CDPAP, or the Consumer Directed Personal Assistance Program, is a New York State Medicaid program that lets people who need home care choose their own caregiver and direct their own services. Unlike traditional home care, where an agency assigns an aide and dictates the care plan, CDPAP puts the person receiving care (called the “consumer”) in charge. You pick who helps you, train them yourself, and decide how and when care is provided.
The program is specifically designed for people who want more control over their daily care, and it’s one of the only Medicaid programs in the country that allows family members and friends to be paid caregivers.
How CDPAP Differs From Traditional Home Care
In a traditional home care arrangement, an agency hires and assigns an aide to you. That aide follows a predetermined care plan, and you have limited say in who shows up at your door. The caregiver may be a stranger, and the agency manages scheduling, training, and supervision.
CDPAP flips that model. You select your own caregiver, someone you already know and trust if you prefer. You act as the employer: you hire, train, supervise, and if necessary, fire your personal assistant. You decide the order tasks get done and how they’re performed, as long as they fall within your approved plan of care. The program is overseen by the state Department of Health and Medicaid rather than a private home care agency.
This structure makes a significant practical difference. A family member who already understands your routine, preferences, and medical needs can step into the caregiver role and get paid for work they may already be doing informally.
Who Is Eligible
To qualify for CDPAP, you must be enrolled in New York State Medicaid and have a stable medical condition with a documented need for home care services. An assessment using a state-approved tool determines that need. If you’re 21 or older, you also have to meet minimum needs requirements: you must need at least limited help with physical movement in more than two activities of daily living (things like bathing, dressing, eating, or transferring in and out of bed). For people with a dementia or Alzheimer’s diagnosis, the threshold is lower: needing at least supervision with more than one activity of daily living.
There’s one more requirement that’s central to the program’s design. You must be able to self-direct your care, meaning you can make decisions about how your services are provided. If you can’t do that independently, you can designate a representative to make those decisions on your behalf.
Which Family Members Can Be Caregivers
One of CDPAP’s biggest draws is that family members can serve as paid personal assistants. A 2016 law specifically expanded the program to allow parents of adult children (age 21 and older) to be hired as their caregivers. Siblings, adult children, cousins, and other relatives are also eligible. Living in the same home as the consumer does not disqualify a family member.
There are three clear restrictions. A spouse cannot be a consumer’s personal assistant. A parent cannot be a paid caregiver for a child under 21. And whoever serves as the consumer’s designated representative (the person making care decisions on their behalf) cannot also be that consumer’s personal assistant.
What the Consumer Is Responsible For
Being in CDPAP means taking on real employer responsibilities, either yourself or through your designated representative. You hire your personal assistant, train them to perform the specific tasks in your care plan, set the schedule, supervise the work, and sign off on their timesheets. If the arrangement isn’t working, you’re responsible for letting the caregiver go and finding a replacement.
A designated representative handles all of these same duties if the consumer can’t. They essentially step into the consumer’s shoes for every management decision, from scheduling to collaborating with the fiscal intermediary to participating in reassessments.
Personal assistants in CDPAP don’t need prior certification or training as home health aides. The consumer or their representative provides all training, which is part of what allows the program to include family and friends who wouldn’t qualify to work for a traditional agency.
The Role of the Fiscal Intermediary
While you manage the caregiving side, a fiscal intermediary handles the administrative and financial side. This organization processes payroll, withholds taxes, manages benefits, and handles billing. You don’t write checks to your caregiver directly; the fiscal intermediary pays them based on the timesheets you approve.
In 2024, New York’s legislature moved CDPAP to a single statewide fiscal intermediary model, replacing a patchwork of hundreds of smaller intermediaries across the state. The transition took effect in early 2025. The statewide fiscal intermediary uses an electronic visit verification system called Time4Care to track and confirm caregiver hours, which is required under federal law. If you run into issues, you can contact your managed care plan, your local Department of Social Services, or the state Department of Health directly.
How the Application Process Works
Getting into CDPAP involves several steps and multiple agencies. The process begins when you (or someone on your behalf) submit documentation to your local Department of Social Services. This includes an attestation of need and a practitioner statement from a doctor or nurse practitioner familiar with your condition.
Your local social services office reviews the paperwork and, within 12 calendar days, refers you to the New York Independent Assessor for a clinical evaluation. That evaluation has two parts: a community health assessment conducted by a nurse assessor, and a clinical appointment with a physician, nurse practitioner, or physician assistant. Both appointments are typically scheduled within six days of the referral call. After both are complete, you receive a written notice with the outcome. If approved, your local social services office works with you to develop a plan of care that specifies which services you’ll receive and how many hours are authorized.
If you’re already enrolled in a Medicaid managed care plan, you can also start by contacting your managed care organization directly.
Caregiver Pay Rates
CDPAP personal assistants are classified as home care aides under New York law, which means they’re covered by the state’s home care aide minimum wage. As of January 1, 2026, the minimum hourly rate is $19.65 in New York City, Long Island, and Westchester, and $18.65 in the rest of the state. Actual pay depends on your region and managed care plan, but these minimums set the floor. Caregivers are paid through the fiscal intermediary based on hours worked and verified.
What Services a CDPAP Caregiver Can Provide
CDPAP personal assistants can perform a broader range of tasks than traditional home health aides. Because the consumer directs and trains the caregiver personally, assistants can handle certain skilled tasks that would normally require a licensed nurse in a traditional agency setting. This can include medication administration, injections, wound care, suctioning, and other health-related tasks, as long as they’re part of the approved plan of care and the consumer or representative has trained the assistant to perform them safely.
Beyond medical tasks, personal assistants help with the everyday activities that make independent living possible: bathing, grooming, dressing, meal preparation, light housekeeping, and help getting around. The specific tasks covered are those listed in your individualized plan of care, so the scope varies from person to person based on assessed needs.