The CDPAP Program Guide: 2022 Edition

If you are looking for the most up to date understanding of the CDPAP program for the State of New York, you are in luck! Read on to learn more about this amazing program offered to Medicaid patients across the state.

Table of Contents

What is the CDPAP program?

CDPAP stands for Consumer Directed Personal Assistance Program, a Medicaid program in the state of New York that makes it possible for patients who need care to choose and hire their own personal caregivers.  Every state Medicaid program has something similar, but CDPAP specifically relates to the New York program. This means that people who need personal care in their homes can choose friends or family as their caregivers and these people are eligible to receive payment for their services through a Fiscal Intermediary. This company will work with Medicaid to make payments for the services provided.

Medicaid enrollment is required to participate in CDPAP. Not Medicare. Medicare does not offer these benefits to enrollees.

Medicare patients can and are encouraged to enroll in Medicaid to access home health benefits.

The CDPAP program recognizes that no one can take care of a patient as well as loved ones can. Close friends and family members who take care of loved ones without getting paid often do so because they feel it is their duty. They often see this work as more than just a job.

This level of care and concern is very important, and the CDPAP program exists to help support caregiving within families and among friends. The program provides financial reimbursement for caregivers.

The CDPAP program lets elderly and disabled people get help with their care from family members or friends. These people can be paid for their time, which helps both the elderly/disabled person and the helper.

To get the benefits of the CDPAP program, you have to go through a fiscal intermediary or CDPAP . This CDPAP agency will take care of payments from Medicaid for your chosen caregiver.

What are the eligibility requirements for CDPAP?

CDPAP has simple eligibility requirements. In order to be able to receive care under the CDPAP program, the patient must meet the following requirements:

  • The patient must be a Medicaid recipient in New York State.
  • The patient must require assistance with daily living activities in the home. The patient may be asked to take an ADL or IADL test as proof.
  • The patient or their representative must be able to show that they can direct how to care for themselves or that they have someone who can direct someone else on how to care for them.

The CDPAP program helps people who need help with their everyday activities. Before you can apply for the program, you need to be sure that you can direct a caregiver in essential tasks. You also need to be able to prove that you need the help of a caregiver. There are tests that can help you prove this need.

If you want to apply to become a caregiver through the CDPAP program, you must meet certain requirements. These include being able to provide:

  • Proof that a patient already wants to or would be willing to hire you as their caregiver
  • Proof of American citizenship or legal working status in the United States
  • Proof that you are of legal working age
  • Completed Personal Assistant (PA) application package provided by the fiscal intermediary
  • Completed pre-employment physical exam to prove that you are physically capable of providing the level of care that will be needed

CDPAP care providers do not need any formal training to become members of the CDPAP program. However, they must be willing and able to learn from their patient (or a patient representative), and they also must be physically capable of providing the care that is needed.

CDPAP patient vs. caregiver

How do I apply for CDPAP?

The simplest way to apply is to sign up here. Our dedicated partners will walk you through the process. However, to give you a better understanding of the process we have broken down the stages for you here:
  • Patient assessment
  • Consumer forms
  • Selection of caregiver
Let’s take a look at each of these areas in more depth:

    Patient Assessment

      If you want to apply for the CDPAP program, the patient must have a medical examination and assessment. The nurse will do this. Some patients might need more than one assessment, depending on the situation. This assessment is used to show that the patient needs home care. It also helps identify which areas the patient will need help with. The assessment will help future caregivers understand the needs of the patient better when they take care of them. The nurse will figure out how much care you need and how often you need it. This happens during the assessment. The assessment may also involve tests to see how well you can take care of yourself. These tests are called ADL or IADL tests. Some people have to do these tests, but other people don’t. It depends on your situation.

