The Consumer Directed Personal Assistance Program — CDPAP — lets a New York Medicaid member hire their own caregiver instead of using an agency-assigned aide. That caregiver can often be a family member or friend, paid through the state’s fiscal intermediary.
Two things about eligibility changed for the worse in the last year, and most of what’s written about CDPAP online doesn’t mention either: a new clinical bar introduced in September 2025, and a narrower list of who you’re allowed to hire than most people assume. This page covers both, plus what enrollment actually involves.
Who qualifies for CDPAP
Per New York State’s Department of Health, to be eligible for CDPAP an individual must:
- be eligible for NYS Medicaid
- have a stable medical condition
- have a determined need for home-care services, using a state-approved assessment tool
- meet the Minimum Needs Requirements, if age 21 or over
- be capable of self-directing their own care, or have a designated representative who can make decisions on their behalf
That fourth point is new, and it’s the one worth understanding before you apply.
The Minimum Needs Requirement: what changed on 1 September 2025
As of 1 September 2025, New York added a clinical threshold that didn’t exist before. It applies to Medicaid recipients aged 21 and over seeking Personal Care Services (PCS) or CDPAP, and to anyone 18 or older enrolling in a Managed Long Term Care Plan (MLTCP) or Medicaid Advantage Plan.
| To meet the requirement, you must be assessed as needing | Applies to |
|---|---|
| At least limited assistance with physical maneuvering, with more than two Activities of Daily Living (ADLs) | Most applicants |
| At least supervision with more than one ADL | Applicants with a Dementia or Alzheimer’s diagnosis |
Two exceptions worth knowing:
- It doesn’t apply to PACE enrollment (Program of All-Inclusive Care for the Elderly).
- You’re grandfathered in if you don’t have to re-qualify. If you were already authorized for or receiving PCS/CDPAS, or continuously enrolled in an MLTC plan, as of 1 September 2025, you continue under the old criteria. The new bar applies to initial assessments and reassessments from that date onward — not retroactively to people already in the program.
Practically: if a parent was already receiving CDPAP hours before September 2025, this change doesn’t touch them. If you’re applying fresh now, or coming up for reassessment, the assessor is checking against this specific standard — and “needing some help sometimes” may not clear it. The bar is more than two ADLs (or, for dementia, more than one with supervision), not one.
Who you’re allowed to hire
This is where the mismatch with popular expectation is sharpest. The state page is specific:
| Can they be your paid CDPAP caregiver? | Answer |
|---|---|
| Adult child | Yes |
| Sibling, other relative, friend | Yes |
| Your spouse | No |
| Your designated representative (the person managing your case) | No |
| A parent, if the consumer is under 21 | No |
The spousal exclusion catches people off guard most often: a husband cannot be paid to care for his wife under CDPAP, or the reverse, regardless of how much care he’s already providing unpaid. The same goes for the parent of a consumer under 21 — that parent can supervise and manage the case, but can’t also be the one on payroll for that same child’s care.
What the recipient (or their representative) is responsible for
CDPAP shifts real administrative work onto the consumer or their designated representative. Per the state, that means:
- recruiting, hiring, training, supervising and terminating personal assistants
- arranging back-up coverage when the regular assistant is unavailable
- arranging and coordinating any other services the person needs
- keeping personal assistant payroll records
- working with the fiscal intermediary to process payroll
The fiscal intermediary — Public Partnerships LLC (PPL), statewide since the 2025 transition — handles the payroll mechanics, tax withholding and employment records. It does not do the recruiting, training or supervising. That stays with you.
How enrollment works
- Get assessed. If you don’t already have an assessment on file, contact the New York Independent Assessor Program (NYIAP) at 1-855-222-8350 (TTY 1-888-329-1541). PPL’s own CDPAP registration page walks through what happens after that.
- Get approved by your health plan or LDSS. Before registering with PPL, you need approval from your Managed Long Term Care plan, Medicaid Advantage plan, or Local Department of Social Services, plus the completed assessment.
- Register with PPL. Create a PPL@Home account, sign the Memorandum of Understanding, and complete registration.
- Set up Time4Care. Your personal assistant downloads the app to clock in and out and for you to approve their hours.
