New York · Medicaid home care · family caregivers

Paying a family member to provide care in New York, by the State’s own rules.

In short: New York Medicaid pays for help at home in two forms: an aide from a licensed agency, or a personal assistant the consumer chooses, which can be a friend or most relatives. This site explains both, using the State Department of Health’s own rules, and what to do when a notice reduces hours.

Get the caregiver checklist Read the CDPAP overview

Five questions, a plain-language summary, and the free checklist by email. Prefer an official helpline? NY Connects is free at 1-800-342-9871 (any age, on Medicaid or not, Relay 7-1-1) and HIICAP at 1-800-701-0501.

At a glance · who can be the assistant

Allowed: A friend or a relative; An adult child, a sibling, a neighbor. The consumer hires and directs them.
Not allowed: Spouse · designated representative; Nor the parent of a consumer under 21.

If a notice cuts hours

10 days to ask for aid continuing

Services keep running while you appeal. ICAN helps for free.

From the State Department of Health’s CDPAP rules. Not a decision about anyone’s care.

Free to useNot a home care agencyNot the government

Start here

Which one sounds like you?

The numbers families need on day one

Two deadlines, one intermediary, and a free advocate.

Each figure is cited to the New York rule or program it comes from. None of them is a decision about anyone’s hours.

10 days
From the date of a reduction notice to ask for aid continuing, so services keep running while you appeal.: 60 days
The window to request a State fair hearing after a notice reducing or ending home care.: 1
Statewide fiscal intermediary for CDPAP. It handles registration, timekeeping, and payroll, not hours.: $0
What ICAN, the Medicaid long-term care ombudsprogram, charges to help with an appeal.

Notice periods and program rules change. Your notice controls; confirm current deadlines on otda.ny.gov or with ICAN before assuming one still applies.

The short version

Two ways Medicaid pays for care at home, and one deadline

Three things to know before you make any call. The guides cover each one in detail.

01
An aide from a licensed agency
The agency hires, trains, and schedules the aide. Your plan or the local district authorizes the hours after an assessment.
02
A personal assistant you choose (CDPAP)
The consumer picks and directs the assistant, who can be a friend or relative. The statewide fiscal intermediary handles registration, timekeeping, and payroll. It does not decide hours.
03
If a notice cuts hours
You have a short window, generally 10 days from the notice, to ask for a fair hearing with aid continuing so services keep running while you appeal. ICAN helps for free.

Read the CDPAP overview Read the appeals guide

Help where you live

Your borough, your county name, and what usually happens for a family choosing CDPAP

The rules are the same across New York. The practical parts change by borough: which county goes on the form, where the nearest free counselor sits, and the mistakes people in your area tend to make.

All boroughs and neighborhoods

Longer reads

The decisions families actually face

All posts

September 28, 2026 · 4 min read

How to meet a Medicaid spend-down in New York (excess income)

In short: a spend-down (New York calls it "excess income" or "surplus income") works like a monthly deductible. Each month, once you show medical bills equal to your excess income, Medicaid…

Straight answers

Questions families ask first

Can my spouse be my CDPAP personal assistant?

No. Under the State Department of Health’s rules the personal assistant can be a friend or relative, but not the consumer’s spouse, the consumer’s designated representative, or the parent of a consumer under 21.

Who pays the personal assistant?

The consumer chooses, hires, trains, and supervises the assistant. The statewide fiscal intermediary designated by the State (PPL) handles registration, timekeeping, and payroll. It does not decide hours.

What is “aid continuing” and how fast do I have to act?

Aid continuing keeps services running at the current level while you appeal a reduction. You generally have 10 days from the date of the notice, or until the effective date if that is later, to ask for it. Say clearly that you want aid continuing when you request the hearing. ICAN helps for free.

Official resources

Where the official answers live

Every fact on this site comes from these government programs. We link to them by name. They do not endorse this site, and this site is not the government.

These are government websites. We link to them. They do not endorse this site.

Guided help, free

This site does not decide who gets home care or how many hours, and it is not a government agency. Want help sorting out the next step?

For a relative preparing to become a personal assistant, or a family choosing between CDPAP and agency care. Held by this site only, never passed to any agency, intermediary, trust, or attorney.

You can also call NY Connects, New York’s free line for long-term services and supports: 1-800-342-9871. Free, any age, on Medicaid or not. They do not sell services. Relay 7-1-1 HIICAP: 1-800-701-0501.

Get the caregiver checklist

Paying a family member to provide care in New York, by the State’s own rules.

Which one sounds like you?

I want to be paid to care for my parent

CDPAP or an agency aide?

A notice says our hours are being cut

Medicaid says we have a “surplus”