CDPAP New York: Can a Family Member Get Paid to Care for You? (2026)
CDPAP lets a New York Medicaid recipient hire a family member or friend as their paid personal assistant. Since April 1, 2025, Public Partnerships LLC (PPL) is the sole statewide fiscal intermediary handling CDPAP enrollment and payroll.
Possibly. New York's Consumer Directed Personal Assistance Program (CDPAP) lets a Medicaid recipient choose and direct their own paid personal assistant — and that assistant can usually be a family member or friend. Three relationships are excluded: a spouse, the consumer's designated representative, and the parent of a consumer under 21.
Quick answer
| Program | Consumer Directed Personal Assistance Program (CDPAP), New York Medicaid |
|---|---|
| Can a family member be paid | Many adult relatives and eligible non-relatives may serve as CDPAP personal assistants if they meet New York's applicable requirements — the person receiving care must qualify first |
| Can a spouse be paid | No — a spouse cannot be the personal assistant, nor can the designated representative, nor a parent of a consumer under 21 |
| Can an adult child, sibling or friend be paid | Potentially, if they are at least 18 and all applicable requirements are satisfied — relationship alone does not decide it |
| Is Medicaid required | Yes — the person receiving care must be enrolled in New York Medicaid |
| Is an assessment required | Yes — a physician's order plus an independent assessment through NYIAP |
| Is certification or experience required | No — the consumer chooses and trains their own personal assistant |
| Is training required | Yes — mandatory training through the state's designated training portal |
| Who decides the hours | The independent assessment — care is paid only within the authorised hours |
| Fiscal intermediary | Public Partnerships LLC (PPL) — the sole statewide fiscal intermediary since 1 April 2025 |
| Who handles payroll and timesheets | PPL — timesheets are submitted and wages are paid through them |
| Minimum needs requirement | Since 1 September 2025, people 21+ generally must be assessed as needing at least limited assistance with physical maneuvering with more than two ADLs — or, with Alzheimer’s or dementia, at least supervision with more than one ADL |
| Who directs the care | The consumer, or their designated representative — the designated representative cannot also be the paid personal assistant |
| Is this automatic | No — it depends on Medicaid enrolment, the assessment outcome, and enrolment through PPL |
New York CDPAP requirements changed in 2025
New York implemented new Minimum Needs Requirements for Personal Care Services (PCS) and Consumer Directed Personal Assistance Services (CDPAS), effective September 1, 2025. If you are applying now, this is the part most older articles get wrong.
For Medicaid recipients age 21 or older seeking PCS or CDPAS, the person generally must be assessed as:
- needing at least limited assistance with physical maneuvering with more than two Activities of Daily Living (ADLs); or
- if the person has Alzheimer's disease or dementia, needing at least supervision with more than one ADL.
These requirements apply to initial assessments and to subsequent reassessments occurring on or after September 1, 2025.
Exceptions and legacy treatment
- People already authorized for or receiving PCS or CDPAS before September 1, 2025 may retain Legacy Status and continue to be assessed under the previous criteria.
- PACE (Program of All-Inclusive Care for the Elderly) is treated separately.
- Pediatric cases follow separate assessment rules.
- Exact eligibility is determined through the applicable New York assessment process, not by reading a checklist.
Note the wording carefully. This is not simply a "you need three ADLs" rule — the standard is about the level of assistance needed (limited assistance with physical maneuvering, or supervision where dementia is present) as assessed through New York's process.
Do I meet New York's CDPAP minimum needs requirement?
Only New York's assessment process can answer this. But you can prepare well by understanding what an ADL is and by writing down the help that is already being given each day.
What counts as an Activity of Daily Living?
ADLs are the basic self-care tasks a person does every day. They commonly include:
- Bathing
- Dressing
- Toileting
- Transferring — for example moving from a bed to a chair
- Walking and mobility inside the home
- Eating
- Personal hygiene and grooming
Questions worth answering before the assessment
- Which of these tasks does the person need hands-on help with, and how often?
- Does the help involve physically maneuvering the person — steadying, lifting, guiding, repositioning?
- Has a clinician documented Alzheimer's disease or dementia? If so, the supervision standard may apply instead.
- Were PCS or CDPAS already authorized before September 1, 2025? Legacy Status may apply.
