Understood Care (04/22/25)

Written by Debbie Hall - Director of Operations at Understood Care | 20+ years of experience in CDPAP program management and home care coordination | Updated February 2026

CDPAP - the Consumer Directed Personal Assistance Program - is a New York Medicaid program that lets you choose your own caregiver, including a family member or trusted friend, and have them paid to help you at home. If you qualify for Medicaid and need help with daily tasks like bathing, dressing, or taking medications, you may be eligible for CDPAP - even if you also have Medicare.

Key Takeaways

CDPAP is a New York State Medicaid program that lets you choose your own caregiver - including a family member - and have Medicaid pay them.
You must be enrolled in Medicaid and need help with daily activities (bathing, dressing, eating) or require skilled nursing services.
Income limits for Medicaid in 2026 are $1,732/month (individual) or $2,351/month (couple). Asset limit is $31,175.
Your caregiver does not need any certification - they just need to be 18+, legally authorized to work, and not your spouse.
All CDPAP services are now managed through PPL (Public Partnerships LLC) as the statewide fiscal intermediary since 2025.

This article is part of our Complete Guide to Medicare and CDPAP in New York - a comprehensive resource covering Medicare benefits, CDPAP eligibility, caregiver pay rates, appeals, and patient advocacy.

Quick Answer

CDPAP (Consumer Directed Personal Assistance Program) lets Medicaid-eligible New Yorkers hire their own caregiver - including family members (except spouses). You need to be enrolled in Medicaid, have a doctor's order for home care, and be able to direct your own care (or have a designated representative). Caregivers need no medical training.

Most home care programs assign you a stranger from an agency. You get whoever shows up. CDPAP flips that. You pick the person. You train them. You decide when they come and what they do. For many families across New York, this changes everything.

We hear from patients every week who had no idea this program existed. They were struggling to afford help at home, or they were relying on a family member who was doing the work for free and burning out. CDPAP can put that family caregiver on a payroll - with real wages and benefits.

Here is what you need to know about how the program works, who qualifies, what it pays, and how to apply.

Quick Summary

CDPAP stands for Consumer Directed Personal Assistance Program.
You choose your own caregiver - it can be a family member or friend.
Your caregiver gets paid by Medicaid. No certifications needed.
You must have active Medicaid in New York and need help with daily activities.
One company handles all payroll statewide: PPL (Public Partnerships LLC).

How Does CDPAP Work?

CDPAP is built on a simple idea: nobody knows your care needs better than you do. Instead of a home care agency picking your aide, you become the employer. The program calls this "self-direction."

Self-direction means you handle four things:

Recruiting - You find your own caregiver. This can be a family member, neighbor, or friend.
Hiring - You choose who gets the job.
Training - You teach them what you need help with.
Supervising - You set the schedule and oversee the care.

If something is not working out, you also have the right to let that caregiver go and find a new one.

A fiscal intermediary (FI) handles the paperwork side. The FI (fiscal intermediary - the company that handles your caregiver's payroll and paperwork) processes payroll, manages taxes, and handles workers' compensation insurance for your caregiver. Think of them as the behind-the-scenes employer on paper, while you stay in charge of the actual care.

Can Family Members Get Paid as CDPAP Caregivers?

Yes. This is one of the biggest reasons families choose CDPAP over traditional home care. Your caregiver can be your adult child, parent, sibling, cousin, or close friend.

There is one major exception: in most New York counties, your spouse cannot be your paid CDPAP caregiver. Some counties have allowed exceptions in limited situations, but the standard rule excludes spouses.

Your caregiver does not need a home health aide certification or nursing license. CDPAP was designed so that everyday people - the ones who already know you best - can provide your care and earn a paycheck for it.

Who Qualifies for CDPAP in New York?

To be eligible for CDPAP, you need to meet three requirements:

You must be eligible for Medicaid. CDPAP is a Medicaid-funded program. If you already have Medicaid, you have cleared the biggest hurdle. If you have both Medicare and Medicaid (called "dual eligibility"), you qualify too. Many seniors 65 and older fall into this category.
You must need home care services. A medical professional has to confirm that you need help with activities of daily living - things like bathing, getting dressed, eating, or moving around your home. You may also qualify if you need skilled nursing tasks performed at home, like medication administration or wound care.
You must be able to self-direct your care. This means you can make decisions about your own care - or you have a designated representative who can do it for you. A representative is often an adult child or other family member who manages care decisions on your behalf.

There is no age minimum or maximum. Adults of any age who meet these three criteria can apply. Parents can also apply on behalf of children with disabilities who need home care.

What Are the Medicaid Income Limits for CDPAP?

