Take home care into your own hands. Tue, 21 Aug 2018 12:53:57 +0000 en-US hourly 1 CDPAP: Everything You Need to Know About the Consumer Directed Personal Assistance Program Fri, 06 Apr 2018 07:52:00 +0000 The post CDPAP: Everything You Need to Know About the Consumer Directed Personal Assistance Program appeared first on .


cdpap guideIn this article, we’ll learn a great deal about CDPAP, starting from the history of CDPAP at its inception until how it evolved into the type of program it is today. We’ll also go through all of the benefits of being enrolled. Additionally, we’ll provide the basic information about who qualifies for receiving the care, and who can be a CDPAP home care provider. Finally, we’ll detail how to get the process started with CDPAP, and how it can be managed after the initial eligibility is authorized.

Besides a comprehensive article on virtually everything you would want to know about CDPAP, we also included several questions after each section for your convenience. This will also help to summarize each of the sections regarding CDPAP information.

What Is the CDPAP?

CDPAP, or the Consumer Directed Personal Assistance Program, is a New York State Medicaid initiative that helps people who require home care services with additional ways to receive their care. Instead of outside parties making most or all of the decisions regarding who provides the home care, people who qualify for CDPAP, or the ones in charge of their healthcare, can make them instead.

Not only are the decisions regarding the health care decided by the consumer, but even if the personal aide chosen is a family member (as long as they are not the patient’s spouse), the aide can still receive compensation for the health care provided. In essence, one of the benefits of the CDPAP program is that it enables patients or their designated representatives to pay most adults to take care of their friends and family.

This program gives health care consumers the right to have people who they’ve known for years assisting them in various health related ways, while at the same time, knowing that these aides are being compensated for their time and effort. The payments and benefits for the Personal Assistant are handled by a fiscal intermediary.


History of CDPAP

This Medicaid program goes back many years. In 1977, advocates of improvement in the home healthcare industry started sending strong messages around New York State and to its legislative bodies. They argued that elderly, sick and disabled persons needed to be in the driver’s seat when it came to how their health care was provided, and more specifically, by whom.

Until that point in time, people who needed significant health assistance were very limited. Whether it meant being sent to institutions, rehab centers in poor condition, or being provided with subpar home health care, the situation seemed very bleak at the time. With the subsequent advocacy and awareness provided to the public and many lawmakers, things started to change for the better for many healthcare consumers.

As early as 1979, people throughout the state of New York saw plans created by various healthcare conscious groups. These groups stressed that significant decision making about home healthcare provided by insurance companies and government programs like Medicaid, should be made by the consumers themselves, as opposed to the insurers and government themselves.

Q. When was the first idea of reform for home healthcare suggested

A. The initial ideas date back to the late 1970’s, with 1979 being the year the movement started to really gain steam.


Breakthrough in Home Health Care

Finally, in 1992, the New York State Department of Health took over these private home healthcare programs, and named it the Patient Managed Home Care Program, which was renamed three years later the “Consumer Directed Personal Assistance Program,” or “CDPAP,” as we know it today.

Right before the year 2000, CDPAP boasted over 1000 consumers involved with the program. By 2002, more than three quarters of county health departments had active CDPAP services, and by 2008, there were increases of 60% participation in CDPAP. The numbers enrolling in CDPAP continue to grow each year.

With continued success, the State of New York expanded CDPAP services, including having government health counselors guide potential consumers to determine whether they were in fact eligible for the program. Subsequently, the scope of who could be a CDPAP Personal Assistant was expanded and included almost any adult who the consumer requested.

These days, every county must offer CDPAP services, and must let any resident know if they are eligible for the program. But more importantly, beginning with the 2012 State-wide move to managed care, enrollment with the program has expanded even more significantly, with most consumers receiving CDPAP services through managed care organizations (MCOs), rather than through social services districts.

Q. When were CDPAP programs first legislated?

A. The first program was introduced in 1992, and three years after it was renamed CDPAP.

Q. Is the CDPAP program gaining momentum?

A. By the turn of the millennium, there were more than 1000 people who joined the CDPAP program, and each year since then has seen significant percentage increases in participation. By now, every county health department and every MCO provides CDPAP services.


consumer directed personal assistance program

Home Care Services without CDPAP Meant Limited Decision-Making

As was noted above, in the past, when someone required home care health services, or was already having them provided, it was usually the health agencies or private vendors who would make a majority of the pertinent decisions regarding the consumer’s care. This may have included, but was not limited to, the selection of who the aides providing the service would be, scheduling when these aides would come and provide those said services and providing the necessary training for the aides.

According to CDPAP guidelines, either the consumer or the one designated to supervise the consumer’s care, which is called, in the language of the program, their designated representative (“DR”), are the ones that make the healthcare decisions, though it is they who bear all responsibility.

The consumer or DR can decide who the aide or Personal Assistant will be, and what the ideal schedule will work for both of them. They also will decide which services will be provided by the CDPAP Personal Assistant. The consumer or DR is responsible for finding the potential Personal Assistant candidate and having them go through the application process.

Though it provides the consumer with the ability to choose nearly anyone they want as the Personal Assistant, it means that they can’t just rely on some preorganized list of candidates. Training must also be provided to the potential aide, and is the responsibility once again of the consumer or DR.

Besides for the consumer being given the ability to decide who’s hired to provide them with home health care, they are also the one to monitor the one chosen, and if need be, to terminate them as the Personal Assistant.

These actions cannot be implemented by the insurance company or government agency without authorization by the consumer or DR. Remember, that without CDPAP, all of these decisions were primarily, if not entirely decided by the health care providers and nursing aide agencies.

Q. What was home healthcare before CDPAP?

A. Prior to the existence of the CDPAP program, instead of the consumer making most of the decisions regarding their care, it was the healthcare providers.

Q. What decisions are now made by the consumer or the one responsible for their healthcare?

A. They may decide who the Personal Assistant will be, what their schedule will be, and which services they’ll provide. They also handle any potential terminations.

CDPAP Coverage Across the State

As was mentioned above, there currently isn’t a single county in the state of New York that doesn’t qualify for CDPAP. Not only that, but there are even rules requiring all mainstream Managed Care plans to include CDPAP programs whereby anyone who’s eligible is told about the opportunity for CDPAP home care provider eligibility. That translates into CDPAP possibilities for absolutely anyone who qualifies in the entire state. Additionally, even those who are unaware of the program, are guaranteed to be informed of it sooner than later.

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

A. No, currently every county in the state has services provided for those in the CDPAP program

Q. How can one find out if they’re eligible for CDPAP?

A. One can contact their county’s health department or FreedomCare (at 718.989.9768), the only fiscal intermediary which provides CDPAP services in all sixty-two Counties of New York State.

Q. If one is eligible to receive home care services, does that exclude them from the benefit of the CDPAP program?

A. No, they can still join CDPAP.

cdpap aide

Your Loved One Can be Your CDPAP Personal Aide

Arguably the biggest benefit of the CDPAP home care program is the scope of candidacy for who can be one’s Personal Assistant, as nearly any adult can be someone else’s personal aide. There are exclusions to the rule, i.e., who is already a designated representative of the one receiving the home care or the consumer’s spouse.

It’s noteworthy to mention that parents of children under 21 may not personally be their Personal Assistant, though they may designate someone as their child’s Personal Assistant through the CDPAP program. And parents of disabled children over 21 years old may be their child’s caregiver as long as the other parent or a different party is the child’s DR.

