New York CDPAP 2026: Consumer Directed Personal Assistance Guide

New York's Consumer Directed Personal Assistance Program (CDPAP) lets you hire and direct your own aide, often a family member or friend, and have Medicaid pay the wages. It is the largest consumer-directed Medicaid personal-care program in the country, and the 2025-2026 stretch reshaped almost every operational detail. This guide covers 2026 wage rates, the September 1, 2025 minimum-needs ADL test, the Engesser class settlement (final October 3, 2025), the Calderon and Flanagan PA wage-theft suits, the NYIAP three-stage assessment, the Andryeyeva 13-hour live-in rule, IRS Notice 2014-7 difficulty-of-care exclusion, Public Partnerships LLC's onboarding pipeline, Time4Care EVV, and the federal OBBBA Section 71121 horizon, in one reference for New York families.

TL;DR, CDPAP in One Page

The Consumer Directed Personal Assistance Program (CDPAP) is the largest consumer-directed Medicaid personal-care program in the United States. It is codified at NY Soc. Serv. Law § 365-f and implemented by 18 NYCRR § 505.28. CDPAP lets a Medicaid-eligible New Yorker choose, hire, train, schedule, supervise, and direct her own personal-assistant, including most family members, friends, or neighbors, and have that personal-assistant paid by Medicaid as a W-2 employee of Public Partnerships LLC (PPL), the sole statewide fiscal intermediary since April 1, 2025.

Eight things to know going into 2026:

1. PPL is now the only fiscal intermediary statewide. The roughly 600 prior FIs were eliminated under the FY 2024-25 enacted state budget amendment to § 365-f(4-a). Litigation challenging the rollout (Engesser v. McDonald, EDNY 1:25-cv-01689) settled with final approval on October 3, 2025.

2. 2026 base wages: $20.65/hr in NYC, $20.05/hr in Nassau/Suffolk/Westchester, $18.65/hr elsewhere. All PAs received a +$0.55/hr bump on January 1, 2026.

3. Wage parity supplement (downstate only): $2.54/hr in NYC and $1.67/hr in Nassau/Suffolk/Westchester. These are the operative figures under PHL § 3614-c as amended by Part HH of Chapter 57 of the Laws of 2023, effective 1/1/2024, NOT the historic $4.09/$3.22 figures still circulating online. Total minimum compensation: $23.19/hr NYC, $21.72/hr Nassau/Suffolk/Westchester, $18.65/hr rest of state.

4. Spouses cannot be paid as CDPAP PAs. This is a state-law choice under § 365-f(2)(c), not a federal mandate, federal law at 42 USC § 1396n(j)(4) explicitly permits states to elect to pay legally responsible relatives. New York has chosen not to.

5. Parents of CDPAP consumers under 21 cannot be paid. Parents of adult children 21+ may serve as paid PAs per Chapter 511 of the Laws of 2015.

6. The September 1, 2025 minimum-needs ADL test (25 OHIP/ADM-03; MLTC Policy 25.04) raised the entry bar: new applicants must require limited assistance with three or more ADLs, OR supervisory assistance with two ADLs if a documented Alzheimer's/dementia diagnosis is on file.

7. There is no statewide 60-hour weekly cap. What exists is the NYIAP IRP review trigger at 12+ hours/day under 22 OHIP/ADM-01 (a medical-necessity review, not a cap), MLTC plan-level overtime authorization, and the 18 NYCRR § 505.14(a)(5) Level I PCS 8-hour cap (PCS only, not CDPAP).

8. Difficulty-of-care payments to live-in PAs are excluded from federal gross income under IRS Notice 2014-7 / IRC § 131(c). NY conforms. SSI, SNAP, and SSDI also exclude. Section 8 housing does not.

If a single sentence captures CDPAP in 2026, it is this: CDPAP is the most generous consumer-directed Medicaid program in America, but it lives inside a consolidated, litigated, just-tightened operational shell that families need to walk through one careful step at a time.

1. Statutory Framework

CDPAP is built on three nested layers of authority.

Federal authority. State Plan Personal Care Services are authorized at 42 USC § 1396d(a)(24). Self-Directed Personal Assistance Services are authorized at 42 USC § 1396n(j), the "1915(j)" option, which explicitly permits states to elect to pay legally responsible relatives (§ 1396n(j)(4)). NY's CDPAP currently operates outside the formal 1915(j) State Plan amendment but on substantively similar consumer-direction principles, layered into the Medicaid Redesign Team (MRT) 1115 demonstration approved by CMS for managed long-term care. The 1115 framework is what allows CDPAP to operate inside the MLTC capitated rate structure rather than as a stand-alone fee-for-service benefit.

State statute. NY Soc. Serv. Law § 365-f is the foundational CDPAP statute, originally enacted in 1995 and substantially amended over time. Key subsections:

• § 365-f(1), purpose and consumer self-direction principle.
• § 365-f(2)(a), eligibility criteria (Medicaid recipient; assessed need for PCS, home health aide, or skilled nursing services; capable of making informed decisions or having a designated representative).
• § 365-f(2)(b), NYIAP authority (added by 2020 amendments; effective May 1, 2022).
• § 365-f(2)(c), PA exclusions (spouse; parent of consumer under 21; designated representative).
• § 365-f(4-a), statewide single fiscal intermediary mandate (added by FY 2024-25 enacted budget; effective April 1, 2025).
• § 365-f(7), definitions of personal assistant, consumer, and designated representative.

State regulation. 18 NYCRR § 505.28 implements § 365-f. This is the regulation that governs day-to-day CDPAP operations: PA qualifications and exclusions (b)(11); designated representative role (b)(7); self-directing definition (b)(16); eligibility (c); consumer responsibilities (h)(1); fiscal intermediary obligations.

Adjacent state authority. Three other statutes shape CDPAP:

• NY Soc. Serv. Law § 365-a(2)(e), Personal Care Services (PCS) authority, which CDPAP inherits its task list from.
• NY Public Health Law § 3614-c, home care worker wage parity (downstate counties).
• NY Public Health Law § 4403-f, Managed Long Term Care plans, the delivery vehicle for most CDPAP enrollees.

1115 demonstration relationship. New York operates CDPAP through MLTC plans, MAP plans, and PACE, all 1115-authorized. A consumer enrolled in MLTC receives CDPAP authorization from her plan, which contracts with PPL. A consumer outside MLTC (e.g., children, dual-eligibles in fee-for-service Medicaid, or some upstate cases) receives CDPAP authorization through the local department of social services (LDSS), which also contracts with PPL. Either way, PPL is the fiscal intermediary, the W-2 employer of record for the PA, but the plan or LDSS is the entity that authorized the hours and the consumer's plan of care.