Since CDPAP runs through Medicaid, you need to meet New York's Medicaid income and resource limits. For 2026, the key numbers are:

Category	Monthly Income Limit	Resource Limit
Individual (age 65+ or disabled)	$1,732	$31,175
Couple (age 65+ or disabled)	$2,351	$46,385
Individual (under 65, non-disabled)	Varies by county	Varies by county

If your income is above these limits, do not assume you are out of luck. New York has a Medicaid Spend-Down program that works like a deductible. You pay the difference between your income and the limit toward your medical expenses, and then Medicaid kicks in. Many people with moderate incomes qualify this way.

Consider talking with a SHIP counselor or Medicaid enrollment specialist to understand your specific situation. Income rules can be confusing, and small details - like whether certain income is counted - can make the difference between qualifying and not.

How Much Do CDPAP Caregivers Get Paid?

We cover pay rates in detail in our dedicated guide: How Much Does CDPAP Pay Caregivers in New York (2026)?

Caregiver pay rates through CDPAP depend on where you live in New York. As of 2026, typical rates are:

New York City, Long Island, and Westchester: $23.81 per hour
Rest of New York State: $18.10 per hour

These rates reflect the state's home care minimum wage requirements, which have been increasing in recent years. Overtime rules apply - caregivers who work more than 40 hours per week are entitled to overtime pay at 1.5 times their regular rate.

Your caregiver is paid through the fiscal intermediary. They submit their hours, and the FI handles payroll, tax withholding, and direct deposit. Caregivers may also be eligible for health insurance benefits depending on the number of hours they work.

What Services Does CDPAP Cover?

CDPAP covers a wide range of home care services. Your caregiver can help with:

Personal care: Bathing, grooming, dressing, toileting, and feeding
Mobility assistance: Transferring from bed to wheelchair, walking support, and repositioning
Skilled nursing tasks: Medication administration, insulin injections, wound care, and catheter management
Meal preparation: Planning and cooking meals that meet your dietary needs
Light housekeeping: Laundry, cleaning, and organizing your living space
Transportation: Getting you to and from medical appointments
Errands: Grocery shopping and picking up prescriptions

One thing that makes CDPAP stand out from standard home care is the skilled nursing piece. In a traditional home care setup, a home health aide cannot administer medications or perform medical tasks - that requires a licensed nurse. Under CDPAP, your caregiver can perform these tasks because you are directing and supervising the care yourself.

If you are managing a chronic condition that requires daily medical tasks at home, this flexibility can be a significant advantage.

How Many Hours of Care Can You Get Through CDPAP?

There is no fixed number of hours for everyone. Your care hours are determined by an assessment conducted by your local Department of Social Services or your Managed Long-Term Care (MLTC) plan.

During the assessment, a nurse evaluator visits your home and reviews what you can and cannot do on your own. Based on that evaluation, you may be approved for:

A few hours per week for light assistance
Several hours per day for moderate care needs
Up to 24/7 live-in care for individuals with extensive needs

If your condition changes - for example, after a hospital stay or a new diagnosis - you can request a reassessment to increase your hours. We recommend keeping detailed notes about what tasks you need help with before your assessment. The more specific you are, the better your chances of getting the hours that match your real needs.

How Do You Apply for CDPAP?

The application process involves several steps, and it can take a few weeks from start to finish. Here is the typical path:

Confirm Medicaid eligibility. If you do not already have Medicaid, apply through your local Department of Social Services or online at myBenefits.ny.gov. Gather your income documentation, identification, and proof of residency.
Get a physician's order. Your doctor needs to write an order stating that you require home care services. This is a standard medical form - ask your primary care physician.
Complete an assessment. Your local Department of Social Services or your MLTC plan will schedule a home assessment. A nurse evaluator will determine what services you need and how many hours per week.
Get approved for CDPAP. Once the assessment confirms you need home care and can self-direct (or have a representative), you will be authorized for CDPAP specifically.
Choose a fiscal intermediary. You select an FI to handle payroll and administrative tasks for your caregiver. New York consolidated its fiscal intermediaries in 2023 and 2024, reducing the number of available FIs. Your MLTC plan or local social services office can provide you with the current list of approved FIs in your area.
Hire your caregiver. Once you have an FI in place, you recruit and hire your caregiver. They will need to complete some onboarding paperwork through the FI, including a background check and employment forms.

The whole process typically takes 4 to 8 weeks, though delays are common - especially during the Medicaid application stage. If you already have Medicaid and an MLTC plan, you can often move faster.

What Is the Difference Between CDPAP and Traditional Home Care?

The biggest difference is control. Here is a quick comparison:

Feature	CDPAP	Traditional Home Care
Who picks the caregiver	You do	The agency assigns one
Family members as caregivers	Yes (except spouse in most counties)	No
Caregiver certification required	No	Yes (HHA or PCA certification)
Skilled nursing tasks by caregiver	Yes, under consumer direction	No - requires a licensed nurse
Who sets the schedule	You do	The agency does
Funding source	Medicaid	Medicaid, Medicare, or private pay

For patients who want consistency - the same trusted face every day, on a schedule that works for their life - CDPAP tends to be the better fit. Traditional home care can work well if you do not have a specific person in mind and prefer the agency to handle staffing.

