Consumer Directed Personal Assistance Program in New York State

Presentation to the Department of Health Discharge Planning Workgroup

June 2, 2010

What is Consumer Directed Personal Assistance (CDPAP)?

CDPAP is a Medicaid funded Personal Care program that empowers self-directing seniors, people with disabilities or their designated representatives to recruit, hire, train, supervise and terminate their choice of personal assistant home care worker. Each local County Department of Social Services assesses potential enrollees to determine if they are suitable for CDPAP and to determine the appropriate number of personal care hours. The contracted fiscal intermediary (FI) company provides the necessary supports to administer the program such as facilitate paperwork, payroll, benefits and administration.

What are some of the Advantages of CDPAP?

Since consumers or designated representatives:

  • Have complete choice as to who the worker is there is a much higher level of satisfaction;
  • Manage the direct employment components they are able to schedule their care to suit their personal situation such as the time to get out of or get into bed;
  • Recruit to their own criteria there is a much larger pool of potential workers (no certification required);
  • Through the exemption to the Nurse Practice Act consumers may train their personal assistants to perform tasks that fall under the scope of nursing;
  • By eliminating unnecessary bureaucracy CDPAP costs are substantially less expensive than other forms of home care.

What are some of the Challenges of CDPAP and Hospital Discharge?

TIME! Discharge is the result of every hospital admittance so the process must begin ASAP!

  • County assessments: many counties have limited resources and it may take time for a county to send the personnel to complete the mandatory prior approval assessments before discharge is imminent;
  • Setting up the CDPAP program: if the county has authorized CDPAP, the fiscal intermediary must provide the consumer or designated representative with a program orientation;
  • Setting up the CDPAP program: the consumer or designated representative must recruit staff (if there is no one in mind) and train them in the appropriate tasks.

Tackling the Challenges of CDPAP and Hospital Discharge

  • Again, TIME is your enemy! Discuss this potential model with the individual ASAP – if he or she needs more information it would be best for him or her to speak with the fiscal intermediary staff to provide nuanced details and support to assist the person to make an informed choice;
  • Work with the appropriate fiscal intermediary to ensure the process flows seamlessly. Different FIs offer different levels of recruitment assistance that assist consumers or designated representatives;
  • Work with local County Departments of Social Services identifying individuals who are at risk for institutionalization to potentially prioritize those assessments.

For More Information:

Go to our website:

Call Lew Dubuque, Executive Director, 518-813-9537 or Constance Laymon, President, 518-598-9490