If you live in New York and receive Medicaid, the Consumer Directed Personal Assistance Program (CDPAP) may allow you to receive home care from a personal assistant you choose.

CDPAP remains available in 2026, but several important rules have changed since earlier versions of the program. New eligibility standards introduced in September 2025 are now fully in effect, Public Partnerships LLC (PPL) serves as New York’s statewide fiscal intermediary, and personal assistants have specific registration, health assessment and training requirements.

Here’s what consumers and caregivers should know about CDPAP requirements in New York in 2026.

What Is CDPAP?

The Consumer Directed Personal Assistance Program is a New York State Medicaid program that gives eligible individuals more control over their home care.

Instead of having an agency assign a home health aide, an eligible CDPAP consumer can recruit, hire, train and supervise a personal assistant of their choosing. This may include certain relatives or friends.

CDPAP personal assistants may perform personal care, home health aide tasks and certain skilled nursing tasks that are included in the consumer’s authorized plan of care.

What Changed for CDPAP in 2026?

PPL Is Now the Statewide Fiscal Intermediary

Public Partnerships LLC (PPL) is New York State’s statewide fiscal intermediary for CDPAP. PPL handles administrative responsibilities such as payroll, tax withholding and employment records for personal assistants.

Consumers no longer choose among hundreds of independent fiscal intermediaries as they could under the former CDPAP structure. New York State requires CDPAP consumers to work with PPL for fiscal intermediary services.

The Minimum Needs Requirements Are Now in Effect

New Minimum Needs Requirements took effect on September 1, 2025. They generally apply to people age 21 or older who are newly seeking Personal Care Services or CDPAP services.

To satisfy the Minimum Needs Requirements, an individual must generally be assessed as:

• Needing at least limited assistance with physical maneuvering for more than two Activities of Daily Living (ADLs); or
• If diagnosed with Alzheimer’s disease or dementia, needing at least supervision with more than one ADL.

In practical terms, the first standard generally means assistance with at least three qualifying ADLs.

Examples of Activities of Daily Living may include functions such as bathing, dressing, toileting, transferring, walking and eating. The actual determination is made through the applicable state-approved assessment process.

Who Can Qualify for CDPAP in New York?

Requirement	What It Means
New York Medicaid	CDPAP is a Medicaid-funded program, so the consumer must be eligible for New York State Medicaid.
Need for home care	A state-approved assessment must establish a need for home care services.
Stable medical condition	The consumer must have a medical condition stable enough for care needs to be planned and provided safely at home.
Minimum Needs Requirements	Most new applicants age 21 or older must meet the ADL requirements that became effective September 1, 2025.
Ability to direct care	The consumer must be capable of directing their own care or have a qualified designated representative who can do so.
Participation in assessments	The consumer or designated representative must participate in required assessment and reassessment processes.

These requirements determine whether someone may qualify for CDPAP. The number and type of authorized home-care hours are determined separately based on the individual’s assessed medical and functional needs.

What Is CDPAP Legacy Status?

The Minimum Needs Requirements do not automatically apply to everyone already receiving CDPAP.

People who were authorized for or receiving Personal Care Services or CDPAP before September 1, 2025 may have Legacy Status. These consumers generally continue to be assessed under the eligibility standards that applied before the new Minimum Needs Requirements took effect.

Similarly, certain people who were continuously enrolled in a Managed Long Term Care plan before September 1, 2025 may retain legacy protections while they remain continuously enrolled.

This distinction can be particularly important for an existing CDPAP consumer who might not satisfy the newer three-ADL standard.

Who Can Be a CDPAP Caregiver in 2026?

CDPAP continues to provide significant flexibility in choosing a personal assistant.

A personal assistant may be a friend or qualifying family member, and living in the same household does not automatically prevent an otherwise eligible relative from serving as a caregiver.

However, some individuals cannot be paid as the consumer’s CDPAP personal assistant.

Relationship	Can They Be a CDPAP Personal Assistant?
Friend	Generally yes
Adult child	Generally yes
Sibling or other adult relative	Generally yes
Parent of a consumer age 21+	Generally yes
Spouse	No
Consumer’s designated representative	No
Parent of a consumer under age 21	No

New York State specifically allows parents to serve as personal assistants for adult children age 21 or older. A consumer’s spouse, designated representative or parent when the consumer is under 21 cannot serve as that consumer’s paid CDPAP personal assistant.