This three-actor model (consumer → MLTC plan/LDSS → PPL → PA) is what makes CDPAP work and what makes it confusing. The consumer "employs" the PA in the everyday sense (recruits, schedules, supervises, fires); PPL is the legal employer for tax, insurance, and labor-law purposes; the plan or LDSS authorizes hours and pays PPL.

2. Eligibility Deep Dive

CDPAP eligibility has four parts: (1) underlying Medicaid coverage; (2) assessed need for personal-care services meeting the September 2025 minimum-needs floor; (3) capacity to self-direct or, if non-self-directing, an approved designated representative; and (4) for managed-care enrollees, MLTC enrollment.

1. Medicaid coverage. The consumer must be enrolled in NY Medicaid. For most CDPAP consumers this means Community Medicaid (medical-only Medicaid for individuals living at home or in the community). For dual-eligibles age 65+, the most common pathway is MAGI Medicaid (if income permits), the Medicaid Buy-In for Working People with Disabilities (for working consumers under 65), or Aged-Blind-Disabled (ABD) Medicaid under 18 NYCRR Part 360 (for consumers 65+ or otherwise disabled who exceed MAGI thresholds). 2026 community Medicaid income limit is $1,836/month for a single applicant (roughly 138% FPL) before pooled-income trust depositing.

2. Assessed need, the September 1, 2025 minimum-needs ADL test. Under 25 OHIP/ADM-03 (revised August 22, 2025) and companion MLTC Policy 25.04, new CDPAP applicants effective September 1, 2025 must meet one of these floors:

• Three or more ADLs requiring limited assistance (bathing, dressing, transferring, toileting, eating, mobility); OR
• Two ADLs requiring supervisory assistance if there is a documented diagnosis of Alzheimer's disease or another form of dementia.

This is materially stricter than the pre-2025 standard. Consumers who could previously qualify on the basis of significant IADL needs alone (managing medications, shopping, finances, meal preparation) without ADL needs will not qualify under the new test. The change does not affect existing CDPAP consumers grandfathered before September 1, 2025, but it does affect new applicants and reauthorizations.

The specific tasks that count as ADLs are defined in the Uniform Assessment System for New York (UAS-NY), the assessment instrument used in the NYIAP Community Health Assessment (Section 6 below). "Limited assistance" means the consumer needs hands-on help to complete the task; "supervisory" means the consumer needs verbal cueing or standby supervision to complete it safely.

3. Self-direction or designated representative. Per 18 NYCRR § 505.28(b)(16), a "self-directing" consumer is one "capable of making informed decisions about his or her care… understanding the impact of these choices and assuming responsibility for the results." The capacity assessment is part of the social and nursing assessment in NYIAP.

When the consumer is not self-directing, a designated representative (DR) is required. Per § 505.28(b)(7), the DR is the consumer's parent, legal guardian, or, subject to LDSS approval, a responsible adult surrogate. The DR may be a family member, friend, or neighbor. The DR cannot also be the paid PA (Section 9 below).

4. MLTC enrollment. In counties where MLTC is mandatory (NYC, Nassau, Suffolk, Westchester, Rockland, Orange, and most of upstate), dual-eligibles age 21+ requiring 120+ days of community-based long-term care must enroll in an MLTC plan to access CDPAP. The MLTC Policy 25.04 minimum-ADL test applies at enrollment. Outside mandatory MLTC counties or for excluded populations (e.g., consumers under 21, residents of OPWDD-certified residences, individuals with primary mental health diagnoses receiving OMH services), CDPAP is administered by the local LDSS in fee-for-service Medicaid.

Mental health primary diagnosis. CDPAP requires assessed personal-care need; psychiatric needs alone are insufficient. A consumer whose primary functional limitation is mental-illness-driven (e.g., severe depression, schizophrenia, bipolar disorder) qualifies for CDPAP only if she also has an ADL/IADL deficit that meets the September 2025 minimum. Behavioral-health-only consumers should be evaluated for OMH ACT teams, Personalized Recovery Oriented Services (PROS), Health Home enrollment, or Article 31 clinic services rather than CDPAP.

Children (0-21). Children with active Medicaid (parental MAGI Medicaid; Disabled Child / Family Care under 42 USC § 1396a(e)(3); or Child Health Plus consumers who also qualify for Medicaid) and an assessed personal-care need can access CDPAP. Per current NYSDOH practice, children under 18 submit physician orders directly to their MLTC plan (or LDSS if outside MLTC) and bypass the NYIAP CHA/IPP process. Older minors 18-20 follow the standard NYIAP three-stage path.

Progressive conditions (ALS, Huntington's, advanced MS, Parkinson's with dementia). Standard authorization periods are 6-12 months per 11 OHIP/ADM-6, but per Mayer v. Wing, 922 F. Supp. 902 (S.D.N.Y. 1996), the consumer (or DR) may request interim reassessment at any time based on functional decline, hospitalization, new diagnosis, or caregiver-burden change. ALS Association of Greater New York and the MDA recommend establishing CDPAP eligibility at diagnosis to lock in baseline authorization, then requesting reassessment at clinically-significant decline.

Concurrent OPWDD Self-Direction. Children and adults with developmental disabilities served by NY's Office for People with Developmental Disabilities can receive OPWDD Self-Direction services through OPWDD's separate 1915(c) HCBS waiver. OPWDD Self-Direction is not CDPAP and operates under different family-pay rules. The two programs cannot pay for the same hour, but a consumer may be authorized for both, with each covering distinct hours and services.

3. Who Can Be Paid as a CDPAP Personal Assistant

CDPAP is famously generous on this dimension, but the family-as-PA rules have material exceptions that catch many families by surprise.

Permitted relationships. Per § 365-f and 18 NYCRR § 505.28(b)(11):

• Adult children (21+) of the consumer.
• Adult siblings (18+) of the consumer.
• Grandparents, aunts, uncles, cousins of the consumer.
• Adult grandchildren (18+) of the consumer.
• Friends and neighbors of the consumer.
• Estranged relatives, there is no household-of-residence requirement for non-spouse relatives.
• Step-parents in most cases (though if the step-parent has legally adopted a minor child, the parent-of-minor exclusion can apply).

Excluded relationships. Three categories are absolutely excluded:

1. Spouse of the consumer, regardless of separation status, regardless of household composition, regardless of consumer preference. This is the single most-asked question in CDPAP intake and the single most-frequent disappointment.

   The exclusion is a state-law choice under § 365-f(2)(c), not a federal mandate. 42 USC § 1396n(j)(4) explicitly permits states to elect to pay legally responsible relatives including spouses; New York has chosen not to. A husband cannot be paid through CDPAP to provide personal care to his wife (or vice versa). The workaround for spouses is the VA Veteran-Directed Care (VDC) program for veteran consumers (which does pay spouses) or VA Aid & Attendance pension (cash benefit the veteran can spend any way).

