CDPAP designated representative in New York: who can be one and what they must do

• If the consumer is self-directing: an adult the consumer chooses to hand these duties to, who is willing and able.
• If the consumer is not self-directing: the consumer's parent, legal guardian, or, if the district approves, a responsible adult "surrogate" who is willing and able.
• In every case, the DR must be approved by the local Department of Social Services (LDSS) or the managed care plan.

• The consumer's personal assistant (the paid aide).
• An employee, representative, or affiliated person of the fiscal intermediary.

Under the rules, these people cannot be the consumer's personal assistant:

• The consumer's spouse.
• The consumer's designated representative.
• A person legally responsible for the consumer's care, which GIS 23 MA/18 says means a parent of a child under 21.

GIS 23 MA/18 says a parent or a court-appointed guardian of an adult 21 or older can be the paid aide, as long as they are not also the DR. A Social Security representative payee or a power-of-attorney agent is not "legally responsible" in this sense. So a family often picks one relative to be the DR and a different relative to be the aide. See our family member paid CDPAP guide.

The regulation lists these duties for the consumer or the DR:

1. Recruit and hire enough aides, and train, supervise, and schedule them. End their employment when needed.
2. Tell the LDSS or plan quickly about changes: health, hospital stays, a new address or phone, or a job change.
3. Tell the fiscal intermediary about changes in an aide's employment.
4. Attest that each aide's timesheets are accurate, and send them in.
5. Hand out paychecks if needed.
6. Arrange backup coverage when an aide is out.
7. Sign the memorandum of understanding with the fiscal intermediary and the LDSS or plan.

The DR must be available so these duties happen without delay. For a consumer who is not self-directing, the DR must be present at every scheduled assessment or visit by the independent assessor, the examining medical professional, or LDSS or plan staff. A consumer or DR can work with only one fiscal intermediary at a time.

1. Pick someone who can be reachable and show up for assessments and visits. The state says the LDSS must approve someone who can.
2. Make sure they are not the aide. If the person you want as DR is also the planned aide, choose one role for them.
3. Tell the LDSS or plan who the DR is and ask how they want it documented. Our how to apply for CDPAP guide covers the application.
4. Update the fiscal intermediary so timesheets and paperwork go to the DR.
5. If the DR can't continue, tell the LDSS or plan right away. GIS 23 MA/18 says the LDSS must immediately assign a new DR or send a notice of intent to discontinue CDPAP.

• Naming the same person as DR and paid aide.
• Choosing a DR who works long hours and can't attend assessments.
• Assuming a power of attorney makes someone "legally responsible" and unable to be the aide. The state says it does not.
• Not planning a backup DR. If the DR drops out, CDPAP can be discontinued if no replacement is assigned.