What If You Cannot Self-Direct Your Own Care?

CDPAP requires that the consumer can direct their own care. But that does not mean you have to do it alone. If you have a cognitive impairment, a developmental disability, or another condition that limits your ability to manage care decisions, you can designate a representative.

A designated representative is typically a family member or legal guardian who takes on the self-direction responsibilities on your behalf. They recruit the caregiver, set the schedule, and supervise the care - all while you receive the services you need at home.

This is especially important for families caring for aging parents with dementia or children with complex medical needs. The representative model makes CDPAP accessible even when the person receiving care cannot manage the program independently.

Does Medicare Play a Role in CDPAP?

CDPAP is funded by Medicaid, not Medicare. However, if you have both Medicare and Medicaid - which is common among seniors 65 and older with limited income - your Medicaid coverage is what funds your CDPAP services.

Medicare Part A covers hospital stays and short-term skilled nursing. Medicare Part B covers doctor visits and outpatient care. Neither Part A nor Part B covers long-term personal care at home the way CDPAP does.

Some dual-eligible beneficiaries are enrolled in Managed Long-Term Care (MLTC) plans, which coordinate both their Medicare and Medicaid benefits. If you are in an MLTC plan, your CDPAP services will be managed through that plan rather than directly through your county's Department of Social Services.

If you are not sure whether you are dual-eligible, check your benefits card or call 1-800-MEDICARE (1-800-633-4227). Understanding your full coverage picture is the first step toward getting the right help at home.

Next Steps: How to Get Started with CDPAP

If CDPAP sounds like it could help you or someone in your family, here is what we recommend:

Check your Medicaid status. If you do not have Medicaid yet, start the application. Contact your local Department of Social Services or visit myBenefits.ny.gov.
Talk to your doctor. Ask for a home care order. Explain what tasks you need help with at home.
Identify your caregiver. Think about who you would want to hire. A family member who is already helping you is often the best starting point.
Contact a patient advocate. Navigating Medicaid paperwork and assessments is easier with someone in your corner.
Call the NY Medicaid helpline. For program-specific questions, reach them at 1-800-541-2831.

You deserve care from someone who knows you, in the place where you feel most comfortable. CDPAP makes that possible - and it is fully covered through your Medicaid benefits.

Do You Qualify? CDPAP Eligibility Checklist

Run through this checklist to determine if you are likely eligible for CDPAP. You need to meet all five criteria.

☐ You are a New York State resident
☐ You are enrolled in Medicaid (or Medicaid + Medicare dual-eligible)
☐ You need help with activities of daily living (bathing, dressing, eating, toileting, mobility) or require skilled nursing services
☐ You can self-direct your care (or have a designated representative who can direct care on your behalf)
☐ You have a willing caregiver who is 18+, legally authorized to work in the US, and not your spouse or designated representative

If you checked all five, you are likely eligible. The next step is a medical assessment through your Managed Long-Term Care (MLTC) plan or local Department of Social Services.

2026 Medicaid Income and Asset Limits for CDPAP

Since CDPAP is a Medicaid program, you must meet New York's Medicaid financial eligibility requirements. These limits are updated each year by the NY Department of Health.

Household Size	Monthly Income Limit	Annual Income Limit	Asset Limit
Individual	$1,732/month	$20,784/year	$31,175
Couple	$2,351/month	$28,212/year	$46,385
Family of 3	$2,680/month	$32,148/year	$46,385

Important exceptions:

Spend-down: If your income exceeds the limit, you may qualify through Medicaid spend-down, where medical expenses reduce your countable income.
Exempt assets: Your primary home, one car, personal belongings, and pre-paid funeral expenses are typically exempt from the asset test.
Dual-eligible: If you have both Medicare and Medicaid, you automatically meet the financial requirements for CDPAP.

Who Can Be Your CDPAP Caregiver?

One of the biggest advantages of CDPAP is the flexibility to choose your own caregiver. But there are specific rules about who qualifies.

Relationship	Can Be Your CDPAP Caregiver?	Notes
Adult child (son, daughter)	Yes	Most common arrangement. Must be 18+.
Parent	Yes (if consumer is 21+)	Cannot be caregiver for a minor child under 21.
Sibling	Yes	Must be 18+.
Friend or neighbor	Yes	No family relationship required.
Grandchild	Yes	Must be 18+.
Spouse	No	Spouses are explicitly excluded under CDPAP rules.
Designated representative	No	The person directing your care cannot also be paid as the caregiver.