2. Parents of CDPAP consumers under 21. A mother cannot be paid through CDPAP to provide personal care to her 16-year-old child. The rationale is the legally-responsible-relative doctrine, parents are legally responsible for the care of their minor children, and Medicaid does not pay for legally-required care. Once the child turns 21, Chapter 511 of the Laws of 2015 permits parents of adult children 21+ to serve as paid PAs.

3. The designated representative. A person serving as DR for a consumer cannot simultaneously be that consumer's paid PA. § 505.28(b)(11) explicitly prohibits this dual role. The rationale is conflict-of-interest in timesheet approval.

Workarounds and special cases.

• Adult sibling for a minor child. A 22-year-old sister can be the paid PA for her 15-year-old brother. Common arrangement when both parents are working and a sibling provides care.
• Grandparent for a minor child. A grandmother can be the paid PA for her 10-year-old grandchild with disabilities.
• Adult child for a parent. The most common CDPAP arrangement nationwide.
• Court-appointed legal guardian as PA. Per October 23, 2023 NYSDOH guidance (LeadingAge NY summary), a court-appointed guardian may serve as PA only if a different person serves as DR. The guardian-DR-and-PA dual role is prohibited.
• Multiple PAs for one consumer. A consumer can hire multiple PAs to cover different shifts (e.g., one PA for daytime, another for overnight). All PAs must register with PPL.
• Out-of-state PA residence. A PA may live in NJ, CT, PA, or any other state, provided she is legally able to work in the U.S. (I-9 compliance) and physically performs services in NY where the consumer is located. Time4Care EVV captures geolocation at clock-in/clock-out. The PA pays NY State nonresident income tax under NY Tax Law § 631(b)(1) and her home-state tax with a credit for NY taxes paid (e.g., NJ § 54A:4-1). NY has no income-tax reciprocity with NJ, CT, or PA, multi-state PAs file two state returns.

PA qualifications. Per § 505.28(b)(11), a PA must be:

• 18 or older.
• Legally able to work in the U.S. (I-9 documents).
• Capable of performing the personal-care tasks in the consumer's plan of care.
• Not the consumer's spouse, parent of consumer under 21, designated representative, or fiscal-intermediary employee.

No CHHA training required. Unlike PCS aides who need Home Health Aide or Personal Care Aide training, CDPAP PAs require no prior healthcare training, certification, or licensure. This is the program's signature feature: Medicaid trusts the consumer to train her own PA. This also means CDPAP PAs can perform skilled-nursing tasks (within the scope of the consumer's plan of care and consumer-direction) that an untrained aide could not perform under PCS or HHA rules, including, when authorized, medication administration, wound care, and ostomy care.

4. Pay Rates, Wage Parity, and the 13-Hour Live-In Rule

Base wages, effective January 1, 2026 (per NY DOL Home Care Aide Minimum Wage Fact Sheet P105):

These are floors. PPL pays at these rates by default; the consumer cannot direct PPL to pay below the floor but may negotiate a higher PA-specific rate within plan-budget constraints (rare in practice).

Wage parity supplement (downstate only). Under NY Public Health Law § 3614-c, home-care PAs in NYC, Nassau, Suffolk, and Westchester receive a "wage parity" supplemental benefit in addition to the cash base wage. The supplement was originally set at $4.09/hr in NYC and $3.22/hr in Nassau/Suffolk/Westchester when enacted in 2011, those figures still circulate widely online but are not operative law for any year from 2024 forward.

Operative figures (2024-2026):

The reduction from $4.09/$3.22 to $2.54/$1.67 was made by Part HH of Chapter 57 of the Laws of 2023, effective January 1, 2024, as a partial offset against the home-care minimum-wage increase enacted in the same budget. Wage parity is delivered as a benefits-equivalent supplement (health, retirement, paid time off) rather than cash on every paycheck. PPL provides the supplement through its benefits package (BasicWellness health plan in wage-parity counties, MEC/Flex Card supplemental coverage, 401(k), holiday pay, paid sick leave).

Live-in PAs, the Andryeyeva 13-hour rule. When a PA works a 24-hour live-in shift and is "afforded" 8 hours of sleep (with 5 uninterrupted hours actually slept) plus 3 hours of meal-break time, the PA is legally compensated for 13 hours of work per 24-hour shift, not 24. The rule was upheld by the NY Court of Appeals in Andryeyeva v. New York Health Care, Inc., 33 N.Y.3d 152 (2019), consolidated with Moreno v. Future Care Health Services, Inc., reversing the First Department's conflict in Tokhtaman v. Human Care, LLC, 149 A.D.3d 476 (2017).

The four conditions, anchored in NY DOL Op. Letter RO-09-0169 (March 11, 2010) and 12 NYCRR § 142-2.1(b):

1. The shift must be 24 hours.
2. The PA must be afforded at least 8 hours for sleep.
3. The PA must in fact get 5 uninterrupted hours of actual sleep.
4. The PA must be afforded 3 hours of meal-break time.

If any of these conditions is not met (e.g., the consumer wakes the PA repeatedly through the night and the PA does not get 5 uninterrupted hours), the entire 24-hour shift becomes compensable. Documenting interruptions matters: PPL's Time4Care app permits the PA to log mid-shift wake events, which support pay disputes if the conditions break down.

Difficulty-of-care exclusion, IRS Notice 2014-7. Live-in PAs whose payments are "qualified Medicaid waiver payments" under IRC § 131(c) exclude those payments from federal gross income. This is the single most valuable tax benefit available to family caregivers in America. To qualify:

• The PA and consumer must share a household residence (the same home).
• The PA's services must be authorized under a Medicaid program that pays family caregivers (CDPAP, NHTD, TBI, Veteran-Directed Care, or other 1915(c)/1915(j)/State Plan PCS waivers).

NY State conforms; the wages are also excluded from NY taxable income. SSI excludes per SSA POMS SI 00830.555. SSDI excludes from substantial-gainful-activity per SSA POMS DI 10515.015. SNAP excludes. HUD does not, Section 8 income includes difficulty-of-care payments. EITC inclusion election under IRS Notice 2020-15 (post-Feigh v. Commissioner, 152 T.C. No. 15 (2019)) lets the PA elect to include the excluded payments as earned income for EITC purposes, often a several-thousand-dollar tax benefit for low-income live-in caregivers.

PPL reports difficulty-of-care payments on Form W-2 Box 12 with code II for live-in PAs who self-attest to live-in status.