Eligibility for being a CDPAP Personal Assistant includes siblings, children, other relatives, friends, neighbors or even past personal aides. One’s legal spouse is excluded from being a CDPAP home care attendant in every circumstance.

Q. Can anyone be a CDPAP Personal Assistant?

A. Not everyone, but close to it. As long as they’re an adult, not the consumer’s spouse, not the consumer’s designated representative, and not the parent of a disabled child under 21 years old, one can serve as a CDPAP Personal Assistant.


CDPAP Will Not Cost Anything for the Consumer

One of the many benefits of CDPAP is that it’s a Medicaid program, which means no extra cost to the beneficiary of the home care service. Once the individual requests a CDPAP Personal Assistant, all they need is to be on Medicaid and prove that they’re in need of home care, which is decided by their MCO based on a nurse’s visit and documentation from one’s doctor.

The aide is paid by a fiscal intermediary (as explained later in the article), and there is no additional cost incurred by the consumer.

Q. Does CDPAP cost anything for the consumer?

A. No, all the consumer must do is be on Medicaid and be approved as needing home care.


Training is Done on Site

Anyone chosen by the consumer to be a CDPAP Personal Assistant can qualify, even without any prior education or certification in healthcare. All the training that’s needed in the provision of the healthcare of the consumer is completed on site by the consumer or his or her DR, so as to help facilitate the most efficient healthcare possible in the consumer’s home. The amount of hours the CDPAP Personal Assistant will need to work providing home care service will always be determined by the patient’s insurance company.

While immigrants can qualify to be a CDPAP personal aide, they obviously must prove their legal status in the country and must provide all proper work authorization papers ensuring they are all up to date. All of this must be done before CDPAP services can begin.

Besides for the potential CDPAP Personal Assistant needing to be a legal resident of the country, several health aspects relating to the aide must be met. The first is, that they must have taken a full physical examination with their doctor, including Tuberculosis testing (PPD or QuantiFERON) and proof of Measles and Rubella immunization within the past year.

Q. Does one who seeks to become a CDPAP Personal Assistant require any prior healthcare education?

A. No, all training in home care is provided to the potential candidate.

Q. May immigrants serve as CDPAP Personal Assistants?

A. Yes, provided that all their required papers proving their legal status are up to date.

Q. Is anything also required to become a CDPAP Personal Assistant?

A. Yes, a full exam by a doctor with TB test and proof of Measles/Rubella immunity must be submitted.

CDPAP Aides May do More for the Consumer

Unlike classic home aides who are limited in the tasks and medications that they can administer, CDPAP attendants can do more, akin to nurses who must usually come to the house to do such tasks. Some of these actions include administering oxygen and injecting insulin into the consumer.

One of the goals of CDPAP is to make home health care more efficient and more enjoyable for the consumer. Medicaid believes that with the consumer calling more of the shots, it will equal less turnover of the particular Personal Assistants providing care, translating therefore into overall better health care for the consumer, therefore also avoiding the need for a nursing home.

It is also hoped that dealing with someone the consumer knows and trusts, will affect them on a health level. This means potential health issues or hazards can be caught at an earlier point, with the result of fewer hospital visits and a significant decrease in any potential complicated care.

Q. What type of healthcare may CDPAP Personal Assistants take care of?

A. CDPAP Personal Assistants can do nearly anything a registered nurse making a home visit can do including giving oxygen and injections. Guidelines are laid out to each Personal Assistant during their training by the consumer.

Q. Are there any health benefits to the CDPAP program?

A. Definitely. With the consumer choosing the Personal Assistant of their choice, less turnover will happen, and better healthcare will result. Additionally, having one’s loved one dealing with the consumer’s healthcare may mean better care at home and less hospital visits.


How to Become a CDPAP Fiscal Intermediary

If an agency is interested in becoming a CDPAP fiscal Intermediary, they must first contact the DOH and submit an application for initial authorization (licensure). This office will decide whether they want to authorize the agency to provide fiscal intermediary services.

Once that clears, guidelines are provided to the candidate, and the individual or agency must then be in touch with the Bureau of Long Term Care Reimbursement where a Health Provider Network (HPN) account is assigned.

The fiscal intermediary will need to contact MCOs to request a contract and establish their reimbursement rates. If the agency/individual is not enrolled as a Medicaid provider, they must also contact the Division of OHIP Operations, Bureau of Provider Enrollment to gain a provider ID number.

The Department of Health is very strict about the fact that all of these steps be fulfilled before any fiscal intermediary may enter into contracts with MCOs and provide fiscal intermediary services. The state government is constantly working on getting this process to be streamlined to allow more agencies to become fiscal intermediaries.

Q. What steps are needed to become a fiscal intermediary for CDPAP?

A. They must complete an initial authorization application, contact the Bureau of Long Term Care Reimbursement to establish a Health Provider Network account, and enter into contracts with MCOs to establish a reimbursement rate. If they are not enrolled as a Medicaid provider, they must contact the Bureau of Provider Enrollment to become one.

Q. Can an entity contract with a managed home care company to provide fiscal intermediary services before going through the above steps?

A. No. The New York State Department of Health only allows a fiscal intermediary to contract with plans and service consumers once all of their paperwork is completed.


How to Begin the Application Process

If someone who already receives home healthcare, or thinks they need it and wants to see if they qualify for CDPAP personal home caregivers, they have to be in contact with a fiscal intermediary.

Consumers living in all t counties in the state of New York, and all residents of New York City must complete an enrollment process. If they have their DR making the decisions, then the DR must be the one to complete the enrollment process.

Managed Long Term Care or the New York State Department of Health will make the decision whether the consumer is eligible for the CDPAP program.

Q. How does one apply for the CDPAP program?

A. One should contact their county health department to sign up for CDPAP.

Q. What’s involved in the process of becoming part of the CDPAP program?

A. The consumer or the one making the health-related decisions for the consumer must complete the enrollment process, after which the consumer’s MCO makes the final decision on the eligibility for the CDPAP program.

CDPAP Looking Forward

Healthcare is constantly changing, due to the needs and concerns of patients and consumers country wide becoming more complex by the day. While several decades ago, no one could have even dreamed of home healthcare being so easily accessible, the efforts of many individuals helped to effect lasting reform in that arena.

CDPAP is just one of the many examples of the healthcare industry changing to meet the needs of the many home-bound consumers who want to customize their home healthcare experience. From the ability to choose from an almost infinite pool of candidates to provide healthcare at home, to the Personal Assistants themselves getting paid through neutral fiscal intermediaries, it’s no wonder that CDPAP has taken healthcare to the next level.

With all of the benefits, it’s become a no-brainer for thousands of people who require healthcare in their own home. With CDPAP coverage across the state, more decision making in the hands of the consumer and all at no additional expense to the consumer, home healthcare has never been this enjoyable, and based on the reactions of the thousands already involved in the program, the results speak for themselves.

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Caregiver Self-Care 101 – The Importance of Taking Care of YOU Mon, 22 Jan 2018 08:06:16 +0000 The post Caregiver Self-Care 101 – The Importance of Taking Care of YOU appeared first on .


How to Start Caring for YOU – Expert Tips & Help for Caregivers

Chances are, if you’re a caregiver, you know all too well how easy it is to forget to take care of yourself. When was the last time you took a few hours to relax, clear your mind, and do something just for you?

If it’s been a while, you’re not alone—it’s natural for a caregiver to forget about their personal needs. After all, the very definition of being a caregiver includes making one sacrifice after another to put someone else’s needs first.

Providing personal care for another person is truly an act of kindness, love, support, and loyalty, especially when the recipient is unable to express their gratitude. When the recipient is a family member, spouse, or friend, there is a strong emotional and personal bond, intensifying the experience for all parties involved.

