CDPAP Explained: Eligibility, Caregivers, and Enrollment

New York’s Consumer Directed Personal Assistance Program, known as CDPAP, is a Medicaid-funded home care program that lets you hire, train, and supervise your own caregivers — including adult children, other relatives, and friends — instead of accepting whoever a home care agency sends. CDPAP eligibility and enrollment turn on three things: being enrolled in New York Medicaid, having a stable medical condition that needs help with daily activities, and being able to direct your own care or designating someone who can. The program is authorized under New York Social Services Law § 365-f and runs statewide.¹

Who Qualifies Clinically

You need a stable medical condition that can be safely managed at home rather than in a hospital or nursing facility, and you must need help with activities of daily living.² For anyone who first applied on or after October 1, 2020, the statute sets a specific floor: you must need at least limited physical assistance with more than two activities of daily living. If you have a dementia or Alzheimer’s diagnosis, the threshold drops to at least supervisory help with more than one activity of daily living.¹

You also have to be able to direct your own care, meaning you can decide what services you need and how they should be provided. If a cognitive impairment or other condition prevents that, you can designate a representative — a family member or another trusted adult — to make those decisions and handle hiring, training, and supervision on your behalf.²

Medicaid Income and Asset Limits

CDPAP sits inside New York Medicaid, specifically the Non-MAGI rules, so eligibility depends on your monthly income and your countable assets. As of January 1, 2026, the monthly income limit for a single individual is $1,330. The asset limit is $33,038 for one person and $44,796 for a couple.³

Being over the income limit does not automatically disqualify you. New York uses a “spend-down” that treats the excess income like a deductible applied to your care costs. Many participants whose Social Security or pension puts them slightly above the threshold use a pooled income trust, an irrevocable trust managed by a nonprofit. You deposit the excess each month into a sub-account, the trust pays your living expenses from those funds, and Medicaid treats your income as within the limit.

Who You Can Hire

Adult children, siblings, parents, and close friends can all serve as your paid personal assistant. A few relationships are off-limits. Your spouse cannot be your paid assistant. The person acting as your designated representative cannot also be the paid assistant. Anyone legally responsible for your care and support, such as a legal guardian, is barred as well.⁴ Every assistant must be legally authorized to work in the United States and must complete a health assessment before starting.⁵

What Services CDPAP Covers

Your assistant can perform anything that would otherwise be done by a personal care aide, home health aide, or licensed nurse.² That covers bathing, dressing, grooming, meal preparation, and light housekeeping, and it also extends to skilled nursing tasks such as wound care, medication administration, and catheter maintenance, provided you have trained the assistant to perform them.

The specific tasks allowed in your case must appear in your authorized plan of care, which is built from your clinical assessment. For people with the most intensive needs, the program can authorize round-the-clock split-shift or multi-shift coverage when continuous 24-hour care is medically necessary.⁶

One trade-off worth knowing before you enroll: you (or your designated representative) are the employer. You recruit, hire, train, supervise, and if necessary terminate the assistant, and you arrange backup coverage when your regular assistant is sick or on vacation.² No agency does that work for you. Having a second trained assistant lined up as backup is the single most useful thing you can set up early.

How to Enroll

Start by gathering your documents. You need:

Your Medicaid identification number (and Medicaid enrollment, if you don’t already have it).
A Physician’s Order for Services, Form DOH-4359, completed by your doctor. This establishes medical necessity and supports the hours you’re asking for.⁷
The full legal name, contact information, and identity documents (such as a Social Security card) for the person you plan to hire, since payroll setup needs them.

With the paperwork in hand, contact your Medicaid Managed Care plan to initiate the request. If you’re not enrolled in a managed care plan, your local Department of Social Services handles intake instead.

The New York Independent Assessor (NYIA) then performs a clinical assessment to decide the level and amount of care you need. This step drives the number of hours you’ll ultimately be authorized. Be specific and complete about your medical history and the parts of daily life you struggle with; downplaying your limitations here can cost you hours later.

The Statewide Fiscal Intermediary

Every CDPAP consumer works with a fiscal intermediary, which handles payroll, tax withholding, and insurance for the personal assistant. As of April 1, 2025, New York consolidated all CDPAP fiscal intermediary services under a single vendor, Public Partnerships LLC (PPL).⁸ PPL acts as the co-employer of your assistant for tax and administrative purposes. Your assistant submits timesheets through PPL’s Time4Care app and must complete Electronic Visit Verification (EVV) training in the app before starting, and paychecks come directly from PPL.⁹

The switch to a single intermediary did not change eligibility, authorized service hours, or the requirements for personal assistants. You still choose and direct your caregiver. Only the administrative pipe is different.⁹

If You’re Denied or Your Hours Are Cut

If your application is denied, your hours are reduced, or your services are terminated, you can challenge that decision through a Medicaid fair hearing. Medicaid must notify you in writing of any decision affecting your eligibility or services, and that notice has to explain how to request a hearing and the deadline for doing so.¹⁰

Timing is the thing that trips people up. If you file your hearing request before the effective date on the notice, your current services must continue unchanged while the case is pending. This is called “aid continuing.” There can be as few as 10 days between the mailing of the notice and the effective date, so open your mail and act quickly.¹⁰ If you have an urgent health need that could cause serious harm without prompt care, you can request an expedited hearing; the written notice should include instructions. Fair hearings are handled by the New York Office of Temporary and Disability Assistance, and you can bring documentation, medical records, and witnesses to support your case.

1
New York State Senate. New York Social Services Law 365-F – Consumer Directed Personal Assistance Program
2
New York State Department of Health. Consumer Directed Personal Assistance Program (CDPAP)
3
New York State Department of Health. New York State Income and Resource Standards for Non-MAGI Populations – Effective January 1, 2026
4
New York Codes, Rules and Regulations. New York Code 18 CRR-NY 505.28 – Consumer Directed Personal Assistance Program
5
Cornell Law Institute. New York Comp Codes R and Regs Tit 18 505.28 – Consumer Directed Personal Assistance Program
6
New York State Department of Health. Consumer Directed Personal Assistance Program (CDPAP)
7
New York State Department of Health. GIS 10 OLTC/006 – Physicians Order for Use in the Personal Care Services Program and the Consumer Directed Personal Assistance Program
8
New York State Department of Health. Consumer Directed Personal Assistance Program Statewide Fiscal Intermediary Policy for Medicaid Managed Care Plans
9
New York State Department of Health. Transitioning to PPL as the CDPAP Fiscal Intermediary
10
Medicaid.gov. Understanding Medicaid Fair Hearings