Brooklyn family caregivers, CDPAP, and agency personal care

On Medicaid paperwork Brooklyn is Kings County, which trips up people who have lived in Flatbush or Bensonhurst for fifty years. Medicaid itself is administered citywide by HRA, so there is no Kings County social services office to find. Brooklyn's home care households speak Yiddish, Russian, Haitian Creole, Spanish, Chinese, and Arabic, and the borough has five NYC Aging counseling sites, the most of any. The CDPAP rules do not bend by neighborhood, but the way families arrive at them does.

Brooklyn's home care conversations usually start inside a family. A daughter in Borough Park has been caring for her mother for years and hears that Medicaid can pay a relative. A son in Bay Ridge is comparing an agency aide with hiring his cousin. A grandmother in Crown Heights just got a letter cutting her hours. This hub is for all three.

For the caregiver question, the Department of Health's rule is short: a personal assistant can be a friend or family member as long as they are not the consumer's spouse, designated representative, or the parent of a consumer under 21. Adult children and in-laws generally can serve. A relative who lives with the consumer can serve when the amount of care makes that relative's presence necessary (11 OHIP/ADM-6). Whether a specific person fits is a question for HRA, the plan, and the fiscal intermediary.

For the CDPAP-or-agency question, the tradeoff is control against administration. CDPAP consumers hire, train, schedule, and can dismiss their own worker, and a personal assistant may help with things an agency aide often cannot, like health measurements and self-administered medications (DOH comparison chart). Agency personal care puts hiring, training, and supervision on the agency. Switching between them requires a new authorization and plan of care.

Brooklyn residents call the same HRA Medicaid Helpline as the rest of the city for eligibility and renewals. Fee-for-service consumers, meaning those not in a managed long term care plan, get personal care and CDPAP authorizations from HRA's Home Care Services Program; the DSS OneNumber (718-557-1399) is the published contact, and HRA's Home Care CASA offices are listed on nyc.gov/hra. Managed long term care members work with the plan for assessments and authorizations; New York Medicaid Choice (1-800-505-5678, TTY 1-888-329-1541) is the state's official plan-enrollment line.

The fiscal intermediary is the same for every CDPAP consumer in the state: Public Partnerships LLC (PPL), designated by the Department of Health (health.ny.gov/cdpap). Brooklyn had many fiscal intermediaries before 2025; none of them is the fiscal intermediary now. The DOH consumer resources document lists a PPL in-office appointment location in Brooklyn; check pplfirst.com or health.ny.gov/cdpap for the current list.

Fair hearings run through the state Office of Temporary and Disability Assistance for every county. Managed care members generally file a plan appeal first (within 10 days of the notice date, or the effective date, whichever is later, to keep services unchanged), then may request a fair hearing. Fee-for-service consumers request the hearing directly, generally within 60 days of the notice, with aid to continue if requested before the effective date or within 10 days of mailing, whichever is later (DOH GIS 25 MA/07). Request it through OTDA (online at otda.ny.gov/hearings, by phone, fax, or mail; the current channels are on that page).

Typically requested when a Brooklyn relative registers with the statewide fiscal intermediary. Confirm the current list at health.ny.gov/cdpap and in the DOH "How To Register With PPL" document.

• Government photo ID and proof of eligibility to work in the United States, for the employment forms the fiscal intermediary processes.
• A health assessment; DOH requires each personal assistant's health status to be assessed before service delivery (11 OHIP/ADM-6, citing 10 NYCRR 766.11).
• PPL registration for both the consumer and the personal assistant.
• The consumer's Medicaid ID and the current service authorization from HRA or the plan.
• If the consumer cannot self-direct, the name of the designated representative, who cannot also be the paid personal assistant.

Orientation only: Maimonides in Borough Park, NYC Health + Hospitals / Kings County in East Flatbush, NYC Health + Hospitals / Coney Island near Brighton Beach, and NYU Langone Hospital-Brooklyn in Sunset Park. Discharge planners at these hospitals are often where Brooklyn families first hear the word "CDPAP," usually in a hurry.