5. The NYIAP Three-Stage Assessment

Since May 1, 2022, all CDPAP and PCS applicants must go through the New York Independent Assessor Program (NYIAP) under 22 OHIP/ADM-01 before service authorization. NYIAP is administered by Maximus (operating as NY Medicaid Choice) under contract with NYSDOH. The process has three stages and an appeals overlay.

Stage 1, Community Health Assessment (CHA). A registered nurse contracted through NYIAP visits the consumer in her home (or by video for some upstate cases) and conducts a comprehensive functional assessment using the Uniform Assessment System for New York (UAS-NY). The CHA documents the consumer's ADL and IADL status, cognition, mood, social supports, medications, and skilled-nursing needs. Typical CHA visit lasts 90-120 minutes. The CHA is the gateway: it produces the UAS-NY data record on which all later authorization decisions are built.

Stage 2, Independent Practitioner Panel (IPP) Practitioner Order. A medical practitioner (physician, nurse practitioner, or physician assistant) on the IPP, independent of the consumer's treating provider and the MLTC plan, reviews the CHA results, examines the consumer (in person or by telehealth), and issues a practitioner order documenting medical necessity for personal-care services. The IPP order is required separately from the consumer's treating physician's records. The IPP determines (i) whether the consumer meets the September 2025 minimum-needs ADL test, (ii) whether the consumer is self-directing or requires a DR, and (iii) what level of services (PCS Level I, PCS Level II, or CDPAS) is medically necessary.

Stage 3, Independent Review Panel (IRP), only when 12+ hours/day are requested. When the requested service authorization averages 12 or more hours per day, or any live-in case, the case is automatically referred to the Independent Review Panel, a separate medical-review panel staffed with NYSDOH-contracted clinicians. The IRP reviews the case for medical necessity, Olmstead v. L.C., 527 U.S. 581 (1999) community-integration, and consistency with the consumer's plan of care. The IRP is a review for medical necessity, not a 60-hour cap or a hard ceiling on hours. The IRP can approve hours as authorized, modify the authorization, or recommend an alternative care plan.

Practical timing. End-to-end NYIAP processing takes 2-6 weeks under normal volumes. CHA scheduling typically takes 1-2 weeks; IPP order typically 1-2 weeks after CHA; IRP review (when triggered) adds 1-2 weeks. Expedited processing is available for hospital discharges and for consumers with rapidly deteriorating conditions, request expedited review at intake.

Reassessment timing. Standard CDPAP authorizations are 6-12 months. Reassessments use the same three-stage process (CHA, IPP, optional IRP). Per Mayer v. Wing, the LDSS or MLTC plan must conduct a new social and nursing assessment plus a new physician's order at each reauthorization; the plan cannot reduce hours without a new assessment supporting the reduction.

Three-layer appeals when hours are reduced.

1. MLTC plan internal appeal first. Per 42 CFR § 438.402, the consumer must exhaust the plan's internal appeal before fair hearing in most cases. Plans must respond within 30 days (standard) or 72 hours (expedited).

2. NYSDOH External Appeal (where applicable for medical-necessity denials in MLTC). Available for treatment-denial-style decisions; less commonly used for CDPAP hours-reduction appeals, which usually move directly to fair hearing.

3. Fair Hearing, NY OTDA Office of Administrative Hearings under 18 NYCRR Part 358.

   • Filing deadline: 60 days from notice (18 NYCRR § 358-3.5).
   • Aid Continuing under 18 NYCRR § 358-3.6: services continue at the prior authorization level pending hearing decision if the hearing request is filed (a) before the effective date of the action, OR (b) within 10 days of the agency's mailing of the notice. Per Mayer v. Wing, the agency must provide written notice of the proposed reduction with all required elements (effective date, reason, regulatory citation, fair-hearing rights, and Aid Continuing instructions); a defective notice tolls the 60-day window and entitles the consumer to retroactive Aid Continuing.

Notice requirements. 18 NYCRR § 358-3.3 requires notice to be timely (10 days before effective date for adverse actions), adequate (sufficient detail to allow defense), and specific (cite regulation, factual basis, and action taken). A defective notice is independently actionable and, with Mayer v. Wing, supports a request for retroactive Aid Continuing.

Practical NYIAP tips for families.

• Get a baseline assessment on file early, even before you think you need 24/7 care. The UAS-NY data record is the foundation for every later authorization.
• Document everything before the CHA visit. Keep a 7-day care log showing what tasks the consumer needs help with, when, and how often. Bring it to the CHA.
• Bring a witness or advocate. A family member who has been providing daily care knows what the consumer needs; the consumer in front of an unfamiliar nurse may understate her needs.
• Don't accept a defective notice. If the reduction notice is missing the regulatory citation, the effective date, or the Aid Continuing language, request a corrected notice and document the request.
• File for fair hearing immediately when in doubt. Aid Continuing is preserved if the request is filed within 10 days of the notice.

6. Public Partnerships LLC (PPL) Onboarding

Since April 1, 2025, PPL is the W-2 employer of record for every CDPAP PA in New York. Onboarding involves four distinct steps for the consumer and four for the PA.

Consumer onboarding.

1. Plan or LDSS authorizes services, the MLTC plan (or LDSS for fee-for-service consumers) issues an authorization to PPL specifying the consumer's hours per week and effective date.

2. Consumer registers with PPL, through PPL's online portal at https://pplfirst.com/programs/new-york/ny-consumer-directed-personal-assistance-program-cdpap/ or by phone. Required: Medicaid CIN, plan information, contact information, designated representative information (if applicable), and consumer/DR signed memorandum of understanding (MOU).

3. Consumer recruits and selects PAs, the consumer chooses who she wants as her PA(s). PPL does not assign PAs; the consumer recruits.

4. Consumer maintains the employment relationship, schedules, supervises, evaluates, and (if needed) terminates the PA. PPL is the legal employer; the consumer is the everyday employer. The consumer or DR approves PA timesheets weekly.

PA onboarding. Required forms:

• Form I-9 (Employment Eligibility Verification, USCIS), establishes legal authorization to work in the U.S.
• Form W-4 (Federal Income Tax Withholding), federal withholding allowances.
• Form IT-2104 (NY State Income Tax Withholding), state withholding allowances.
• Form IT-2104.1 (Certificate of Nonresidence, if applicable), submitted by NJ, CT, or PA-resident PAs to allocate withholding correctly.
• PA Application, PPL's CDPAP-specific application capturing prior-FI history (for transition continuity), PPL benefits enrollment elections, EVV setup.
• Direct Deposit Authorization, bank routing/account for biweekly direct deposit (paper checks available but slower).
• Difficulty-of-Care self-attestation (live-in PAs only), for IRS Notice 2014-7 W-2 Box 12 Code II reporting.
• Background check authorization, PPL conducts a criminal-background check; certain offenses (e.g., recent crimes against vulnerable populations) disqualify.
• Mandatory PA orientation, covers PA responsibilities under 18 NYCRR § 505.28(b)(11), permitted vs. prohibited tasks (PAs cannot perform tasks outside the consumer's plan of care), EVV use, timesheet submission, and consumer-direction principles.