      Consumer Forms

      For CDPAP applicants, there are a few forms you must complete in order to apply for CDPAP. Two of these forms are:
      • The DOH Form (Physician’s Order) which is filled out by your doctor and says that they approve of you receiving home care services from a CDPAP caregiver.
      • The PCP Transfer Form which your doctor will fill out for you. This form authorizes your new doctor to manage all of your CDPAP care.
      You will also need to provide identifying documents (such as proof of American citizenship) and medical documents (like your Medicaid card).

      Selection of Caregiver

      At this point, the patient will need to choose and officially hire  a caregiver. There are specific rules about who can and cannot be a caregiver on the CDPAP program. These rules are discussed later in this guide. Also, remember that the patient will need to choose a caregiver who can provide the necessary documentation and information so that they can become a CDPAP caregiver

      Spouses, legal guardians, and parents of minors under 21 years old cannot be paid as caregivers under the CDPAP program in New York. Representatives (those responsible for directing medical care of the patient) are also not allowed to be a paid caregiver of the patient.

      Does a patient have to be on Medicaid to qualify for CDPAP?

      Yes, in order to be a part of the CDPAP program, you must have Medicaid. The CDPAP program is government funded and is only available to Medicaid recipients. If you do not have Medicaid and wish to apply for it, you will need to first apply for Medicaid.

      I don’t have Medicaid but I think I am eligible. How do I obtain Medicaid?

      If you want to register for the CDPAP program, you need to have Medicaid first. So you might be wondering if you are eligible for Medicaid and how to get it. Here are the eligibility requirements for Medicaid in New York State:

      To be eligible for Medicaid in New York State, an individual must meet all of the following requirements:

      Medicaid requirements for CDPAP

      If you think you might be able to get Medicaid, the next step is to gather your documents and apply. You can either do it online or at your local office. The New York Medicaid Application can be submitted:

      • online through the eMedNY portal
      • in person at your local District Service Office
      • through mail sent to the District Social Service Office in your area.

      If you need help filling out the Medicaid application, you can contact your local service office. If you go to the office in person, a representative can help you fill out the form and give you advice on what documents to bring.

      The key documentation you will need to be able to apply for Medicaid are:

      •   Proof of American citizenship
      •   Proof of New York State residency
      •   Completed Medicaid application form
      •   Proof of assets and current savings
      •   Proof of all sources of income
      •   Completed Medicaid supplement form
      •   Any other documents that may be requested of you by the local and state government offices during the application process.

        Medicaid recipients must renew their membership in the program on an annual basis. You will not be able to apply to become a part of the CDPAP program until after you have completed and successfully received membership as a Medicaid recipient.

        CDPAP Pay Rate and Salary

        Payment and benefits depend on the patient’s location and insurance plan. At simplyCDPAP, our goal and focus is to match patients and caregivers with the highest paying CDPAP agencies in New York that provide the best pay and benefits.

        Who can provide care under the CDPAP program?

        There are a set of people who are allowed to provide care for someone who needs help at home. This program is called CDPAP. If you are an adult relative or friend of someone who needs help, it is likely that you can be a caregiver in this program. But there are some rules you need to follow before applying.

        Those who are able to provide care under the CDPAP program include:

        •   Children of elderly parents or parents who need home care
        •   Siblings of individuals who require home care
        •   Friends of individuals who require home care
        •   Parents of disabled or individuals over the age of 21 
        •   Other adult family members, friends, or associates of a patient

        People who cannot provide care services include:

        •   The spouse of the patient who requires home care
        •   The parent of the patient under the age of 21 who requires home care OR the parent of a patient over the age of 21 who has not specifically requested that their parent be their caregiver.

        All CDPAP providers must be American citizens and be able to show proof of citizenship or they must have legal immigration status in the United States and be able to show the necessary paperwork (such as a green card or other immigration papers) to show ability to work inside in the United States.

        If you want to become a CDPAP caregiver, you must be of legal working age and be able to provide the care services required. You will also need to have some medical testing (like a TB test) and provide documents that show you are eligible to be a patient’s caregiver.

        Can a caregiver live at the same address as the patient?

