CDPAP Explained: Eligibility, Hiring, and Enrollment

New York’s Consumer Directed Personal Assistance Program, known as CDPAP, is open to New York Medicaid recipients who have a stable medical condition that can be managed at home, need help with a set number of daily activities, and can either direct their own care or name someone to do it for them. It lets you hire, train, and supervise your own caregiver — including most family members and friends — rather than accepting whoever a home care agency sends. The program is authorized under New York Social Services Law § 365-f and runs statewide.

Clinical Eligibility

You need a stable medical condition that can be safely managed at home rather than in a hospital or nursing facility.¹ You also have to need help with activities of daily living, and the law sets a specific floor for anyone who first applied on or after October 1, 2020: you must need at least limited physical assistance with more than two activities of daily living. If you have a dementia or Alzheimer’s diagnosis, the threshold drops to at least supervisory help with more than one activity of daily living.²

The other clinical requirement is self-direction. You have to be able to make informed decisions about what services you need and how they should be delivered. If a cognitive impairment or other condition gets in the way, you can name a designated representative — usually a family member or another trusted adult — who takes on the hiring, training, and supervision duties on your behalf.¹

Medicaid Income and Asset Limits

Because CDPAP runs through Medicaid, you must be enrolled and financially eligible under Non-MAGI Medicaid rules. As of January 1, 2026, the monthly income limit for a single individual is $1,330, and the asset limit is $33,038 for one person or $44,796 for a couple.³

Going over the income limit does not automatically disqualify you. New York allows a spend-down, where the excess functions like a deductible you put toward your care. A common workaround is a pooled income trust: an irrevocable trust managed by a nonprofit, into which you deposit your surplus each month. The trust pays your living expenses from that sub-account, and because the money goes in before it counts, Medicaid treats your income as within the limit. This is the standard planning tool for people whose Social Security or pension pushes them slightly over.

Who You Can Hire

Most family members and friends qualify. Adult children, siblings, parents, and close friends can all be paid as your personal assistant.

The exclusions are narrow but firm. Your spouse cannot be paid as your personal assistant. Neither can the person acting as your designated representative. Anyone legally responsible for your care and support, such as a legal guardian, is also barred.⁴ Every assistant must be legally authorized to work in the United States and must complete a health assessment before starting, with medical documentation kept on file by the fiscal intermediary.⁵

What Services Are Covered

A CDPAP personal assistant can perform any task that would otherwise be done by a personal care aide, home health aide, or licensed nurse.¹ That includes everyday help with bathing, dressing, grooming, meal preparation, and light housekeeping, and it also includes skilled nursing tasks like wound care, medication administration, and catheter maintenance, provided you have trained the assistant to do them.

What your assistant is actually authorized to do is set by your plan of care, which flows from your clinical assessment. For people with the most intensive needs, the program can authorize round-the-clock split-shift or multi-shift coverage when continuous 24-hour care is medically necessary.⁶

What You Take On as the Employer

Control comes with responsibility. You (or your designated representative) act as the employer. You recruit and interview candidates, decide who to hire, and personally train your assistant to carry out the tasks in your care plan. No agency staff will come train them for you.¹

You verify hours worked each week, monitor quality of care, and can terminate the employment if performance falls short. You also arrange backup coverage when your regular assistant is sick, on vacation, or otherwise unavailable.¹ If your assistant calls out at short notice, finding a replacement is on you, not on an agency. Having a second trained assistant lined up is one of the more practical steps you can take.

How to Enroll

Start by gathering documentation. You need your Medicaid identification number and a Physician’s Order for Services (Form DOH-4359) completed by your doctor. This form establishes the medical necessity for home care and supports the number of hours you are asking for.⁷ You will also need the full legal name, contact information, and identity documents (such as a Social Security card) for whomever you plan to hire, since payroll setup depends on it.

Once the paperwork is ready, contact your Medicaid Managed Care plan to open the request. If you are not enrolled in a managed care plan, your local Department of Social Services handles the intake instead. The New York Independent Assessor (NYIA) then conducts a clinical assessment to determine how much care you need. That assessment drives the number of hours you will be authorized to receive, so be specific and thorough about your medical history and daily limitations. Do not downplay what you struggle with.

The Statewide Fiscal Intermediary

Every CDPAP consumer works with a fiscal intermediary, which handles payroll, tax withholding, and insurance for the personal assistant. As of April 1, 2025, New York consolidated all CDPAP fiscal intermediary services under a single vendor: Public Partnerships LLC (PPL).⁸ PPL is now the only entity authorized to provide those services statewide. Your assistant submits and approves timesheets through PPL’s Time4Care app, and paychecks come from PPL. Assistants must complete Electronic Visit Verification training in the app before starting work.⁹

The switch to PPL did not change eligibility rules, authorized service hours, or the requirements for personal assistants. You still choose who provides your care.⁹

If You Are Denied or Your Hours Are Reduced

You can challenge a denial, reduction, or termination through a Medicaid fair hearing. Medicaid must notify you in writing of any decision affecting your eligibility or services, and the notice explains how to request a hearing and the deadline.¹⁰

Timing is critical. If you file before the effective date on the notice, your current services must continue unchanged while the hearing is pending. That protection is called “aid continuing.” There can be as few as 10 days between when the notice is mailed and when the action takes effect, so open your mail promptly. If your health could seriously worsen without prompt care, you can request an expedited hearing; the written notice includes instructions. Hearings are handled by the New York Office of Temporary and Disability Assistance, and you can bring documentation, medical records, and witnesses.¹⁰

1
New York State Department of Health. Consumer Directed Personal Assistance Program (CDPAP)
2
New York State Senate. New York Social Services Law 365-F – Consumer Directed Personal Assistance Program
3
New York State Department of Health. New York State Income and Resource Standards for Non-MAGI Populations – Effective January 1, 2026
4
New York Codes, Rules and Regulations. New York Code 18 CRR-NY 505.28 – Consumer Directed Personal Assistance Program
5
Cornell Law Institute. New York Comp Codes R and Regs Tit 18 505.28 – Consumer Directed Personal Assistance Program
6
New York State Department of Health. Consumer Directed Personal Assistance Program (CDPAP)
7
New York State Department of Health. GIS 10 OLTC/006 – Physicians Order for Use in the Personal Care Services Program and the Consumer Directed Personal Assistance Program
8
New York State Department of Health. Consumer Directed Personal Assistance Program Statewide Fiscal Intermediary Policy for Medicaid Managed Care Plans
9
New York State Department of Health. Transitioning to PPL as the CDPAP Fiscal Intermediary
10
Medicaid.gov. Understanding Medicaid Fair Hearings