How to qualify for and receive CDPA services

In order to apply for Consumer Directed Personal Assistance (CDPA), you need to have health insurance coverage through Medicaid.

• For more info on how to apply for Medicaid, click here.

If you have Medicaid and are ready for the next step, contact the New York Independent Assessor, or NYIA for short, to determine that you are eligible for CDPA. 

NYIA assessments are carried out by a private company under the direction of the New York State Department of Health (DOH). Under rules created by DOH and the NYIA, the person calling for the evaluation must be the consumer or designated representative.

To schedule a NYIA assessment, call: 1-855-222-8350.

For an overview of the full NYIA assessment process, please visit our Understanding the New York Independent Assessor resource.

Your plan of care is the document that says what tasks your personal assistant (PA) is allowed to do for you. As you look to schedule and supervise your PAs, this document guides the way and serves as the PA’s job description, in a way.

Your managed care plan or local department of social services will use the information from the NYIA assessment to develop your plan of care, then authorize specific hours and issue you a final notice. 

For most people, this will be the final step, and you can move to step 4. However, if you are found to need 12 or more hours per day, there is more.

Consumers found to need 12 or more hours a day must see the Independent Review Panel (IRP). This is an extra step that only applies to new consumers. The IRP recommends whether a proposed plan of care is reasonable and appropriate to maintain health and safety in the home. The IRP may recommend changes in plan of care but NOT specific amount of hours.

Your managed care plan or county may or may not change authorized hours based on the IRP’s recommendations. After reviewing the IRP’s recommendations, they will issue the final plan of care, hours and notice to you. You will not receive any information from the IRP, and you will not receive the plan of care or authorization before the plan receives it back from the IRP.

Once the plan of care and authorization are issued, you will receive information on how to appeal decisions about hours and tasks if you are not satisfied. This is called an internal appeal (with the plan) and then a fair hearing (through the state). This process is time limited, so it is important to act quickly if you wish to appeal.

Once you have been awarded your hours, you may contract with a fiscal intermediary (FI) and begin hiring personal assistants (PAs).

What is a fiscal intermediary?

A fiscal intermediary, or FI, is the agency you will work with in CDPA. The FI is responsible for supporting you as you navigate the process, as well as all of the backroom employment tasks such as paying your personal assistants (PAs), making sure that taxes and other legal requirements are met; and making sure all required paperwork is submitted and on file for you and your PAs.

New York State’s Medicaid program requires every CDPA consumer to use an FI. 

Please consult our resource on choosing & changing FIs to help you make that decision. 

Who can I hire as a personal assistant? 

New York allows you a tremendous amount of flexibility in who you hire as a PA. 

Here is a detailed list of who can and cannot work as your PA.

As a self-directing consumer or a designated representative, it is your responsibility to recruit, train, supervise, schedule and, if necessary, terminate your PAs. This includes making sure you have backup PAs in case of a call-out, illness or no-show. 

Your FI cannot supply you with PAs in CDPA. Likewise, with very few exceptions, your FI cannot tell you that someone cannot be your PA. Parents of children under 21, spouses, people not legally allowed to work in the United States, and those who cannot pass a health exam or refuse vaccination for measles, mumps, and rubella are forbidden from being a PA. Criminal background checks and other items are not part of CDPA.