What Is CDPAP and Who Qualifies in New York?

CDPAP - the Consumer Directed Personal Assistance Program - is a New York Medicaid program that lets you choose your own caregiver, including a family member or trusted friend, and have them paid to help you at home. If you qualify for Medicaid and need help with daily tasks like bathing, dressing, or taking medications, you may be eligible for CDPAP - even if you also have Medicare.

Your daughter has been helping you get dressed every morning for the past two years. She drives over before work, makes sure you take your medications, and sometimes stays late to cook dinner. She has never been paid a dollar for any of it. Here is the thing - she could be. CDPAP makes that possible.

We talk to families every single week who had no idea this program existed. They were burning out, stretching themselves thin, or paying out of pocket for strangers from an agency who did not know their parent's routine. CDPAP flips all of that. You pick your caregiver. You train them. You decide when they come and what they do.

Here is what you need to know about how the program works, who qualifies, what it pays, and how to apply.

How Does CDPAP Work?

Think about the last time an agency sent someone to your home. Did they know how you like your coffee? Did they know which side of the bed is easier for you to get out of? Probably not. CDPAP is built on something agencies have never figured out - that nobody knows your care needs better than you do. You become the employer. The program calls this "self-direction."

What this means for you - you handle four things:

1. Recruiting - You find your own caregiver. This can be a family member, neighbor, or friend.
2. Hiring - You choose who gets the job.
3. Training - You teach them what you need help with.
4. Supervising - You set the schedule and oversee the care.

If something is not working out, you also have the right to let that caregiver go and find a new one.

Now, you are not dealing with taxes and workers' comp yourself. A fiscal intermediary - that is the company that handles your caregiver's payroll and paperwork - takes care of all of that. They process paychecks, manage tax withholding, and handle insurance. You stay in charge of the actual care. They handle the paperwork.

Can Family Members Get Paid as CDPAP Caregivers?

Yes - and this is the number one reason families come to us about CDPAP. Your caregiver can be your adult child, parent, sibling, cousin, or close friend. We see daughters, sons, and grandchildren getting paid every day for the care they were already providing for free.

Here is the one exception you need to know: in most New York counties, your spouse cannot be your paid CDPAP caregiver. Some counties have allowed limited exceptions, but the standard rule excludes spouses. Everyone else in the family is fair game.

And here is what surprises most people - your caregiver does not need a home health aide certification or nursing license. No training requirements. No classes. CDPAP was designed so that everyday people, the ones who already know you best, can provide your care and earn a real paycheck for it.

Who Qualifies for CDPAP in New York?

We get this question more than any other. The good news - the requirements are straightforward. You need to meet three things:

1. You must be eligible for Medicaid. CDPAP is a Medicaid-funded program. If you already have Medicaid, you have cleared the biggest hurdle. If you have both Medicare and Medicaid (called "dual eligibility"), you qualify too. Many seniors 65 and older fall into this category.
2. You must need home care services. A medical professional has to confirm that you need help with activities of daily living - things like bathing, getting dressed, eating, or moving around your home. You may also qualify if you need skilled nursing tasks performed at home, like medication administration or wound care.
3. You must be able to self-direct your care. This means you can make decisions about your own care - or you have a designated representative who can do it for you. A representative is often an adult child or other family member who manages care decisions on your behalf.

There is no age minimum or maximum. Adults of any age who meet these three criteria can apply. Parents can also apply on behalf of children with disabilities who need home care.

What Are the Medicaid Income Limits for CDPAP?

This is where people get nervous, but the numbers might surprise you. Since CDPAP runs through Medicaid, you need to meet New York's income and resource limits. For 2026:

If your income is above those limits, do not walk away yet. Here is something most people do not know - New York has a Medicaid Spend-Down program that works like a deductible. You pay the difference between your income and the limit toward your medical expenses, and then Medicaid kicks in. We have helped families who thought they made too much money get approved through spend-down.

Talk to a SHIP counselor or Medicaid enrollment specialist. Small details - like whether certain income is counted or exempt - can make the difference between qualifying and not. Do not try to figure this out alone.

How Much Do CDPAP Caregivers Get Paid?

We cover pay rates in detail in our dedicated guide: How Much Does CDPAP Pay Caregivers in New York (2026)?

Caregiver pay rates through CDPAP depend on where you live in New York. As of 2026, typical rates are:

• New York City, Long Island, and Westchester: $23.81 per hour
• Rest of New York State: $18.10 per hour

These rates reflect the state's home care minimum wage requirements, which have been increasing in recent years. Overtime rules apply - caregivers who work more than 40 hours per week are entitled to overtime pay at 1.5 times their regular rate.

Your caregiver is paid through the fiscal intermediary. They submit their hours, and the FI handles payroll, tax withholding, and direct deposit. Caregivers may also be eligible for health insurance benefits depending on the number of hours they work.

What Services Does CDPAP Cover?

