The Consumer Directed Personal Assistance Program (CDPAP) is a statewide Medicaid program that provides an alternative way of receiving home care services, in which the consumer has more control over who provides his or her care and how it is provided. This program enables consumers or their guardians to be self-directing and to assume the responsibility for their own care, giving the consumers more independence and allowing them to feel more autonomous.

This Medicaid program provides services to chronically ill or physically disabled individuals who have medical needs and who require assistance in their activities of daily living (ADLs). These services can include, but are not limited to, any of the services provided by a personal care aide (home attendant), home health aide, or nurse.

Recipients of the program have the flexibility and freedom to choose their caregivers. The consumer or the person acting on the consumer’s behalf (such as the parent of a disabled or chronically ill child), assumes full responsibility for hiring, training, supervising and, if needed, terminating the employment of the service providers.

Recipients, their legal guardians or other persons designated to help and guide them must be able and willing to make informed decisions regarding the management of the services they receive.

The consumer or designee must also be responsible for recruiting, hiring, training, supervising-including payroll record keeping and terminating the caregiver’s service. In the event that back-up coverage is needed, an alternative plan of care should be implemented by the consumer or designee.

The consumer can hire almost anyone, including some extended family members. Regulations adopted in April 2011 expanded the definition of a family member to include a person's adult child, son-in-law or daughter-in-law, any of whom is allowed to be hired as an aide.

New York State regulations prohibit one’s spouse or parent from being hired as one’s CDPAP aide, but makes an allowance for other family members. Any person hired must have valid work authorization and need not be "certified", as the training is done by the consumer or the consumer’s family.

As of April 2016 there have been updates to CDPAP laws. They state that the Medicaid consumer has the ability to control the home care they receive by hiring and paying almost anyone they want, which can include any member of the family besides his/her spouse. Notably, this act allows parents of disabled adult children that require care, to be paid caregivers as long as the parent is not also the recipient’s designated representative.

CDPAP aides have the special benefit of being allowed to perform "skilled" care that may otherwise only be performed by a nurse. These "skilled" tasks include, but are not limited to, suctioning tracheostomies, insulin injections, and the administration of oxygen and medication that cannot be self-administered. See N.Y. Educ. Law § 6908(1)(a). Tasks that cannot be performed by home health aides or personal care aides are indicated in the scope of tasks for home health aides and personal care.

1. Enrollment Registration
   1. The consumer (patient) completes an online application;
   2. The consumer’s designated caregiver completes an online application and submits any required documents either online or directly to the ABI FI office;
   3. Any other caregiver who would like to be listed on the ABI FI caregiver database and be chosen by CDPAP consumers can complete an online application and submit any required documents online or directly to ABI FI office as well.
2. The consumer or his/her representative chooses and confirms the choice of the aides.
3. ABI FI submits the application to the MLTC plan that the consumer requests.
4. The MLTC plan sends an enrollment nurse to the consumer’s home for a nursing assessment to determine the eligibility of the consumer. A nurse assessor determines whether the recipient can appropriately participate in CDPAP, and recommends the amount, frequency and duration of services.
5. The MLTC plan submits all enrollment applications to HRA/Medicaid for approval.
6. Upon approval, ABI FI receives authorization from the MLTC Plan. ABI FI will inform the consumer (patient) and then authorize the aide to start the service.
7. Aides submit all duty sheets to ABI FI.
8. ABI FI processes the payroll based on the duty sheets and pays the aides’ wages and benefits.