Caregivers find themselves constantly devoting time and effort to helping others—but along the way, caregivers are also risking their own emotional, mental, and physical health.

In this article, we’ll look at the unique benefits and challenges faced by caregivers, show you how to recognize signs of stress, address common misconceptions, and outline a few simple, effective tips for caregivers to keep themselves healthy and happy.

caregiving benefits

Benefits of Caregiving

Although caregiving comes with its own set of challenges, there are plenty of genuine benefits that caregivers can receive from helping another person.

In fact, a caregiver health effects study published by the Society of Behavioral Medicine found that even when demands and distress intensified, about one-third of caregivers still reported positive effects.

These included increased self-esteem, feeling valued and needed, experiencing a deeper meaning for their lives, learning new skills, and strengthening personal relationships.

As the American Journal of Nursing points out, strengthening personal and social relationships is often a key benefit of caregiving. Those in supportive social roles are often happier, healthier, and live as much as five years longer.

Of course, the trick is to find a balance between caring for others and caring for yourself. Despite the benefits of caregiving, neglecting to nurture your own emotional and physical needs can have serious consequences.

Unique Caregiving Challenges

Caregivers face a multitude of unique challenges, but two of the most significant come from maintaining balance and managing stress, detailed below.


It almost goes without saying that caregivers characteristically struggle with creating a healthy balance between work, caregiving, and their personal lives.

According to the Family Caregiver Alliance®, 44 million Americans are actively providing unpaid support, meaning that caregivers must have other means to pay the bills.

Balancing time spent at work with time spent caregiving is a challenge experienced by young and old caregivers alike, and can also cause them to experience:

  • Delaying life events like marriage or buying a home
  • Putting education on hold or dropping out
  • Difficulties securing employment

For caregivers that must also juggle relationships between their children, significant other, friendships, and family, striking a balance becomes increasingly difficult, leading to increased levels of stress and frustration.


Everyone experiences stress at some point in their lives, but caregivers are particularly susceptible to its negative side effects.

In fact, despite the wide range of benefits, caregiving is such an innately stressful experience that it is used as a model for studies on long-term effects of chronic stress.

According to the American Journal of Nursing, caregiving is stressful by nature because:

  • It creates and supports prolonged periods of both physical and mental stress
  • It can be highly unpredictable and is rarely controllable
  • It sparks secondary stressors in personal areas like work, family, and romantic relationships
  • It often requires high levels of focused care, or vigilance

Stress can affect your body, thought process, and lifestyle in surprising ways. In fact, prolonged stress can contribute to serious physical issues, like high blood pressure, obesity, diabetes, and heart disease.

Emotionally, prolonged stress can have serious consequences for caregivers. In fact, a 2006 study estimates that 40-70 percent of caregivers demonstrate significant signs of clinical depression resulting from untreated stress.

How to Recognize Signs of Stress

The most common physical signs of stress include:

  • Insomnia or difficulty sleeping
  • Headaches or muscle tension
  • Chest pain
  • Fatigue
  • Changes in libido
  • Digestion issues

Each caregiver deals with stress in their own unique ways, making it important to pay attention to your personal reactions. The most common emotional and mental signs of stress are:

  • Overeating or undereating
  • Irritability
  • Forgetfulness
  • Depression
  • Increase in drinking or smoking
  • Anxiety or restlessness
  • Difficulty concentrating
  • Mood swings
  • Feeling overwhelmed

caregiver misconceptions

Common Caregiver Misconceptions

By nature, caregivers tend to be giving, nurturing individuals, with a genuine desire to help another person.

These are wonderful qualities, but they can also result in deeply-rooted misconceptions about roles and responsibilities, making it difficult for caregivers to remember to practice caregiver self-care.

Some of these misconceptions include:

  • Setting boundaries or spending time and energy on themselves is selfish
  • Being seen as a failure for taking time off or asking for help
  • Being judged as a poor caregiver or as inadequate
  • Feeling as though they receive more love, attention, and respect by sacrificing their own comfort
  • No one else will step in to help if they don’t
  • Caregiving takes up too much time to focus on themselves

These fears and misconceptions have valid roots, but it’s important to remember the importance of balance. Each person has their own identity, unique goals, relationships, and an entire life to participate in outside of caregiving.

Adopting these misconceptions often leads caregivers to experience unnecessary frustration and stress by taking on too much, attempting to controlling situations that are inherently uncontrollable, and trying to achieve unattainable goals.

How can you get around these pitfalls?

Caregivers must be willing to be honest with themselves and identify when they are falling into these patterns of thought. What is holding you back from taking care of yourself? What are your hidden—or not so hidden—fears and anxieties?

Once you have recognized the common misconceptions that you are subconsciously falling into, you’ll be much more open to start implementing the strategies listed below in our expert tips for caregivers.

caregiver tips

5 Expert Tips for Caregivers to Start Caring for Themselves Today

1. Join a Community of Other Caregivers

Caregivers experience wholly unique challenges and frustrations, and it can help to share these with a community of like-minded people who have had similar experiences.

For caregivers, finding a place in a community can help caregivers feel less isolated, get practical advice, discover new resources, and simply feel relieved that all emotions—both positive and negative—are completely normal.

  • Check your local hospitals or community centers for caregiver groups
  • Use the Eldercare Locator to find a variety of local services for older adults and their families
  • Caregiver Connect, created by Family Caregiver Alliance®, connects caregivers across the country to support groups, up-to-date research, newsletters, and even a forum for caregivers to share their personal stories
  • For those that care for individuals with Alzheimer’s or Dementia, the Alzheimer’s Association can help caregivers find local support groups in their area

2. Know Your Limits

Everyone has their limits when it comes to how much time, energy, and emotion they can give without compromising their own happiness. Unfortunately, caregivers often don’t communicate this or feel guilty for even considering that they might need limits.

Communicating your boundaries to doctors, family members, friends, and anyone else involved can go a long way in alleviating present and future stress.

If you’re stuck on how to start defining your limitations, here are a few good ideas:

  • Be honest about what you are willing to do
  • Consider your personal goals and whether your level of caregiving will get in the way
  • Make a list of caregiving needs and identify any you are uncomfortable with

3. Reach Out for Support

Asking for help is difficult for anyone, but especially when it comes to caregivers. It’s a natural inclination to want to be the sole source of care and support, but it’s also a huge (and unnecessary) stressor.

Once you know your personal boundaries and limitations, you can look to family, friends, neighbors, and health professionals for assistance filling in the gaps.

Being hesitant to approach friends and family members for help is natural. Many times, people want to help but simply don’t know how, especially when it comes to caregiving.

If you can clearly identify areas where you need support and small ways to contribute, you’ll make it much easier for the people around you to volunteer their help. Whether it’s calling once a week, stopping by to mow the lawn, or dropping off a homecooked meal, every little bit helps.

If you prefer to reach outside your group of family and friends, there are plenty of alternative sources of support, including:

  • A therapist, social worker, or counselor
  • Support groups at a local hospital
  • Organizations for the specific disability or illness
  • Community health care, personal care, or transportation services

4. Validate Your Situation & Your Feelings

Caregivers tend to neglect their personal situation and emotions—but bottling everything up is a surefire way to create and magnify stress.

Acknowledging personal struggles, emotions, fears, and worries can alleviate stress, help you gain a better understanding of your role as a caregiver, and even identify boundaries, skills, and ideas you couldn’t see before.

