New York Caregivers: Complete Guide to Pay, Respite, and Programs

A daughter managing her mother's dementia in Queens. A husband navigating Managed Long Term Care enrollment in Buffalo. A grandmother in Onondaga raising the grandchildren. A working son in Westchester juggling a job and a parent's hospital discharge. If you are helping a family member get through the day, you are a caregiver, and in New York you are one of an estimated 2.2 million to 4 million of them, providing roughly 2.1 billion hours of unpaid care a year valued at about $39 billion. Most of us learn the system in a panic, one phone call at a time, after a fall, a discharge, or a diagnosis.1

It does not have to be that way. New York spent the last few years rebuilding its caregiver infrastructure, and there is real money and real relief on the table if you know where to look. This is the navigation guide. It walks every New York caregiver through the four questions that matter most, how do I get paid, how do I get a break, what programs exist, who do I call, with links to a deep-dive guide on each.

The single most important number to save right now: NY Connects at 1-800-342-9871. One call screens you for every funding stream in a single intake.1

How This Guide Is Organized

The four central caregiver questions in New York map to dedicated guides:

The sections below preview each guide and link to the full article. Read this overview first, then dive into the specific guide that matches your most-pressing question.

1. Who Counts as a Caregiver in New York?

If you spend any meaningful share of your time helping a family member, friend, or neighbor with the activities of daily living, medication, transportation, finances, medical appointments, supervision, or care coordination, and you are not paid through an agency to do it, you are a caregiver. New York's federally funded caregiver support flows through the National Family Caregiver Support Program (NFCSP), authorized under Title III-E of the Older Americans Act (42 USC § 3030s-1). Following the program's 2020 reauthorization, the Administration for Community Living recognizes four caregiver groups:6

1. Adult family members or other informal caregivers caring for a person age 60 or older.
2. Adult caregivers of any age caring for a person of any age with Alzheimer's disease or a related disorder, the care recipient does not have to be 60+.
3. Older relatives (age 55+, excluding parents) who live with and care for children under 18 they are related to (kinship).
4. Older relatives (age 55+, including parents) who live with and care for adults aged 18-59 with disabilities. A relative caring for someone 60 or older comes in through group 1 instead, not this one.5

Separately, spouses and family members of veterans with serious service-connected conditions can be recognized as caregivers under the VA Program of Comprehensive Assistance for Family Caregivers (PCAFC). NY-specific programs sometimes widen or narrow these rules: CDPAP and the agency-employed pathway permit non-relatives, EISEP serves caregivers of anyone 60+, and the NYSCRC Lifespan Respite voucher includes any caregiver providing unpaid assistance regardless of relationship. Read the deep guides for the program-specific rules.6

Who you are, in context

You are far from alone, and the numbers keep climbing. Nationally, the 2025 AARP/National Alliance for Caregiving Caregiving in the U.S. report counts about 63 million family caregivers, nearly 1 in 4 adults. Of them, 44% provide high-intensity care, about six in 10 family caregivers are employed on top of caregiving, and nearly 1 in 3 are "sandwich generation" caregivers supporting both a child and an adult at once. New York mirrors that picture at scale, with its 2.2 million to 4 million caregivers. If any of this describes you, the programs in this guide were built for you.7

2. How Do I Get Paid as a Family Caregiver in New York?

The dedicated guide: How to Get Paid as a Family Caregiver in New York · New York CDPAP, The Complete 2026 Guide

New York runs the largest consumer-directed Medicaid caregiver program in the United States through CDPAP, and there are several other pathways. Below is the orientation; the deep guide owns the eligibility tables, wage rates, and application steps.8

CDPAP, The Family-Hired Pathway

Authority: NY Soc. Serv. Law § 365-f; 18 NYCRR § 505.28.

