CDPAP Eligibility and Fiscal Intermediary in New York (2026)

CDPAP Eligibility Changed in September 2025 — Here's What Applies Now

The Consumer Directed Personal Assistance Program lets Medicaid recipients in New York hire their own caregivers — including adult children and other family members — instead of receiving care from an agency-assigned home health aide. It's one of the most valuable programs available to families caring for aging parents, but the eligibility rules tightened significantly in 2025, and the administrative infrastructure underwent a massive (and controversial) overhaul.

If you're exploring CDPAP for a parent in 2026, you need to understand both the clinical eligibility changes and the fiscal intermediary transition. Getting either wrong can delay enrollment by months.

Clinical Eligibility Requirements (2026)

Since September 1, 2025, new CDPAP applicants must meet the same "Minimum Needs" thresholds that apply to Managed Long Term Care enrollment:

• General standard: The applicant must require limited physical assistance with at least three Activities of Daily Living (ADLs — bathing, dressing, toileting, transferring, feeding, continence management)
• Dementia/Alzheimer's exception: Individuals with a documented cognitive diagnosis need only supervisory assistance with at least two ADLs
• Self-directing requirement: The applicant must be able to direct their own care — or have a designated representative who directs care on their behalf. This is the "consumer-directed" part: the individual (or their representative) is responsible for recruiting, hiring, training, scheduling, and supervising their personal assistant

The self-directing requirement creates an important distinction from regular MLTC home care. Under standard MLTC, the plan's agency assigns an aide and manages the relationship. Under CDPAP, the family manages everything. A designated representative — typically an adult child — can handle these responsibilities for a parent who lacks the cognitive ability to self-direct.

One critical rule: the designated representative cannot also be the paid personal assistant. If you're the one directing your parent's care, you cannot simultaneously be the caregiver getting paid for providing it. Another family member, friend, or neighbor would need to serve as the paid assistant.

The PPL Fiscal Intermediary Transition

Effective April 1, 2025, New York consolidated approximately 600 local fiscal intermediaries into a single statewide entity: Public Partnerships LLC (PPL). The fiscal intermediary handles the administrative and payroll functions — processing timesheets, paying caregivers, managing tax withholding, providing workers' compensation coverage, and maintaining employment records.

The transition has been turbulent. PPL settled a $162 million class-action lawsuit (Calderon v. PPL) in July 2026 over wage-theft claims from personal assistants in New York City, Long Island, and Westchester. In June 2026, the U.S. Department of Justice filed a federal lawsuit against PPL and New York Department of Health officials alleging fraud during the contract bidding process.

For families enrolling now, the practical implications are:

• All new CDPAP enrollments go through PPL — there are no alternative fiscal intermediaries
• Timesheet submission is electronic through PPL's portal or mobile app
• Payment processing times have been inconsistent — some caregivers report delays of 2–4 weeks, particularly during the initial setup period
• If your parent was previously enrolled through a local FI, their case should have been transferred to PPL automatically, but verify that the transfer completed and that pay rates, hours, and caregiver assignments carried over correctly

How to Apply for CDPAP

The application process involves multiple steps across different entities:

Step 1: Medicaid eligibility. The parent must be enrolled in Medicaid. For 2026, that means countable assets at or below $33,038 and monthly income at or below $1,836 (with a pooled income trust available to shelter excess income). Apply through the local Department of Social Services or, in New York City, through the Human Resources Administration.

Step 2: MLTC enrollment. CDPAP is accessed through an MLTC plan. The parent first enrolls in an MLTC Partial Capitation plan, MAP plan, or PACE program. Not all MLTC plans offer CDPAP — confirm CDPAP availability before selecting a plan.

Step 3: Clinical assessment. The NYIAP (New York Independent Assessor Program) conducts an in-home assessment to determine clinical eligibility based on the ADL thresholds described above.

Step 4: CDPAP authorization. Once enrolled in an MLTC plan and assessed as clinically eligible, request CDPAP specifically. The MLTC plan's care manager must authorize CDPAP as the service delivery method in the care plan.

Step 5: Register with PPL. Both the consumer (your parent or their designated representative) and the personal assistant must complete onboarding with PPL — background check for the assistant, employment paperwork, direct deposit setup, and orientation on timesheet submission.

The timeline depends on county processing, MLTC enrollment, the clinical assessment, and PPL onboarding, so families should plan for multiple steps before a first paid caregiver shift.

What CDPAP Covers

Authorized services under CDPAP include everything a traditional home health aide provides, plus certain skilled tasks that would normally require a licensed professional:

• Personal care (bathing, dressing, grooming, toileting, transferring)
• Medication administration (a key advantage — agency aides in New York cannot administer medications; CDPAP assistants can, with training)
• Skilled nursing tasks delegated by the consumer (wound care, injections, catheter management)
• Nutritional support and meal preparation
• Light housekeeping related to the consumer's health and safety

The number of authorized hours is determined by the MLTC plan's care manager based on the clinical assessment. Hours can be adjusted if the parent's condition changes — request a reassessment through the MLTC plan if the current allocation is insufficient.

The New York Power of Attorney & Guardianship Kit covers the legal authority documents needed to apply for CDPAP on a parent's behalf — including the POA modifications required to sign Medicaid applications and MLTC enrollment agreements when the parent cannot sign independently.

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