If you live in New York and qualify for Medicaid, CDPAP (Consumer Directed Personal Assistance Program) could provide the assistance you’ve been looking for. This article explains what CDPAP is, shares the updated requirements for the program and how we can assist you in applying for CDPAP.

What Is CDPAP?

The Consumer Directed Personal Assistance Program (CDPAP) is a New York Medicaid program that allows eligible individuals to hire, train, and manage their own home caregivers. One of the key benefits is the ability to employ trusted family members or friends (with certain restrictions).

In 2025, CDPAP is undergoing significant administrative changes under the New York State budget, especially in how caregiving services and payments will be handled.

What’s Changing in CDPAP in 2025?

Before diving into eligibility, it’s important to note two major changes underway for CDPAP in 2025:

1. Consolidation to a Single Fiscal Intermediary (FI)

• In March 2025, New York State started the move from having over 600 separate fiscal intermediaries to using one statewide fiscal intermediary (FI) to manage payments, paperwork, and administration.
• This consolidation aims to reduce administrative complexity, curb fraud, and standardize processing.
• However, the transition has faced legal challenges. A court has partially blocked aspects of the transition, allowing certain FIs to continue servicing users who haven’t yet registered with the new FI, Public Partnerships LLC (PPL).

2. Tighter Medical Criteria for New Applicants

• Later in 2025, new applicants may be required to demonstrate a need for physical assistance in at least three (3) Activities of Daily Living (ADLs).
• This change is intended to restrict CDPAP to individuals with more substantial care needs.

Because of these changes, it’s especially important for applicants, caregivers, and care recipients to be up to date and to act proactively during the transition period.

Who Can Be a CDPAP Recipient (Care Consumer)?

To be eligible as a care recipient (i.e. the person receiving services), you must meet all of the following:

Requirement	Details / Notes
New York residency	Must be a resident of New York State.
Medicaid eligibility	You must be enrolled in or qualify for New York Medicaid.
Need for home care services	Assessed medical or functional need (assistance with daily living tasks or skilled care).
Stable medical condition	Your condition must be relatively stable to plan ongoing services.
Self-direction or representation	You must have the cognitive or physical capacity to direct your care (or designate a representative who can).

Important note on new ADL requirement: As noted above, under new rules expected in 2025, new applicants may have to show they need physical help with at least 3 ADLs.

Who Can Be a CDPAP Caregiver (Personal Assistant)?

If you want to be hired under CDPAP, here are the usual eligibility and restrictions:

Basic Criteria

• Must be at least 18 years old.
• Must be legally authorized to work in the U.S. (e.g. valid work authorization, Social Security).
• Must provide valid identification (unexpired government-issued photo ID), proof of Social Security number, etc.
• Must undergo a pre-employment physical exam (usually no older than 6 months) to confirm ability to provide the required care.
• May need immunization/lab proof (e.g. rubella, rubeola immunity).

Who Cannot Be a CDPAP Caregiver

• You cannot be the consumer’s spouse.
• You cannot be the consumer’s designated representative (if that role is separate).
• You cannot be the parent of a consumer under age 21. (But if the consumer is over 21, a parent can serve as caregiver.)

Other Notes & Flexibility

• There is no special license or certification requirement to be a CDPAP caregiver.
• Training is typically provided by the care consumer (or their representative), not mandated by the state.
• In 2025, caregivers may need to register anew under PPL or comply with transitional rules due to the FI consolidation.

CDPAP Application & Process (2025)

Here’s a streamlined “step-by-step” outline for applying or transitioning in 2025:

1. Confirm Medicaid eligibility
   If not already on Medicaid, apply first. CDPAP is strictly a Medicaid-funded service.
2. Obtain a physician’s certification or order
   A licensed healthcare provider must document your need for personal care / home care services.
3. Select or register with a Fiscal Intermediary (FI)
   With the 2025 changes, new and existing participants must transition to the designated statewide FI (PPL).
4. Schedule and complete nurse assessments
   Usually, a nurse assessment verifies and measures your care needs.
5. Hire and document caregiver(s)
   Recruit, screen, and submit required documents (IDs, physical exam, work authorization, etc.).
6. Approval of hours and service plan
   The approved care plan defines how many hours of service per week you will receive. Additional hours can sometimes be approved if your condition changes.
7. Begin services and log care
   Once approved, your caregiver starts performing services, submitting timesheets, and adhering to the care plan.

Why the 2025 Changes Matter

• Centralization = Standardization & Efficiency
  Consolidating all administrative tasks under one FI seeks to create consistency in payments, reduce delays, and cut waste.
• Access becomes more selective
  The requirement of needing assistance in 3 ADLs will likely reduce eligibility among milder cases, making the program more focused on people with higher levels of need.
• Transition risks
  Because of the massive systemic change, some caregivers and recipients face risks like payment delays or administrative confusion during the switch. The partial court block and calls for a delayed transition underscore these concerns.

Tips & Warnings for 2025

• The transition to a single FI means delays in registration or payments are possible.
• Make sure you (and your caregiver) register or re-register with PPL promptly.
• Group advocacy and legal action are already underway to protect consumers during the change.
• Document everything (timesheets, orders, assessments) to avoid disputes.