CDPAP stands for the Consumer Directed Personal Assistance Program, a New York State Medicaid program that lets people who need home care choose their own caregivers, including family members and friends, and pay them through Medicaid. Unlike traditional home care, where an agency assigns you an aide, CDPAP puts you in charge of hiring, training, and managing the person who helps you.
How CDPAP Differs From Traditional Home Care
In a standard home care arrangement, a licensed agency selects an aide and sends them to your home. You have limited say in who shows up or how they do things. CDPAP flips that dynamic. You recruit your own caregiver, set their schedule, and direct their work. The program treats you as the employer.
The other major difference is the scope of what your caregiver can do. Traditional home health aides are restricted to basic personal care tasks. Under CDPAP, your personal assistant can perform tasks that would normally require a personal care aide, a home health aide, a licensed practical nurse, or even a registered nurse. That includes skilled nursing tasks like administering medications, managing feeding tubes, or wound care, as long as those tasks are on your approved plan of care and you (or your representative) can train and supervise the assistant. This flexibility is one of the main reasons people choose CDPAP over agency-based care.
Who Qualifies for CDPAP
Eligibility has several layers. You must be enrolled in New York State Medicaid, have a stable medical condition, and be assessed as needing home care services through a state-approved evaluation tool. You also need to be capable of directing your own care. If you can’t do that yourself due to a cognitive or physical condition, a designated representative (a family member or trusted person) can make decisions on your behalf.
For adults 21 and older, there’s an additional threshold called the Minimum Needs Requirements. You must be assessed as needing at least limited help with physical movement in more than two activities of daily living. Activities of daily living include things like bathing, dressing, eating, toileting, and moving around. If you have a dementia or Alzheimer’s diagnosis, the bar is slightly different: you need at least supervisory assistance with more than one activity of daily living.
There are exceptions. People enrolled in the Program of All-Inclusive Care for the Elderly (PACE) don’t have to meet the minimum needs threshold. And anyone who was already authorized for personal care services or CDPAP, or was continuously enrolled in a managed long-term care plan as of September 1, 2025, remains eligible under the previous, less restrictive criteria.
Who You Can Hire as a Caregiver
One of CDPAP’s biggest draws is that your caregiver doesn’t need to be a certified home health aide or nurse. You can hire a friend, neighbor, or family member, including a spouse or adult child. The person you choose does not need professional credentials or prior training. You’re responsible for teaching them the specific tasks on your care plan and supervising their work.
If your care plan includes skilled nursing tasks, you may be asked during your assessment to demonstrate the procedure or provide written step-by-step instructions showing how the task should be performed. This ensures your personal assistant can safely carry out the care you need.
What Caregivers Get Paid
CDPAP personal assistants are paid through Medicaid, not out of your pocket. New York sets minimum wage rates specifically for home care aides, and CDPAP assistants fall under those rules. As of January 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.
Caregivers are also entitled to overtime pay (time and a half for hours over 40 per week), spread-of-hours pay if their workday exceeds ten hours, and call-in pay if they’re sent home early from a scheduled shift. These protections apply the same way they would for any home care worker in New York.
The Role of the Fiscal Intermediary
Even though you direct your own care, you don’t handle payroll or tax filings yourself. That’s the job of a fiscal intermediary, an organization that processes your caregiver’s wages, manages benefits, handles billing, and takes care of employment paperwork. The fiscal intermediary acts as a joint employer alongside you.
New York has been consolidating this function into a single statewide fiscal intermediary (SFI) rather than allowing dozens of smaller organizations to serve this role. Under the current structure, consumers and their personal assistants must register with the SFI and use its system to submit and approve timesheets electronically. The SFI also provides training materials and support for care managers and managed care plans.
If you’re enrolled in a Medicaid managed care plan, your care manager will help coordinate the connection between you, your personal assistant, and the SFI. But the core responsibilities remain yours: choosing your caregiver, directing their daily tasks, and approving their timesheets.
Limits on Services
Your personal assistant can only perform tasks that appear on your approved plan of care. The number of hours you’re authorized depends on your assessed needs. One specific limit worth knowing: if you only need help with nutritional and environmental support (meal prep and light housekeeping, essentially), your authorized hours cannot exceed eight per week.
If at any point you decide CDPAP isn’t the right fit, your managed care plan can work with you to switch to a different long-term care service. Similarly, if your personal assistant doesn’t complete their registration with the fiscal intermediary, your care team will reach out to help you find and register a replacement.
How to Get Started
The process begins with Medicaid eligibility. If you’re already enrolled in Medicaid, the next step is a needs assessment conducted through your managed long-term care plan or local department of social services using a state-approved tool. This assessment determines whether you qualify for home care and how many hours you need. Once approved for CDPAP specifically, you’ll sign an agreement outlining your responsibilities as the consumer (or your designated representative’s responsibilities), identify and recruit a personal assistant, and complete registration with the statewide fiscal intermediary. Your care manager serves as the main point of contact throughout enrollment, helping coordinate between you, the SFI, and your health plan.