The Consumer Directed Personal Assistance Program (CDPAP) is a unique healthcare model that redefines how individuals with chronic illnesses or physical disabilities receive long-term home care. This state-level Medicaid initiative moves away from the traditional agency-managed approach to in-home support. CDPAP’s core purpose is to empower the recipient, referred to as the consumer, by giving them the responsibility and authority to manage their own care services. This structure allows consumers to select, train, and supervise their own Personal Assistant (PA), granting significant autonomy over their daily lives and care routines.
Eligibility Requirements for Consumers
To qualify for CDPAP, an individual must first be eligible for Medicaid, as this is the primary funding source. Applicants must demonstrate a medically determined need for long-term home care services, established through a comprehensive health assessment. This assessment verifies the individual requires assistance with daily activities (such as bathing, dressing, and mobility) or needs skilled nursing tasks.
A stable medical condition is also a prerequisite. Most importantly, the consumer must either be capable of directing their own care or must appoint a designated representative. This ensures the consumer-directed model can be effectively implemented, as the consumer or representative is ultimately responsible for managing the caregiver. The capacity for self-direction is a non-negotiable factor for enrollment.
The Range of Covered Services
The scope of services a Personal Assistant (PA) can provide under CDPAP is intentionally broad, covering tasks traditionally performed by multiple types of home care workers. PAs routinely assist with Activities of Daily Living (ADLs) like personal hygiene, transferring, and feeding, as well as instrumental tasks like meal preparation and light housekeeping. The PA’s duties are tailored to the specific needs outlined in the consumer’s plan of care.
A key distinction of CDPAP is the allowance for PAs to perform tasks typically classified as skilled nursing services. Unlike traditional home health aides, CDPAP PAs, once trained and directed by the consumer or their representative, may administer skilled care such as insulin injections, wound care, or suctioning tracheostomies. This allows consumers with complex medical needs to receive comprehensive care from a single, trusted individual. The PA is not required to hold specific medical certifications, relying instead on the consumer’s direction and training for these specialized tasks.
Managing Your Own Care through Consumer Direction
The principle of consumer direction fundamentally shifts the power dynamic from the home care agency to the individual receiving care. The consumer, or their designated representative, acts as the employer, taking on responsibility for the Personal Assistant. This includes recruiting, interviewing, hiring, and training the person who will provide in-home assistance.
This level of control extends to day-to-day management, requiring the consumer to set the PA’s work schedule and supervise their performance. The consumer also holds the authority to terminate the PA’s employment. A valued feature of CDPAP is the ability to hire certain family members or friends (excluding spouses and parents of minor children), which allows care to be provided by someone with an existing, trusting relationship.
While the consumer manages the care, a separate entity known as a Fiscal Intermediary (FI) handles the administrative and financial functions. The FI serves as the employer of record for financial purposes, responsible for processing the PA’s payroll, managing tax withholdings, and providing benefits. This administrative support frees the consumer to focus exclusively on directing the actual provision of care. The Fiscal Intermediary does not involve itself in care management or scheduling, maintaining the consumer’s complete control over their personal care arrangement.