Am I Eligible?
How Do I Access the CDPAP?
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.
What Does Medicaid Driven Program Mean?
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.
What is a Self-Directing Person?
To participate fully in the CDPA/CDPAP, a consumer must be a self-directing person. This requirement exists because the consumer must hire, teach, monitor the caregivers, and line up alternative services if the caregiver is not available on a given day. The consumer must also keep up with documentation such as timesheets and payroll records for the caregiver. Here are the three main components indicative of a self-directing person.
- The consumer must be able and willing to make informed decisions about his or her lifestyle and the kind of care needed.
- The consumer must also be able to structure the home environment so that the care can be provided.
- The consumer must understand the consequences of hiring a personal assistant and the ability to take responsibility for the hiring process.
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.
In the alternative, the consumer may have a competent representative who can make these decisions on his or her behalf. The representative does not have to be present at all times while care is delivered to a non-self-directing person.
A Trusted Choice representative will help you get started