        Yes, however this will vary from CDPAP agency to CDPAP agency. In most cases, this isn’t a problem.

        According to the government’s policy, a CDPAP personal assistant can be the adult relative of a patient who can reside with the patient. Or the personal assistant can be the adult relative who resides with the patient because the amount of care that’s required by the patient necessitates a live-in caregiver.

        In the event that live-in or 24/7 care is needed for the patient, each agency may have a different protocol for this and could depend on the insurance plan administering the Medicaid benefits for CDPAP. Regardless, patients and caregivers CAN live together under current CDPAP rules.

        Which family members cannot work as CDPAP aides?

        Most family members are eligible to work as CDPAP aides so long as they fulfill the following requirements:

        •   They are of legal working age.
        •   They are legal American citizens or residents.
        •   They are physically capable of providing the care required.
        •   The patient has requested them as a caregiver.

        Spouses, legal guardians, and parents/guardians of minor children cannot work as a CDPAP caregiver. Parents of children over the age of 21 may work as CDPAP caregivers if the patient requests them to provide care. Spouses rarely, if ever, get approved by the state to be a caregiver under New York’s CDPAP program.

        What type of training is needed to work as a CDPAP caregiver?

        There is no need for caregivers to have any formal training or hold any special licenses in order to work as a home care provider through the CDPAP program. The majority of the training that CDPAP caregivers receive comes from the person receiving care (the patient or their representative) according to their individual needs.

        New York State offers training to help people become caregivers. This training is not required, but it is helpful. Caregivers who complete the training are authorized to provide care that is as good as what a registered nurse can provide. 

        Some caregivers choose to get more training so they can give the best care possible. However, this additional training is not required by the state of New York.

        What types of home care services can CDPAP caregivers provide?

        CDPAP caregivers can provide many types of services for people at home. Traditional home health aides and personal care aides can only do a few things. But CDPAP caregivers are able to do more, like give oxygen and insulin injections.
        CDPAP caregiver list

        If the patient asks for something that is not listed above, it is up to them to tell you, the caregiver, what they need. CDPAP is a consumer-directed program, which means that it is up to the patient or their representative to tell you what they need from you in terms of care.

        The list of things to do to get help for a loved one is not complete and it can vary a lot. So, caregivers and patient representatives need to be prepared to work with the county caseworker and/or medical professional who will determine the level of care the patient needs.

        After the level of care is assessed by qualified professionals, a personalized care plan is created. This plan includes the number of hours of care that have been approved, making a selected caregiver eligible for compensation for those hours.

        After the level of care has been determined, patients can choose someone to take care of them in their home for a set amount of time. This person can be anyone who is not the legal parent or spouse of the patient, as long as they are paid through a financial management company (fiscal intermediary).

        What is a fiscal intermediary (FI) and why do I need one to sign up for CDPAP?

        A fiscal intermediary is an organization that helps process benefits and wages for two groups of people: Medicaid patients and caregivers who work through the CDPAP program.

        The fiscal intermediary makes sure that patients get the help they need and that caregivers receive the money they need to continue working.

        If personal caregivers did not have a fiscal intermediary to help them get paid by Medicaid, they would not be able to provide services. Every state has different ways of paying caregivers, but the CDPAP program in New York is one of the best-developed models for personal care in the country.

        Before caregivers can sign up through their local Department of Social Services, the patient must be eligible for Medicaid. This program acknowledges that family members or friends who provide care have a special value and need financial support to continue providing that care.

        What are the benefits of CDPAP compared to traditional home care?

        One of the best things about CDPAP care is that patients can choose their own caregivers. These can be family members or friends. When the patient and caregiver have a strong emotional bond, it leads to better care results and a more satisfying work environment. Both patient and caregiver benefit from the relationship.

        CDPAP gives more freedom to both the patient and the personal care assistant. Without the need for special licensing or certification to do their jobs, caregivers are able to be more flexible to the needs of the patient they are caring for. Patients who need advanced care services, like insulin shots or wound care, can be taken care of by friends or family members who receive special training.

