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CDPAP in New York: A Comprehensive Guide With Pros and Cons

Note: CDPAP is NOT an offer of employment. Please do not contact us for employment. If you already live with or care for an elderly person, family, or friend who is in need of care (permanent or temporary disability, aging, disease, etc.), the CDPAP program allows you to get paid up to $21.09/hour to take care of your loved one. Again, this is NOT an employment offer.


As the aging population in New York continues to grow, so does the demand for flexible and personalized home care options. Enter the Consumer Directed Personal Assistance Program (CDPAP). This pioneering initiative empowers New Yorkers in need of home care to play an active role in their health management by choosing their caregivers. This article provides a comprehensive introduction to CDPAP in New York, illuminating its benefits, eligibility criteria, application process, and how it stands out from traditional home care services.

Understanding CDPAP

The Consumer Directed Personal Assistance Program (CDPAP) is a Medicaid program offered in New York State. It’s designed to allow individuals requiring long-term home care to direct their care. Unlike traditional home care services, where agencies assign healthcare professionals to deliver care, CDPAP empowers the consumers, or their designated representatives, to select, train, and supervise their caregivers.

One of the unique aspects of CDPAP is that the caregivers can be almost anyone the consumer chooses, including family members, friends, or acquaintances, excluding legally responsible individuals such as spouses or parents of a child. This flexibility allows consumers to receive care from people they trust and are comfortable with, enhancing the care experience.

The Importance of CDPAP

CDPAP recognizes the significance of personal choice and familiarity in healthcare. The program promotes independence and dignity by involving consumers in their care processes. It contributes to a more satisfactory healthcare experience. It acknowledges that individuals are the foremost experts on their needs and are best equipped to manage their care, given the proper support.

Eligibility Criteria

To be eligible for CDPAP, applicants must:

  • Be residents of New York State.
  • Be eligible for Medicaid.
  • Require assistance with activities of daily living or skilled nursing services.
  • Be capable of making informed choices about their care or having a designated representative make those decisions.

Application Process

The journey to accessing CDPAP services begins with an application to Medicaid for those not already enrolled. The next step involves obtaining a medical evaluation from a healthcare professional detailing the applicant’s need for home care services. This assessment is then reviewed by the local social services district, which also evaluates the applicant’s ability to make informed choices about their care or to appoint a suitable representative.

The Role of Fiscal Intermediaries

A significant component of CDPAP is the engagement of fiscal intermediaries (FIs). These organizations handle the administrative aspects of the program, including caregiver payroll, tax withholdings, and other employment-related responsibilities. They act as a bridge between the consumer and the state, ensuring compliance with legal and program requirements while allowing consumers to focus on their care.

Benefits of CDPAP

The benefits of CDPAP are manifold:

  • Personalization of Care: Consumers receive care from individuals they know and trust, tailoring their care to their personal, cultural, and linguistic preferences.
  • Flexibility: There is considerable flexibility in how care is provided, including setting schedules that work best for both the consumer and the caregiver.
  • Empowerment: Consumers or their representatives are in the driving seat, managing their care according to their needs and preferences.
  • Economic Empowerment: Caregivers, who may be family members or friends providing care without compensation, can receive a wage for their invaluable service.

CDPAP vs. Traditional Home Health Care Services in NY

When it comes to home health care in New York, individuals have significant choices. The Consumer Directed Personal Assistance Program (CDPAP) and traditional home health care services are prominent options among them. Selecting the correct type of care is pivotal for the quality of life of those needing assistance. This comprehensive analysis aims to delineate each service’s differences, pros, and cons, providing a foundational understanding for making informed decisions.

Defining the CDPAP Services

CDPAP, as previously mentioned, is a Medicaid program that grants consumers the liberty to recruit, hire, and direct their personal caregivers. These aides can perform various services, including skilled nursing tasks, and can even be family members or friends.

Traditional Home Health Care involves care provided by professionals employed through licensed home health agencies. These caregivers are typically assigned to consumers and are managed by the agency’s administrative team.

