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

Page Reviewed / Updated - May 2016

Waiver Description

New York's Consumer-Directed Personal Assistance Program goes by several names including the abbreviations CDPAP, CDPAPNYS or CDPA.  It is less a program and more a method of receiving benefits under other programs.  However, many people think of it as a distinct program and it may be easier to do so.  In short, Consumer-Directed Personal Assistance is designed for elderly or disabled persons that require personal care, home health or skilling nursing care 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, readers should note that consumer-direction is also sometimes referred to as participant direction, self-direction, or cash and counseling.

This program allows adult children to be hired as caregivers for their aging parents.  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, 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.

CDPAP is a Medicaid program offered under the NY Managed Medicaid Long Term Care as well as the new Community First Choice options. It a Medicaid entitlement program

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, elderly or disabled NY residents have to demonstrate 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 a laborious process. State employees will review a family's income, assets and asset transfers as far back as five years, a process known as a "lookback." For 2016, the New York Medicaid income limit for a single applicant over the age of 65 is $825 / month and for a two-person household it is $1,209. If an individual is applying, they are permitted to keep up to $14,850 in resources for a two-person household with two applicants, they are permitted $21,750. If one spouse of a married couple is applying, the "community spouse" or spouse not seeking Medicaid is allowed up to $119,220 in assets not including the value of their home equity (provided it is less than $828,000).

Persons with complicated cases or who assets or income are greater than Medicaid's allowable limits may wish to work with an eldercare financial planner or elder law attorney to structure their assets appropriately to qualify for Medicaid. Learn more about how Medicaid planners work.

Finally, in addition to being medically and financially qualified, program participants must access the CDPAP program through the Managed Medicaid Long Term Care Program or Community First Choice.


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.  Services provides under this program are self-directed meaning the program participant or their legal representative can choose their provider of services. 


How to Apply / Learn More

Interested New York residents should contact their local Department of Social Services to learn more about accessing for this program through their Medicaid plan. One can also learn more about this program on the New York Health Access webpage.