No certification required. Unlike home health aides or certified nursing assistants, CDPAP caregivers do not need any license, certification, or prior training. Your caregiver can perform tasks that would normally require a nurse - including wound care, insulin injections, and catheter management - as long as you (or your representative) train and supervise them.

What Changed with the CDPAP Fiscal Intermediary Transition

In 2025, New York State completed the biggest structural change to CDPAP since the program was created. Previously, more than 700 fiscal intermediary (FI) agencies operated across the state, each with its own pay schedules, enrollment processes, and payroll systems. The state consolidated all of them into a single statewide FI: Public Partnerships LLC (PPL).

Here is what changed and what stayed the same:

Before (Pre-2025)	After (2025-2026)
700+ fiscal intermediary agencies across NY	One statewide FI: PPL
Each agency set its own pay rates and processes	Standardized pay rates and enrollment statewide
Consumers could choose their FI	All consumers use PPL
Variable payroll schedules	Biweekly payroll through PPL's BetterOnline portal
Some agencies offered health insurance	PPL does not offer health insurance to caregivers

The important thing to know: the core CDPAP program rules have not changed. Who qualifies, what services are covered, and how caregivers are paid all remain the same. The transition was about the business side - payroll and administration - not the care side.

If you are a current CDPAP consumer: You should have already been transitioned to PPL. If you have not received your PPL enrollment packet, call PPL at 1-833-563-1285 or visit pplfirst.com. Your authorized hours, caregiver assignment, and services remain the same.

CDPAP Questions? Call PPL

Call Public Partnerships LLC (PPL) at 1-833-563-1285 or visit pplfirst.com. They handle all CDPAP payroll and enrollment in New York.

If you are a new applicant: Your application now goes through your Managed Long-Term Care (MLTC) plan, which coordinates directly with PPL. You do not need to choose a fiscal intermediary - PPL is the only option statewide.

CDPAP vs. Traditional Home Care: Which Is Right for You?

	CDPAP	Traditional Home Care (Agency)
Choose your caregiver	Yes - family, friends, anyone you trust	No - agency assigns an aide
Caregiver certification	Not required	HHA or PCA certification required
Caregiver can give medications	Yes (consumer-directed skilled tasks)	Only nurses can administer medications
Schedule flexibility	You set the schedule	Agency sets the schedule
Backup if caregiver is sick	Your responsibility to arrange	Agency provides a substitute
Cost to consumer	$0 (Medicaid pays)	$0 (Medicaid pays)
Managed by	You (or your representative) + PPL	Home care agency

Bottom line: CDPAP is the better choice if you want control over who provides your care and when. Traditional home care is better if you need guaranteed backup staffing and prefer not to manage the caregiver relationship yourself.

Watch: Consumer Directed Personal Assistance Program (CDPAP)

This 4-minute video from the New York State Department of Health provides an official overview of the CDPAP program, including eligibility requirements, how self-directed care works, and the application process.

Your Next Step

Ready to apply for CDPAP? Start by confirming your Medicaid is active. Then call your Managed Long-Term Care (MLTC) plan and ask for a home care assessment. If you do not have an MLTC plan yet, call the Medicaid Helpline at 1-800-541-2831.

Key Takeaway

CDPAP lets you choose your own caregiver - even a family member - and they get paid for helping you. The program is free to you as long as you have Medicaid. Your caregiver does not need any certifications or prior experience.

Frequently Asked Questions

Can I use CDPAP if I live in assisted living or a nursing home?

No. CDPAP is a home-based program. You must live in your own home or a family member's home to receive services. If you are in a nursing facility or assisted living residence, you would not qualify. However, if you are transitioning home from a facility, you can apply for CDPAP as part of your discharge plan.

How long does it take to get approved for CDPAP?

The process typically takes 4 to 8 weeks if you already have Medicaid. If you need to apply for Medicaid first, add another 4 to 6 weeks. The longest delays usually happen during the assessment scheduling phase. Calling your local Department of Social Services to follow up can help speed things along.

Can my caregiver work for more than one CDPAP consumer?

Yes, a caregiver can work for multiple CDPAP consumers as long as the schedules do not overlap. Each consumer is a separate employer, so the caregiver would have separate timesheets and pay arrangements through each consumer's fiscal intermediary.

What happens if my caregiver calls out sick?

Unlike agency-based home care, CDPAP does not provide backup staffing. If your caregiver is unavailable, it is your responsibility to arrange a substitute or go without care that day. Some families designate a second caregiver through the program as a backup. We recommend having at least one alternate caregiver registered with your fiscal intermediary.

Can I switch from traditional home care to CDPAP?

Yes. If you are currently receiving home care through an agency and want to switch to CDPAP, contact your MLTC plan or local Department of Social Services to request the change. You will still need to meet the self-direction requirement, but your existing assessment and authorized hours can often carry over without a new evaluation. If you need help navigating the process, a patient advocate can assist.