New York caregiver benefits guide
Last checked: May 18, 2026
New York has a Medicaid self-directed home care route called the Consumer Directed Personal Assistance Program, often called CDPAP or CDPAS. It may let a Medicaid member choose and hire a family member or friend as a paid personal assistant.
The rules are strict. A spouse cannot be paid through CDPAP for that spouse’s care. A designated representative also cannot be the paid aide. The care plan, approved hours, payroll steps, and timesheets must still follow New York Medicaid rules.
Quick answer
Yes, New York Medicaid may allow a family member to be paid through CDPAP if the Medicaid member is approved for home care and the family member is allowed under program rules. The Medicaid member, or an approved designated representative, chooses, trains, schedules, and supervises the aide.
The paid aide cannot be the Medicaid member’s spouse. The paid aide also cannot be the person’s designated representative. Parents may be paid to care for an adult child age 21 or older, but parents of a CDPAP consumer under age 21 cannot be paid through CDPAP.
Start here
- If the person already has Medicaid home care: call the managed care plan, MLTC plan, or local Department of Social Services and ask for CDPAP or CDPAS.
- If the person has Medicaid but no home care yet: ask how to request a personal care or CDPAP assessment through the correct New York Medicaid route.
- If the person does not have Medicaid: start with New York Medicaid, the local Department of Social Services, or HRA in New York City. If you are not sure where to start, call NY Connects.
Say this clearly: “I am asking about Consumer Directed Personal Assistance, CDPAP or CDPAS. We want to know if a family member can be the paid personal assistant.”
Main programs and routes in New York
| Route | Who it may help | Where to start |
|---|---|---|
| CDPAP / CDPAS | New York Medicaid members who need home care and can direct their own care, or have a designated representative who can do it for them. | The person’s Medicaid managed care plan, MLTC plan, or local Department of Social Services. In New York City, this may mean HRA. |
| Managed Long Term Care (MLTC) | Many adults who have Medicaid, Medicare, and need long-term home and community services for more than 120 days. | Ask New York Medicaid Choice or the current Medicaid plan about MLTC and CDPAS options. |
| Agency personal care services | People who need Medicaid home care but do not want to recruit, train, and supervise their own aide. | The Medicaid plan, MLTC plan, or local Department of Social Services. |
| New York Paid Family Leave | Eligible workers who need time away from work to care for a close family member with a serious health condition. | The caregiver’s employer or the employer’s Paid Family Leave insurance carrier. |
| NY Connects and Area Agencies on Aging | Families who need help finding long-term care services, Medicaid contacts, respite, and local caregiver supports. | NY Connects or the local Area Agency on Aging. |
Need a broader starting point? See Can I get paid to be a caregiver? and the caregiver pay quiz.
What self-directed care means
Self-directed care means the person getting care has more control over who helps them at home. In New York CDPAP, the worker is called a personal assistant.
The consumer, or the consumer’s designated representative, is responsible for many day-to-day employer tasks. This includes finding aides, choosing whom to hire, training them, making schedules, supervising the work, approving time, and ending the aide’s work if needed.
This does not mean New York hands the family a cash budget to spend any way they want. The Medicaid plan, MLTC plan, or local Department of Social Services decides if services are approved. It also decides the tasks and number of hours in the plan of care.
CDPAP can cover personal care, home health aide tasks, and some skilled nursing tasks when they are part of the approved plan. The personal assistant works under the instruction and direction of the consumer or designated representative.
Program name in New York
The main New York Medicaid self-directed home care program is the Consumer Directed Personal Assistance Program. You may hear these names:
- CDPAP
- CDPAS
- Consumer Directed Personal Assistance Services
- consumer direction
- personal assistant, often shortened to PA
- statewide fiscal intermediary, often shortened to SFI
Do not worry if a plan, county, or agency uses one name and another office uses a different name. When you call, use both terms: “CDPAP or CDPAS.”
New York CDPAP changed its payroll setup
New York moved CDPAP to a statewide fiscal intermediary model. Public Partnerships LLC, also called PPL, is the statewide fiscal intermediary. Some local groups may still help as facilitators, but the payroll and fiscal intermediary setup is not the same as the older system with many separate fiscal intermediaries.