EVV, Time4Care. PPL's proprietary mobile app (NOT HHA Exchange, which serves other states' Medicaid HCBS programs) is the federally-mandated Electronic Visit Verification tool under 42 USC § 1396b(l)(1) (added by 21st Century Cures Act § 12006, P.L. 114-255). The PA clocks in at the start of each shift and clocks out at the end; the app captures GPS location, timestamps, and task list.

The consumer or DR must approve each timesheet by 12:00 noon ET every Sunday for the prior week. Timesheets approved by Sunday noon are paid on the following biweekly cycle; missed approvals delay pay. Disputes (PA submitted hours the consumer believes are inflated; consumer believes PA worked unrecorded hours) are resolved through PPL's dispute-resolution protocol.

Pay cadence. Biweekly. PPL's pay schedule operates two weeks in arrears: hours worked Sunday through Saturday are approved by the following Sunday; payment for that week pays out approximately 7-10 days after approval.

Onboarding timeline. From consumer plan-authorization to PA's first paycheck: typically 2-4 weeks. Bottlenecks: (i) I-9 documentation for PAs without standard ID (passport, driver's license + Social Security card, etc.); (ii) background-check delays for PAs with prior arrests requiring disposition records; (iii) consumer's MOU sign-off.

The Engesser-era enrollment rules. The October 3, 2025 Engesser v. McDonald class settlement (Section 11 below) established protections for consumers and PAs who experienced enrollment delays during the April 1, 2025 transition. 25 OHIP/ADM-02 governs SFI Payment Policy for late registrants, addressing PAs who provided care during the transition but had not yet completed PPL onboarding. The settlement provides retroactive pay mechanisms and prospective enrollment protections through the end of 2026.

7. Hours Authorization, Fair Hearings, and Aid Continuing

Three persistent CDPAP myths need correction:

Myth 1: There is a 60-hour weekly cap on CDPAP PA hours. Not law. No statewide 60-hour weekly cap exists in any NYSDOH OHIP/ADM directive, MLTC Policy memo, GIS message, statute, or regulation as of May 2026. What exists:

1. Authorized hours under UAS-NY assessment. Hours are individually authorized based on the CHA + IPP + IRP outputs, with no statutory ceiling. Hours can range from 4-8 hours/week to 24 hours/day live-in.

2. MLTC plan-level overtime authorization. Many plans require prior authorization when an individual PA's hours exceed plan-set thresholds (40 hours/week is common; some plans use 60). This is plan utilization management, not a state cap. A consumer can hire two PAs, each working 40 hours/week, for 80 hours of total coverage with no plan-level OT trigger.

3. NYIAP IRP threshold at 12+ hours/day. Average daily authorization of 12+ hours triggers IRP review for medical necessity. This is a review, not a cap.

4. 18 NYCRR § 505.14(a)(5) Level I PCS 8-hour cap. Applies only to PCS Level I (nutritional and environmental support, no hands-on care). Does not apply to CDPAP.

5. 18 NYCRR § 505.14(b)(5)(iii) over-24-hour utilization review. OBRA-era PCS rule integrated into the IRP framework.

Myth 2: An MLTC plan can reduce hours without notice. Not law. § 358-3.3 requires timely (10-day), adequate, and specific notice. Mayer v. Wing makes a defective notice independently actionable.

Myth 3: If you appeal, services stop while you wait for the hearing. Not law. § 358-3.6 Aid Continuing preserves the prior authorization level pending hearing if the request is filed before the effective date or within 10 days of mailing.

Hours-reduction playbook. When a consumer receives a notice proposing to reduce CDPAP hours:

1. Read the notice carefully. Verify that it includes effective date, reason for reduction, regulatory citation, fair-hearing rights, and Aid Continuing instructions. Missing elements = defective notice.

2. File for plan internal appeal within 60 days. Use the plan's appeal form or written letter. Request expedited review if the consumer's health is at risk without the prior level of services.

3. File for fair hearing within 60 days (typically simultaneous with internal appeal). Use NY OTDA's online portal at https://otda.ny.gov/oah/ or call 1-800-342-3334. Request Aid Continuing in the hearing-request form.

4. Gather documentation. UAS-NY records, treating physician's letters supporting medical necessity, 7-day care logs, prior MLTC authorizations, prior CHA reports.

5. Consider legal representation. New York Legal Assistance Group (NYLAG), Legal Aid Society, Empire Justice Center, and county legal-aid organizations represent CDPAP consumers in fair hearings without charge. NY Connects (1-800-342-9871) refers consumers to local legal-aid resources.

6. Attend the hearing. Fair hearings are held by phone, video, or in person at OTDA hearing offices. Decisions issued within 60-90 days of hearing.

What a successful hearing produces. An OTDA Administrative Law Judge can: reverse the plan's decision and restore prior authorization; modify the decision to authorize a different level than what the plan proposed; remand to the plan for a new assessment with specific instructions; or affirm the plan's decision (in which case the consumer can appeal to Article 78 in NY Supreme Court).

8. The Designated Representative Role

The DR is the most-misunderstood role in CDPAP. A DR can do or be a great deal, and cannot do or be one specific thing.

Definition. Per 18 NYCRR § 505.28(b)(7):

• For self-directing consumers: an adult to whom the consumer has voluntarily delegated authority to instruct, supervise, and direct the personal assistant. Optional.
• For non-self-directing consumers: the consumer's parent, legal guardian, or, subject to LDSS approval, a responsible adult surrogate. Required.

Who can serve as DR.

• Adults willing and able.
• Parents, legal guardians, court-appointed conservators, or LDSS-approved responsible adult surrogates.
• May be a family member, friend, or neighbor.
• Cannot be: a fiscal-intermediary employee or representative; a person legally responsible for the consumer's care (e.g., spouse, parent of a minor child) where that responsibility creates a conflict; the same consumer's paid PA.

Why the DR-cannot-be-PA rule matters so much. § 505.28(b)(11) explicitly bars the DR from also being the consumer-directed personal assistant. This is the single most important conflict-of-interest safeguard in CDPAP, designed to prevent self-dealing in timesheet approval, a person approving her own hours.

A family with one available adult who could fill either role must choose: DR (unpaid, supervisory) OR PA (paid, hands-on). Many families use a two-person split: one adult child as DR (manages scheduling, paperwork, plan communication) and another adult child or relative as PA (performs hands-on care).

