New York's Consumer-Directed Personal Assistance Program (CDPAP)

Page Reviewed / Updated - Mar. 2014

What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through "Medicaid Waivers" which are also called Home and Community Based Services (HCBS Waivers) or Waiver Funded Services.

Waiver Description

New York's Consumer-Directed Personal Assistance Program, abbreviate as CDPAP or sometimes CDPAPNYS, is a Medicaid program. It is designed for elderly or disabled residents that require and are eligible to receive home care, personal care or skilled nursing services and wish to maintain control over whom provides these services. As consumers of care services, they are choosing to direct their own care hence the phrase "consumer direction". To avoid confusion, it is worth noting that consumer-direction is sometimes referred to as participant direction, self-direction or cash and counseling.

CDPAP allows adult children of aging parents to be paid for their caregiving efforts.  Spouses, however are prohibited from receiving compensation.

The CDPAP program works as follows. An eligible individual elects to participate in the program; they work with a county caseworker and medical professional to determine the level of care they require and to create a "Care Plan". The Care Plan contains the number of hours of care they will require each week. The participating individual is then given the flexibility to hire, train and supervise their care providers (also referred to as "PA"s). One factor that makes this program especially popular is that friends and certain family members can be hired as care providers / PAs. To be clear, parents, spouses and legal guardians are excluded from being paid caregivers, but siblings, ex-spouses and the adult children are eligible. While program participants are responsible for the hiring and management of their care providers, a Fiscal Intermediary is used to oversee time-sheet processing and employee payments.

Did You Know? In New York alone, nearly a quarter million people receive assistance from Medicaid for long term care.   A surprise to many is that 2/3rds of them receive assistance at home or in assisted living. 


Eligibility Guidelines

To be eligible, NY residents must be elderly or disabled and have a demonstrated need for assistance with their activities of daily living; they must qualify for home care, personal care or skilled nursing and they must be eligible to receive Medicaid.

Qualifying for Medicaid financially can be an laborious process. State employees will review a family’s income, assets and asset transfers as far back as 5 years, a process known as a "lookback". For 2014, the New York Medicaid income limit for one person is $809 / month and for two person it is $1,192.  If an individual is applying, they are permitted to keep up to $14,550 in resources. If one spouse of a married couple is applying, the "community spouse" or spouse not seeking Medicaid is allowed up to $117,240 in assets not including the value of their home equity (provided it is less than $814,000).

Persons who assets or income are greater than Medicaid's allowable limits may wish to work with an eldercare financial planner or elderlaw attorney to structure their assets appropriately to qualify for Medicaid.  Learn more.

Finally, in addition to being medically and financially qualified, program participants must voluntarily sign up for the CDPAP program and they must be mentally capable of self-directing their own care or have a designated representative to do so on their behalf.


Benefits and Services

The CDPAP program provides for a wide range of care services. During the creation of the Care Plan, all of the necessary service and hours required will be determined. Possible benefits can include personal care, assistance with the activities of daily living, mobility as well as skilled nursing services.


How to Apply / Learn More

Interested New York residents should contact their local Department of Social Services to learn more about applying for the program.  Find your local county contact information here. One can also learn more about this program on the New York Department of Health webpage.