Queens families and CDPAP, from Astoria to Bayside

Queens is Queens County on every Medicaid form, Medicaid here is run citywide by the NYC Human Resources Administration (HRA), and every CDPAP consumer in the borough works with the same statewide fiscal intermediary as the rest of New York State. What is different about Queens is the households: more languages than any other county in the country, a lot of three-generation homes in Flushing, Jackson Heights, and Jamaica, and a large number of adult children who are already doing the work of a personal assistant without being paid for it.

This hub is for three kinds of Queens households. The first is the family caregiver, usually a daughter, son, daughter-in-law, or niece, who has heard that Medicaid can pay a relative to provide care and wants to know whether that is true for their family and what it would take. The second is the person, or the family around the person, who has been offered Medicaid home care and has to choose between an agency aide (personal care services, or PCS) and hiring their own personal assistant through CDPAP. The third is the household that already has hours and just received a notice that the hours are being reduced or ended.

None of these pages decides anything. They explain the program rules the New York State Department of Health publishes, tell you which office handles which piece in Queens, and give you the free numbers to call.

Medicaid itself is HRA. Eligibility, renewals, and address changes for Queens residents go through the NYC HRA Medicaid Helpline, not a county office; HRA's Queens office locations are listed on nyc.gov/hra. If the person is 65 or older or has a disability and is not in a managed care plan, home care runs through HRA's Home Care Services Program, reached through the DSS OneNumber. Most Queens adults who need long-term home care are in a Managed Long Term Care plan, and for them the plan, not HRA, authorizes hours.

Plan questions are New York Medicaid Choice. The state's enrollment broker answers questions about joining or changing a Medicaid managed care or Managed Long Term Care plan. It does not run CDPAP and it does not decide hours.

The fiscal intermediary is statewide. 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 handles the personal assistant's wages, tax withholding, and employment records; it does not decide who is eligible or how many hours are authorized. PPL lists an in-office appointment location in Forest Hills among its New York locations in the Department of Health's consumer resources packet; check health.ny.gov/cdpap for current locations rather than relying on this page.

Fair hearings are statewide. A cut in hours is appealed first inside the plan (for managed care members) and then through the New York State Office of Temporary and Disability Assistance (OTDA) fair hearing system, which serves every county. Queens residents have the same deadlines as everyone else; see the appeals post linked below.

The exact list comes from the fiscal intermediary and can change, so treat this as orientation and confirm on health.ny.gov/cdpap. A Queens family preparing to have a relative become the personal assistant typically needs:

• The consumer's Medicaid ID and the service authorization from the plan or HRA. CDPAP needs its own authorization; the Department of Health's comparison chart says switching between CDPAP and agency care requires a new authorization, including a new person-centered service plan and plan of care.
• Confirmation that the proposed assistant is allowed. The Department of Health says the assistant may 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, sons- and daughters-in-law, and a parent of an adult consumer are named as allowed on the Department's chart.
• Government photo identification and documents showing the assistant may work in the United States, for the employment paperwork the intermediary processes.
• A health assessment for the assistant. Department of Health guidance requires that each personal assistant's health status be assessed before service delivery.
• Registration with PPL for both the consumer and the assistant, by phone, through the PPL@Home online system, with a community facilitator, or at an in-person session, as described in the Department's "How to Register with PPL" document.

For getting your bearings only: NYC Health + Hospitals / Elmhurst on Broadway, NYC Health + Hospitals / Queens in Jamaica Hills, Flushing Hospital Medical Center, and Long Island Jewish Forest Hills are the hospitals most Queens families name first. None of them is endorsed here, and none of them decides Medicaid home care.