        In traditional home care, a home health aide or nurse is hired by an agency. The patient usually does not know the aide or nurse and does not choose who comes to care for them during a given shift.

        If the patient has a problem with a particular nurse or aide, they can complain and request a different caregiver. If the home care agency doesn’t have another caregiver available to take the shift, then the patient must either do without a caregiver or put up with a caregiver they don’t like or don’t trust.

        The CDPAP program helps everyone. The program saves patients money and it allows friends and family members to be paid to help the patient. This is better than traditional home care, which has many rules that don’t apply when family members are caregivers instead of strangers.

        The CDPAP program is a good way to take care of people. It is better for the caregiver and the patient. The taxpayers also benefit from this program.

        Maximum Effort Deserves Maximum Pay

        At simplyCDPAP, we believe in one thing… that a happy and valued CDPAP caregiver gives the best service and patient care to the people they serve.

        We help patients and caregivers both locate CDPAP agencies across New York who also share in the same sentiment.

        Regardless to whether you are new to CDPAP or a multi-year veteran of this patient care program, you deserve to know which agencies are the best option for not only patient care, but also for caregiver pay and benefits.

        For patients, their caregiver is often a loved one they know personally and someone who brings joy to their lives and recovery.

        Take the time now to fill out the form to see if your caregiver is getting what they most deserve!

         

        Is any part of New York State not included in the CDPAP program?

        The CDPAP program is available in all sixty-two counties in the state of New York. This means that Medicaid patients in any part of the state can access home care services. If you have any questions about eligibility, please call your local Medicaid office.

        Does a caregiver need to work a minimum amount of hours per week?

        There is no required minimum number of hours that caregivers must work. Caregivers are paid for the number of hours they work each week, no matter how many or few hours they work.

        If you need to work full-time, but your patient has been approved for less than 40 hours of care each week, you may wish to take on more patients to fill your schedule.

        Can a caregiver take care of more than one patient at a time?

        Absolutely! You can care for more than one patient at a time, but the hours have to be split up. That means that you can’t be caring for more than one patient at the same time.

        For example, if you are caring for your parents, you may spend 60 hours per week at their home providing care. Your mom may qualify for 40 hours of care per week and your dad may qualify for only 20 hours.

        Though you will likely provide care for both of them during your 60 hours of time in their home, you can only be on the clock for 40 hours for your mom and 20 hours for your dad.

        You may also have patients who live in different areas. If one patient is only authorized for 20 hours, you can seek out other Medicaid patients who qualify for CDPAP and become their caregiver as well. You are not obligated to only one patient as a caregiver, however you may only be “on the clock” for one patient at a time.

        Can a person with special needs qualify for the program?

        If you have a special needs patient and they meet the eligibility requirements, they can qualify for the CDPAP program. They must be able to get Medicaid, need home care, and be either self-directing or have someone who will direct their care for them.

        A special needs patient must have someone who is responsible for hiring, training, supervising, and firing employees. That person is called the Designated Representative (DR). The DR must be an adult over 21 years old and have proof of legal status in the United States.

        Some people need help with activities of daily living because they are chronically ill or have a physical disability. They may also need skilled nursing services.

        If the patient needs this kind of help, a CDPAP caregiver can provide it. CDPAP caregivers can be trained to do the same things that nurses and home care aides do.

        Important note: Those with a code of 95 or 81 on their Medicaid may need to speak with a caseworker on removing these codes. These are modifiers to the Medicaid that often provide more specialized services like OPWDD (Office for People with Developmental Disabilities) or for TBI (traumatic brain injury). Having these codes removed could cause certain services the patient is receiving to be removed.

        Those with a code of 95 or 81 on their Medicaid may need to speak with a caseworker on removing these codes.

         Having these codes removed could cause certain services the patient is receiving to be removed.

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