CDPAP stands for the Consumer Directed Personal Assistance Program, a New York State Medicaid program that lets eligible people choose, hire, train, and supervise their own home caregiver instead of being assigned an aide by a home care agency. You pick someone you trust — often a family member, friend, or neighbor — and direct how your care is delivered day to day. The program covers personal care, home health aide services, and skilled nursing tasks that would normally require a licensed professional.
What CDPAP Pays For
CDPAP authorizes three categories of help at home. Personal care covers the everyday basics: bathing, dressing, grooming, toileting, and meal preparation. Home health aide services go a step further. And skilled nursing tasks — administering medication, wound care, managing a feeding tube — are also covered, which is the key difference from most traditional home care programs where aides cannot perform those procedures.1New York State Department of Health. Guidelines for Consumer Directed Personal Assistance Services Under CDPAP, you (or your designated representative) train your personal assistant to carry out those tasks according to your plan of care.
Who Qualifies
Eligibility is set by New York Social Services Law § 365-f. You need to meet three conditions:
- Active New York Medicaid coverage. If you get Medicaid through a Managed Long Term Care (MLTC) plan, you request CDPAP through that plan.
- A medical need for home care — a chronic illness or physical disability that requires help at home or skilled nursing.2New York State Senate. New York Code 365-F – Consumer Directed Personal Assistance Program
- The ability to self-direct your care, or someone willing to serve as your designated representative who can make those decisions for you.2New York State Senate. New York Code 365-F – Consumer Directed Personal Assistance Program
A designated representative can be a legal guardian, a family member, or another trusted adult. That person takes on recruiting, training, and supervising the personal assistant and making sure the plan of care is followed. The representative cannot also be your paid personal assistant; those have to be two different people.3New York State Department of Health. Administrative Agreement for the Provision of Fiscal Intermediary Services for the Consumer Directed Personal Assistance Program
Medical necessity is confirmed through a clinical assessment that looks at your functional limitations and health history and determines how many weekly hours you’ll be authorized to receive.
Who You Can Hire as Your Personal Assistant
This is the piece most people are asking about. Your personal assistant can be a friend, a neighbor, or most family members, including adult children caring for aging parents, siblings, aunts, uncles, and cousins.4Department of Health. Consumer Directed Personal Assistance Program (CDPAP) The assistant has to be at least 18 and legally authorized to work in the United States.
A few specific people cannot be your paid assistant:
- Your legally married spouse.5New York Codes, Rules and Regulations. 18 CRR-NY 505.28 – Consumer Directed Personal Assistance Program
- A parent of a child under 21. A 2016 change in the law does allow parents to serve as the paid assistant for an adult child who is 21 or older.6New York State Department of Health. Clarification to the New Law in Relation to the Consumer Directed Personal Assistance Program
- Your designated representative.3New York State Department of Health. Administrative Agreement for the Provision of Fiscal Intermediary Services for the Consumer Directed Personal Assistance Program
- Anyone with a legal duty to support you, such as a legal guardian.
Other adult relatives, including those who live with you, can serve as personal assistants as long as the local district or managed care organization confirms the arrangement fits your plan of care and does not cost more than hiring a non-relative would.5New York Codes, Rules and Regulations. 18 CRR-NY 505.28 – Consumer Directed Personal Assistance Program Every assistant also has to pass a health assessment before starting work.3New York State Department of Health. Administrative Agreement for the Provision of Fiscal Intermediary Services for the Consumer Directed Personal Assistance Program
What You Have to Do as the Consumer
CDPAP shifts the work of managing a caregiver from an agency to you. You (or your designated representative) are essentially the employer. That means recruiting and interviewing candidates, training them on your specific medical and personal needs, setting their schedule, evaluating how they’re doing, and letting them go if the arrangement is not working.2New York State Senate. New York Code 365-F – Consumer Directed Personal Assistance Program
Record-keeping matters too. The Fiscal Intermediary runs payroll based on the hours you approve, and submitting inaccurate timecards can trigger an investigation by the Office of the Medicaid Inspector General, which may seek to recover improperly spent funds.7New York State Office of the Medicaid Inspector General. New York State Office of the Medicaid Inspector General 2026 Work Plan If a consumer consistently cannot handle the management side, the state may move them back to traditional agency-based home care.
How to Apply
If you have fee-for-service Medicaid, you start by contacting your local Department of Social Services. If you’re already in a Managed Long Term Care plan, you request CDPAP through that plan. Either way, your application needs a physician’s order confirming you need home care, which documents the type and amount of help you require and becomes the basis for your plan of care.
A clinical assessment then determines your level of need. Since 2022, that assessment runs through the New York Independent Assessor Program (NYIAP), operated by Maximus Health Services, which replaced the former Conflict-Free Evaluation and Enrollment Center. A registered nurse completes a Community Health Assessment and a clinical practitioner conducts an exam.8New York State Department of Health. New York Independent Assessor Program (NYIAP)
Once services are authorized, you register with Public Partnerships LLC (PPL), the sole statewide Fiscal Intermediary for CDPAP. You don’t choose a Fiscal Intermediary; PPL is the only one. PPL acts as the employer of record for your personal assistant and handles payroll, tax withholding, benefits, and workers’ compensation, as well as the assistant’s required health screening and background check.9New York State Department of Health. New York State Department of Health Announces Court Affirms Statewide Fiscal Intermediary Contract You can reach PPL at 1-833-247-5346. Consumers not enrolled in managed care who need extra help can call the Department of Health at 518-474-5888.10New York State Department of Health. Consumer Directed Personal Assistance Program (CDPAP) From first application to the start of services, plan on several weeks.
If You’re Denied or Your Hours Are Cut
You can challenge a denial or a reduction in authorized hours. If you’re in a managed care or MLTC plan, you file a plan appeal first, within 60 calendar days of the denial notice. The plan has 30 days to decide a standard appeal, or 72 hours for an expedited appeal if your health is at immediate risk. If the plan upholds the denial, you have 120 days from that final decision to request a fair hearing through the New York State Office of Temporary and Disability Assistance.11New York State Department of Health. Denial Notice – Adverse Determination Guidance
Timing is the thing to watch. If you’re already receiving CDPAP and the plan proposes to reduce or terminate your services, filing your appeal before the effective date of the reduction generally keeps your current services in place while the appeal is decided. This is called “aid continuing.” Miss that window and you could go without services for the months an appeal can take.