How the CDPAP Program May Be Affected by NY State Budget Changes

How the CDPAP Program May Be Affected by NY State Budget Changes

August 18, 2023   574

How the CDPAP Program May Be Affected by NY State Budget Changes


The Consumer Directed Personal Assistance Program (CDPAP) has been a boon for many New York residents, offering them personalized care solutions tailored to their needs. How might the NY State budget changes impact this vital program? Let's delve deep into the recent proposals and their potential implications.

NY 2024 Executive Budget Proposal for CDPAP

The recent New York State 2024 Executive Budget, unveiled on February 1, 2023, presents transformative modifications to the state's beloved CDPAP. The budget suggests replacing wage parity with subsidies, aiming to aid CDPAP workers in obtaining health insurance through the state’s health plan marketplace. But what's causing a stir are the proposed amendments to the CDPAP FI request for offers (RFO) legislation. This amendment could radically reshape the landscape of CDPAP RFO for all fiscal intermediaries (FIs).

Governor Hochul’s plan proposes a novel authorization process, one that seems to shift significant responsibility away from the Department of Health (DOH) and onto managed long-term care (MLTC) plans and other entities. By redefining FIs and how they operate, this shift indicates an intention to offload some responsibilities from the DOH to health plans and counties.

Governor Kathy Hochul’s 2023-2024 Budget Implications

When Governor Kathy Hochul signed the 2023-2024 NY State Budget Bill into law on May 3, 2023, she charted a new course for home care providers and the broader health care industry. The final budget is set to significantly change home care agencies, skilled nursing facilities, and other medical practices.

One notable aspect of the Budget is the greater oversight the DOH now holds. They can request any records related to wages, benefits, and compensations from any home care aide employer. Furthermore, the wage parity benefit and hourly wage components are to undergo changes, particularly for home care workers. However, the finalized Budget does not adopt the previously proposed schedule, suggesting a different pathway.

Increased Home Care Wage and Hour Oversight

The latest budget changes allow the DOH to demand records from any home care aides’ employer, which includes both Licensed Home Care Services Agencies (LHCSAs) and Certified Home Health Agencies (CHHAs)[2]. This increased oversight will mandate employers to provide a timely written response within 15 days of the DOH's request. The stakes are high, with the DOH authorized to impose civil penalties for delinquent responses.

Oversight of Managed Long Term Care (MLTC)

The finalized Budget introduces a less stringent oversight standard for MLTC than previously proposed. MLTC plans now have a twofold requirement: they must include an active Medicare Dual Eligible and ensure compliance with the Medicare Improvements for Patients and Providers Act.

What These Changes Mean for the Future of CDPAP

The current trajectory suggests a profound transformation of the CDPAP landscape. With more stringent oversight and regulatory changes, the CDPAP program's future remains uncertain. For many fiscal intermediaries (FIs), this could be a challenging time, especially given the prolonged RFO and attestation process many have grappled with over the years.


As the NY State budget changes unfold, the future of CDPAP hangs in the balance. While some modifications might offer a more streamlined process, others could pose significant challenges for both service providers and recipients. As we continue to monitor the situation, one thing is clear: the healthcare landscape in New York is poised for a dramatic transformation.


  1. What is the CDPAP program?

    • CDPAP stands for Consumer Directed Personal Assistance Program, a New York-based program that allows consumers to recruit, hire, and manage their personal assistants.
  2. How might the new budget affect CDPAP?

    • The proposed changes in the NY 2024 Executive Budget could significantly reshape the CDPAP landscape, potentially impacting wage standards, authorization processes, and more.
  3. What are fiscal intermediaries (FIs) in the context of CDPAP?

    • FIs are entities responsible for processing payroll and ensuring that personal assistants are paid according to state and federal labor laws.
  4. How will the DOH's increased oversight impact home care providers?

    • Providers will now need to ensure timely compliance with any DOH requests or face potential civil penalties.
  5. Will the minimum wage for home care workers be affected?

    • Yes, the Budget proposes changes to the minimum wage rate for home care workers, with different schedules for various regions.


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