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

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.  There are also other programs in New York that pay family caregivers.

The CDPAP program works as follows. An eligible individual decides 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. Spouses and legal guardians are not permitted to be 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.

One common question candidates have is if beneficiaries must live at home.  The program's regulations make no mention either way.  However, persons familiar with program have stated that beneficiaries must reside at home or be in the process of moving back into a private home.  

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 two-thirds of them receive assistance at home or in assisted living.


Eligibility Guidelines

Functional / Medical Requirements
To be eligible, elderly or disabled NY residents must demonstrate the need for assistance with their activities of daily living. In other words, they must qualify for home care, personal care, or skilled nursing and they must be eligible to receive New York Medicaid.

Financial Requirements
Qualifying for Medicaid financially can be a laborious process. State employees review a family's income, assets and asset transfers as far back as five years, a process known as a "Medicaid lookback." For 2018, the New York Medicaid income limit for a single applicant over the age of 65 is $842 / month and for a two-person household, the limit is $1,233. If an individual is applying, they are permitted to keep up to $15,150 in resources for a two-person household with two applicants, they are permitted $22,200.

If one spouse of a married couple is not applying, they are called the "community spouse," and are permitted to retain much higher financial resources. The community spouse may hold up to $123,600 in funds across all their financial accounts. The applicant’s home equity should not exceed $858,000. One car is exempt from the asset limits under Medicaid.
Persons with complicated cases or who assets or income are greater than Medicaid's allowable limits may wish to work with an elder care financial planner or elder law attorney to structure their assets appropriately to qualify for Medicaid. Learn more about how Medicaid planners work.

Finally, once an applicant has met the medical and financial criteria, participants must access the CDPAP program through New York’s Managed Medicaid Long Term Care Program or Community First Choice option.


Benefits and Services

The CDPAP program provides for a wide range of care services. During the creation of the Care Plan, all the necessary service and hours required will be determined. Possible benefits can include personal care, assistance with the activities of daily living and instrumental activities of daily living, and 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. New applicants must first complete the enrollment process with Medicaid Managed Long Term Care. One can also learn more about this program on the Customer Directed Personal Assistance Association of New York State webpage.