DR duties (per § 505.28(h)(1), consumer responsibilities the DR assumes when the consumer cannot self-direct).

1. Recruiting, hiring, and training the PA.
2. Determining the PA's schedule.
3. Supervising and directing the PA.
4. Terminating the PA when needed.
5. Notifying the LDSS or MLTC plan of medical or social changes.
6. Notifying PPL of PA employment-status changes.
7. Attesting to and approving timesheets.
8. Ensuring substitute coverage during PA absences.
9. Entering into and complying with required memoranda of understanding with PPL.

DR liability. The DR is not personally liable for Medicaid overpayments arising from good-faith timesheet approval, but is liable for fraud, misrepresentation, or willful misuse of the program.

The 2024 budget proposal that did not pass. Governor Hochul's FY 2024-25 executive budget proposed eliminating the non-self-directing CDPAP pathway, barring CDPAP for individuals with dementia, TBI, or significant cognitive impairment unless they could direct care themselves. This proposal was not enacted in the final FY 2024-25 budget. The DR framework remains operative. Watch FY 2027 budget cycle for any revival.

9. PA Workplace Rights (Workers Comp, UI, Paid Sick Leave, Paid Family Leave)

PPL's W-2 employer-of-record status since April 1, 2025 brought a suite of mandatory employment-law protections that were inconsistently provided under the prior 600-FI structure.

Workers' Compensation (NY Workers' Compensation Law § 10). PPL provides workers' compensation insurance covering all PAs for work-related injuries. Coverage starts on first day of work; the PA does not contribute to the premium. Claims handled through PPL's WC carrier.

Unemployment Insurance (NY Labor Law Article 18, § 510 et seq.). PPL pays NY State unemployment insurance contributions and federal FUTA. PAs who lose CDPAP employment (consumer's death, hospitalization, or termination decision) can file UI through NY DOL with PPL as employer of record. Pre-PPL, this was a chronic problem because hundreds of small FIs handled UI inconsistently or not at all.

NY Statewide Paid Sick Leave (NY Labor Law § 196-b). 1 hour of sick leave per 30 hours worked, up to 56 hours/year for employers with 100+ employees (PPL qualifies). PPL provides this as PTO accruing at 1 hour per 30 hours.

NYC Paid Sick Leave (NYC Earned Safe and Sick Time Act, NYC Admin. Code § 20-911 et seq.). PAs working in NYC get the more generous of state and city floors. NYC also requires up to 32 hours of unpaid sick time per calendar year for some workers, applies to NYC-borough PAs.

NY Paid Family Leave (NY Workers' Compensation Law § 200 et seq.). Up to 12 weeks of job-protected paid leave at 67% of average weekly wage (capped at 67% of statewide average weekly wage). Employee-funded via small payroll deduction. PAs employed by PPL for 26 consecutive weeks (or 175 days for part-time) are eligible. Used for: bonding with a new child, caring for a family member with serious health condition, military exigency. Note: an active CDPAP PA cannot use PFL to care for the same CDPAP consumer, that would be double-payment. PFL is for caring for other family members.

NY Statutory Short-Term Disability (WCL § 200 et seq.). Up to 26 weeks at 50% of average weekly wage, capped at $170/week (statutory minimum since 1989, not indexed). Funded by employee premium capped at 0.5% of weekly wages.

PPL employee benefits beyond statutory floor.

• 401(k) plan, no employer match.
• Holiday pay for eight federal holidays.
• BasicWellness health plan for part-time workers in wage-parity counties.
• MEC/Flex Card supplemental plan.
• Minimum Value Plan for full-time PAs (130+ hours/month).
• Difficulty-of-Care W-2 reporting (Box 12, Code II) for live-in PAs whose payments are excludable under IRS Notice 2014-7.

FLSA coverage. CDPAP PAs are non-exempt FLSA-covered employees under 29 USC §§ 201 et seq. This is the basis for the Calderon and Flanagan class actions (Section 11 below). PPL must pay overtime at 1.5× the regular rate for hours over 40 in a workweek (with the Andryeyeva live-in shift exception in Section 4).

10. The 2025 Engesser Settlement and the PPL Transition

The April 1, 2025 transition from approximately 600 fiscal intermediaries to PPL alone was the largest single change in CDPAP's history. It triggered immediate litigation.

Engesser v. McDonald, 1:25-cv-01689 (E.D.N.Y., Hon. Frederic Block). Filed by NYLAG and co-counsel on March 26, 2025, Engesser challenged the rollout: thousands of consumers and PAs experienced enrollment gaps, PA timesheet rejections, lost wages, and service interruptions because they had not yet completed PPL onboarding when their prior FIs ceased operations on April 1.

Procedural history.

• March 31, 2025: Temporary Restraining Order (ECF No. 37) requiring NYSDOH to maintain payments to PAs who had been enrolled with prior FIs and who had filed PPL applications by April 1, regardless of whether onboarding was complete.
• April 11, 2025: Preliminary Injunction with detailed enrollment-protection FAQs.
• August 2025: Class settlement preliminary approval.
• October 3, 2025 (ECF No. 140): Final approval order, certifying three subclasses and approving comprehensive relief.

Class definition. Three subclasses, all comprising consumers and PAs from March 2025 forward:

1. Consumers whose CDPAP services were interrupted or terminated during the transition.
2. PAs who provided services during the transition but did not receive full timely pay.
3. Consumers and PAs whose PPL enrollment was delayed beyond the rollout's intended timeframe.

Five categories of relief.

1. Retroactive pay for PAs who provided services during gaps but had not yet been paid by PPL. PAs file claim forms with timesheet documentation.
2. Service-restoration protocols for consumers whose services were interrupted. Consumers receive priority-track PPL onboarding.
3. Continued late-registrant protections through 2026 (codified in 25 OHIP/ADM-02). Consumers and PAs who experience future enrollment delays can invoke the same protections.
4. NYSDOH oversight reporting to the court through 2026, including monthly reports on PPL onboarding metrics, complaint volumes, and resolution times.
5. Attorneys' fees and class-administration costs paid by NYSDOH.

How class members file claims. Class members do not typically file affirmative claim forms, relief is automatic upon class membership for service-restoration. PAs seeking back pay file claim forms with timesheet documentation through NYLAG's class-administration process at https://nylag.org/engesser/. NYLAG class-administration contact: 212-946-0359.

Status as of May 2026. Most class-action relief has been distributed; the settlement's late-registrant protections remain operative through end of 2026. NYSDOH continues to file court-ordered monthly compliance reports.

