CDPAP New York: Get Paid To Care For A Family Member

No. Since a 2011 reform of CDPAP, spouses are specifically excluded from being paid personal assistants under this program. The same rule applies to legal guardians. New York lawmakers decided that the spousal relationship is one where unpaid caregiving is legally expected, so CDPAP funds are reserved for other family members or friends. The good news is that almost everyone else can be paid — adult children, siblings, grandchildren, in-laws, nieces, nephews, friends, and neighbors are all eligible. If you specifically need a spouse to be paid for caregiving in New York, look into VA Veteran Directed Care (if the consumer is a veteran), which does allow spouses to be paid in some cases.

CDPAP pay rates depend on where the consumer lives. In New York City and the surrounding downstate counties (Nassau, Suffolk, Westchester, Rockland), most personal assistants earn $18 to $22 per hour in 2026. Upstate New York rates are typically $15 to $19 per hour. Rates are set in line with New York's regional minimum wage and Department of Health guidance, and they have risen steadily over the past several years. Personal assistants are W-2 employees, so federal and state income taxes, Social Security, and Medicare are withheld from each paycheck. Many also qualify for paid sick leave and other benefits through the Fiscal Intermediary. Live-in arrangements may use a daily rate rather than hourly.

From start to finish, CDPAP approval typically takes 60 to 120 days. The bottleneck is usually the nurse assessment process through the New York Independent Assessor (NYIA), which can take several weeks to schedule. Once the assessment is done and Medicaid eligibility is confirmed, enrollment in an MLTC plan (if applicable) and onboarding with the Fiscal Intermediary usually takes another 2-4 weeks. If the consumer is not yet enrolled in Community Medicaid, add 30-90 days for that application. You can speed things up by gathering documents in advance: proof of New York residency, identification, Social Security card, proof of income and assets, and any medical records that support the need for home care.

This is one of CDPAP's biggest advantages: no formal training, certification, or license is required. You do not need to be a Certified Nursing Assistant (CNA), Home Health Aide (HHA), or any other licensed professional. The consumer (or their designated representative) trains the personal assistant on the specific tasks they need help with. There are some basic onboarding requirements through the Fiscal Intermediary — usually a tuberculosis (PPD) test, a basic health screening, employment paperwork (I-9, W-4), and signing off on training materials about reporting hours and recognizing abuse or neglect. But there is no clinical exam or skills test. This makes CDPAP especially welcoming to family members who have been informally caregiving for years and want to be paid for that work.

Yes. Many CDPAP aides live with the person they care for, especially adult children caring for aging parents. There is no rule against sharing a household. In fact, "live-in" CDPAP is a common arrangement for consumers who need around-the-clock support. Live-in cases typically pay a daily rate that covers a defined number of awake hours plus an uninterrupted sleep period — the exact structure depends on state guidance and recent court rulings about live-in wage rules. If the consumer needs constant overnight attention (more than a few wake-ups per night), they may be assessed for a 24-hour "split-shift" instead, which uses two aides on overlapping shifts.

Yes — many aides work for two or more Medicaid consumers, though each consumer is a separate employment relationship through the Fiscal Intermediary. Overtime rules are calculated per consumer, so an aide working 30 hours a week for their mother and 20 hours a week for a neighbor would not automatically trigger overtime. However, the Fair Labor Standards Act has joint-employer provisions that can apply in some situations, so check with the Fiscal Intermediary if you plan to work for multiple consumers. Many family caregivers in CDPAP do exactly this: cover their own parent during the week and pick up extra hours with a friend's elderly relative on weekends.

Home care agencies hire and assign their own aides to you — you usually do not get to choose who shows up. The agency supervises the aide, sets the schedule (with input from you), and handles all employment matters. CDPAP flips that model: you (the Medicaid consumer) are the employer. You choose the aide — typically a family member or friend you already know and trust — you train them on your specific needs, you set the schedule, and you can fire them if things are not working out. The Fiscal Intermediary handles payroll and paperwork, but it does not supervise care. For people who want continuity, trust, and control, CDPAP is the gold standard. For people who do not have a family member or friend available, a traditional Medicaid home care agency may be a better fit.

No. Enrolling in CDPAP does not change the consumer's eligibility for other Medicaid services — they keep their doctor visits, hospital coverage, prescription drug benefits, durable medical equipment, and other services. CDPAP is one specific Medicaid-funded program for personal care, and it sits alongside the rest of the Medicaid benefit package. If the consumer is dually eligible for Medicare and Medicaid, Medicare continues to cover acute care (hospital, doctor visits, short-term skilled home health) and Medicaid covers the long-term personal care through CDPAP. The two programs coordinate but do not interfere with each other.