New York’s CDPA Program –
Caring for Elderly Loved Ones

CDPAP stands for the Consumer Directed Personal Assistance Program. The program is also referred to as the CDPAPNYS or the CDPA. This New York State Medicaid program allows chronically ill or physically disabled consumers who need help with everyday activities or skilled nursing to hire their home care assistants. Consumers can choose their caregivers, who may or may not be family members or friends. The primary benefit of the CDPAP model is that it gives people more control over who provides their care and how it is delivered. Rather than having a home health agency assign a stranger, patients can choose someone they trust. This concept is called consumer-directed care, though it is sometimes called participant direction, self-direction, or cash and counseling.

While the patient gains control and cost savings through the Consumer Directed Personal Assistance Program (CDPAP), he or she also takes on specific responsibilities. The consumer or his or her representative assumes the responsibility for training, supervising, and terminating the caregivers, tasks that would otherwise be handled by the home care agency. The CDPAP may cover services typically provided by a personal care attendant, home health care aide, or a nurse, known as Consumer Directed Personal Assistance Services or CDPAS.

The purpose of the CDPA is to help those who have to leave a job to take care of a loved one who is disabled or chronically unwell. For example, an older person who needs daily assistance may be uncomfortable hiring a stranger to enter the home every day. Some medical tasks, such as giving injections, maybe outside the scope of a personal assistant. The CDPA allows the person to pay an adult child over the age of 21 or another trusted relative to provide care. The caregiver cannot be a spouse or legal guardian, but he or she may live in the home of the person they care for if the level of care required makes that necessary.

To access the CDPA program, the individual needs an order from his or her physician or medical care provider. The referral goes to the social services district for a social and nursing assessment. The assessment must determine that the person can participate fully in the program and recommend a schedule for the services, including how often the caregiver will attend to the consumer, the length of each visit, and how long the services will continue.

A quarter-million New Yorkers receive assistance for long-term care through Medicaid, and two-thirds of them receive their care at home or in an assisted-living facility. All counties in New York state and all of the primary managed care and long-term care plans must include a provision for a CDPAP. These entities must notify eligible consumers of the availability of the program. Here are the criteria for eligibility:

• The patient must be eligible for Medicaid based on an evaluation of assets, income, and asset transfers history.
• The patient must qualify for home health services through a home care agency, private duty nursing, long-term home health care waiver, AIDS home care program, or personal care assistance program.
• The patient must have a stable medical condition that can be managed by a CDPAP aide.
• The patient must be a self-directing person or a non-self-directing person with a competent, designated representative who can participate in the care plan and its implementation.

Eligible persons participating in the CDPAP work with a caseworker and medical professional to establish a care plan, which outlines the care needed each week. Once the plan is approved, the patient and family hire, train, and supervise their providers.

The CDPA/CDPAP is a Medicaid driven program, which means that you must be enrolled in Medicaid to be eligible. If you don’t have Medicaid, but you feel you may be eligible, Trusted Choice Homecare can help you with the application process. The process can be intimidating, but help is available every step of the way.

For people covered by Medicaid only and not by Medicare, most are enrolled in a Mainstream Medicaid Managed Care plan that handles the authorization and management of CDPAP services. Clients covered by Medicare and Medicaid enroll in a Managed Long-Term Care plan to access CDPAP services, except in some specific circumstances.