If you get advice from an old agency, an old flyer, or a friend who used CDPAP years ago, confirm it with the New York State Department of Health, PPL, the Medicaid plan, or the local Department of Social Services.
Who can be hired
New York says a CDPAP personal assistant must be an adult. A personal assistant may be a friend or family member if the person is allowed under the rules and can safely do the approved tasks.
A family member is not approved just because the family needs money. The person receiving care must first be eligible for Medicaid home care. The plan or local office must approve CDPAP services. The aide must complete the required hiring and payroll steps.
In general, New York CDPAP may allow these people if they meet the program rules:
- an adult child caring for a parent;
- a parent caring for an adult child age 21 or older;
- another adult relative;
- a friend or neighbor;
- more than one personal assistant, if the care plan needs more than one worker.
New York rules also say the social services district or managed care organization must decide that services from a relative fit the plan of care and do not cost more than the same services from a non-relative personal assistant.
For more on Medicaid home and community services, see Medicaid HCBS waivers explained.
Spouse and adult child rules
A spouse cannot be the paid CDPAP personal assistant for their spouse. This is one of the most important New York rules.
The designated representative cannot be the paid aide. A designated representative is the adult who agrees to direct the care when the Medicaid member cannot do it alone. This person may handle hiring, training, scheduling, timesheets, and other program duties. Because that role has control over the aide, New York does not allow the same person to be both the representative and the paid personal assistant.
An adult child may often be considered. For example, an adult daughter or son may be able to work as a personal assistant for a parent if all CDPAP rules are met.
A parent may be considered for an adult child age 21 or older. New York clarified that parents of adult children can be hired as personal assistants in CDPAP. But a parent of a CDPAP consumer under age 21 cannot be paid through CDPAP for that child’s care.
Live-in family members need extra care in the paperwork. Living in the same home does not always block a person from being hired. But the approved hours, sleep rules, and the difference between live-in 24-hour care and continuous care are technical. If the aide lives with the person, ask the plan or local office to explain how the hours will be authorized and paid before work starts.
Important: If the family member is a spouse, legal guardian, designated representative, parent of a minor child, or someone legally responsible for the person’s care and support, do not guess. Ask the plan, local Department of Social Services, or PPL for a written answer.
Payroll and timesheets
CDPAP is not a cash payment to the family. The personal assistant is paid through the required payroll system after the person is approved, the aide is enrolled, and time is submitted correctly.
The statewide fiscal intermediary handles wage and benefit processing, tax withholding, workers’ compensation, disability insurance, unemployment insurance steps, records, and other payroll duties. In New York, PPL is the statewide fiscal intermediary for CDPAP.
The consumer or designated representative still has duties. They must make sure the personal assistant works only approved hours and tasks. They must review and confirm time. They must report changes, such as a hospital stay, address change, change in the aide’s work status, or a change in care needs.
Before the aide can be paid
The personal assistant may need to complete:
- enrollment with the statewide fiscal intermediary;
- identity and work forms;
- tax forms;
- health paperwork or a health assessment required for the role;
- program training or orientation steps;
- time entry setup, which may include electronic visit verification.
Ask before the first shift: “Is this personal assistant fully cleared to work and be paid?” If the answer is not clear, do not rely on a verbal promise. Ask what step is missing.
For tax basics outside Medicaid, see caregiver tax deductions. CDPAP payroll tax questions should go to the fiscal intermediary, a tax professional, or the official payroll documents.
How to switch from agency care
Some New York families start with agency personal care and later ask to switch some or all hours to CDPAP. Others start with CDPAP and later add agency care because they cannot find enough personal assistants.
Start with the office that controls the service authorization. This is often the MLTC plan or Medicaid managed care plan. For some people it may be the local Department of Social Services. In New York City, HRA may be part of the Medicaid route.
Phone script
“I am calling about home care for [name]. They have Medicaid and need help at home. We want to ask for Consumer Directed Personal Assistance, CDPAP or CDPAS, so a family member can be considered as the paid personal assistant. What assessment or service authorization step is needed? If you cannot approve it, please send the denial or explanation in writing.”
