If your mother or father gets home care through New York Medicaid, you have probably heard of CDPAP, the program that lets a family member or friend be paid as their caregiver. You may also have heard that it changed a lot. Here is a plain-English look at where CDPAP stands in 2026, how a family signs up today, and how to decide whether it is the right fit or whether agency care would serve your loved one better.
What CDPAP is, in one paragraph
The Consumer Directed Personal Assistance Program (CDPAP) is a New York Medicaid program for people who need help with everyday tasks like bathing, dressing, moving around the home and eating. Instead of an agency sending an aide, the person receiving care (the “consumer”), or someone acting for them, recruits, hires, trains and supervises their own personal assistant. That assistant can be a trusted relative, neighbor or friend.
CDPAP is a New York program. If your loved one lives in Connecticut, the options are different; our guide to who pays for home care in New York and Connecticut covers both states.
What changed: one statewide payroll company
For years, families could choose from hundreds of “fiscal intermediaries,” companies that handled the caregiver’s paychecks and paperwork. On April 1, 2025, New York moved the program to a single statewide fiscal intermediary, Public Partnerships LLC (PPL). According to the New York State Department of Health, existing consumers had until June 6, 2025 to register with PPL.
The same Department of Health update reported that about 280,000 consumers were authorized for CDPAP before April 1, 2025, and that roughly 75,000 of them moved to agency-based Personal Care Services instead of registering with PPL.
A higher bar for new applicants
The second big change affects people applying for the first time. Since September 1, 2025, the state’s minimum needs requirement applies to anyone seeking initial eligibility for Personal Care Services or CDPAP. A new applicant generally must need at least limited hands-on help with more than two activities of daily living. For someone with a dementia or Alzheimer’s diagnosis, the threshold is needing at least supervision with more than one activity of daily living. People who were already enrolled before that date keep the earlier criteria.
Caregiver pay in 2026
PPL reports that personal assistants received a $0.55 per hour raise on January 1, 2026. Its New York CDPAP FAQ lists current base rates of $20.65 an hour in the Bronx, Manhattan, Brooklyn, Queens and Staten Island; $20.05 in Nassau, Suffolk and Westchester; and $18.65 in the rest of the state.
Who can be the paid caregiver
Most adult relatives can be hired, including adult children, siblings, grandchildren, nieces and nephews. Under New York’s CDPAP regulation, three groups cannot be the paid assistant:
- A spouse. A husband or wife cannot be paid to care for their partner through CDPAP.
- Anyone legally responsible for the consumer’s care and support, such as a parent of a child under 21.
- The consumer’s designated representative. If your parent cannot direct their own care, someone must take on that role, and that person cannot also be the paid caregiver.
That last rule trips up many families. If Dad needs a daughter to manage his care, a different relative or friend has to be the paid assistant, or the daughter needs to step out of the representative role so someone else can take it on.
How a family enrolls in CDPAP in 2026
- Confirm Medicaid coverage. Your loved one needs active New York Medicaid that covers community long-term care. If they are not enrolled yet, NY Connects can point you to the right local office.
- Request an assessment. For adults, the New York Independent Assessor (NYIA) completes a Community Health Assessment and a clinical appointment with a practitioner, who issues an order confirming the need for services.
- Get the CDPAP authorization. Your loved one’s Medicaid managed care plan or local Department of Social Services reviews the assessment and decides how many hours to authorize.
- Register with PPL. The consumer (or designated representative) registers with PPL, and the chosen caregiver completes PPL’s hiring paperwork before they can be paid.
- Plan for backup. The state is clear that consumers must arrange back-up coverage when needed. Decide in advance who covers if the main caregiver is sick, on vacation or simply exhausted.
CDPAP or an agency? Questions to ask
CDPAP works beautifully for some families and is a poor fit for others. A few honest questions can help you decide.
Is there a willing, reliable caregiver?
CDPAP depends on one person, or a small circle, showing up every shift. If the person you have in mind already works full time or is raising young children, the hours may not be realistic.
Who will handle the employer duties?
Under CDPAP, the family recruits, trains and supervises the caregiver, keeps records and finds replacements. With agency care, the agency does all of that.
What happens on a bad day?
When a CDPAP caregiver calls out, the family has to fill the gap. A licensed agency has a bench of trained aides and a coordinator who arranges coverage.
Does your loved one need more than one caregiver?
Long days, overnights and 24-hour care are hard for a single family member to sustain. Agencies can build a team across shifts.
Many families use a mix: a relative covers some hours, and an agency covers the rest or steps in for respite. If you are leaning toward agency care, Medicaid and Managed Long Term Care plans can cover personal care services in New York through a licensed agency like UniversaCare, with the same assessment process up front.
How UniversaCare can help
UniversaCare is a New York State–licensed home care services agency with local offices serving Queens, Brooklyn, the Bronx, Manhattan, Nassau and Westchester County. We do not run CDPAP payroll, but we regularly help families weigh CDPAP against agency care and are happy to walk you through both paths.
If you choose agency care, we handle caregiver screening, training, scheduling, supervision and backup coverage, and we work with your Medicaid plan on authorized hours. If you are paying privately while waiting for approval, families typically pay $35–$42 per hour, or $450–$550 per day for live-in care. Our New York home care cost guide explains what affects the price.
Frequently asked questions
Can I get paid to take care of my mother in New York?
Often, yes. If your mother has Medicaid, meets the program’s needs requirements and is authorized for CDPAP, an adult child can usually be her paid personal assistant, as long as you are not also serving as her designated representative.
Can my mother be paid to care for my father through CDPAP?
No. New York’s CDPAP rules do not allow a spouse to be the paid personal assistant. Another relative, a friend or an agency caregiver can provide the paid hours.
Can we switch from CDPAP to agency home care?
Yes. Many families did exactly that during the 2025 transition. Talk to your loved one’s Medicaid plan or local social services office about changing to Personal Care Services, and ask the agency you choose to help coordinate the start date so there is no gap in care.
Talk it through with us
Every family’s situation is different, and the rules keep evolving. Call (866) 986-3356 for a free consultation. We will help you understand your options, whether that means CDPAP, agency care or a mix of both.