CDPAP covers a wide range of home care services. Your caregiver can help with:

• Personal care: Bathing, grooming, dressing, toileting, and feeding
• Mobility assistance: Transferring from bed to wheelchair, walking support, and repositioning
• Skilled nursing tasks: Medication administration, insulin injections, wound care, and catheter management
• Meal preparation: Planning and cooking meals that meet your dietary needs
• Light housekeeping: Laundry, cleaning, and organizing your living space
• Transportation: Getting you to and from medical appointments
• Errands: Grocery shopping and picking up prescriptions

Here is the thing that really sets CDPAP apart - the skilled nursing piece. In traditional home care, a home health aide cannot give you your insulin or change a wound dressing. That requires a licensed nurse to come to your home separately. Under CDPAP, your caregiver can do all of that because you are directing the care yourself. Your daughter can give you your insulin injection at 7 AM without waiting for a nurse who may not show up until 10.

If you are managing a chronic condition that requires daily medical tasks at home, this flexibility is not just nice to have - it can change your entire quality of life.

How Many Hours of Care Can You Get Through CDPAP?

There is no one-size-fits-all answer here, and that is actually a good thing. Your care hours are determined by an assessment - a nurse evaluator comes to your home and looks at what you can and cannot do on your own.

Based on that evaluation, you may be approved for:

• A few hours per week for light assistance
• Several hours per day for moderate care needs
• Up to 24/7 live-in care for individuals with extensive needs

If your condition changes - after a hospital stay, a fall, or a new diagnosis - you can request a reassessment to increase your hours. Here is a tip we give every family: keep a written log of what tasks you need help with in the week before your assessment. Write down every time you needed assistance. The more specific you are, the better your chances of getting the hours that match your real needs.

How Do You Apply for CDPAP?

The application process involves several steps, and it can take a few weeks from start to finish. Here is the typical path:

1. Confirm Medicaid eligibility. If you do not already have Medicaid, apply through your local Department of Social Services or online at myBenefits.ny.gov. Gather your income documentation, identification, and proof of residency.
2. Get a physician's order. Your doctor needs to write an order stating that you require home care services. This is a standard medical form - ask your primary care physician.
3. Complete an assessment. Your local Department of Social Services or your MLTC plan will schedule a home assessment. A nurse evaluator will determine what services you need and how many hours per week.
4. Get approved for CDPAP. Once the assessment confirms you need home care and can self-direct (or have a representative), you will be authorized for CDPAP specifically.
5. Choose a fiscal intermediary. You select an FI to handle payroll and administrative tasks for your caregiver. New York consolidated its fiscal intermediaries in 2023 and 2024, reducing the number of available FIs. Your MLTC plan or local social services office can provide you with the current list of approved FIs in your area.
6. Hire your caregiver. Once you have an FI in place, you recruit and hire your caregiver. They will need to complete some onboarding paperwork through the FI, including a background check and employment forms.

The whole process typically takes 4 to 8 weeks, though delays are common - especially during the Medicaid application stage. If you already have Medicaid and an MLTC plan, you can often move faster.

What Is the Difference Between CDPAP and Traditional Home Care?

The biggest difference is control. Here is a quick comparison:

For patients who want consistency - the same trusted face every day, on a schedule that works for their life - CDPAP tends to be the better fit. Traditional home care can work well if you do not have a specific person in mind and prefer the agency to handle staffing.

What If You Cannot Self-Direct Your Own Care?

We hear this concern all the time: "My mom has dementia - she can't direct her own care. Does that mean she can't use CDPAP?" No. It does not.

You can designate a representative - typically an adult child or legal guardian - who takes on the self-direction responsibilities. That representative recruits the caregiver, sets the schedule, and supervises the care. Your mom still receives everything she needs at home.

We work with families in this situation every day. A daughter managing care for a parent with Alzheimer's. A son coordinating services for a father after a stroke. The representative model makes CDPAP accessible even when the person receiving care cannot manage the program on their own.

Does Medicare Play a Role in CDPAP?

This is one of the most common points of confusion we see. CDPAP is funded by Medicaid, not Medicare. They sound alike, but they are different programs. If you have both - which is common among seniors 65 and older - your Medicaid coverage is what funds your CDPAP services.

Medicare Part A covers hospital stays and short-term skilled nursing. Medicare Part B covers doctor visits and outpatient care. Neither Part A nor Part B covers long-term personal care at home the way CDPAP does.

Some dual-eligible beneficiaries are enrolled in Managed Long-Term Care (MLTC) plans, which coordinate both their Medicare and Medicaid benefits. If you are in an MLTC plan, your CDPAP services will be managed through that plan rather than directly through your county's Department of Social Services.

If you are not sure whether you are dual-eligible, check your benefits card or call 1-800-MEDICARE (1-800-633-4227). Understanding your full coverage picture is the first step toward getting the right help at home.

