Key takeaway
New York is one of the most caregiver-friendly states in the country. Through CDPAP and Managed Long-Term Care, family members — including, in many cases, adult children — can be hired and paid to care for a Medicaid-eligible loved one at home.
- CDPAP (Consumer Directed Personal Assistance Program) lets the Medicaid member hire almost any family or friend (spouses and legal guardians excluded).
- Managed Long-Term Care (MLTC) plans coordinate long-term services for dually eligible and Medicaid-only New Yorkers.
- The NHTD Waiver supports people transitioning from a nursing home back to the community.
- VA Aid & Attendance and Veteran Directed Care offer additional pathways for veterans (VDC can pay a spouse).
Overview
New York funds family caregivers primarily through Medicaid. The most well-known option is the Consumer Directed Personal Assistance Program (CDPAP), which gives Medicaid-eligible New Yorkers the right to hire — and pay — almost any caregiver they choose, including most family members. CDPAP requires no formal caregiver certification, which is a major reason it’s so popular: an adult child, sibling, grandchild, or friend can step in and be paid for the hours of care they’re already providing.
Beyond CDPAP, New York’s Managed Long-Term Care (MLTC) plans coordinate personal care, home health, and other long-term supports for adults who need help with daily living. The NHTD (Nursing Home Transition and Diversion) Waiver helps people who would otherwise be in a nursing home live at home with services. Veterans have additional options through the VA, and limited state-funded programs (such as EISEP, run by Area Agencies on Aging) can help families that don’t yet qualify for Medicaid.
Programs that pay family caregivers in New York
| Program (Type) | Care recipient eligibility | Paid family caregiver provisions |
|---|---|---|
| Consumer Directed Personal Assistance Program (CDPAP) (Medicaid) | Medicaid-eligible; needs help with activities of daily living per assessment; consumer (or authorized representative) can direct their own care. | Consumer hires and supervises the caregiver. Most family members can be paid (spouses and legal guardians are excluded; rules on adult children paying parents vary). |
| Managed Long-Term Care (MLTC) (Medicaid managed care) | Age 21+ (or 18+ in some cases), Medicaid-eligible, and needs community-based long-term care for more than 120 days. | MLTC plans coordinate personal care, home health, adult day care, and CDPAP. Family caregivers are typically paid through CDPAP delivered inside the MLTC plan. |
| Nursing Home Transition and Diversion (NHTD) Waiver (Medicaid HCBS waiver) | Medicaid-eligible adults who meet a nursing-home level of care and choose to live in the community. | Funds service coordination, home modifications, and personal care; family caregivers can be paid through CDPAP or other personal care services within the waiver. |
| Personal Care Services Program (PCS) (Medicaid State Plan) | Medicaid-eligible with documented need for assistance with ADLs/IADLs after a home care assessment. | Hours of personal care delivered through a Licensed Home Care Services Agency (LHCSA); family members can apply to work for the LHCSA. |
| Expanded In-Home Services for the Elderly Program (EISEP) (State-funded) | New Yorkers age 60+ with functional needs who do not qualify for Medicaid; income and assets reviewed on a sliding scale. | Provides case management and in-home services (personal care, housekeeping, respite); pay-to-family is limited but can offset care costs. |
| Aid & Attendance / Veteran Directed Care (VA benefits) | A&A: wartime veteran or surviving spouse needing help with ADLs. VDC: veteran in VA care needing nursing-home level of care at a participating VAMC. | A&A increases monthly pension to pay caregivers (not the spouse). VDC provides a self-directed budget that can pay a spouse, adult children, and other relatives. |
New York Medicaid programs
New York Medicaid funds the lion’s share of paid family caregiving in the state. The two most important programs are the Consumer Directed Personal Assistance Program (CDPAP) and Managed Long-Term Care (MLTC), which often work together.
Consumer Directed Personal Assistance Program (CDPAP)
CDPAP is New York’s flagship self-directed care program. The Medicaid member — called the “consumer” — recruits, hires, trains, supervises, and (if needed) terminates their own caregiver, called a personal assistant. The consumer can choose almost any adult who is legally able to work in the U.S.
- Most family members can be paid: adult children, siblings, grandchildren, nieces/nephews, in-laws, and close friends.
- Excluded: the spouse and legal guardian of the consumer.
- No certification required — the consumer trains the caregiver to their own needs.
- A Fiscal Intermediary (FI) handles payroll, taxes, and benefits.
- CDPAP is being consolidated under a single statewide Fiscal Intermediary; the consumer’s right to hire family remains.
Managed Long-Term Care (MLTC)
Most New Yorkers who need long-term home care must enroll in an MLTC plan that coordinates personal care, home health, and CDPAP. The MLTC plan authorizes hours after an independent assessment.
- Eligibility: Medicaid-eligible adults who need community-based long-term care for more than 120 days.
- CDPAP can be delivered through the MLTC plan — the family caregiver is paid via the FI.
- The plan completes an independent assessment (NYIA) to determine eligibility and hours.