- Your personal assistant clears their own requirements. A health assessment before starting (repeated annually), and required training within 90 days of their PPL start date.
New York’s Department of Health does not publish a fixed turnaround time for this process. In practice, the assessment step through NYIAP is usually what takes longest — everything downstream of it (PPL registration, Time4Care setup) tends to move faster once the assessment and health-plan approval are in hand. Be skeptical of any site that quotes you an exact number of days as an official figure; it isn’t one.
CDPAP vs. Personal Care Services (PCS)
The state runs both programs for the same broad goal — helping people stay in their own home — but they’re structured differently:
| CDPAP | Personal Care Services (PCS) | |
|---|---|---|
| Who hires the aide | You (the consumer) or your representative | A licensed home care agency |
| Who can be the aide | Family or friends (with the exclusions above) | Agency-employed, certified aides only |
| Aide certification required | No — you train them | Yes — HHA/PCA certification |
| Who supervises | You | The agency |
If self-directing the hiring, training and scheduling sounds like more than you want to take on — or there’s no family member available or willing to do the paid work — agency-based home care covers the same daily needs without that administrative load.
Where CDPAP doesn’t reach
CDPAP covers personal-care and custodial tasks, including some skilled tasks the consumer trains the assistant to do. It does not turn a personal assistant into a licensed clinician. If care involves wound management, injections, or ongoing medication administration that needs a nurse’s judgment rather than a trained layperson’s routine, that’s skilled nursing, not CDPAP.
We’re a licensed home care agency in Brooklyn and Queens — licence #2572L001, New York State Department of Health — and we’re not a fiscal intermediary; we don’t process CDPAP payroll or replace PPL. What we do see often is families using both at once: CDPAP for the hours a relative can realistically cover, and agency aides or nursing for the rest. If you want to work out whether CDPAP fits your situation, or what to combine it with, call (718) 232-2777 or use our contact page. No cost, no obligation.
Frequently asked questions
Who is eligible for CDPAP in New York?
Someone who is eligible for NYS Medicaid, has a stable medical condition, has a documented need for home care from a state-approved assessment, meets the Minimum Needs Requirement if they’re 21 or older, and can direct their own care or have a representative who can.
Can my spouse be my paid CDPAP caregiver?
No. New York State explicitly excludes spouses from being paid personal assistants under CDPAP, regardless of the care they already provide.
What is the Minimum Needs Requirement?
A clinical threshold introduced 1 September 2025 for Medicaid recipients 21 and over seeking CDPAP or Personal Care Services. It requires being assessed as needing at least limited assistance with more than two Activities of Daily Living, or — for a Dementia or Alzheimer’s diagnosis — at least supervision with more than one ADL. People already authorized or enrolled before that date are grandfathered under the previous criteria.
Can a parent be paid to care for their child under CDPAP?
Not if the child is under 21. A parent of a CDPAP consumer under 21 cannot be that consumer’s paid personal assistant, though they can act as the designated representative managing the case.
How long does CDPAP enrollment take?
New York State doesn’t publish an official timeline. The assessment through the New York Independent Assessor Program is typically the longest step; registration with PPL and setting up Time4Care generally move faster once the assessment and health-plan approval are complete.
Does a CDPAP caregiver need a license or certification?
No. Unlike a home health aide or personal care aide under traditional Personal Care Services, a CDPAP personal assistant does not need formal certification — the consumer or their representative trains them directly.
What’s the difference between CDPAP and Personal Care Services?
Under CDPAP, the consumer hires, trains and supervises their own personal assistant, who can be a family member or friend and does not need certification. Under Personal Care Services, a licensed agency employs and supervises certified aides.
Who do I contact to start the CDPAP assessment?
The New York Independent Assessor Program (NYIAP), at 1-855-222-8350 (TTY 1-888-329-1541), for anyone who doesn’t already have an assessment on file.
Program rules change; the Minimum Needs Requirement in particular took effect within the last year. Everything above was checked against health.ny.gov and pplfirst.com on 27 September 2026. Confirm your own eligibility with the New York Independent Assessor Program or your Managed Long Term Care plan.