Next Steps: How to Get Started with CDPAP

If CDPAP sounds like it could help you or someone in your family, here is what we recommend:

1. Check your Medicaid status. If you do not have Medicaid yet, start the application. Contact your local Department of Social Services or visit myBenefits.ny.gov.
2. Talk to your doctor. Ask for a home care order. Explain what tasks you need help with at home.
3. Identify your caregiver. Think about who you would want to hire. A family member who is already helping you is often the best starting point.
4. Contact a patient advocate. Navigating Medicaid paperwork and assessments is easier with someone in your corner.
5. Call the NY Medicaid helpline. For program-specific questions, reach them at 1-800-541-2831.

You deserve care from someone who knows you, in the place where you feel most comfortable. CDPAP makes that possible - and it costs you nothing out of pocket. It is fully covered through your Medicaid benefits.

Do You Qualify? CDPAP Eligibility Checklist

Run through this checklist to determine if you are likely eligible for CDPAP. You need to meet all five criteria.

If you checked all five, you are likely eligible. The next step is a medical assessment through your Managed Long-Term Care (MLTC) plan or local Department of Social Services.

2026 Medicaid Income and Asset Limits for CDPAP

Since CDPAP is a Medicaid program, you must meet New York's Medicaid financial eligibility requirements. These limits are updated each year by the NY Department of Health.

Important exceptions:

• Spend-down: If your income exceeds the limit, you may qualify through Medicaid spend-down, where medical expenses reduce your countable income.
• Exempt assets: Your primary home, one car, personal belongings, and pre-paid funeral expenses are typically exempt from the asset test.
• Dual-eligible: If you have both Medicare and Medicaid, you automatically meet the financial requirements for CDPAP.

Who Can Be Your CDPAP Caregiver?

One of the biggest advantages of CDPAP is the flexibility to choose your own caregiver. But there are specific rules about who qualifies.

No certification required. Unlike home health aides or certified nursing assistants, CDPAP caregivers do not need any license, certification, or prior training. Your caregiver can perform tasks that would normally require a nurse - including wound care, insulin injections, and catheter management - as long as you (or your representative) train and supervise them.

What Changed with the CDPAP Fiscal Intermediary Transition

In 2025, New York State completed the biggest structural change to CDPAP since the program was created. Previously, more than 700 fiscal intermediary (FI) agencies operated across the state, each with its own pay schedules, enrollment processes, and payroll systems. The state consolidated all of them into a single statewide FI: Public Partnerships LLC (PPL).

Here is what changed and what stayed the same:

The important thing to know: the core CDPAP program rules have not changed. Who qualifies, what services are covered, and how caregivers are paid all remain the same. The transition was about the business side - payroll and administration - not the care side.

If you are a current CDPAP consumer: You should have already been transitioned to PPL. If you have not received your PPL enrollment packet, call PPL at 1-833-563-1285 or visit pplfirst.com. Your authorized hours, caregiver assignment, and services remain the same.

If you are a new applicant: Your application now goes through your Managed Long-Term Care (MLTC) plan, which coordinates directly with PPL. You do not need to choose a fiscal intermediary - PPL is the only option statewide.

CDPAP vs. Traditional Home Care: Which Is Right for You?

Bottom line: CDPAP is the better choice if you want control over who provides your care and when. Traditional home care is better if you need guaranteed backup staffing and prefer not to manage the caregiver relationship yourself.

Frequently Asked Questions

Can I use CDPAP if I live in assisted living or a nursing home?

No. CDPAP is a home-based program. You must live in your own home or a family member's home to receive services. If you are in a nursing facility or assisted living residence, you would not qualify. However, if you are transitioning home from a facility, you can apply for CDPAP as part of your discharge plan.

How long does it take to get approved for CDPAP?

The process typically takes 4 to 8 weeks if you already have Medicaid. If you need to apply for Medicaid first, add another 4 to 6 weeks. The longest delays usually happen during the assessment scheduling phase. Calling your local Department of Social Services to follow up can help speed things along.

Can my caregiver work for more than one CDPAP consumer?

Yes, a caregiver can work for multiple CDPAP consumers as long as the schedules do not overlap. Each consumer is a separate employer, so the caregiver would have separate timesheets and pay arrangements through each consumer's fiscal intermediary.

What happens if my caregiver calls out sick?

Unlike agency-based home care, CDPAP does not provide backup staffing. If your caregiver is unavailable, it is your responsibility to arrange a substitute or go without care that day. Some families designate a second caregiver through the program as a backup. We recommend having at least one alternate caregiver registered with your fiscal intermediary.

Can I switch from traditional home care to CDPAP?

Yes. If you are currently receiving home care through an agency and want to switch to CDPAP, contact your MLTC plan or local Department of Social Services to request the change. You will still need to meet the self-direction requirement, but your existing assessment and authorized hours can often carry over without a new evaluation. If you need help navigating the process, a patient advocate can assist.

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