Some find it helpful to keep a daily journal to record their thoughts, feelings, and experiences. Others prefer to talk one-on-one with a close friend, family member, or counselor that can understand what they are going through.

Whether you choose to start writing, initiate a conversation, or both, having your voice heard and expressing yourself free from judgement or censorship is invaluable to your mental and emotional health.

5. Focus on Stress Relief

Just as everyone reacts to stress in different ways, everyone has their own unique ways to cope with and dispel feelings of anxiety.

Part of proper caregiver self-care means finding effective, manageable ways to relieve stress, relax, and set aside time just for yourself. If you don’t already have a stress relief system in place, keep an open mind and consider trying any of the following methods:

  • Reading a book
  • Writing in a journal
  • Meditation
  • Gardening
  • Listening to music
  • Visit with friends or family
  • Use essential oils or light a scented candle
  • Limit caffeine intake
  • Watch a funny movie or see a comedy show
  • Practice deep breathing
  • Spend time with your pet (if you have one)
  • Get a massage
  • Spend time outdoors

Exercise is also a great way to get your body moving, release endorphins, and relieve tension. Getting out of the house and taking in the fresh air—or simply a new change of scenery at the gym—can also be a wonderful stress relief in itself.

Consider trying yoga, jogging, lifting weights, or simply walking around the block a few times a week.

There are endless methods of relieving stress to choose from, varying from a night out dancing with friends to simply making dietary changes. Whatever you choose, make sure you keep caregiver self-care in mind—don’t let caregiving duties distract you from taking care of yourself.

caregiver stress


Forgetting to take care of the caregiver can have serious consequences for all parties involved, not only for yourself, but for those that you are providing care for.

No matter what level of care you are providing, it’s important to ensure that the responsibility of caring for another person does not eclipse your own basic emotional, mental, and physical needs.

If you’re feeling overwhelmed, know that you are not alone—and even better, that there are plenty of simple, actionable ways to start practicing great caregiver self-care today.

Start paying attention to signs of stress, embrace the inherent challenges of caregiving, and use the caregiver tips above to ensure that you are providing the best care possible for yourself and for those that depend on you.

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Medicaid Programs for New York Seniors – Eligibility & How to Apply Thu, 09 Nov 2017 21:54:06 +0000 Medicaid Programs for New York Seniors In This Report: OVERVIEW – MEDICAID AND NEW YORK’S ELDERLY MANAGED LONG-TERM CARE (MLTC) – NY CONSUMER DIRECTED PERSONAL ASSISTANCE PROGRAM (CDPAP) WHO IS ELIGIBLE FOR MLTC PLANS IN NY? HOW TO APPLY FOR MLTC PLANS IN NY NYS MLTC HELPLINES   1. Overview – Medicaid and NY’s Elderly […]

The post Medicaid Programs for New York Seniors – Eligibility & How to Apply appeared first on .


Medicaid Programs for New York Seniors

In This Report:



1. Overview – Medicaid and NY’s Elderly

While Medicaid programs target different groups of people, this report is concerned only with long-term care that benefits the elderly, with a focus on the state of New York.
Medicaid is a joint venture between the Federal government and each state, catering mostly to low-income people. The Federal government provides subsidies and sets basic standards while, generally speaking, each state sets eligibility requirements and other rules that govern services. Some 73 million people received Medicaid benefits in 2016, making it the largest payer of healthcare benefits in the United States.

Here is a brief summary of the type of elderly-related programs that Medicaid offers in the state of New York:

  • Nursing homes: If you are a Medicaid beneficiary, Medicaid has traditionally paid for long-term care in all Medicaid-certified nursing homes.
  • Home-based programs: For at-home care, Medicaid has several programs in the state of New York that cover home health care (skilled nursing, short-term care) as well as personal care (assistance with daily life tasks – non-medical, long-term care).

Home and community-based programs: In 2017, every state in the country, as well as D.C., offered at least one program that pays for elderly-related services for those who choose not to become nursing home residents. The state of New York has various programs (that will be discussed in detail in subsequent sections) that provide assistance at home, in assisted living facilities (ALFs), in day care, and with other home-related chores.

2. Managed Long-Term Care (MLTC) – NY

managed long term careWhether for at-home care, day care, or community-based facilities, the New York State Department of Health offers several programs, referred to as Medicaid managed long-term care (MLTC) plans, that assist, among other demographics, the elderly community.

Here are the basic elements of such plans:

Network of providers: When you become a plan beneficiary, you get all services from a specified network of providers. These networks include skilled nursing home health agencies, non-medical home care agencies, and various healthcare professionals and other providers.

Plan of Care and Care Manager: When you join a plan, a Care Manager will help you (and members of your family) develop your own Plan of Care from among the following three different types:

  • MLTC Medicaid Plan: This offers only Medicaid services, typically chosen by people who need home or other long-term care services (day care, specialty care and other services) but are happy with existing arrangements for doctors and other Medicare-type services.
  • Medicaid Advantage Plus: This offers Medicaid and Medicare services, typically selected by individuals who want to combine all long-term care services under one plan.
  • Program for All-Inclusive Care for the Elderly (PACE): You can join PACE if you are 55 or older, typically selected by people who get all their health-related services at home or in day care centers from the provider network assigned to them.
  • Consumer Directed Personal Assistance Program (CDPAP): This is discussed separately in a subsequent section.

Two other less referred-to plans are FIDA (Medicare Advantage + MLTC) and Medicaid Advantage Plan.

Mandates to join a plan: If you are 21 or over, a beneficiary of both Medicare and Medicaid, and in need of long-term care (defined as 120 days or longer), then you are mandated to join one of the three types of plans. You can choose to join one of the Medicaid plans where you live, but you can switch plans if you choose at any point later on. In addition, if you already have home care services, the plan you choose will first approve a set of services for you, and then will take over.

Plan services: Each of the three plan types provide:    

  • At-home or community-based long-term care
  • Other health-related services such as medications, supplies, and equipment
  • In addition, some plans offer Medicare-type services like visits to physician and hospital care

How to choose a plan and enroll: If you need assistance choosing and/or enrolling in a plan, you may wish to contact a New York Medicaid Choice counselor at 1-888-401- 6582 (TTY: 1-888-329-1541).

You will subsequently receive a confirmation letter from New York Medicaid Choice that gives you:

  • A Member Handbook
  • A starting date for your plan
  • A Plan Identification card

3. Consumer Directed Personal Assistance Program (CDPAP):

The CDPAP program is tailor-made for:

  • NY-State’s elderly community and Medicaid beneficiaries
  • Individuals who receive either at-home skilled nursing home health services, or at-home non-medical long-term care
  • And those who prefer to manage their own personal assistance care

cdpap family careCDPAP allows such individuals, together with those who support them at home, to hire, manage, supervise, and fire caregivers at their own discretion.

The program commonly appeals to individuals who receive at-home assistance with their activities of daily living (ADLs), including, for example, grooming, bathing, dressing, eating, and other ADLs. When they hire their own caregivers (typically loved ones or friend), they get the opportunity to train them to their specific needs, while Medicaid, through the CDPAP Program, covers all caregiver-related expenses.

Because the CDPAP program allows you to include family and friends among the caregivers that the program covers, it is among the few programs nationwide that financially reward some of the 40 million family caregivers who devote their lives and leave their jobs and other sources of income in order to care for a loved one at home.

