CDPAP is a New York State Medicaid program that empowers individuals to recruit, hire, train, and supervise their own personal care providers. This self-directed model allows the person receiving care, or a designated representative, to manage services, often including the ability to hire family members or friends as paid caregivers. While the structure of self-directed care is available in Florida, the specific CDPAP program name is unique to New York. Florida offers similar alternatives that place control over care services and budgets directly into the hands of the recipient.
The Florida Alternative to Consumer-Directed Care
Florida utilizes two primary mechanisms that serve as the functional equivalent to New York’s CDPAP, both operating under the state’s Medicaid framework. The first is the Participant Directed Option (PDO), offered within the Statewide Medicaid Managed Care (SMMC) Long-Term Care Program. This option targets older adults and individuals with physical disabilities who require a nursing facility level of care but wish to receive services at home or in the community.
The second alternative is the Consumer Directed Care Plus (CDC+) program, tailored for Floridians with developmental disabilities who qualify for the iBudget waiver. Both models shift decision-making authority from a traditional home health agency to the individual consumer. Participants are allocated a monthly budget for services, which they manage to purchase personal assistance and other approved supports. These programs operate under federal Home and Community-Based Services (HCBS) waivers.
Who Qualifies for Florida’s Self-Directed Care
Accessing Florida’s self-directed care options requires meeting specific eligibility criteria across three main areas.
Financial Eligibility
Applicants must meet the financial eligibility requirements for Medicaid, including limits on income and countable assets. These limits are determined by the Florida Department of Children and Families (DCF) and are a prerequisite for enrollment in any Medicaid waiver program.
Functional Eligibility
A functional eligibility determination must confirm the medical necessity for long-term care services. For the SMMC Long-Term Care Program, this means the applicant must require a nursing facility level of care (NFLOC). This is assessed through the Comprehensive Assessment and Review for Long-Term Care Services (CARES) program, which evaluates the need for assistance with daily living activities.
Program-Specific Status
Eligibility is also defined by age and status, varying between programs. PDO applicants are typically 65 or older, or individuals 18 and older who are eligible for Medicaid by reason of disability and require NFLOC. The CDC+ program is tailored for individuals with developmental disabilities who qualify for the iBudget waiver.
Managing Care and Caregiver Payment
Once enrolled, the consumer assumes the role of the employer, taking on responsibilities typically handled by a traditional home health agency. This includes recruiting, interviewing, hiring, training, supervising the chosen caregiver, and approving timesheets. The consumer, or their designated representative, is responsible for ensuring the quality and scheduling of the care received.
A third-party organization, known as a Fiscal Intermediary (FI) or financial management service, handles the administrative and financial burdens of the employment relationship. The FI manages payroll processing for caregivers, withholds and files all necessary federal and state taxes, and ensures compliance with labor laws. This allows the consumer to focus on managing the care rather than the complex financial paperwork of being an employer.
A significant feature of these self-directed models is the ability to hire certain family members as paid providers. Caregivers, who can include adult children or other relatives (excluding the spouse), must pass a background screening but do not require formal certification for personal care tasks. The CDC+ program also allows caregivers to perform certain skilled tasks, such as administering insulin injections, which are normally restricted to licensed nurses in a traditional agency setting.
Steps for Enrollment and Access
The process to access Florida’s self-directed long-term care begins by contacting the local Area Agency on Aging (AAA) or Aging and Disability Resource Center (ADRC). These agencies conduct an initial pre-screening to determine potential eligibility and assign a priority score for placement on the waiting list. This screening is important because the SMMC-LTC program is not an entitlement, meaning available slots are limited.
The applicant must then undergo two formal eligibility determinations: one for financial eligibility by the DCF and one for medical necessity by the Department of Elder Affairs (DOEA). The DOEA conducts a full assessment to confirm the applicant meets the nursing facility level of care requirement. Once approved and a program slot becomes available, the applicant is contacted to complete the enrollment process.
The final step involves selecting a Medicaid Managed Care plan within their region that offers the self-directed option, such as the Participant Directed Option. The Agency for Health Care Administration (AHCA) oversees this final placement. Once enrolled, the consumer receives training to manage their budget and assume their role as the employer of their care team.