How it works: The Medicaid recipient (or their designated representative) hires the personal assistant (PA) directly, a family member, friend, or neighbor. As of April 1, 2025, Public Partnerships LLC (PPL) is the sole statewide Fiscal Intermediary for CDPAP, replacing the roughly 600 fiscal intermediaries that served the program before. PPL handles W-2 payroll, tax withholding, workers' compensation, and Electronic Visit Verification. The recipient supervises the PA's day-to-day work; the recipient's MLTC plan or local Medicaid office authorizes the weekly hours.2

2026 PA wages. The New York home-care-aide minimum wage, the floor that governs CDPAP personal assistants, is set by the state Department of Labor in two tiers effective January 1, 2026:8

• NYC, Long Island, and Westchester: $19.65/hour minimum
• Rest of state: $18.65/hour minimum

Downstate personal assistants are also covered by the Home Care Worker Wage Parity Law (Public Health Law § 3614-c), which adds a supplemental benefit portion on top of the cash wage; the supplement amounts change, so confirm the current figure with PPL rather than a marketing page. Be cautious with sites quoting a three-tier "$20.65/$20.05/$18.65 base wage"; that schedule is not the DOL wage floor.8

The CDPAP exclusion list, read this carefully. Spouses cannot be paid CDPAP PAs. Parents of consumers under 21 cannot be paid CDPAP PAs (parents of adult consumers 21 or older may be paid). Designated representatives cannot also be paid PAs. The spousal exclusion is a state-law choice under § 365-f(2)(c); federal law at 42 USC § 1396n(j)(4) expressly lets states elect to pay legally responsible relatives. Many states do; New York does not. The single-FI transition to PPL prompted litigation over the changeover, and the deep CDPAP guide tracks it.2

Other paid-caregiver pathways

• Personal Care Services (PCS) under 18 NYCRR § 505.14, the vendor-agency model. Family members may sometimes be hired through the agency.
• NHTD and Traumatic Brain Injury (TBI) 1915(c) waivers, service plans authorize approved provider agencies; concurrent CDPAP enrollment is the family-caregiver workaround.
• EISEP (Expanded In-Home Services for the Elderly Program) under NY Elder Law § 214, county-AAA administered, sliding-scale cost-share for adults 60+ above Medicaid.5
• VA Aid & Attendance pension, a tax-free monthly benefit added to a VA pension for a veteran or surviving spouse who needs help with daily activities; the veteran can spend it on any caregiver, including a spouse. The single-veteran maximum with Aid & Attendance is $29,093/year for the period running December 1, 2025 through November 30, 2026.3
• VA PCAFC, a tax-free monthly stipend to a primary family caregiver. Spouses are eligible. The stipend is not a flat national figure: it is the federal GS-4, step-1 annual rate for the locality where the veteran lives, divided by 12, times one of four multipliers under 38 CFR 71.40(c)(4)(i). Under the current program (71.20(a)) it is 0.625, or 1.00 if VA determines the veteran is unable to self-sustain in the community. For a legacy participant or legacy applicant (71.20(b) or (c)) the multiplier instead comes from the sum of the veteran's 2019 clinical ratings, with no self-sustain determination required: 1.00 at a sum of 21 or higher, 0.625 at 13 to 20, 0.25 at 1 to 12. A veteran meeting both is paid whichever amount is higher, and a legacy participant under 71.20(b) is held at no less than what the caregiver was eligible for the day before October 1, 2020 while the veteran stays at the address on record. The legacy schedule and the legacy-participant transition run through September 30, 2028. The paid-caregiver guide works the NY locality dollars.9
• VA Veteran-Directed Care (VDC), a budget the veteran controls and can use to hire a spouse, adult child, friend, or neighbor. Verify participating VA sites with the VA Caregiver Support Line (1-855-260-3274).10
• NYSCRC Lifespan Respite voucher (up to $600 per first-time approved applicant), one of the few state-recognized pathways that can pay a hired family member or friend on a one-off basis. Funded under the federal Lifespan Respite Care Act and run by Lifespan of Greater Rochester for the NY State Caregiving and Respite Coalition.5

Tax treatment

Under IRS Notice 2014-7 and 26 USC § 131(c), a caregiver who lives in the same home as the person they care for may exclude qualified Medicaid waiver payments (CDPAP, NHTD, TBI, VDC) from federal gross income, whether or not they are related. New York State conforms. Under IRS guidance following Feigh v. Commissioner, a live-in caregiver can also elect to count those excluded payments as earned income for the Earned Income Tax Credit, often the most lucrative option for low-to-moderate-income families.11

Difficulty-of-care payments are generally also excluded from SSI and SNAP income counting and, for SSDI, from the substantial-gainful-activity test; federal HUD Section 8 housing assistance, by contrast, does count them. Confirm treatment with each program before you rely on it.11

3. NY Paid Family Leave, How to Take Time Off Work to Care

NY Paid Family Leave (PFL) is wage replacement for time off work, it does not pay you for caregiving labor, but it can keep a paycheck coming while you take hands-on leave. It is administered by the NY Workers' Compensation Board, with rates set by the NY State Department of Financial Services, under NY Workers' Compensation Law Article 9.12