In addition, parents of disabled children over the age of 21 can thus become the paid caregivers as long as:

  • They are not the “legal representative” of the care recipient (as defined by the Department of Health)
  • And the level and amount of care needed by the recipient justify the hiring of a family or professional caregiver

Finally, if you have an immediate and urgent need for at-home care services, you may have your application processed more quickly if:

  • You are not already receiving care from a home care or home health agency
  • You have no family or friendly caregivers who can come to your assistance or continue providing your needed care
  • You don’t possess an insurance policy that can pay for your at-home care
  • You are not qualified to receive Medicare-type at-home services (these would mostly be for skilled nursing or home health services)
  • You do not already possess at-home adaptive equipment that meets your needs

4. Who Is Eligible for MLTC Plans in NYS?

You are eligible for applying for an MLTC plan if you:

  • Are 21 or older and reside in an area serviced by your chosen plan
  • Need at-home services that are commonly provided in nursing home settings
  • Can safely remain at home
  • Are certifiably in need of long-term care, i.e. longer than 120 days (this is demonstrated using a form filled out by your doctor)
  • Are willing to be serviced by the plan’s network of providers

5. How to Apply for MLTC Plans in New York

The first step in enrolling is to contact your chosen plan administrators who will send a counselor to your home to conduct a preliminary needs assessment. Needless to say, you can also recruit the help of a certified counselor on your own, someone who will stay with you until you are completely set up with your plan.

The government’s counselor would have the initial tasks to:

  • Set up a Care Plan that meets your specific needs
  • Help you secure necessary health-related documents from doctors, laboratories, and other previous professional providers
  • Assist you in choosing a plan
  • Familiarizing you and your support people at home with your chosen plan
  • Help you with completing the plan’s application questionnaire and agreement
  • Help you choose a set of providers from among the plan’s provider network
  • And answer any remaining questions you or your support people at home may have

6. NYS MLTC Helplines

Although understanding and then applying to an MLTC plan may at first seem daunting, The NY State Department of Health goes out of its way to make the process more readily accessible to those who qualify.

Here are links that may prove useful at the start for choosing and then applying to a plan:

This link will take you to the government’s “choosing a health plan” official guide.

The NY State Department of Health (The government’s Health Plan Marketplace).

This link will take you to the government’s complete MLTC guide.

Contact information for regional MLTC guides.

To reach your plan administrators, this link provides plan contact information in the various boroughs and cities in the State of New York.

This link will take you to certified MLTC counselors.

If you have urgent needs (as discussed in the CDPAP section), you may find this link helpful for your immediate needs.

This link is for NYS’s Department of Health “pharmacy benefit information” center

This link will also take you to a list of frequently asked questions and answers (FAQs) in regard to managed long-term care.

This “paying for health care” guide includes information on Medicare, Medicaid, MLTC and other long-term care payers.

Good luck with your MLTC plan!

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5 Ways You Can Get Paid as a Family Caregiver Thu, 17 Aug 2017 05:43:05 +0000 How to Become a Paid Caregiver for a Family Member   With our older-age-population continually on the rise and increasingly impoverished, and with related aging issues and illnesses swelling at an even greater clip, the United States is fast becoming dependent on unpaid family caregivers to look after our loved ones. Here is some background: […]

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How to Become a Paid Caregiver for a Family Member


With our older-age-population continually on the rise and increasingly impoverished, and with related aging issues and illnesses swelling at an even greater clip, the United States is fast becoming dependent on unpaid family caregivers to look after our loved ones.

Here is some background:

    • Poverty among our seniors: Our elderly family members find themselves grossly under-funded in their retirement and therefore dependent on family caregivers. According to the National Council on Aging, more than 25 million Americans aged 60+ are living below 250% of the federal poverty level (the FPL for a single person in 2017 is $13,860).
    • Those receiving assistance: 80% of elderly people receiving assistance, including many with several functional physical and/or mental limitations, live in private homes in the community, i.e. not in institutions.
    • The disabled: 66% of older people with disabilities who receive Medicaid Long-Term Services and Support (LTSS) at home get all their care exclusively from their family caregiver, mostly spouses and daughters.
    • Caring for an older relative: The American population of spouse and adult children caregivers is nearly 70 million strong. According to the Pew Research Center, over one half of those are adult children caring for an elderly parent, and almost one quarter (24%) are those assisting aging spouses.
    • Older Americans with dementia: Caregivers of patients with dementia constitute more than 55% of all caregivers, with the cost of healthcare associated with Alzheimer’s alone set to exceed $1 trillion by 2020.


  • Family caregivers and health issues:  A little over 50% of all family caregivers care for a family member with Alzheimer’s (AD) and another 23% assisting persons with other dementias. Parkinson’s disease (PD) and heart-issues (including strokes) come next among the health issues that concern family caregivers.


5 Ways to Get Paid to Take Care of a Family Member

get paid to care for mom

When a spouse (24% of all family caregivers), or an adult child (60%) quit their job in order to devote themselves to the care of a family member, many make often-ignored financial sacrifices beyond lost wages (e.g. pensions or (401)k’s, social security benefits, and other perks).

To all family caregivers, therefore, whether they previously held jobs or not, here are our 5 ways to at least make up for the colossal time and stressful effort you dedicate to caring for a loved one:



Also referred to as a personal care agreement, or elder care contract, a caregiver contract is a formal agreement, usually among family members, to provide that the person providing care to a loved one be compensated, particularly if he or she has to let go of a job so as to care for the elderly parent or relative.

Here are some of the benefits of drawing up such a contractual document:

  • Shedding clarity over caregiving functions: The care recipient may be a person of means, perhaps from a lifetime of productive work, or from other sources.

    Instead of family members arguing over expenditures that could affect what they might ultimately inherit, or receive as gifts, this type of contract does not leave any ambiguity when it comes to compensating the family caregiver.
  • Families pooling resources: Family members may also, on occasion, wish to pool resources to pay for one member of the family to devote themselves to the care of a loved one. This type of contract delineates the terms and tasks to be performed, once again shedding clarity on an issue that may otherwise pit one family member against another.
  • Relationships with outside payers: There are also times when the care recipient would be reimbursed for long-term care expenditures by an outside entity such as a long-term care insurance company, worker’s compensation, the Veterans Administration (VA), or some Medicaid program. In all of those cases, a caregiver contract would pave the way for the family caregiver to be formally recognized and compensated.

It is recommended that you let an elder law attorney help you draft such a contract. You can find the attorney that best meets your requirements at the National Academy of Elder Law Attorneys.


Post-9/11 program: The VA offers its eligible vets a variety of supportive health and financial programs.

care for veteran
The program of interest in this context is called the Veteran Directed Home and Community-Based Services (VD-HCBS) that specifically pays family members to act as caregivers for a home-based loved one.

Also referred to as “Cash and Counseling for Veterans,” the program has other names as well, such as “Veterans Independence Plus Program,” and “Veterans Directed Home Services (VDHS).”


The program allows vets to choose their own care providers instead of receiving the care at VA facilities.


Here is how it works:

  • Eligible care recipients must receive the care in their homes, in their caregiver’s home, or in independent living communities of the type that do not offer care support (i.e. assistance with activities of daily living, such as eating, bathing and walking).
  • Eligibility under this law that passed in 2010 is limited to veterans who were injured in a military conflict after September 11, 2001.
  • Together with a VA advisor, the vet must develop a comprehensive “Care Plan” with budgets, care tasks needed, and details about the family caregiver.
  • The Care Plan may then need several modifications before it is ultimately approved.
  • The vet can then hire a caregiver (including, possibly, a spouse) and obtain other supplies like wheelchairs, special beds, oxygen supplies, etc.
  • Finally, the administering agency, which differs in each state, sets up check or other forms of payments for all pre-approved services and supplies, including home care.

