid home care, or for someone who may fit an NHTD or TBI waiver, say so at intake. The right door depends on age, diagnosis, and which coverage is already active.
The People in a CDPAP Care Team
CDPAP feels confusing because several people share the work, and none of them is the single decision-maker. “Care team” is a plain-English label for the people involved in assessment, authorization, care direction, and payroll administration.
- Consumer: The Medicaid member who needs care. The consumer chooses, trains, and supervises the personal assistant, or asks a designated representative to do that. The consumer does not decide whether Medicaid authorizes services or how many hours are approved.
- Designated representative: A person who directs CDPAP on the consumer’s behalf when the consumer cannot self-direct. The representative may make hiring and supervision decisions but cannot also be the paid personal assistant.
- Personal assistant: A friend or allowed family member chosen by the consumer or representative. The assistant provides the approved hands-on support and follows the training and direction provided. The assistant does not set authorized hours or replace the required clinical order.
- Ordering clinician: The medical professional who supplies the required order or clinical information for the home-care process. This role is different from the person who completes the functional assessment.
- Assessor, managed care plan, or local district: The assessment process evaluates functional need. Depending on the person’s coverage, the managed care plan or local social services district applies program rules and authorizes services and hours. These parties do not choose the personal assistant or supervise the consumer’s daily direction of care.
- Statewide fiscal intermediary: Public Partnerships LLC (PPL). PPL handles payroll, required withholdings, benefits, and employment records. It does not decide medical need or provide the consumer’s day-to-day supervision.
The Department of Health says the consumer or designated representative must recruit, hire, train, and supervise the assistant. They can also end that working relationship if it is not working. They arrange backup coverage, coordinate other services, and keep payroll records. They work with the fiscal intermediary so the assistant is paid. That is a real job. Families who want consumer direction should plan for it before the first shift, not after a call-out.
For care managers, social workers, and hospital discharge teams, the useful handoff is concrete. Note who can self-direct, who would be the designated representative, which family members are willing to help, and whether Medicaid is already active. Amelia's intake can then tell the family which conversation to have next. That may be CDPAP, agency personal care, or another program. It is not a guarantee that CDPAP is the right fit.
What a Personal Assistant Can and Cannot Be
A personal assistant is the caregiver the consumer chooses. State rules allow a friend or a family member. They do not allow everyone. The Department of Health says the assistant cannot be the consumer's spouse or the designated representative. The parent of a CDPAP consumer who is under 21 is also barred. An adult child can sometimes be paid to help a parent. A parent cannot be the paid CDPAP assistant for their own minor child. Other programs, including some OPWDD self-direction arrangements, treat family caregivers differently. Do not mix those rules.
The work itself follows the approved plan. The Department of Health says CDPAP can cover help that a personal care aide, home health aide, or nurse would normally give. That is only true when the consumer has that level of need and the assistant is trained for it. Day to day, the work often looks like the support on Amelia's companion and personal care page. That includes bathing, dressing, meals, mobility, and being present safely at home. Skilled tasks are not automatic. They depend on the assessment and on training.
Pay is processed through the fiscal intermediary. It is not a private wage the family sets, and this article does not quote an hourly rate. Rates, overtime, and benefits follow program rules and can change. If a relative is asking "what will I be paid," treat that as a separate question for the fiscal intermediary after someone is actually authorized. Do not budget the household on a number from a blog or a neighbor.
How the Statewide Fiscal Intermediary Fits In
New York moved CDPAP payroll to one statewide fiscal intermediary. The Department’s statewide fiscal intermediary policy identifies Public Partnerships LLC as the statewide intermediary. PPL became the only entity authorized to provide these fiscal intermediary services on April 1, 2025. The Department’s CDPAP program page says every CDPAP recipient must work with PPL.
PPL's job is administrative. It processes wages and benefits, handles income tax and other required withholdings, and keeps the employment records for the personal assistant. It is the joint employer for payroll purposes. It is not the care supervisor, and it is not the agency that decides medical need.
Amelia Home Care is a New York Licensed Home Care Services Agency. Amelia is also an OPWDD-approved fiscal intermediary for eligible self-direction services. That OPWDD role is not the same as being the CDPAP statewide fiscal intermediary. Families should not list Amelia where a form asks for the CDPAP fiscal intermediary. For CDPAP, that entity is PPL.
What Amelia can do is help a family or a referral partner sort the choice. Some people want to hire someone they already trust, and they can direct that person. Others want an agency to assign and supervise an aide. Both can be Medicaid-funded when the person qualifies. Eligible Medicaid-funded services are provided at no cost to the family. Not every person, hour request, or family caregiver qualifies.
A Practical Way to Start the Conversation
Bring a short list to the first call. You do not need a finished application.
- The person's name, age, county, and whether New York Medicaid is already active.
- Who would direct the care: the person, or a designated representative.
- Who might serve as the personal assistant, and whether that person is a spouse, a parent, or the representative.
- The daily tasks that already need hands-on help, in the person's own words.
- Any other coverage in play, such as MLTC, NHTD, TBI, OPWDD, or VA benefits.
A care manager can send that same list with the referral. Hospital teams can add the expected discharge date and whether anyone at home can be present for the first few days. Those facts do not create eligibility. They stop the family from being sent down the wrong program.
If consumer direction turns out not to fit, agency-arranged home care may still be the right support. Amelia works with New York families across Brooklyn, the Bronx, Manhattan, Queens, Staten Island, and Westchester on Medicaid-funded home care, pediatric care, and OPWDD process help. A coordinator can walk through the options in a free consultation. The outcome still depends on the assessment and on program rules.
Talk with Amelia about CDPAP or other home care
Frequently Asked Questions
Can a family member get paid to be a caregiver in New York?
Sometimes. Under CDPAP, some relatives and friends can be the paid personal assistant when the consumer is authorized for the program. A spouse cannot fill that role. Neither can the designated representative, or the parent of a consumer under 21. Other programs have their own family-caregiver rules. Payment still requires authorization and enrollment with the fiscal intermediary.
What are the requirements for CDPAP in New York?
The person must have New York Medicaid and a stable medical condition. A state-approved assessment must find a need for home care. They must be able to self-direct, or have a designated representative. For people age 21 and older, the Minimum Needs Requirements apply to initial assessments on or after September 1, 2025 and to later reassessments, subject to applicable legacy exceptions for people already authorized or receiving services or continuously enrolled in managed long-term care on that date. A checklist on a website does not mean someone is approved.
Who is the CDPAP fiscal intermediary?
Public Partnerships LLC, called PPL, is the statewide fiscal intermediary. The Department of Health says all CDPAP recipients must work with PPL for payroll, tax withholdings, and employment records. Amelia's fiscal-intermediary work is for eligible OPWDD self-direction, which is a different program.
Is CDPAP the same as getting an agency aide?
No. An agency aide is assigned and supervised by a licensed agency. In CDPAP, the consumer or a designated representative recruits, trains, and supervises the personal assistant. PPL handles the paycheck. Some families want that control. Others would rather have the agency manage staffing. A consultation can help you compare the two. Neither option is guaranteed to be approved.
Does CDPAP cost the family anything?
When Medicaid authorizes the service, the family does not pay Amelia for that authorized care. CDPAP does not cover private-pay hours, and it does not approve every request. If the person is not eligible, or the authorized hours are less than the family hoped, other home care options may need a separate conversation.