2026 numbers

• Weekly maximum benefit: $1,228.53, that is 67% of the 2026 New York State Average Weekly Wage of $1,833.63.
• Wage replacement: 67% of your average weekly wage, up to the maximum.
• Duration: 12 weeks per 52-week period.
• Your 2026 payroll contribution: 0.432% of gross wages, capped at $411.91 for the year.3

Source: NYS Paid Family Leave 2026 update. (These figures rose from 2025, the 2025 contribution rate of 0.388% is no longer operative.)3

Eligible relationships

PFL family-care claims cover: spouse, domestic partner (same or different gender, and no legal registration is required), child or stepchild and anyone you have legal custody of, parent or stepparent, parent-in-law, grandparent, grandchild, and sibling. The family member does not have to live in New York, you can take PFL to care for a parent in Florida. Not covered as of 2026: chosen family / a designated person, aunts and uncles, nieces and nephews, and in-laws beyond a parent-in-law.1

Eligibility, job protection, and how PFL stacks with other leave

Private-sector employees regularly working 20+ hours a week qualify after 26 consecutive weeks; under-20-hour employees qualify after 175 days worked. Public employers may opt in; the self-employed can buy voluntary coverage. On return, your employer must restore you to the same or a comparable position and maintain your health insurance during leave.

• PFL and FMLA can run concurrently if the employer requires it, you get FMLA's job protection plus PFL's wage replacement over the same period.
• PFL and NY Disability Benefits Law (DBL) cannot be paid at the same time, and together they are capped at 26 weeks in any 52-week period.
• PFL and Workers' Compensation: PFL is not payable while you receive total-disability workers' comp.
• PTO: your employer may permit (but cannot require) you to use PTO alongside PFL to top up to full pay.12

4. How Do I Get a Break? Respite Care in New York

The dedicated guide: Respite Care in New York, The Complete 2026 Guide for Family Caregivers

There is no single "New York respite program." Respite is a layered patchwork of distinct funding streams, each with its own eligibility door, its own definition of "respite," and its own dollar cap. Qualifying for one stream does not automatically qualify you for another. The orientation:5

1. NFCSP / Title III-E (federal, channeled by the New York State Office for the Aging (NYSOFA) through the Area Agencies on Aging), the largest non-Medicaid respite stream. Eligibility covers caregivers of a person 60+, caregivers of any-age person with Alzheimer's or a related disorder, and 55+ relatives who live with the person they care for, either a related child under 18 (parents excluded) or an adult aged 18-59 with a disability (parents included). To get respite specifically, the care recipient must also be determined functionally impaired: unable to perform at least two activities of daily living without substantial assistance, or needing significant supervision because of a cognitive or mental impairment that poses a health or safety risk.6,5
2. NYSCRC Lifespan Respite voucher, up to $600 for a first-time applicant, and one of the few streams that can reimburse a hired family member or friend.
3. NYSOFA State Respite Program, a state-general-fund stream, separate from Title III-E, delivered through community grantees in a subset of counties.
4. NYSOFA Caregiver Resource Centers, offering counseling, training, support groups, and respite-voucher administration; NYSOFA funds 17 Area Agencies on Aging to run them, so they cover a subset of counties, and the remaining counties serve caregivers through their AAA caregiver coordinator.1
5. EISEP, for caregivers of seniors 60+ above Medicaid; respite delivered through Social Adult Day programs or in-home aides.
6. Medicaid 1915(c) waiver respite, NHTD and TBI (provider-delivered) and the OPWDD waivers, which include a Self-Direction Family Reimbursed Respite option of up to $3,000/year, the only Medicaid family-reimbursement respite pathway in New York.3
7. MLTC supplemental respite, varies by plan and is not a guaranteed benefit.
8. Medicare hospice short-term inpatient respite under 42 CFR § 418.302, up to 5 consecutive days at a time, reusable (not a once-a-year benefit) subject to the hospice team's approval, with a 5% patient coinsurance capped at the year's inpatient hospital deductible. The FY 2026 inpatient respite per-diem rate is $532.48/day.5
9. VA respite, through PCAFC and the general caregiver program; PCAFC respite is available for at least 30 days per year and may exceed that if clinically appropriate, while nursing-home (institutional) respite is capped at 30 days per calendar year.5

The deep respite guide includes a decision tree that routes you to the right stream by age, diagnosis, Medicaid status, county, and care-recipient income.

