In New York alone, nearly a quarter of a million citizens receive assistance from Medicaid for long-term care. However, not everybody knows that two-thirds of them receive assistance at home or in assisted living through programs like CDPAP.
What does CDPAP stand for?
Consumer-Directed Personal Assistance Program.
However, you may also find it referred to as CDPA (Consumer-Directed Personal Assistance) or CDPAPNYS (Consumer-Directed Personal Assistance Program New York State).
So what is it exactly?
Is it really a program?
Despite the word program in the name, it is more like a method of receiving benefits under other programs. This doesn’t stop many people from thinking that it is a distinct program and, in a way, that is perhaps not such a bad thing because in practice it functions like one.
Who does it help?
The CDPAP Program is for elderly or disabled people who:
a) are in need of the following services and
b) want to have control over who provides those services:
- personal care,
- home health, or
- skilled nursing care.
What is consumer direction?
Consumer direction is when the consumers of care services choose to direct their own care.
It is also known as:
- participant direction,
- self-direction, or
- cash and counseling.
So how does it work?
The program allows adult children to get paid to work as caregivers for their aging parents (but spouses do not receive payment).
This is how it works:
- Those individuals who are eligible decide to participate in the program;
- they work with a county caseworker and medical professional to work out the level of care they need;
- together they create a Care Plan.
The twist in the tale
But who’s the boss?
The Care Plan details how many hours of care they will need every week.
But here’s where it gets interesting!
The participating individuals themselves are given the flexibility to:
- train, and
- supervise their care providers or Personal Assistants (PAs).
No more stranger danger
What accounts for the popularity of this program?
A familiar face
This is mainly down to the fact that friends and certain family members may be hired as care providers.
Who is and isn’t eligible?
Who is eligible to be a paid caregiver?
- Adult children
Who is not eligible?
- Legal guardians
Even though the program participants are responsible for the hiring and management of their care providers, a Fiscal Intermediary oversees time-sheet processing and employee payments.
Must beneficiaries live at home?
While the program’s regulations make no clear statement on this, people familiar with the program have said that beneficiaries must either live at home or at least be in the process of moving back into a private home.
Who is behind it all?
CDPAP is a Medicaid entitlement program offered by the NY Managed Medicaid Long Term Care Program and the Community First Choice option.
Who is eligible to receive care?
What are the medical requirements?
Elderly or disabled New York residents must be able to demonstrate the need for assistance with their daily activities.
They must qualify for:
- home care,
- personal care, or
- skilled nursing.
They must also be eligible to receive New York Medicaid.
What are the financial requirements?
This can be the tricky part because the process of qualifying financially for Medicaid is sometimes a long and winding road.
In a process called Medicaid look back, state employees go back as far as five years to review a family’s:
- assets, and
- asset transfers.
If you have violated the look-back rule, you may be penalized with a period of Medicaid ineligibility.
These are the New York Medicaid income limits for:
- a single applicant over the age of 65 = $875 / month
- a two-person household = $1,284.
If one spouse of a married couple is not applying, they are referred to as the community spouse or well spouse. In this case, the applicant spouse is able to transfer monthly income to their non-applicant spouse. As of 2020, up to $3,216 / month can be transferred to the non-applicant spouse to bring their income up to this amount.
Here are the asset limits for the following, when applying for benefits:
- A single individual = $15,750
- A two-person household = $23,100.
- The community spouse = $128,640 (in funds across all the couple’s financial accounts; in addition to the $15,750 in assets the applicant spouse can keep).
Some assets are excluded from the asset limit under Medicaid:
- the primary home (if the equity value does not go beyond $893,000),
- household furnishings,
- personal items,
- one car.
If you have a complicated case or your assets or income exceed Medicaid’s allowable limits then you could work with an elder care financial planner or elder law attorney to structure your finances appropriately so as to qualify for Medicaid.
When the applicant has finally met the medical and financial criteria, participants must access the Consumer-Directed Personal Assistance program through:
- New York’s Managed Medicaid Long Term Care Program or
- Community First Choice option.
The CDPAP program provides a wide range of care services. During the creation of the Care Plan, all the necessary services and hours needed will be worked out in detail.
The services provided under this program are self-directed, which means that the program participant or their legal representative is able to choose the provider of those services.
Care with benefits
The benefits will include:
- personal care,
- assistance with all activities of daily living,
- skilled nursing services.
To find out more about the benefits of this program please read the following post:
Benefits of hiring someone you trust as a home caregiver with the CDPAP program
How to apply?
Any New York residents interested in applying for this program can reach out to REGENCY HEALTH CARE, INC. and we will help you through the process.