CDPAP regulations and rules: How CDPAP Works

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Updates to the Consumer-Driven Personal Assistant Program (CDPAP) laws as of April of 2016, 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. Certain restrictions on whether they live with the consumer of home health services will apply.

Previously, spouses and parents were unable to be hired as CDPAP caretakers. Now, only spouses are now prohibited. Points of consideration from the CDPAP guidelines include:

  • The adult who is “legally responsible” for the child consumer may not be the CDPAP caregiver. Rationale is that spouses and parents of minor are always legally responsible.
  • State regulations allow a parent that lives with the adult child consumer to be designated CDPAP personal assistants, according to state law, only if he/she does, “…not reside with the consumer or … who resides with the consumer because the amount of care the consumer requires makes such relative’s presence necessary….”
  • A Medicaid Update released in March of 2016 by the NYS DOH explains the new law and this provision for caregivers for adult children.
  • Immigrants that want to be a caregiver need to have a valid work authorization.
  • If a CDPAP consumer has a “designated representative,” this representative may not be their personal assistant. According to state government regulations, “…With respect to a non self-directing consumer, a “designated representative” means the consumer’s parent, legal guardian or, subject to the social services district’s approval, a responsible adult surrogate who is willing and able to perform such responsibilities on the consumer’s behalf. The designated representative may not be the consumer directed personal assistant or a fiscal intermediary employee, representative or affiliated person.”
  • No special certifications are needed for the personal assistant as the consumer and family will train them.

In order to meet eligibility requirements, disabled and elderly NY residents must demonstrate that they need assistance completing their activities of daily living; they must qualify for personal care, home care, or skilled nursing services; and they need to be eligible to enroll in the Medicaid CDPAP program.

Contact your county department of health or department of social services to apply for Medicaid. You must fall into a certain financial classification in order to qualify for Medicaid. If your assets or income is greater than the allowable limits, it may be in your best interest to work with an elder law attorney or eldercare financial planner in order to restructure your assets. If you are medically and financially eligible, you must go through the Managed Medicaid Long Term Care Program to access the CDPAP program.

Interested in learning more about the CDPAP program? Reach out to us at FreedomCare today. Our staff has over 50 years experience in the healthcare administration/compliance. When you call us at 718-989-9768, an agent here in the US will be happy to talk with you personally, you will never be sent to any off-shore call center.

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