Implications for new CDPAP applicants. If you apply for CDPAP after May 4, 2026, the Engesser class is closed for new entrants, but the substantive protections (priority onboarding, retroactive pay for documented service gaps) remain available administratively under 25 OHIP/ADM-02. If your PPL onboarding is delayed beyond 30 days from your plan's authorization, request escalation through your MLTC plan and document the delay for any back-pay claim.

11. The 2025-2026 PA Wage-Theft Class Actions (Calderon and Flanagan)

Two parallel class actions filed in April 2025 allege that PPL underpaid CDPAP PAs during the transition.

Calderon v. Public Partnerships, LLC (E.D.N.Y., filed April 25, 2025). Lead counsel: Legal Aid Society and Katz Banks Kumin LLP. Allegations:

• Deleted timesheets after PA submission, leading to underpaid hours.
• Missed minimum wage for some pay periods.
• Missed overtime for hours over 40 in workweeks.
• Missed wage-parity supplement for some downstate PAs.
• Failure to provide accurate wage statements per NY Labor Law § 195(3) (NY Wage Theft Prevention Act).

Flanagan v. Public Partnerships, LLC, 6:25-cv-06225 (W.D.N.Y., filed April 23, 2025). Lead counsel: Poricanin Law. Parallel allegations targeting upstate PA wage practices.

Status as of May 2026. Motions to dismiss pending; class certification not yet ruled. Settlement discussions reportedly underway in Calderon; Flanagan in earlier procedural stage.

For PAs who believe they were underpaid in 2025 or 2026. Document with: paystubs, timesheets (Time4Care exports), pre-transition FI records, and a written log of hours worked by week. Contact:

• Legal Aid Society (NYC; Calderon class): https://legalaidnyc.org/
• Poricanin Law (statewide; Flanagan class): https://www.poricaninlaw.com/
• NY Department of Labor wage-theft complaint: https://dol.ny.gov/wage-theft/

The Wage Theft Prevention Act provides for liquidated damages on top of the unpaid wages, plus attorneys' fees. PAs need not be class members to file an individual NY DOL wage-theft complaint.

12. APS, Fraud Safeguards, and Capacity Issues

CDPAP's consumer-direction principle, Medicaid trusts the consumer to direct her own care, creates intentional flexibility and unintentional vulnerability. Two scenarios warrant particular family attention.

Scenario A: Consumer with diminished capacity, family acting as DR. When a family member serves as DR for an elderly consumer with dementia, the family member effectively controls the CDPAP services on the consumer's behalf. The conflict-of-interest safeguards (§ 505.28(b)(11), DR cannot be paid PA) prevent the most obvious abuses, but other risks remain: a DR may make care-management decisions that prioritize the family's preference over the consumer's; a DR may enroll a relative as PA who delivers inadequate care; a DR may allow the consumer's needs to be underserved.

Scenario B: Suspected exploitation. Phantom hours (DR or PA reports hours not actually worked); wage diversion (DR takes the PA's wages instead of letting the actual caregiver receive them); coercion of elderly consumers into CDPAP enrollment to channel Medicaid funds; misuse of consumer Medicaid funds.

Detection mechanisms.

• PPL EVV with geolocation (Time4Care), phantom-hour detection; GPS mismatch flags.
• MLTC plan utilization review, flags outliers vs. care plan.
• NYSDOH Office of the Medicaid Inspector General (OMIG), Medicaid fraud audits per Soc. Serv. Law § 35-a; fraud hotline 1-877-87-FRAUD (1-877-873-7283).
• Adult Protective Services (APS) investigations triggered by hospital, neighbor, or law-enforcement reports.

APS framework.

• NY Soc. Serv. Law § 473 authorizes APS investigations and protective services for adults 18+ unable to protect themselves due to physical or mental impairment.
• § 473(5) requires APS workers to report suspected criminal offenses to law enforcement.
• § 473-b grants civil immunity for good-faith reporting of suspected elder abuse.
• NY does not have universal mandated reporting of elder abuse, only certain professionals (e.g., physicians for incapacitated adults under Penal Law § 260.32) are mandated reporters. Pending legislation (S.6136-2025) would expand mandated reporting.

When and how to contact APS.

• Statewide referral hotline: 1-844-697-3505.
• NYC HRA Adult Protective Services: 212-630-1853.
• Local DSS APS unit, county-by-county outside NYC.

For families at the start of CDPAP enrollment. Consider:

• Power of attorney for financial decisions, executed before capacity declines.
• Health care proxy for medical decisions, also executed before decline.
• Two-family-member oversight of CDPAP, one as DR, another reviewing timesheets and Time4Care data periodically.
• Annual capacity reviews with the treating physician documenting consumer's continuing self-direction or non-self-direction status.

13. Federal Landscape, OBBBA Section 71121 and Beyond

The One Big Beautiful Bill Act (OBBBA), Public Law 119-21, signed by President Trump on July 4, 2025, contains the most consequential federal Medicaid reforms in a decade. Three sections directly or indirectly affect CDPAP.

Section 71121, New 1915(c) HCBS Waiver Flexibility (effective July 1, 2028).

• Allows states to establish 1915(c) HCBS waivers for individuals who do not require an institutional level of care.
• Removes the long-standing nursing-facility / ICF-IID level-of-care requirement that has anchored 1915(c) since 1981.
• Requires states to demonstrate new waivers will not increase the average wait time for institutional-LOC populations on existing waiting lists.
• Appropriates $50 million for FY 2026 for CMS implementation; $100 million for FY 2028 for state distribution.
• CMS implementation guidance issued November 18, 2025 (CMS State Medicaid Director Letter).

Direct effect on CDPAP: limited. CDPAP operates under § 1905(a)(24) state plan PCS authority and the 1115 MRT demonstration, not 1915(c). Section 71121 expands 1915(c) flexibility, which affects NY's NHTD and TBI waivers more directly than CDPAP.

Section 71117, Provider Tax Restrictions. Reduces the Medicaid provider-tax safe harbor from 6% to 3.5% by 2032 (gradual reduction). NY's Managed Care Organization (MCO) tax, enacted in 2024, generates roughly $3.7B over two years. Reduced provider-tax revenue means less state Medicaid match capacity, which can pressure CDPAP capitation rates downward.

Section 71112, Work Requirements. Imposes work requirements (80 hours/month of work, education, or volunteer activity) on non-disabled adults age 19-64 enrolled in Medicaid Expansion. CDPAP consumers are typically disabled and exempt, but family members applying for community Medicaid may face new requirements.

Section 71113-71115, Eligibility Redeterminations. Redeterminations every 6 months instead of annual, increases administrative burden and creates more churn risk.

Federal-funding reduction estimates. Independent analyses estimate NY will lose a substantial share of federal Medicaid funding over the coming decade (see, e.g., the Rockefeller Institute's January 2026 analysis). The Hochul administration has stated NY cannot fully backfill federal cuts. Watch FY 2027 enacted budget (April 2026) and FY 2028 executive budget (January 2027) for OBBBA-driven CDPAP rate or eligibility adjustments.

