What is CDPAP?

CDPAP is the provision of some or total assistance with personal care services, home health aide services, and skilled nursing tasks by a consumer-directed personal assistant under the instruction, supervision, and direction of a consumer or the consumer’s designated representative. One highlight of the program is the ability to hire family members or friends to provide your authorized services.

In New York, the Consumer Directed Personal Assistance Program (CDPAP) is a Medicaid program that offers elderly, chronically ill, and disabled participants more control over who provides in-home care. Instead of traditional home health care where an agency chooses, trains, and supervises direct care staff, the consumer can choose a family member, friend, or guardian to handle all of these tasks. All New York counties and Managed Care or Managed Long Term Care plans must offer a CDPAP program and notify their clients who are eligible for it that they have this choice available to them. Everyone eligible for services from a home health agency, a long-term home health care program, an AIDS home care program, or personal care attendant benefits is suitable for a Consumer Directed Personal Assistance Program (CDPAP).

How Does the CDPAP Work?

When an eligible person chooses care through the CDPAP, they are assigned a caseworker through the county or work with a medical provider to develop a Care Plan. A medical professional must certify that the consumer’s condition meets the criteria for care under the CDPAP. The Care Plan lays out the number of hours of care the CDPAP will pay for each week. The consumer then chooses who they want to hire and what tasks they want the aide to provide. The aide offers the care and works through a fiscal intermediary for payment and benefits.

The primary goal of the CDPAP is to help caregivers who have to give up a job to care for an elderly, sick, or disabled family member. This arrangement gives the caregiver a source of income while their loved one still gets the care they need. One additional benefit is greater peace of mind for the consumer who receives care from someone they know rather than a stranger from an agency. The state saves money on care when consumers can stay at home living independently instead of moving into a residential facility, which is far more expensive.

Am I Eligible for the CDPAP?

Eligibility for the CDPAP involves four factors:

• You must be eligible for Medicaid.
• You must be eligible for personal care, certified home health care, private nursing, AIDS care, or another form of the waiver program.
• You must have a stable medical condition that is amenable to in-home care.
• You must direct your care or have a designated representative who can do it for you. This requirement is necessary because you or your representative must hire, train, supervise the care provider, and manage the associate paperwork.

If you have Medicaid but not Medicare, you probably already have a Mainstream Medicaid Managed Care (MMC) plan. That entity authorizes CDPAP benefits for its members. With a few exceptions, if you have Medicaid and Medicare, you must enroll in a Managed Long Term Care (MLTC) plan to get approval for the CDPAP.

Who Can I Hire as My CDPAP Aide?

You can choose any family member other than your spouse, and you can train them to provide the care you need. The parents of a disabled adult over the age of 21 years can serve as the CDPAP aide as long as they aren’t also the consumer’s designated representative. Adult children can be hired to take care of aging parents. Some restrictions may apply on whether or not the parent can live with the client, depending on the amount and type of care required. If the person providing the care is an immigrant, he or she must have valid work documentation.

What Can My CDPAP Aide Do?

The caregiver does not have to hold any particular license or certification since you or your designated representative will train them. That gives you the flexibility to have your CDPAP aide do specific tasks that a nurse would ordinarily perform. Some examples are suctioning tracheostomy sites, injections, and administering medication.

In a traditional home health care model, care relates to daily living activities to help the patient maintain mobility, take care of personal hygiene, and take in appropriate nutrition. The tasks required to make those things happen fit into one of four categories:

• Homemaker tasks are non-medical housekeeping tasks such as cleaning and providing meals.
• Personal care tasks may or may not be medical, but they involve the care for the body, including bathing, dressing, and wound care.
• Home health tasks may be medical, but they are basic tasks that don’t require a nurse to perform them.
• Nursing tasks are those carried out by an appropriately credentialed nurse.

In a CDPAP model, there is only one kind of care, the category of personal assistance. These personal assistants can perform tasks, usually considered home health or nursing tasks when authorized and trained to do so by the consumer or the consumer’s representative. Because the consumer takes on the responsibility for training and supervising CDPAP caregivers, they are not subject to the same regulations as a home health agency.

Is My CDPAP Aide My Employee?

The CDPAP aide is not your employee and not an employee of a home health care agency. Instead, the aide is an independent contractor paid by an entity called a fiscal intermediary or FI. The FI contracts with the county or a managed care plan for the payment of wages and benefits. Most of these fiscal intermediaries are members of CDPAANYS, the Consumer Directed Personal Assistance Association of New York State. Consumers can also find a list of agencies who contract with the New York Human Resources Administration (HRA) to provide CDPAP care on a fee-for-service basis.

How Can Trusted Choice Homecare Help?

Applying for Medicaid and subsequently, the CDPAP can be an intimidating process. Trusted Choice Homecare can help you with the paperwork and other requirements. As a fiscal intermediary (FI), Trusted Choice pays the caregivers and files for Medicaid reimbursement. We work with the Department of Social Services’ local offices, and we work with most insurance companies. If you think you might qualify for Medicaid and the CDPA program, contact Trusted Choice today and let us help you start the journey to greater control of your healthcare.