- What changes on a bad day, compared with a typical day?
Bring specifics rather than summaries. "She needs help bathing" tells an assessor less than "she cannot step over the tub edge safely, so I steady her in and out twice a day, and she needs prompting to finish because she loses track of what she's doing." The second version describes both the task and the level of assistance.
Meeting these descriptions does not guarantee eligibility or approval. Eligibility is determined through the applicable New York assessment process, including the independent assessment and clinician review.
CDPAP and dementia or Alzheimer's
New York's Minimum Needs Requirements include a separate pathway where Alzheimer's disease or dementia is documented. For applicable recipients, the standard involves needing at least supervision with more than one Activity of Daily Living, rather than the general standard of limited assistance with physical maneuvering with more than two ADLs.
Where this pathway applies, New York uses the Alzheimer's Disease or Dementia Form (DOH-5821), completed by a qualifying clinician, as part of the documentation supporting the assessment.
A dementia or Alzheimer's diagnosis by itself does not guarantee CDPAP eligibility. The applicable assessment determines whether the person meets New York's requirements, subject to New York's assessment rules.
Important 2025 change: PPL is now the only fiscal intermediary
As of 1 April 2025, Public Partnerships LLC (PPL) became the sole statewide fiscal intermediary for CDPAP, replacing roughly 600 fiscal intermediaries that previously handled enrolment, timesheets and payroll. The consolidation came from an amendment to New York Social Services Law § 365-f(4-a) in the FY2024-25 state budget.
In practice: older articles, agency websites and phone numbers you may find online often reference intermediaries that no longer operate CDPAP. Enrolment, onboarding paperwork and payroll now run through PPL.
NYIAP and PPL are not the same thing
These two organisations come up constantly in CDPAP, and families often expect one of them to do the other's job. They are separate.
NYIAP
The New York Independent Assessor Program carries out the assessment function for applicable Medicaid home-care services, including CDPAS. It is part of how need and authorised hours are established.
NYIAP does not pay the caregiver.
PPL
Public Partnerships LLC is New York's statewide CDPAP fiscal intermediary, responsible for administrative functions such as enrolment paperwork, employment administration, timekeeping and payroll.
PPL does not decide whether someone qualifies for CDPAP.
Start here: what do you want to do?
Pick what matters most right now and we'll help you find your next step.
First: can your family member be the paid caregiver?
Choose the relationship between the caregiver and the person receiving care.
Do you meet the basic CDPAP requirements?
Four questions. Your answers stay on this page.
Does the person receiving care have New York Medicaid?
Have they had an independent assessment (NYIAP)?
Do they need ongoing help with daily activities or skilled care?
Can they direct their own care, or do they have a designated representative?
How CDPAP works, step by step
- 1
Check the person receiving care
CDPAP is for a New York Medicaid recipient who needs help at home. They must live in their own home or a family member’s home rather than a facility, though you can apply as part of a discharge plan if they are transitioning home.
- 2
Check your relationship
Many adult relatives and eligible non-relatives may serve as the personal assistant if they meet New York’s applicable requirements. A spouse cannot, nor can the consumer’s designated representative, nor a parent of a consumer under 21.
- 3
Check the care needs
There must be a medical need for help with daily living activities, or a need for skilled nursing-level tasks, supported by a physician’s order.
- 4
Confirm Medicaid
The person receiving care must be enrolled in New York Medicaid. If they are not, apply through your local Department of Social Services or, in New York City, HRA.
- 5
Complete the independent assessment
An independent assessment through NYIAP establishes the level of need and the hours that may be authorised.
- 7
Choose the caregiver
The consumer chooses and directs their own personal assistant — that is the defining feature of CDPAP. No prior certification, licensure or medical experience is required.
- 8
Complete PPL enrolment
Register with Public Partnerships LLC and complete the employment paperwork, including W-4 and I-9 forms.
- 9
Complete required training
Mandatory training runs through the state's designated training portal and must be finished before payment begins.
- 10
Start providing care
Once approved, care can begin within the authorised hours, with timesheets submitted through PPL.
The CDPAP journey, start to finish
A simplified view of how the pieces follow one another. The exact steps can vary with the individual's Medicaid status, age, plan and circumstances.
