Part 1: Receive health coverage through Medicaid.
In order to apply for Consumer Directed Personal Assistance (CDPA), you need to have health insurance coverage through Medicaid.
Part 2: Contact the New York Independent Assessor for an assessment.
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 called Maximus under the direction of the New York State Department of Health. The person calling for the evaluation needs to be the consumer or designated representative.
To schedule a NYIA assessment, call: 1-855-222-8350.
Part 3: Receive your plan of care.
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 & 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 also receive information on how to appeal this decision if you are not satisfied.
Part 4: Choose a Fiscal Intermediary & begin hiring Personal Assistants.
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 is a business which is responsible for paying your personal assistants (PAs), making sure that taxes for Medicare, social security, and other legal requirements are paid; 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?
Under New York State laws & regulations, you have the freedom to hire nearly anyone to work as your PA.
As a self-directing consumer or a designated representative, it is your responsibility to recruit, train, supervise, schedule and terminate your PAs. This includes making sure you have backup PAs in case of a call-out, illness or no-show.