Other benefits also apply, including traveling expenses, mental health services (greatly in demand by Post Traumatic Stress Disorder -PTSD- and other mental health patients), and respite care for 30 days per year (to give the primary family caregiver time off).

For more information, call 1-877-222-VETS (ext. 8387).



CDPAP paid loved oneThis is another way for you to get paid for taking care of your family member, as long as the state you live in has a Medicaid-type program that suits your needs and for which your loved one could qualify.

CDPAP (Consumer Directed Personal Assistance Program) is a Medicaid-funded program that allows care recipients to hire almost any caregiver they choose, including the family member who is currently providing the care.

A sister program is CDPAS –  Consumer Directed Personal Assistance Services. This decides on the type of services you need, for example, assistance with companionship and/or activities of daily living. As far as you are concerned, the two programs are in essence the same.

Here is a step-by-step guide to help you reap some benefits from that program:

  • To be eligible, your loved one must already be in the Medicaid program, need home care, and either be in charge of their own affairs or have a designated representative, i.e. someone with a power of attorney, advance health directive, or be otherwise empowered to make decisions on the patient’s behalf regarding how their home care services are provided.
  • The care recipient tell his or her plan about the request for CDPAP services and have a doctor sign off that he or she needs home care. And their caregiver (family or friend) must provide evidence that they are legal to work in the U.S. and get a physical and bloodwork done showing that they are healthy enough to care for a patient.
  • When successful, your loved one will be allotted a certain number of hours per week, depending on their overall physical and mental health conditions.
  • You, the caregiver, will receive a paycheck based on an hourly pay rate for each hour worked servicing the patient.

This program is not very complicated, and for the forms, as well as more detailed information, you can visit the program here.

To recap, many states have programs that pay family or a friend to serve as a caregiver, although searching for them and then helping them get qualified can be daunting. You can find out more about your state’s relevant programs by contacting:

  • Medicaid (or Cash and Counselling Programs): Medicaid offers a variety of programs that aim at assisting with long-term in-home or in-community care, meal deliveries, and day care centers so that care recipients may get home-based rather than institutional help.

    To get you started with your research, contact the Eldercare Locator at 1-800-677-1116 or go to a good starting point for Medicaid Home Attendant Services.
  • National Resource Center for Participant-Directed Services

This national program caters for people with disabilities (including the aging population) with objectives that are similar to the above-described Medicaid-type programs.  

Here is a link to that National Resource Center.



If your loved one, in the past, had the foresight to purchase a long-term care insurance policy of the type that pays for home care (as is the case with the vast majority of these policies), then you have a great opportunity to get paid, as follows:

  • If the policy requires the in-home care to be performed by a licensed home care agency, then you and your family member can contact your nearest home care agency. They will welcome you both with open arms, your loved one as their latest client, paid by the insurer, and you as their latest caregiver, paid by the agency. This arrangement is ideal for the home care agency since it adds to their revenues without any additional staffing effort.
  • If the policy is not limited to licensed home care agencies, then a caregiver contract would serve you well. You would still need to negotiate with the insurance carrier, based on your caregiver contract. If you don’t have such a contract, then develop one, stipulating that you as the caregiver would be paid as much as a home care agency non-certified nursing assistant is paid.

By the way, using a home care agency is something to contemplate in all cases where your loved one is being reimbursed for long-term care expenditures. For example, the Worker’s Compensation (or a court) may be reimbursing for a work-related injury that your loved one may have sustained.


Not only are you perhaps not being paid to take care of your family member, but you may also be using your personal savings for expenditures relating to your loved one’s home modifications, transportation, food, assistive devices, medical supplies, and more.

According to the AARP (membership association for people 50+ years of age – it has tens of millions members), family caregivers spent $7,000 in 2016, on average, for their loved one’s needs apart from the actual caregiving.

The IRS Tax Credit: the IRS’s Credit for Caring Act gives eligible family caregivers the opportunity to obtain a tax credit equal to 30% of expenditures outlaid on behalf of their loved one in excess of $2,000 a year, up to a maximum credit of $3,000 a year.

Here are the IRS’s eligibility requirements:

  • You need to be a direct relative of the care recipient (parent, adult child, spouse and others who qualify per the “dependent” definition)
  • You need to assist a person of any age with physical or mental functional disabilities
  • You need to have adequately documented the expenses  
  • And you need to have earned taxable income of at least $7,500 for the year in which you claim a tax credit

For more information on tax credits, here is a link to the AARP.

Final Thoughts On Getting Compensated for Taking Care of Your Loved One

paid to take care of grandma

The statistic that struck us from the opening “background” section was the fact that the vast majority of family caregivers care for persons with Alzheimer’s or other types of dementia. Anyone who knows anything about caring for a family member with dementia knows only too well how overwhelming and totally immersing that can be.

As a family caregiver, irrespective of what your loved one suffers from, you take on enormous open-ended responsibilities that are stressful, often financially devastating, and always disruptive when it comes to your own personal growth and well-being.

The least that you can do is look for ways to at least get compensated for a portion of the time, effort and expenses you lay out on behalf of your loved one.

We therefore sincerely hope that some of the venues we described in this article prove appropriate for your circumstances and useful to you receiving compensation for what you do.


Were any of these programs helpful to you? Please let us know in the comments below about your experiences with any of them. And if you know of any other options to get paid for taking care of a family member feel free to leave a comment.

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History of CDPAP Thu, 13 Apr 2017 15:03:34 +0000 The post History of CDPAP appeared first on .

History of CDPAP

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History of New York’s Consumer Directed Personal Assistance Program (CDPAP)

The Consumer Directed Personal Assistance Program (CDPAP) is a New York State Medicaid program benefiting elderly and disabled individuals with stable medical conditions, by giving them the freedom to hire, train, and manage their own personal care assistants. While the program officially started serving consumers under the “CDPAP” name in 1995, its roots go back nearly two decades before that.

Until the late 1970s, patients receiving benefits to help them manage severe disabilities had few options as to the care they were given. They could be placed in institutions, which suffered from overcrowding and other poor conditions, or have their home care dictated, staffed, and run by a state-approved agency. Neither option gave patients much choice, independence, or dignity in directing their own care based on their needs and preferences (for instance, being cared for by a close friend or relative).

Then, in 1977, a group of individuals being served by existing home attendant services founded Concepts of Independence for the Disabled (later shortened to Concepts of Independence) in order to advocate and lay groundwork for allowing people with disabilities to control how and from whom they received care. Not long after, a group of citizens in wheelchairs staged a protest at the (now defunct) New York City Board of Estimate, resulting in the formation of a task force aimed at creating better state-sponsored solutions for disabled individuals’ self-directed care.  

In 1979, that task force moved forward the Client Maintained Home Attendant Plan, which split the responsibilities of overseeing care between the patients/consumers and an agency. Within the next few years, the number of people enrolled in the program through Concepts of Independence grew exponentially.

The New York State Department of Health began managing the home care program in 1992, and launched the Patient Managed Home Care Program demonstration project to determine what changes might have a positive and cost-saving impact. The successful Patient Managed Home Care Program was renamed the Consumer Directed Personal Assistance Program (CDPAP) in 1995.

By 1999, program participants numbered over 1000. Three years later, over 75% of county Medicaid offices had established CDPAP services. And by 2008, the number of enrolled statewide recipients had increased again by 60%.

