About the Program
What is Consumer Directed Personal Assistance(CDPA)?
Consumer Directed Personal Assistance allows Medicaid recipients in need of personal care, home health and nursing services to recruit, hire, train, supervise and terminate their own personal assistants. Under CDPA, people with long-standing illnesses or disabilities have much greater control and freedom over their own care than under traditional home care services. They are able to hire friends or loved ones to work for them, thus eliminating potential stress from strangers in the home or language/cultural barrier issues. CDPA consumers allocate weekly hours on a flexible day-to-day basis, rather than following a daily schedule of hours set by a third party. The program ultimately provides consumers with controls that many take for granted.
For further information on CDPA, you should call a CDPAANYS Peer Mentor at the toll-free number, 1-855-423-7733 (1-855-4CDP-PEER), or send an email to firstname.lastname@example.org. Informational brochures are available in English and Spanish, and digital copies are available in several other languages. Please contact CDPAANYS if you would like to request copies by calling our office at (518) 813-9537, or sending an email to email@example.com.
Click here for current, unabridged CDPA regulations (While most of the regulations are included in managed care contracts, the regulations in 505.28 only apply to Fee for Service CDPA).
Who Can Use the Program?
To be eligible for CDPA, an individual must:
- Be Medicaid eligible;
- Be eligible for home care services, personal care services, or private duty nursing;
- Require some or total assistance with one or more home care, personal care, or skilled nursing service;
- Have a stable medical condition; and
- Be self-directing or have a designated representative who is willing and competent to assume the roles and responsibilities that go with the program.
The definition of a self-directing consumer is:
“a consumer who is capable of making choices regarding the consumer’s activities of daily living and the type, quality and management of his or her consumer directed personal assistance; understands the impact of these choices; and assumes responsibility for the results of these choices.” (10 NYCRR 505.28(b)(9))
Since the consumer assumes employer responsibilities, (to recruit, hire, train, supervise and terminate) s/he must be capable off performing these duties. Directing the personal assistant and completing required paperwork are core competencies.
In counties where cases are authorized by the local department of social services, county caseworkers and nurses assess each individual for his/her CDPA eligibility. In counties where mandatory managed care and managed long term care have been implemented, case workers and nurses from the consumer’s plan assume these responsibilities.
CDPA and Managed Care/Managed Long Term Care
Eventually, every county in New York State will transition to managed care and managed long term care. This means that all Medicaid recipients will eventually be required to enroll in a managed care or managed long term care plan, and CDPA will be provided as a benefit through the plan. Click here for an approximate schedule of roll-out dates for mandatory enrollment.
For consumers currently receiving home care or long term care services through the local department of social services, you will receive an “announcement” letter from New York Medicaid Choice informing you that you will need to enroll in a managed long term care (MLTC) plan. You will receive another letter about 30 days later stating that you have 60 days to select an MLTC, and if you do not do so, you will be auto-assigned to one. This is sent as part of a “mandatory enrollment packet” and will include contact information for New York Medicaid Choice. Consumers may change MLTCs on a monthly basis, but it is recommended that switching plans should be done only if another can guarantee the services and hours you require.
Because this process can be daunting, New York Medicaid Choice offers a toll-free help line for new enrollees, comparisons of managed care and MLTC plans by region, and downloadable lists of plans by region. Click here to visit New York Medicaid Choice’s website.
For a current list of MLTC plans in New York, click here to go to the NYS Department of Health’s Managed Long Term Care Plan Directory.
Differences Between CDPA and “Traditional” Home Health Care
Traditional home care programs have what are called “levels.” There are certain tasks that a “homemaker” may provide, others that a “personal care aide” can provide, others a “home health aide” can provide, others a “Licensed Practical Nurse” or “Registered Nurse” can provide. CDPA, on the other hand, has one level of employee – the personal assistant (PA).
What makes the two programs very different are:
1) who selects the PA;
2) who trains the PA and how the PA is trained;
3) who supervises the PA;
4) who schedules the PA;
5) how the tasks are done;
6) who terminates the PA (if the employment relationship isn’t working.)
Since you, the consumer, assume employer responsibilities, (to recruit, hire, train, supervise and terminate) the rules shift a bit. Instead of a nurse from an agency, you are the one who is directing your “Plan of Care” that was developed by the caseworker and nurse who performed your program assessment. Your authorized hours are based on this plan and it is your county caseworker determines how many hours can be paid, per week, to personal assistants who you must find (recruit) and hire.
What makes CDPA different from traditional models of home care is that you are legally able to train your personal assistant to do tasks that a nurse would otherwise have to do. This is possible because: 1) you are training and supervising the personal assistant to perform a task in the way that you want it done, 2) there is an amendment to the Nurse Practice Act that legally allows anyone to perform tasks that typically only a nurse would be allowed to do, such as administer medications, because you are training and supervising the personal assistant (PA). NOTE: During your initial (and ongoing) county assessment(s), a Registered Nurse will work with you to determine whether or not you are confident that you can train and supervise personal assistants to assist you with “higher level” tasks.
You will work with a CDPA organization, known as a fiscal intermediary (FI), who will provide administrative support for you. The FI is responsible for administrative tasks such as: collecting paperwork, payroll, benefits and supporting consumers to navigate directing their program.
The fiscal intermediary members of the Consumer Directed Personal Assistance Association of New York State (CDPAANYS) strive for the best check and balance model while affording consumers the highest level of empowerment, consistent with the original philosophy of CDPA.
How Do Consumers Sign Up?
Anyone who is Medicaid eligible and interested in the program should contact his/her managed care or managed long term care insurance plan or his/her local county Department of Social Services (DSS). Click here for the New York State Map to access county and CDPA fiscal intermediary contact information. A caseworker and nurse will evaluate you to make sure that you are right for the program. Fiscal intermediaries do not evaluate initial or ongoing program eligibility.
Once you have been approved, the plan or county will refer your case to a FI. Once the FI receives the referral the company will contact you.