- 1Medicaid eligibility
- 2Home-care need
- 3Minimum Needs Requirements, where applicable
- 4NYIAP or other applicable assessment
- 5Care plan and authorisation
- 6Choose the personal assistant
- 7PPL enrolment and onboarding
- 8Required training and employment steps
- 9Authorised care begins
- 10Ongoing documentation and care management
Processing time varies depending on Medicaid status, assessment scheduling, authorisation, plan involvement, caregiver enrolment and other circumstances.
How much does CDPAP pay in New York?
New York publishes Medicaid CDPAP reimbursement rates by region and service type. Under the 1 January 2026 rate schedule, the Basic CDPAS reimbursement rates are:
| New York City | $27.34 per hour |
|---|---|
| Nassau, Suffolk and Westchester | $26.46 per hour |
| Rest of State | $24.73 per hour |
The official schedule also sets separate rates for Hard to Serve and Live-In services.
These are Medicaid reimbursement rates, not a guarantee of the personal assistant's take-home wage. Actual caregiver compensation can be affected by payroll, taxes, benefits and other applicable employment and payment factors. Payroll is handled by PPL as the statewide fiscal intermediary, and care is paid only within the authorised hours.
New York State CDPAP reimbursement rate schedules →Important 2026 guidance on caregiver hours
In July 2026, New York issued MLTC Policy 26.02, addressing excessive hours worked by CDPAP personal assistants. For the purposes of that policy, 112 or more hours worked by a personal assistant in a single week is identified as excessive hours.
This does not mean that working 112 or more hours automatically means a consumer or caregiver has broken the law. It means the state and managed-care system monitor excessive-hour situations, and that consumers carry responsibility for maintaining sufficient caregiver coverage and a safe care arrangement.
In practice this is a scheduling and record-keeping point. Knowing who worked which hours, where cover is thin, and who the backup caregiver would be makes these conversations far easier — both with the plan and within the family.
Who can and cannot be the personal assistant
Spouse. A spouse cannot serve as the consumer's CDPAP personal assistant. Designated representative. The designated representative cannot simultaneously serve as the personal assistant. Parent of a consumer under 21. A parent cannot serve as the CDPAP personal assistant for a consumer under age 21.
Many adult relatives and eligible non-relatives may serve as CDPAP personal assistants if they meet New York's applicable requirements. Adult children, siblings, other relatives and eligible non-relatives may potentially serve when permitted and when all applicable requirements are satisfied. Relationship alone does not establish eligibility.
That is not the end of the road. Spousal rules differ from programme to programme: if the person you care for is a veteran, VA's Veteran-Directed Care can pay a spouse. Other home- and community-based supports, respite funding and tax-related caregiver benefits also run on their own rules.
What if the person you care for is a veteran?
Veterans have separate pathways that run independently of CDPAP and Medicaid. VA's Program of Comprehensive Assistance for Family Caregivers (PCAFC) has its own eligibility rules and stipend structure, and VA's Veteran-Directed Care can pay a spouse — unlike CDPAP. If both might apply, it is worth asking a VA social worker which route fits before you plan around either.
PCAFC preparation checklist →Get your documents ready
A reference list of what tends to be asked for. Not every item applies to every household — use it to gather what you can before you start.
For the person receiving care
For the caregiver
Throughout the process
Your personalised CDPAP checklist
Tick items off as you go. This is a working list for you — it isn't saved.
Before you start
During assessment
After approval
Once care begins
Where are you right now?
I haven't started yet
Check the relationship rules first — that decides whether CDPAP is even the right route.
Go to this step →I'm not sure the person I care for has Medicaid
Confirm Medicaid enrolment, or start an application through your local DSS or HRA.
Go to this step →I'm waiting on the assessment
Keep the assessment paperwork together so nothing is missing when hours are decided.
Go to this step →The assessment is done and I'm waiting on a decision
Get the documents ready now so enrolment can move quickly once authorisation arrives.
Go to this step →We've been approved
Complete PPL enrolment and the employment paperwork so payment can begin.
Go to this step →I'm in training or onboarding
Finish the required training through the state portal — payment starts after it is complete.
Go to this step →I'm already providing care
Keep hours, timesheets and training records organised, and note when reassessment is due.
