Can a family member be a paid CDPAP personal assistant in New York?

Often, yes. New York's Consumer Directed Personal Assistance Program (CDPAP) lets a Medicaid member who is eligible for home care choose their own personal assistant, and the State Department of Health says that "can include a friend or family member, as long as they are not the Medicaid member's spouse, their designated representative or the parent of a CDPAP consumer under the age of 21."

Everything else on this page is detail around that sentence.

The spouse. A husband or wife cannot be the paid assistant. This is the exclusion that surprises the most families, because spouses are so often the ones already providing care. The rule is stated on the Department's program page and in its administrative directive on CDPAP.

The designated representative. In CDPAP, a consumer who cannot direct their own care can have a designated representative, an adult who makes the hiring, scheduling, and supervising decisions on the consumer's behalf. That person cannot also be the paid assistant. In practice this means a family with one very organized relative has to decide which role that relative takes. One daughter cannot be both the decision-maker and the worker.

A parent of a consumer under 21. A mother or father cannot be the paid assistant for their own minor child in CDPAP. A parent of an adult consumer is a different matter; the Department's comparison chart lists "a parent (of an adult consumer)" among the close relatives who can serve.

The Department's chart says the caregiver "can be a close personal relative, including a parent (of an adult consumer), son, daughter, son-in-law, or daughter-in-law." The Department's administrative directive (11 OHIP/ADM-6) goes further and describes "any other adult relative of the consumer who does not reside with the consumer," and also "any other adult relative who resides with the consumer because the amount of care the consumer requires makes such relative's presence necessary."

Read plainly: adult children, sons- and daughters-in-law, siblings, nieces and nephews, adult grandchildren, and other adult relatives are not on the exclusion list. A relative who lives in the same home is addressed specifically, with the condition that the care needs justify the relative's presence. Friends and neighbors are not excluded either. The consumer, or the designated representative, chooses.

The assistant must be an adult. Beyond that, the Department requires that each assistant's health status be assessed before service delivery, and the fiscal intermediary processes the employment paperwork, which typically means government identification and documents showing the person may work in the United States. This site does not know your relative's situation and cannot say whether they will clear those steps.

The consumer does not pay the assistant, and no agency does. The Department of Health designates Public Partnerships LLC (PPL) as the single statewide fiscal intermediary for CDPAP and states that all CDPAP recipients are required to work with PPL. The intermediary processes the assistant's wages and benefits, handles tax and other withholdings, and keeps the employment records. Both the consumer and the assistant register with the intermediary, by phone (1-833-247-5346, TTY 1-833-204-9042), online through PPL@Home, through a community facilitator, or at an in-person session, as described in the Department's registration guide.

Pay rates, benefits, and schedules are not published on this site because they are not something this site can promise or verify for your case. Ask the intermediary or the plan. What the intermediary does and does not decide is laid out in the fiscal intermediary explained.

CDPAP is called consumer directed because the consumer is the employer. The Department's list of consumer responsibilities includes recruiting, hiring, training, supervising, and terminating assistants; arranging back-up coverage; coordinating other services; keeping payroll records; and working with the fiscal intermediary on payroll. The assistant, in turn, records time through the intermediary's systems and the consumer or designated representative approves it. A family where the "consumer" is a parent with dementia and the "assistant" is the adult child will need a designated representative who is not the assistant to hold the employer role. Think through who that is before anyone registers. The assistant's own steps, from registration to the yearly health assessment, are in how to become a CDPAP personal assistant.

• That your relative "qualifies." Only the plan or the local district authorizes CDPAP, and only after an assessment. Since September 1, 2025, the Department's Minimum Needs Requirements apply to new assessments of adults 21 and over.
• How many hours will be approved, or when.
• What the assistant will be paid.
• That any agency, intermediary, or facilitator is better than another. The intermediary is named here only because the State designates it.