NHTD Waiver
The Nursing Home Transition and Diversion Waiver helps Medicaid-eligible adults at nursing-home level of care live in the community instead. It pairs well with CDPAP for self-directed personal care.
- Provides service coordination, home modifications, assistive technology, and personal care.
- Personal care under the waiver can be delivered through CDPAP, paying a family caregiver.
State-funded option: EISEP and NY Connects
The Expanded In-Home Services for the Elderly Program (EISEP) is administered by Area Agencies on Aging (AAAs) across New York. It serves older adults who don’t qualify for Medicaid but need help to stay at home. NY Connects is the state’s no-wrong-door entry point that helps families compare options.
An AAA care manager assesses the older adult and develops a service plan that may include personal care, housekeeping, respite, and case management. Costs are calculated on a sliding scale.
Family caregivers may be employed through the contracted home care agency. Direct pay to family is more common through Medicaid/CDPAP than EISEP.
Who qualifies
- New York residents age 60+ with functional impairment.
- Income above strict Medicaid limits but consistent with EISEP cost-share rules.
- Not currently receiving the same services through Medicaid; subject to AAA funding and waitlists.
Veterans’ programs
New York veterans and their surviving spouses can use two main VA pathways to fund in-home care: Aid & Attendance and Veteran Directed Care.
Aid & Attendance Pension
A&A increases the monthly VA pension for wartime veterans (or surviving spouses) who need help with activities of daily living. The veteran can use the increase to pay a family caregiver such as an adult child.
- Requires qualifying wartime service, limited income/assets, and need for daily care.
- Spouses cannot be paid directly through A&A because household income is jointly counted.
Veteran Directed Care (VDC)
VDC provides a monthly VA-funded budget that the veteran self-directs to hire caregivers. Family — including a spouse — can be paid. Availability varies by VAMC; New York has multiple participating sites.
- Requires veteran to be in VA health care and to need a nursing-home level of care.
- Spouses, adult children, friends, and neighbors may be paid through a fiscal management service.
Long-term care insurance
If the care recipient owns a long-term care insurance policy that covers in-home personal care, benefits may be used to pay a family caregiver — depending on the policy.
What to check in the policy
- Confirm the policy covers in-home personal care, not just facility care.
- Cash or indemnity policies typically let the policyholder pay any caregiver, including family.
- Reimbursement-only policies usually require a Licensed Home Care Services Agency (LHCSA) to bill.
If the policy reimburses only LHCSAs, the family caregiver can be hired and W-2’d by a New York-licensed home care agency that then bills the insurer.
How to apply in New York (step-by-step)
- Identify the most likely path: CDPAP through MLTC, the NHTD Waiver, EISEP, VA benefits, or LTC insurance.
- Gather documents: photo ID, Social Security card, proof of income/assets, medical records, medication list, and DD-214 if applicable.
- Start with the right agency:
- Medicaid/CDPAP: apply for Medicaid through the NY State of Health or your Local Department of Social Services (LDSS); request the New York Independent Assessor (NYIA) evaluation.
- MLTC: enroll in a Managed Long-Term Care plan after the NYIA assessment confirms eligibility.
- NHTD Waiver: contact a Regional Resource Development Center (RRDC) for the waiver.
- EISEP: call NY Connects or your local Area Agency on Aging.
- VA paths: connect with a VA social worker or VAMC caregiver program coordinator.
- Complete the NYIA (clinical assessment) and submit financial documentation for Medicaid.
- Choose a Fiscal Intermediary (FI) for CDPAP; complete onboarding paperwork for your family caregiver.
- Begin services, submit timesheets, and keep care notes for renewals and audits.
New York paid caregiver FAQs
How do I become a CDPAP caregiver in New York?
CDPAP starts with the consumer (the Medicaid-eligible person needing care). They apply for Medicaid (if not already enrolled), complete a New York Independent Assessor (NYIA) evaluation, and enroll in CDPAP through a Fiscal Intermediary (FI). The consumer then hires you, completes onboarding, and you’re paid via the FI for the authorized hours.
Can I be paid to take care of my mother in New York?
Yes. The most common route is CDPAP — once your mother is Medicaid-eligible and approved through the NYIA, she can hire you as her personal assistant. Adult children, siblings, grandchildren, in-laws, and friends are all eligible. Spouses and legal guardians are excluded.
Can a spouse be paid as a caregiver in New York?
Not under CDPAP. Spouses can be paid through the VA’s Veteran Directed Care (VDC) program at participating VAMCs.
How many hours of CDPAP can I be paid for?
Hours are based on the New York Independent Assessor (NYIA) evaluation. They can range from a few hours per week up to 24-hour live-in or split-shift coverage for people with high needs. Your loved one’s MLTC plan or LDSS authorizes the final hours.
Do I need a license or certification to be a CDPAP caregiver?
No. CDPAP intentionally does not require certification — the consumer trains you to their own needs. You do need to be legally authorized to work in the U.S. and complete the FI’s onboarding (I-9, W-4, health screening, etc.).