Key Differences

The principal distinction lies in control and choice. CDPAP allows consumers or their representatives to maintain autonomy over who provides their care and how it’s administered. It promotes a more personalized relationship between the consumer and caregiver.

Meanwhile, traditional home health care offers less personal control. Still, it provides professional oversight through agency structures, with services rendered by certified and trained healthcare professionals.

CDPAP: Pros and Cons


Personalized Care: Users of CDPAP often report higher satisfaction due to the personal connection with their caregiver, leading to more tailored care experiences.

Flexibility: Schedules and care routines can be set according to the consumer’s preferences, adapting to the rhythm of their life rather than the availability of agency staff.

Empowerment: Consumers involved in directing their care often feel more empowered and engaged in their health outcomes.

Economic Opportunity: Family members or friends acting as caregivers can receive compensation, providing financial relief and recognition for the care they provide.


Administrative Duties: CDPAP requires consumers or representatives to handle administrative tasks that can be complex and time-consuming, although fiscal intermediaries help alleviate this burden.

Training Responsibilities: Consumers are responsible for training their caregivers, which can challenge those requiring specialized care skills.

No Backup Care: The consumer must manage backup care arrangements instead of an agency that typically provides alternatives if the primary caregiver is unavailable.

Traditional Home Health Care: Pros and Cons


Professional Oversight: Agencies oversee the quality and provision of care, offering professional management to maintain standards.

Training and Certification: Caregivers from agencies are likely to be professionally trained and certified, which can give peace of mind regarding the quality and safety of the care provided.

Minimal Management Burden: Consumers and families are not responsible for administrative or management tasks, as the agency handles these aspects.

Backup Options: If the assigned caregiver is unavailable, the agency is generally responsible for providing a replacement ensuring continued care.


Less Control: Consumers have limited agency over when and who provides their care, leading to potential mismatches in caregiver-consumer compatibility.

Inflexible Schedules: Agency-dictated schedules can lead to a lack of flexibility, with consumers having to fit their lives around the availability of caregivers.

Emotional Distance: The professional boundaries set by agencies might not allow for the same depth of personal relationships that can develop through CDPAP arrangements.

Potential for Turnover: Agency caregivers may change over time, leading to a lack of continuity, which can be distressing for some consumers.

When choosing between CDPAP and traditional home health care services, one must weigh personal preferences against practical considerations. For those who value autonomy, are comfortable with taking on a management role, and have a trustworthy network, CDPAP can offer a deeply satisfying care experience. Conversely, those seeking hands-off, professional care due to complex medical needs or a preference for formal healthcare structures may find traditional home healthcare services to be a better fit.

Ultimately, the decision hinges on the unique circumstances and preferences of the person needing care. With the correct information and thoughtful consideration, New Yorkers can select a home healthcare option that best nurtures their well-being and respects their way of life. Traditional home care services involve home care agencies that hire, train, and assign caregivers to consumers. While this model provides quality care, it needs more personalization and direct oversight that CDPAP offers. In contrast, CDPAP fosters a more intimate care environment, with consumers directing their care, which can lead to improved satisfaction and outcomes.

CDPAP Challenges and Considerations

While CDPAP has numerous benefits, prospective consumers should consider several factors. Managing care can be substantial, requiring attention to detail in scheduling, training, and supervising caregivers. Additionally, although primarily handled by FIs, the administrative tasks can be daunting for some.


CDPAP in New York represents a significant shift towards consumer-directed care, acknowledging the value of choice, familiarity, and personalization in the healthcare experience. For eligible New Yorkers, it offers a way to manage their long-term care that prioritizes their preferences and comfort, making it a valuable option in the spectrum of home care services. As with any healthcare decision, it’s crucial to thoroughly understand the program, assess one’s capacity to manage responsibilities and take steps to access its tremendous benefits.

By empowering consumers and recognizing the role of personal relationships in care, CDPAP enriches the care experience, offering a path to care that is both personal and empowering. For those navigating the complexities of long-term care in New York, CDPAP stands out as an innovative option that combines autonomy, flexibility, and the invaluable contribution of known and trusted caregivers.


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