Go to this step →Your CDPAP progress
Track where you are in the process. Nothing here is an eligibility decision — it just keeps your own place.
Medicaid
Care needs
Assessment
Authorization
Caregiver
PPL enrollment
Training/onboarding
Care begins
Ongoing tracking
What should you do today?
Find where you are, and take the one next step that fits.
If you haven't started
Confirm the person you care for has New York Medicaid, and check how your relationship fits the CDPAP rules.
Run the relationship check →If Medicaid is already active
Start documenting the daily care needs — what help is given, how often, and for how long.
See the care-needs step →If the assessment is underway
Keep the assessment paperwork together in one place so nothing is missing when hours are decided.
See the assessment step →If you've been approved
Complete PPL enrolment and the employment paperwork so payment can begin.
See the PPL enrolment step →If you're already providing care
Keep hours, timesheets and training records organised, and note when reassessment is due.
Track where you are →Keep your care records organised
A CDPAP journey can involve keeping track of:
- Care notes
- ADL information
- Assessment information
- Authorisation details
- Caregiver information
- PPL correspondence
- Training records
- Caregiving hours
- Timesheets and timekeeping information
- Appointments
- Changes in condition
- Backup caregiver information
CDPAP can involve a significant amount of information to keep track of. FeatherKeep helps families organise care notes, caregiving hours, documents, appointments and their Care Journey in one place.
FeatherKeep is an organisation and caregiving-management platform. It does not determine eligibility, guarantee approval or payment, and does not replace NYIAP, PPL or Medicaid.
Don't let the paperwork become another caregiving burden
Getting approved is only the beginning. Once CDPAP is set up, hours, training compliance, timesheets and reassessment dates become an ongoing responsibility on top of the care itself. FeatherKeep keeps all of it organised in one place as you go.
Want to save your progress?
The checklists on this page reset when you leave. The progress tracker doesn't — create a free account and where you are in the CDPAP process is still there next time.
Questions about CDPAP in New York
Don't qualify for this program? Don't stop here.
A no on one program doesn't mean a no everywhere. These are the other categories most worth investigating — a case manager or the free benefits check can tell you which apply to your situation.
- • Medicaid home- and community-based services generally — other programs and self-directed options may fund in-home support even where this one doesn't fit.
- • Respite support — short-term relief so you can rest, sometimes funded separately from ongoing care. How respite care works
- • Veterans benefits — if the person you care for is a veteran, veterans' caregiver programs run on their own rules and eligibility.
- • Tax-related caregiver benefits — credits and deductions you may be able to claim, which is a different question from being paid.
Your New York caregiver action plan
- 1
Check — Confirm the person you care for lives at home and may need help with daily activities.
- 2
Confirm — Confirm New York Medicaid enrolment, or start an application through your local DSS or HRA.
- 3
Assess — Arrange the physician's order and the independent NYIAP assessment.
- 4
Authorise — Get the authorisation decision and the authorised hours in writing.
- 5
Choose — Decide who the personal assistant will be, checking the relationship rules first.
- 6
Enrol — Register with PPL and complete the employment paperwork.
- 7
Train — Complete the required training through the state training portal.
- 8
Start — Begin care within the authorised hours and submit timesheets through PPL.
- 9
Track — Keep hours, training records and payroll documents organised from day one.
- 10
Expand — Check what else you may qualify for — respite, veterans benefits, and tax-related caregiver benefits run on separate rules.
Official information
- • New York State Department of Health — CDPAP
- • New York State Department of Health — Medicaid home care and personal care services
- • New York Independent Assessor Program (NYIAP)
- • Public Partnerships LLC (PPL) — statewide CDPAP fiscal intermediary
- • New York State CDPAP reimbursement rate schedules
- • New York State Department of Health — MLTC policy documents
Important information
This page is general information to help you get started — not legal, financial or medical advice, and not an eligibility determination. CDPAP rules, wage rates and requirements change. Confirm current details with the New York State Department of Health, PPL, or your local Department of Social Services before you make decisions based on what you read here.
One more thing
If you are reading this, you are already doing the care. CDPAP doesn't change that — it just means the hours you are already giving can be recognised and paid. Take one step today: confirm Medicaid, or ask the physician for the order. The rest follows from there.