Do CDPAP Caregivers Need a License or Certification?

One major difference between CDPAP and traditional home-care employment is that a personal assistant does not generally need to already hold a Home Health Aide (HHA) or Personal Care Aide (PCA) certification.

The consumer or designated representative remains responsible for directing and training the personal assistant to perform the tasks included in the plan of care.

However, this does not mean there are no employment or training requirements.

Personal assistants must complete PPL’s required onboarding process. Current registration documents include an offer letter, Personal Assistant Agreement, federal and New York tax forms, Form I-9 and supporting employment eligibility documentation, payment information and a health assessment.

PPL also requires personal assistants who begin working with PPL during 2026 to complete CDPAP training within 90 days of their PPL start date.

Health Requirements for CDPAP Personal Assistants

Before starting work, a new personal assistant must complete required health screening.

Current PPL health requirements include a physical examination confirming the PA is medically able to perform the work, documentation of immunity or vaccination for measles, mumps and rubella (MMR), and appropriate tuberculosis testing and risk assessment.

Ongoing health-assessment requirements also apply after employment begins.

How to Apply for CDPAP in New York in 2026

The exact process can vary depending on the consumer’s Medicaid coverage and whether services are authorized through a managed care plan, Managed Long Term Care plan or local social services district. In general, the process includes:

1. Confirm Medicaid eligibility. The person receiving care must qualify for New York State Medicaid.
2. Request an assessment for home-care services. The appropriate state, plan or local assessment process determines the consumer’s functional and medical needs.
3. Complete required medical documentation. Practitioner documentation or orders may be required as part of the authorization process.
4. Receive authorization for CDPAP. The Medicaid plan or appropriate authorizing entity determines eligibility, the plan of care and approved service hours.
5. Register with PPL. The consumer and personal assistant complete the required statewide fiscal intermediary registration process.
6. Complete PA employment requirements. The caregiver submits employment documents, completes required health screening and completes required PPL training.
7. Begin authorized services. Once enrollment and authorization requirements have been completed, the PA can provide care and report authorized working time through PPL’s approved systems.

PPL registration alone does not determine how many CDPAP hours a consumer receives. Service hours are based on the consumer’s assessment and authorized plan of care.

Consumer Responsibilities Under CDPAP

CDPAP gives consumers more control over their home care, but that control also comes with responsibilities.

The consumer or their designated representative is responsible for recruiting and hiring appropriate personal assistants, training and supervising them, arranging backup care when necessary, coordinating services, maintaining required records and working with PPL to ensure authorized services are properly reported and processed.

New York State has also increased attention to situations in which an individual PA works extremely high numbers of hours. In July 2026, the Department of Health issued guidance defining excessive PA hours as certain situations involving more than 16 hours per day every day or 112 or more hours in a single week. The guidance emphasizes the consumer’s responsibility to maintain enough qualified caregivers to safely cover authorized services.

Can You Still Get Paid to Care for a Family Member in New York?

Yes. CDPAP continues to allow many family members to receive compensation for providing approved care to an eligible Medicaid recipient.

The most important relationship restrictions remain spouses, designated representatives and parents caring for a child under age 21.

For qualifying families, CDPAP can provide an alternative to traditional agency-directed home care by allowing the individual receiving services to choose someone they already know and trust.

Understanding CDPAP Requirements in 2026

CDPAP remains an important New York Medicaid home-care option in 2026, but applicants should understand that the program has changed.

The statewide transition to PPL is complete, the Minimum Needs Requirements are now active for most new adult applicants, and personal assistants must comply with PPL registration, health assessment and training requirements.

If you are considering CDPAP for yourself or a family member, start by confirming Medicaid eligibility and determining which organization is responsible for assessing and authorizing your home-care services. Existing consumers should also determine whether they have Legacy Status before assuming that the newer Minimum Needs Requirements apply to them.

Program eligibility and authorization depend on individual circumstances. For official eligibility determinations, consumers should consult their Medicaid plan, local social services district, New York Independent Assessor where applicable, PPL or the New York State Department of Health.