As of May 2026, no specific CDPAP rate or eligibility cut has been attributed to OBBBA. The framework risks materialize over the 2026-2028 budget cycles.

14. 2026 CDPAP Figures Table

15. Frequently Asked Questions

A few more common questions:

Can my mother be paid to care for my 12-year-old child with disabilities? No. Parents of CDPAP consumers under 21 cannot be paid PAs. An adult sibling, grandparent, aunt, uncle, cousin, or family friend can be paid for the same child.

What if I'm a consumer with dementia, can I still get CDPAP? Yes, with a designated representative. The 2024 budget proposal that would have eliminated the non-self-directing pathway was not enacted. The DR framework remains operative. The September 1, 2025 minimum-needs ADL test applies: 2 ADLs supervisory assistance is sufficient with documented Alzheimer's/dementia.

How fast can I get CDPAP set up? Consumer onboarding from MLTC plan authorization to first paid PA shift: 2-6 weeks. NYIAP CHA + IPP: 2-4 weeks. PPL onboarding: 2-4 weeks. Expedited processing available for hospital discharges and rapidly deteriorating conditions.

Does CDPAP pay for skilled nursing tasks? Yes, when the consumer's plan of care includes them and the consumer directs the PA in their performance, including, when authorized, medication administration, wound care, ostomy care, and PEG-tube feeding. CDPAP PAs can perform tasks that PCS aides legally cannot.

I'm a PA, am I owed back wages from PPL? If you provided services during the April 1, 2025 transition or after and were not fully paid, you may be a class member in the Engesser settlement (NYLAG class administration: 212-946-0359) or in the Calderon or Flanagan wage-theft class actions. Document with paystubs, Time4Care exports, and a written hours log. The NY DOL wage-theft complaint pathway is independent.

Can my PA live in NJ but work in NY? Yes, provided the PA is legally able to work in the U.S. and physically performs services at the consumer's NY location. The PA pays NY State nonresident income tax and home-state tax with a credit for NY taxes paid (no income-tax reciprocity with NJ, CT, or PA).

Can I have multiple PAs? Yes. Many consumers hire multiple PAs to cover different shifts. Each PA must register with PPL.

What's the difference between CDPAP and PCS? PCS is the agency-vendor model, a Medicaid-contracted agency sends a credentialed home health aide or personal care aide to your home. The aide is the agency's employee; you do not choose, hire, schedule, or supervise. CDPAP is the consumer-directed model, you choose, hire, schedule, supervise, and direct your own PA, who does not need agency credentials.

What's the difference between CDPAP and OPWDD Self-Direction? OPWDD Self-Direction is for individuals with developmental disabilities, operates under OPWDD's separate 1915(c) HCBS waiver, and has different family-pay rules (more permissive than CDPAP for some family relationships). CDPAP is the personal-care services consumer-direction option. Some consumers qualify for both and use them in combination.

Can CDPAP be combined with NHTD or TBI waiver services? Yes. The NHTD and TBI waivers are 1915(c) waivers without their own participant-direction option. Consumers eligible for NHTD or TBI commonly enroll in CDPAP for their personal-care hours and receive other waiver services (service coordination, environmental modifications, assistive technology) through the waiver itself.

What happens if my CDPAP consumer dies? The PA's CDPAP employment ends. PA may file for unemployment insurance through NY DOL with PPL as the employer of record. Final paycheck pays out on PPL's standard biweekly cycle.

What happens if my consumer goes to the hospital? CDPAP services pause during inpatient hospitalization (Medicaid does not double-pay for personal care during inpatient stay). PA pay resumes when consumer returns home. PA may file UI for the gap if it exceeds standard PPL bridge protocols.

Can I be a CDPAP PA for more than one consumer? Yes, subject to FLSA and overtime rules. PPL aggregates hours across all consumers a PA serves and applies the 40-hour overtime threshold to the aggregate. A PA working 20 hours/week for two different consumers is paid straight time for both; a PA working 30 hours for one and 20 for another is paid 10 hours overtime.

What if I want to fire my PA? You (or your DR) can terminate the employment relationship at any time. Notify PPL of the termination. The PA may be eligible for unemployment insurance.

What if my PA quits without notice? Notify PPL. Your MLTC plan or LDSS may provide bridge services through a PCS agency until you can hire a replacement PA. Ensure the consumer's safety needs are met during the transition.

16. Resources and Contacts

Public Partnerships LLC (PPL).

• New York CDPAP main page: https://pplfirst.com/programs/new-york/ny-consumer-directed-personal-assistance-program-cdpap/
• PA Resources: https://pplfirst.com/cdpap-resources-personal-assistants/
• Customer Service: 1-833-247-5346

NYSDOH.

• CDPAP main page: https://www.health.ny.gov/health_care/medicaid/program/longterm/cdpap/
• 25 OHIP/ADM-03 (minimum-needs test): https://www.health.ny.gov/health_care/medicaid/publications/pub2025adm.htm
• NYIAP page: https://www.health.ny.gov/health_care/medicaid/redesign/nyiap/

NYIAP / NY Medicaid Choice.

• Phone: 1-855-222-8350.
• Website: https://nymedicaidchoice.com/

Legal services and class-action contacts.

• NYLAG Engesser settlement: 212-946-0359; https://nylag.org/engesser/
• Legal Aid Society (Calderon class): https://legalaidnyc.org/
• Empire Justice Center: https://empirejustice.org/
• NY Connects (statewide referrals to legal aid and aging services): 1-800-342-9871.

Fair hearings.

• NY OTDA Office of Administrative Hearings: 1-800-342-3334; https://otda.ny.gov/oah/

Adult Protective Services and fraud reporting.

• NY APS statewide hotline: 1-844-697-3505.
• NYC HRA APS: 212-630-1853.
• OMIG Medicaid fraud hotline: 1-877-87-FRAUD (1-877-873-7283).

VA.

• VA Caregiver Support Line: 1-855-260-3274.
• VA Aid & Attendance Pension: https://www.va.gov/pension/aid-attendance-housebound/
• VA PCAFC: https://www.caregiver.va.gov/
• ACL Veteran-Directed Care: https://acl.gov/programs/veteran-directed-home-and-community-based-services/

Learn More

• How to Get Paid as a Family Caregiver in New York
• New York Community Medicaid
• New York Managed Long-Term Care (MLTC)
• New York Medicaid Eligibility & Income Limits
• New York Pooled Income Trusts
• New York Medicaid Overview

Find personalized help navigating New York Medicaid 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.