If the person already has approved agency hours, ask these questions:
- Can the current approved hours be provided through CDPAP?
- Will there be a new assessment?
- Who sends the authorization to PPL?
- Can the family keep agency care until the CDPAP aide is fully ready?
- What happens if the family cannot find backup aides?
Do not cancel agency care until the CDPAP plan is clear. A gap can leave the person without help for bathing, toileting, transfers, meals, medication reminders, or safe movement around the home.
Who to call first in New York
Use the route that matches the person’s current situation.
- Already in an MLTC plan: call the plan care manager or member services and ask for CDPAP or CDPAS.
- Already in a Medicaid managed care plan: call the plan and ask how to request CDPAP or personal care services.
- Medicaid but no plan contact: call the local Department of Social Services. In New York City, ask HRA about Medicaid home care and CDPAP.
- No Medicaid yet: apply through the correct New York Medicaid route. Some people apply through NY State of Health. Older adults, people with disabilities, and people needing long-term care may need the local Department of Social Services or HRA.
- Not sure where to start: call NY Connects and ask for help finding the right Medicaid long-term care contact.
Use the same words each time: “Medicaid home care, CDPAP or CDPAS, family member as personal assistant, assessment, plan of care, and service authorization.”
Documents to gather before you call
- Medicaid card or Medicaid CIN, if the person has one.
- Medicare card, if the person has Medicare.
- Managed care or MLTC plan card.
- Recent notices from Medicaid, HRA, the local Department of Social Services, or the plan.
- Doctor names, diagnoses, medicine list, and recent hospital or rehab discharge papers.
- A written list of daily care needs, such as bathing, dressing, toileting, transfers, meals, walking, memory support, and night needs.
- Proof of income and resources if Medicaid eligibility or spend-down is part of the issue.
- Name, phone number, address, and date of birth for the family member who wants to be the personal assistant.
- Any old fiscal intermediary letters, PPL letters, timesheet records, or pay issue notes.
If income is too high for regular Medicaid, read Medicaid spend-down. If the family is worried about transfers or nursing home rules, read Medicaid look-back period.
What to do if the first answer is no
A phone answer is not always the final answer. Ask for the reason in writing.
Use this script:
“Please tell me the exact reason CDPAP is being denied or not offered. Is the issue Medicaid eligibility, medical need, the assessment, the family member’s relationship, the designated representative rule, or payroll enrollment? Please send the notice or rule you are using.”
If services are denied, reduced, or stopped, look for appeal instructions on the notice. New York Medicaid disputes may involve a plan appeal, a fair hearing, or both. The notice should tell you what deadline applies.
If the person is already getting services and receives a reduction or stop notice, ask about aid continuing right away. Aid continuing means services may continue while the appeal is pending if the request is made on time and the case qualifies. The deadline can be short, so do not wait.
For call prep, see phone scripts for caregivers and caregiver checklists.
Common problems
The family asks for caregiver pay before Medicaid home care is approved
CDPAP starts with the Medicaid member’s need for home care. The family caregiver’s need for income does not create eligibility by itself. Ask for an assessment and a written plan of care.
The aide starts work before payroll clearance
This can lead to unpaid time. Ask whether the personal assistant is fully enrolled and cleared before the first shift.
The spouse wants to be paid
New York CDPAP does not allow a spouse to be the paid personal assistant for their spouse. Ask about other supports, such as agency care, respite, Paid Family Leave from a job, or VA benefits if the person is a veteran or surviving spouse.
The same person is listed as the designated representative and paid aide
New York does not allow this in CDPAP. If the person receiving care cannot self-direct, the family may need one person to serve as the representative and a different allowed person to serve as the paid aide.
Timesheets or electronic visits are rejected
Keep a simple log with the date, shift time, tasks, and any app or system problem. Contact PPL or the approved facilitator quickly. Also tell the plan or local office if the pay problem puts care at risk.
