How to get CDPAP or home care through Medicaid in NYC

Rules and figures checked against New York State Department of Health and NYC HRA sources on November 1, 2026.

What is CDPAP?

CDPAP stands for the Consumer Directed Personal Assistance Program. It is a New York Medicaid program that lets a person who qualifies for home care choose, hire and train their own caregiver, called a personal assistant.

The caregiver can be a friend or a family member, such as an adult son or daughter. The state rules say it cannot be the person's spouse, their designated representative, or the parent of a CDPAP user under 21.

Getting there takes three steps: Medicaid that covers home care, an assessment, and then a plan or authorization for the hours.

Step 1: Apply for Medicaid that covers home care

In New York City, people who are 65 or older, blind, disabled, or on Medicare apply for Medicaid through the Human Resources Administration (HRA). You can apply online through ACCESS HRA, at a Medicaid office, or start by calling the HRA Medicaid Helpline at 888-692-6116.

With the application goes a form called Supplement A. On it, you check the box for coverage of community-based long-term care. That box is what makes the application cover home care, CDPAP and MLTC plans.

For 2026, the Medicaid income level for a single person in this group is $1,836 a month, and the resource limit is $33,038 (for a couple, $2,489 a month and $44,796). If income is higher, a person may still qualify through what Medicaid calls a "spenddown," or through other options an attorney can explain.

Home care applicants must show current paperwork for certain assets, such as life insurance, stocks and bonds, annuities, burial funds and trusts. Right now there is no look-back for home care. A 30-month look-back was passed in 2020 but has not started. Our look-back guide explains where that stands.

Step 2: The NYIA assessment

Before Medicaid approves home care, your parent needs an assessment from the New York Independent Assessor (NYIA). You or an authorized representative can call the NYIA helpline at 855-222-8350 (TTY 1-888-329-1541) to request one.

There are two appointments. A nurse does the Community Health Assessment, which usually takes two to three hours. A clinician then does a medical exam of up to an hour. Each can be in person or by video.

Since September 1, 2025, adults seeking home care for the first time must meet new "minimum needs" rules. Your parent must need at least limited hands-on help with more than two daily activities, such as bathing, dressing or moving around. For someone with dementia or Alzheimer's, the bar is needing at least supervision with more than one daily activity, and a doctor must document the diagnosis on form DOH-5821.

People who were already approved for home care, or enrolled in an MLTC plan, before September 1, 2025 keep the older rules.

If needs change suddenly and care is urgent, the state says to contact your local Medicaid office (HRA in NYC) or your Medicaid health plan to schedule an assessment right away.

Step 3: Choosing an MLTC plan

If the assessment finds your parent needs home care for more than 120 days, they will often get it through a managed long-term care (MLTC) plan. The plan then decides on hours, and CDPAP can be part of what it covers.

There are three types: MLTC partial capitation plans, Medicaid Advantage Plus plans for people with both Medicare and Medicaid, and PACE for people 55 and older. Enrollment goes through New York Medicaid Choice at 1-888-401-6582. Some people can get home care through HRA without a plan, at least at first; the state notifies them if they later have to enroll.

What changed with CDPAP in 2025? (PPL)

CDPAP caregivers are paid through a "fiscal intermediary" that handles their wages, tax withholding and employment records. Before 2025, families could use different agencies for this. In 2025 the state moved to one statewide fiscal intermediary: Public Partnerships, LLC (PPL).

PPL became the only authorized fiscal intermediary on April 1, 2025. After a court agreement, the final deadline for existing users and caregivers to register with PPL was August 1, 2025. Today, the Department of Health says every CDPAP user must work with PPL.

For a new case, that means both your parent and the caregiver register with PPL once the hours are authorized. Questions about registration or pay go to PPL at 1-833-247-5346. Your parent can also get help from a facilitator, their MLTC plan, or HRA.

The state also watches for caregivers working very long weeks. It recommends at least one personal assistant for every 40 authorized hours, so plan for a backup caregiver.

Get help with the application

Ben Drew has prepared New York Medicaid applications for 12 years, more than 1,000 of them, for families in Brooklyn and across NYC. He can handle the Medicaid application for home care and the MLTC and CDPAP paperwork behind it, and tell you what to have ready for the assessment. For trusts or planning, he works with an elder-law attorney; Ben is not an attorney himself.

This is general information, not legal advice.