As participation climbed, making the CDPAP the second-fastest growing community-based program of its kind, the New York State Department of Health approved grant funding for an outreach and expansion initiative. As part of the initiative, a training curriculum was developed and peer counselors were trained in helping consumers determine whether they were eligible for the CDPAP and if it was the best choice for their needs.

The CDPAP option has been included in all mainstream Managed Care and Managed Long Term Care Medicaid benefit packages since late 2012. Beginning in 2016, the New York State expanded who could work as a CDPAP personal assistant, allowing the parents of adult children with disabilities to be hired for those roles.

Today, every county in the state is required to have a CDPAP program and alert those eligible about it, empowering thousands of people to direct their lives and care as they see fit.

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6 Reasons to Choose CDPAP Over Traditional Homecare Tue, 28 Mar 2017 03:40:11 +0000 The post 6 Reasons to Choose CDPAP Over Traditional Homecare appeared first on .


There are many reasons to choose CDPAP over a traditional homecare program. In this article we’ve given 6 common reasons why people are leaving traditional homecare agencies in droves to join CDPAP.
However, before we begin it is necessary to make sure we are all on the same page as to what CDPAP is.

CDPAP stands for Consumer Directed Personal Assistance Program, and it is just that, Consumer Directed. Let’s say you (or your parent or anyone else you care about) can’t get around as well as you used to and need help with laundry and shopping. Or, for example, you have more advanced medical needs and need help when the nurses are done with the actual medical care.

In such a situation you have two options, CDPAP or a traditional homecare agency. The basic difference is who has responsibility, and therefore control, over the care for the patient. If you choose to have an agency supply the aide, they do just that, but they also control and direct your care. If you choose CDPAP then the patient maintains control and determines who cares for them and what their tasks are.
We should point out at this point that both of these programs are covered by Medicaid and there should be no cost to the patient for either option.

6 Reasons, here we go:

  1. Freedom to choose who takes care of you:

Under CDPAP, the consumer (patient) chooses who works for them. The great thing about this is that it doesn’t have to be an official Home Health Aide. No training is required. The fact that you want this person to take care of you is good enough. Want your brother to do the job? No problem! Son? Daughter? Friend? No problem! It really is as simple as it sounds.

There will be no strangers taking care of your parents, and more importantly, you get to hire someone who cares! Anyone who has experienced nursing home or home health agency care, knows that it is the rare provider who manages to insert that personal loving touch that is natural to a family member taking care of someone they love.

The training for an official Home Health Aide is about a week. Compare one week of training to the care your son can give you… It’s usually a pretty simple decision.

2. Freedom to choose the schedule:

If you receive an aide from a homecare agency, that agency will discuss with you what hours you want the aide to work, but ultimately the decision is in their hands. Under CDPAP the decision is in your hands.

If you feel like you need an aide in the evenings, then you hire the person to come in the evenings. Under CDPAP you have complete control over the aide’s schedule. You can even split the shift; have them come in, leave, then come again. If you want them to come in the mornings then leave come back in the afternoon take you to do errands. That’s just fine, you’re the boss!

The point is control and independence.

3. Freedom to choose the tasks:

We just casually mentioned that you can have an aide do your errands with you, however it is worth stopping to think about for a moment. This is a momentous evolution of what it means to have an aide that has only become possible under CDPAP.

A Home Health Aide from an agency is never allowed the liability to driving you someplace. Even if you use Access-a-Ride the aide almost never will get paid to come or follow along and help you at the destination. With CDPAP yet again, you are the boss! You determine the aides tasks and if that means taking you shopping and the aide is willing… well then, go right ahead.

There are other tasks that are commonly not done or limited by an agency. Keeping someone company at dialysis is one example of a task done almost exclusively under CDPAP. Under CDPAP, you take responsibility for directing the aide and therefore you can direct them how you like. There is no lawyer in the back room of an agency saying this task is too dangerous or has too much liability.

4. Never lose care:

So many homecare agencies promise to deliver an aide for the weekends and then send no one. It’s incredibly and tragically commonplace. If you decide to go with a homecare agency because they promise to supply a qualified aide when you need it, doesn’t guarantee that they will follow through on the commitment. Countless agencies fail to staff their clients on the weekends and holidays leaving the client up the creek. Whatever the reason may be on their end, frequent call outs, poor scheduling, or outright corruption in management, it still leaves the patient in harm’s way.

Under CDPAP you can hire as many aides as you want to make sure that you always have coverage, and more importantly you hire people who care.

5. You’re already doing the work:

All too often when someone is with a homecare agency the children and family of a patient find that they are doing the work the aide should have done anyway.

Whether it’s because the aide was on the phone instead of working or because the agency limits their tasks, the family and friends almost always step in to fill the gaps. So if you are already doing the work, why not file the paperwork and get paid for it?

6. Maintain your independence:

Have you ever see a 20 year old call an 80 year old, Honey? When was the last time someone in the healthcare system took the time to carefully consider the desires of an elderly patient before making decision for them?

These are rhetorical questions and perhaps you are blessed with that doctor who really cares and treats you or your parents with the respect they deserve. However, even if you are so blessed, I’m sure you’ve also experienced the other side.

Nursing homes are often so horrible, not because they offer poor care (although some do), rather because to the busy staff Mom is sometimes just a room number. Nothing destroys a person as quickly as a sense of helplessness and feeling faceless. The more responsibility and independence you or your loved one can maintain the better you will be both physically and mentally.

If a person is still in a position to exercise control over their life then the appeal of CDPAP is obvious. 100% of seniors or disabled people would choose independence over an institution.

Nursing homes and home health agencies come from the same school of thought. It’s not Mom making the decisions and it’s certainly not the family, but with CDPAP you are the boss!

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Tips on choosing the right personal assistant for you Tue, 28 Mar 2017 03:39:29 +0000 When signing up for the Consumer Directed Personal Assistance Program (CDPAP), it is important to make sure to do it in a manner that is safe and benefits the patient. When dealing with older parents there is often a lot of give and take between the children and the parents regarding major decisions about the […]

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When signing up for the Consumer Directed Personal Assistance Program (CDPAP), it is important to make sure to do it in a manner that is safe and benefits the patient.

When dealing with older parents there is often a lot of give and take between the children and the parents regarding major decisions about the parent’s care. However when signing up for CDPAP, it is important that there be a clear distinction between consumer and caregiver. At least on paper, if you choose to be a caregiver for your mother, your mother just became your boss.

If you feel your parent cannot represent themselves and clearly direct the program, then you can step in and run things. However by doing so, you automatically disqualify yourself as a personal assistant.

Whoever is directing things must realize that they are about to become someone’s employer, and as Spiderman’s Uncle said, “With great power comes great responsibility.”

With this in mind let’s explore what you should look for in a CDPAP personal assistant and what details of the program might affect whom you choose.

Analyze the need:

When looking for a caregiver for yourself or your loved one, start by looking at the patient’s needs. There are a wide range of people participating in the CDPAP program. Some people only have trouble getting out of the house. They need someone to take them shopping and to doctor appointments. Others can’t cook, clean or do laundry, and need someone to keep house for them. Yet others need significant help in areas like bathing or basic movements.

Once you analyze the tasks to be done in a clear manner, an image of the kind of person you are looking for will naturally shape itself. Is the person you are hiring physically capable of doing what needs done? Can they get you to and from appointments? Do they need to? Is bathing a task? Are you comfortable around them?

Making a list of tasks the aid will need to do is a great way to start the process.


Understand your role in CDPAP:

In addition to setting the tasks and responsibilities of the personal assistant, the patient participating in CDPAP also agrees to provide any necessary training. This can be as simple as showing the personal assistant your favorite recipe for an omelette, and as serious as what to do in case of emergency.

