CDPAP in New York: Eligibility, PPL Transition, and Family Caregivers

Your mother needs daily help with bathing, dressing, and meals. A home health aide from an agency would be a stranger rotating through your house on unpredictable schedules. Through CDPAP, you — her adult child — can be her paid caregiver instead. But the program has gone through massive upheaval, and understanding how it works in 2026 is essential before applying.

What CDPAP Is and How It Differs from Traditional Home Care

The Consumer Directed Personal Assistance Program lets Medicaid-eligible New Yorkers choose, train, and supervise their own caregivers. Unlike traditional home care through an agency, CDPAP puts the consumer (your parent) in control of who provides the care and how it's delivered.

The biggest draw: family members can be paid caregivers. An adult child, a spouse's adult child, a sibling, a nephew — anyone except a legal spouse can serve as a personal assistant and receive wages through the program.

Traditional home attendant services through an MLTC plan send agency-employed aides to your parent's home. Your parent has limited say over scheduling, who shows up, or how care is provided. The aide follows the agency's protocols.

CDPAP flips this dynamic. Your parent (or their designated representative) hires, trains, schedules, and directs the caregiver. The trade-off is administrative responsibility — your parent is technically the employer.

Eligibility Requirements

To qualify for CDPAP, your parent must:

1. Be eligible for Community Medicaid (meet the $1,836/month income and $33,038 asset limits, or use a Pooled Income Trust for excess income)
2. Meet the clinical ADL threshold — the same September 2025 minimum needs requirements as MLTC (3 ADLs for physical assistance, 2 ADLs for dementia patients)
3. Be enrolled in a Managed Long-Term Care (MLTC) plan — CDPAP is accessed through the MLTC system
4. Be able to self-direct their care or have a designated representative (typically an adult child) who directs care on their behalf

The representative option is critical for parents with dementia or cognitive decline. An adult child can serve as the representative and as the personal assistant — meaning you direct the care plan and provide the care.

The PPL Transition: What Changed

In 2025-2026, New York consolidated all CDPAP administrative operations under a single statewide Fiscal Intermediary: Public Partnerships LLC (PPL). Previously, hundreds of local FIs processed payroll and managed compliance for CDPAP workers across the state.

The centralization has been rocky. PPL handles all payroll, tax withholding, benefits administration, and compliance for every CDPAP personal assistant in New York. The transition involved re-registering existing caregivers, setting up new direct deposit, and navigating an entirely new administrative system.

PPL contracts with approximately 31-42 local CDPAP Facilitators (including 11 Independent Living Centers) that provide in-person, multilingual assistance to help consumers and PAs complete registration requirements.

Wages and Benefits for Personal Assistants

CDPAP personal assistants earn at least minimum wage, with significant variation by region.

In downstate counties (NYC, Long Island, Westchester), the Wage Parity Law mandates additional benefit supplements:

NYC:

• Cash wage add-on: $1.00/hour
• Sick/safe leave: $0.69/hour
• 401(a) retirement (Empower Retirement): $0.80/hour

Long Island and Westchester:

• Cash wage add-on: $0.40/hour
• Sick/safe leave: $0.67/hour
• 401(a) retirement: $0.55/hour

PAs cannot opt out of these benefits to receive cash instead.

The health insurance trap: PPL offers Anthem SecureHealth plans (Silver and Bronze) to PAs working 130+ hours per month. Because these plans meet the ACA's Minimum Value standard, merely being eligible to enroll disqualifies the PA from New York's Essential Plan and from marketplace premium subsidies. A family caregiver who was previously on the Essential Plan may face a coverage gap if they can't afford PPL's plan premiums.

The Caregiver Agreement Trap

If your parent pays a family member for care outside of CDPAP — directly, without a formal program — there are severe Medicaid consequences.

Without a formal, written, notarized caregiver agreement drafted before care begins, Medicaid will classify those payments as uncompensated transfers (gifts). If the parent later needs nursing home care, those payments trigger a lookback penalty.

Additionally, paying a family member informally wastes the potential Caretaker Child Exemption — which allows penalty-free transfer of the family home to a child who provided care that delayed institutionalization for at least two years. Without documentation of the care relationship, this exemption is lost.

CDPAP eliminates this risk entirely. The program provides the formal employment structure, payroll documentation, and care records that protect both the caregiver and the Medicaid application.

For the complete CDPAP enrollment process — including how to designate a representative, navigate PPL registration, and coordinate with your parent's MLTC plan — see the New York Medicaid Long-Term Care Guide.

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