The approved hours do not match the real care need
Write down the tasks that are unsafe without help. Include transfers, toileting, bathing, wandering risk, overnight needs, and missed care. Ask for a reassessment if the person’s condition has changed. If there is a denial or reduction, use the appeal instructions.
Other benefit paths to check
CDPAP is only one route. It may not fit every family.
- New York Paid Family Leave: This may give eligible workers job-protected paid time off to care for a close family member with a serious health condition. It is not the same as being paid as a Medicaid aide.
- VA benefits: If the person served in the military, ask about VA care benefits and VA Aid and Attendance.
- Respite care: If the family needs short breaks, check respite care for caregivers and NY Connects.
- Care cost planning: Use the care cost calculator to compare unpaid care time, home care, and other costs.
New York rules can change
New York Medicaid home care rules can change. Counties, managed care plans, MLTC plans, waiver contractors, PPL, facilitators, and local agencies may use different names for the same route.
Always confirm the current rule with official New York sources, the person’s Medicaid plan, the local Department of Social Services, HRA if in New York City, or PPL for CDPAP payroll issues.
Resumen en español
En Nueva York, el programa de Medicaid llamado CDPAP puede permitir que una persona con Medicaid elija a un familiar o amigo como asistente personal pagado. La persona que recibe cuidado, o su representante designado, debe dirigir el cuidado.
Un esposo o esposa no puede ser pagado por CDPAP para cuidar a su cónyuge. El representante designado tampoco puede ser el asistente pagado. Llame al plan de Medicaid, al plan MLTC, al Departamento local de Servicios Sociales, HRA en la Ciudad de Nueva York, o a NY Connects para preguntar por CDPAP o CDPAS.
FAQ
Can I get paid to care for my parent in New York?
Maybe. If your parent has New York Medicaid, is approved for home care, and CDPAP is approved, an adult child may be considered as the paid personal assistant. You must meet the program and payroll rules.
Can I get paid to care for my spouse in New York?
Not through CDPAP. New York rules do not allow a spouse to be the paid CDPAP personal assistant for their spouse.
Can a parent get paid to care for an adult child?
New York allows parents to be considered as CDPAP personal assistants for adult children age 21 or older. Parents of CDPAP consumers under age 21 cannot be paid through CDPAP.
Does CDPAP pay the family directly?
No. CDPAP is paid through the required fiscal intermediary payroll system. The personal assistant must complete enrollment and time reporting steps.
Who decides the number of hours?
The Medicaid plan, MLTC plan, or local Department of Social Services authorizes the care plan and hours after the required assessment process. The consumer or representative chooses and supervises the personal assistant within the approved plan.
What if the person needs more hours?
Ask for a reassessment if the person’s condition or support needs changed. Keep notes about daily tasks, safety risks, night needs, and missed care. If hours are denied or reduced, read the notice and ask about appeal rights right away.
About this guide
This guide is for family caregivers trying to understand New York Medicaid self-directed home care. It focuses on CDPAP, family caregiver pay rules, first calls, payroll basics, and what to ask when the answer is unclear.
Disclaimer
This is general information, not legal, tax, medical, or financial advice. Rules can change. For legal or tax questions, talk with a qualified professional in your state.
Official sources used
- New York State Department of Health: Consumer Directed Personal Assistance Program (CDPAP)
- New York Codes, Rules and Regulations: 18 NYCRR 505.28 Consumer Directed Personal Assistance Program
- New York State Department of Health: Overview of Managed Long Term Care (MLTC)
- New York State Department of Health: New York Independent Assessor Program document repository
- New York State Department of Health: Consumer Directed Personal Assistance Services (CDPAS) policy documents
- New York State Department of Health: CDPAP Statewide Fiscal Intermediary transition policy for Medicaid Managed Care Plans
- New York State Department of Health: How to apply for NY Medicaid
- New York State Department of Health: Local Departments of Social Services contact listing
- New York Paid Family Leave: Family care leave
- New York Paid Family Leave: 2026 updates
- New York State Office for the Aging: Caring for a Loved One and NY Connects
- New York State Office of Temporary and Disability Assistance: Request a Fair Hearing
- Public Partnerships LLC: New York CDPAP frequently asked questions