The more clearly you can communicate with your personal assistant and the more comfortable you feel doing so, the better the relationship will be. Don’t pick your grandson who has no interest in caring for you and just wants the check. First of all, pretending someone is doing the work when they aren’t is fraud, and big brother is indeed watching. Secondly, if you need the care, then you need the care! Pick someone who will do the job. Just as importantly, pick someone with whom you can communicate with clearly.

Understand the rules:

Being a personal assistant under CDPAP is a job. During the signup process a medical assessment is done to evaluate the patient’s needs. Based on this assessment the patient is authorized to have an personal assistant for a certain number of hours per week.

Although the number of hours the personal assistant can work is not in your hands, the patient has tremendous leeway in setting when those hours are worked. You can set them up bulked in the weekend or even with split shifts at different times on the same day. It’s all based on what you need.

Yet, even with all that leeway, it is still a job. You can set the schedule, but once it is set, the personal assistant is expected to work those hours. That is not to say that a schedule cannot be adjusted as circumstances change. You can change the schedule literally the day before the personal assistant is supposed to work, so long as you inform the agency. But the schedule, is still the schedule.

Meaning that if the personal assistant is set to work from 9 – 3 on Monday and they work  4 – 10 instead, then they will not get paid. If they show up late, they will lose pay etc. etc. CDPAP is a job, just like any other job with hourly shifts.

Before choosing a personal assistant make sure they understand the rules and are willing to play by them.

Consider the hours:

Sometimes people have a need for significant, or even 24 hour care. In such situations it is important to recognize that you have the right to hire as many personal assistants as you would like. You can have two children splitting the week and a friend working the weekends. You are the boss.

In fact, it is a worthwhile practice for everyone to have a backup personal assistant. After all, what happens if the personal assistant is sick?

There is no way to have an agency supply a personal assistant in the morning and have a CDPAP personal assistant work the evenings. You can either choose to have the agency run things and not join CDPAP or you can choose to run things, soup to nuts. Meaning if you choose CDPAP and a personal assistant doesn’t show up, it is your responsibility to find a replacement, not the agency’s.

Once a personal assistant is registered with the agency they can lay dormant and never work any hours until needed. But it is important to get the backup on payroll beforehand, so that if they do have to work, they can be paid.

Keep in mind, that if circumstance change, or your personal assistants don’t work out you can always opt into traditional homecare. Nothing is tying you to CDPAP for any set period of time. In the same way nothing requires you to stay with traditional homecare.

How to find a personal assistant

The place to start looking is always with family and friends. That extra bit of caring makes a tremendous difference and you always want someone who will go the extra mile.

Many people who choose CDPAP, as opposed to a Home Health Aide through an agency, are averse to strangers in their home, so this is the most logical place to start anyway.

There are also an abundance of sites online with caregivers looking for work. A simple Google search will come up with a number or results. If you like your current personal assistant but don’t like the agency, you can even hire your current personal assistant and cut out the agency. In CDPAP you can hire anyone you would like.

Through CDPAP you can choose someone with whom you can easily communicate and trust. You can maintain your independence. Children can make sure their parents get the care they need, and really feel comfortable knowing their care is in the hands of someone they have confidence in. Take control of your or your parent’s care, and do it right!

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Is CDPAP Right for You? Wed, 21 Sep 2016 15:43:43 +0000 If you or a loved needs home care, Consumer Directed Personal Assistance Program (CDPAP), empowers Medicaid eligible patients to hire, monitor and terminate their own home caregivers. Patients have the autonomy to control who their caregiver will be, eliminating the frustration of ever-changing, unknown aides from traditional homecare agencies. CDPAP enables loved ones to care […]

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If you or a loved needs home care, Consumer Directed Personal Assistance Program (CDPAP), empowers Medicaid eligible patients to hire, monitor and terminate their own home caregivers. Patients have the autonomy to control who their caregiver will be, eliminating the frustration of ever-changing, unknown aides from traditional homecare agencies.

CDPAP enables loved ones to care for their family members without sacrificing personal income. You or your loved one can enroll in CDPAP which will train and pay the designated caregiver, whether it be a family member, neighbor or longtime friend.

As a go-to provider for Medicaid organizations, FreedomCare facilitates CDPAP, saving you hours of time and frustration. Our experts will guide your through the process and hold your hand to expedite the program. We will enroll your chosen Personal Assistant in the payroll system which works directly with Medicaid to ensure that your PA is paid on time.

If you don’t have a designated caregiver, we will help find you one and create a plan to train, manage and retain a dependable aid.

Needing at-home care is stressful enough without the added insecurity of bringing multiple strangers into the home. If you or a loved one would feel more comfortable choosing a trusted, familiar, and genuinely caring aide, CDPAP is right for you.

Call FreedomCare at 718-989-4036 or visit to learn more.

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Helpful tips on how to be a good boss Wed, 10 Aug 2016 14:47:10 +0000 Now that you’re employing a Personal Assistant, here are some helpful tips on how to be a good boss.   *Patiently show your personal assistant in detail how you like things to be done. *Give positive feedback when your personal assistant performs well! *When your expectations aren’t met, do not be insulting, but give fair […]

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Now that you’re employing a Personal Assistant, here
are some helpful tips on how to be a good boss.


*Patiently show your personal assistant in detail how you like
things to be done.
*Give positive feedback when your personal assistant performs well!
*When your expectations aren’t met, do not be insulting,
but give fair criticism.
*You may fire personal assistants, but don’t be too quick
to fire someone for minor shortcomings.
*Friends care for friends. If you know someone who may be
interested in our services, please have them call us!

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Caregiving Is Rewarding with FreedomCare Wed, 13 Jul 2016 15:22:03 +0000 From the time you were little, someone was there to hold your hand, give you a pep talk, and take care of you when you were sick. The person doing those things did them out of love. And that’s what being a caregiver means: unselfishly helping someone in his or her time of need. Of […]

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From the time you were little, someone was there to hold your hand, give you a pep talk, and take care of you when you were sick. The person doing those things did them out of love. And that’s what being a caregiver means: unselfishly helping someone in his or her time of need.

Of all the jobs a person can have, being a caregiver is one of the most rewarding. And here are several reasons why joining FreedomCare can bring peace, joy, and happiness to the life of someone you love.

  1. Peace of Mind: Relationships built on trust and love also offer peace of mind.
  2. Restoring dignity: Being “the patient” can make someone feel helpless. Caregivers empower people and help them take control of their lives.
  3. Guaranteed care:  Authentic care is the best form of health care.
  4. A safer environment: Horror stories about in-home health workers are very common. As a caregiver, you can ensure that nothing gets overlooked.
  5. Restoring control: No one wants to feel powerless, and this can happen when healthcare service is dictated by an outside agency. Give the power back to your loved one by being the chosen aide during a medical recovery or long-term illness.
  6. Better communication: When joining FreedomCare, you already have the inside track on the likes and dislikes of your loved ones.
  7. Reducing potential medical mishaps: You naturally pay more attention to your loved ones than a stranger would. You’ll also recognize silent signs that strangers often miss.
  8. Less worrying: People who need in-home health care worry about everything … and you can relieve that burden just by being yourself.
  9. Shifting your loved one’s focus to getting and living better: By generously devoting your time and attention, you can help your loved one mentally as well as physically.
  10. Receiving love: The best reason to join FreedomCare is to share the love you feel in your heart with someone who loves you back. Being a caregiver is an act of generosity that is rewarded in smiles, hugs, and praise.

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