5. The Master Plan for Aging, What's Coming

New York released its first-ever Master Plan for Aging (MPA) Final Report on June 30, 2025, more than 100 proposals across nine pillars, including a dedicated Caregiver and Workforce pillar. For you, the practical takeaway is simple: several caregiver-facing ideas are real and moving, but most are still proposals or partial line items, not benefits you can claim today. Here is what to watch and what it means for your money or care.3

• A refundable Caregiver Tax Credit of up to $6,000 (MPA Proposal #56). This is the one families ask about most. It would put real money back in your pocket, but it is not enacted, reintroduced in January 2026 as A.9587 and still in committee, and NYSOFA has told local offices not to tell you it is claimable. Plan as if it does not exist yet.3
• NY Connects modernization (Proposal #63). This one is funded and live, the front door you will actually use has been rebuilt, so the intake in this guide is easier than it was a year ago.3
• Respite expansion, a Geriatric Care Manager pilot, Paid Family Leave designated-person expansion, and a home-care wage floor, these sit at varying stages of funding, pilot, or pending legislation. If you rely on respite or on a paid home-care worker, these are the proposals that could change what you get; check current status with NY Connects before counting on any of them.3

Source: NYS Master Plan for Aging Final Report.

6. NY Connects and the Caregiver Resource Centers

NY Connects is New York's statutory no-wrong-door entry point for all aging and disability resource navigation. Authority: NY Elder Law § 214-d.1

• Statewide phone: 1-800-342-9871 (TTY 711). If you call after hours, 211 routes to NY Connects coordinators.
• Online directory: nyconnects.ny.gov, a searchable statewide database of long-term-services-and-supports providers.
• Structure: NYSOFA contracts with NY Connects programs covering all 62 counties (New York City's Department for the Aging covers all five boroughs as a single AAA and also runs NYC Aging Connect at 212-244-6469 as the city's front door).
• Federally designated as New York's Aging and Disability Resource Center under the Older Americans Act.
• The intake funnel: you dial 1-800-342-9871, get routed to your county, an intake worker completes an assessment, and they screen you across every funding stream, Medicaid long-term care, NHTD/TBI, OPWDD, NFCSP, EISEP, NYSOFA respite, MLTC, VA, and county DSS, then hand you off to the specific program. One call should screen for everything.1

The Caregiver Resource Centers

NYSOFA funds 17 Area Agencies on Aging to operate local Caregiver Resource Centers, which offer:1

• Individual caregiver counseling and assessment
• Caregiver training
• Support groups (in person and virtual)
• Respite-voucher administration

Counties without a Center still serve caregivers through the AAA's caregiver coordinator (mandated under Older Americans Act Title III-E), though staffing and programming vary.5

When to use NY Connects vs. 211

Use 1-800-342-9871 when you know the need is caregiving, long-term services and supports, or aging and disability. Use 211 when you do not yet know what you need and the situation is a crisis around utilities, housing, food, or general human services, 211 will route to NY Connects when caregiving turns out to be the underlying need.1

7. Pending NY Caregiver Legislation

The 2025-2026 legislative session runs through 2026. For a caregiver, the bottom line on pending bills is this: do not build a plan around a bill that has not become law. The proposal you are most likely to hear about is the refundable Caregiver Tax Credit (A.9587, introduced January 2026), which would reimburse a share of your out-of-pocket costs up to $6,000, but it remains in committee and unfunded, and NYSOFA has directed local offices not to advise families that it is claimable.3

Several other caregiver-related measures, expanding Paid Family Leave to a chosen-family "designated person," rural caregiver support, and home-care worker protections, are also pending as of 2026. Because a bill's status can change quickly and carries no benefit until it is signed, confirm the current status of anything you are counting on with NY Connects or the NYS Senate legislation search before relying on it.3

8. What Makes New York's Caregiver Landscape Distinctive

New York is not Tennessee, not Texas, not California. A handful of features set its caregiver environment apart and shape nearly every program decision you will make:

1. Largest CDPAP in the United States. Roughly 280,000 consumers were authorized before the 2025 fiscal-intermediary transition, by far the largest self-directed Medicaid personal-care program in the country. The single-FI model under PPL, effective April 1, 2025, is itself unusual; most comparable states use multiple intermediaries.2
2. Strict spousal exclusion. Spouses cannot be paid CDPAP PAs under § 365-f(2)(c), a state-law choice, not a federal mandate. Paid-spouse-caregiver families usually turn to VA Veteran-Directed Care or, where eligible, a legacy long-term-care insurance policy instead.2
3. Among the most generous PFL in the nation. $1,228.53 a week for 12 weeks in 2026, at 67% wage replacement.3
4. NHTD is at its cap and is not taking referrals right now. New York raised the NHTD cap from 9,400 to 14,079 participants, then reached it. NYSDOH states it "cannot process any additional referrals ... at this time" and that referrals received will be closed by letter; the Regional Resource Development Centers will work through available spaces first-come, first-served as census space opens, so ask yours to flag an opening rather than expecting enrollment now.5 For new applicants, adult home care most reliably flows through the 1915(k) CFCO entitlement plus MLTC, PCS, and CDPAP.4
5. 1915(k) Community First Choice Option entitlement. A State Plan entitlement, no waiver, no cap, no waitlist, covering personal care and related supports. It is the most consequential alternative for anyone caught by the NHTD cap.4
6. No stand-alone 1915(i). Behavioral-health home-and-community-based services for HARP and HIV-SNP enrollees run through the 1115 MRT demonstration, not a 1915(i) State Plan amendment.4
7. Managed Long Term Care is the delivery vehicle. Most Medicaid long-term care, including CDPAP hours, is authorized through capitated MLTC plans under the 1115 MRT demonstration; the MLTC guide covers enrollment and appeals.13

9. Federal Changes to Watch in 2026-2028

A few federal shifts and one demonstration deadline could reach New York caregivers over the next couple of years. None of these changes your benefits today, but each is worth understanding so a future cut does not catch you off guard.

• The One Big Beautiful Bill Act (P.L. 119-21, enacted July 4, 2025) phases down the Medicaid MCO-tax safe harbor. In plain terms, it squeezes a funding source New York uses for Medicaid, which over time can pressure MLTC plan rates and, downstream, CDPAP wages and personal-care hours. There is nothing to do now, but it is why home-care rates are a live political fight.3
• Medicaid work requirements take effect January 1, 2027. The same law imposes an 80-hour-a-month work-or-community-engagement rule on Medicaid expansion adults. Disabled adults are categorically exempt, and caring for a young child or an incapacitated household member is a qualifying activity, so most family caregivers are covered, but confirm your situation when the state rules are published.3
• New York's 1115 MRT demonstration expires March 31, 2027. It is the legal authority behind MLTC and much of the state's Medicaid long-term-care structure; New York filed its renewal in November 2025. Watch for the renewal to be approved so MLTC keeps running.13
• PCAFC legacy participants keep their stipend through September 30, 2028. VA extended the transition deadline, so legacy families do not lose the caregiver stipend on the old cliff date. Until then a legacy household is paid on its own stipend schedule, set by the sum of the veteran's 2019 clinical ratings rather than by a self-sustain determination, so a household rated 21 or higher is already at the full 1.00 multiplier. Ask your Caregiver Support Coordinator which schedule and multiplier VA has you on before the transition.9

10. Crisis Lines and Primary NY Contacts

Save these to your phone now. If you are in immediate physical danger, dial 911.

Learn More

Other New York caregiver guides in this cluster:

Related New York Medicaid Reading

The Medicaid programs that fund New York caregiving in more depth, including CDPAP and Managed Long Term Care:13

• New York Medicaid (Pillar Landing)
• NY Community Medicaid
• NY CDPAP (Consumer Directed Personal Assistance Program)
• NY Managed Long Term Care (MLTC)
• NY Medicaid Advantage Plus (MAP)
• NY HCBS Waivers (NHTD, TBI, OPWDD, Children's)
• NY Long-Term Care Nursing Home Medicaid
• NY Eligibility and Income Limits
• NY How to Apply for Medicaid
• NY 30-Month Community Medicaid Lookback
• NY Pooled Income Trust
• NY Spousal Refusal
• NY Estate Recovery
• NY Personal Needs Allowance

New York caregiver policy changes frequently. Re-check the NY PFL figures, NHTD waiver enrollment status, the A.9587 caregiver-credit status, and the federal timelines against the primary sources before relying on any specific number.

Find personalized help with caregiving in New York at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.