What CDPAP is — and why autism families use it
The Consumer Directed Personal Assistance Program (CDPAP) is a New York State Medicaid program that flips the usual home-care model. Instead of an agency assigning whichever aide is available, the family recruits, hires, trains, schedules, and supervises their own Personal Assistants (PAs) — and Medicaid pays them.
For autism families, that difference is everything. A child who takes weeks to trust a new person doesn't have to start over every time an agency reshuffles staff. You can hire someone your child already knows — a familiar relative, a trusted neighbor, a former teacher's aide — and keep them.
PAs can help with personal care (bathing, dressing, feeding, toileting), supervision and safety, and certain tasks that agency aides can't legally perform, because in CDPAP the consumer or their designated representative directs the care.
What changed in 2025 — the short version
If you last looked at CDPAP before 2025, the program you remember has been restructured. Three things to know:
1. One statewide fiscal intermediary: PPL
New York eliminated the roughly 600 local fiscal intermediaries that used to run CDPAP payroll and consolidated everything under a single statewide company, Public Partnerships LLC (PPL). Since 2025, every CDPAP consumer and every PA must be registered with PPL — PAs cannot legally log hours until registration is complete. A court challenge to the rollout ended in a settlement finalized in late 2025, so this structure is here to stay.
2. New "Minimum Needs" rules for new applicants
Since September 1, 2025, adults newly applying for personal care or CDPAP services generally must be assessed as needing a minimum level of hands-on assistance with activities of daily living. These rules mainly affect new adult applicants — people already enrolled before the change were not re-screened out by it, and rules differ for children's cases. If you're applying fresh, expect the assessment to matter more than it used to.
3. The care side didn't change
Who qualifies, what services PAs can provide, and how hours get authorized all work the way they did before. The overhaul was about payroll and administration, not about the care itself. If your child had CDPAP before the transition, their authorized hours and services carried over.
Who can be a paid Personal Assistant
This is the question every family asks first, so here it is plainly:
- Usually yes: adult siblings, grandparents, aunts and uncles, adult children, family friends, neighbors — most adults who are legally authorized to work and willing to register with PPL.
- Generally no: the consumer's spouse, and a parent of a consumer under 21. The consumer's designated representative also cannot be their paid PA.
- No certification needed: PAs don't need home-health-aide training or medical credentials. They complete PPL registration, employment paperwork, and a health assessment.
How to enroll, step by step
- Confirm Medicaid. CDPAP is a Medicaid program. For autism families, this is where waiver Medicaid shines — children on the OPWDD HCBS Waiver or the Children's Waiver receive Medicaid regardless of parental income. If you're not waiver-enrolled yet, start with the OPWDD Front Door process.
- Get the medical order. A physician's order for home care starts the clock. Ask your child's doctor to document the specific daily-living tasks your child needs help with.
- Complete the assessment. An independent assessor or your managed care plan evaluates need and authorizes weekly hours.
- Choose your consumer-directed setup. A parent typically serves as the designated representative who directs care on the child's behalf — hiring, scheduling, and supervising the PAs.
- Register everyone with PPL. The consumer registers, and every PA completes PPL onboarding: employment forms, I-9 verification, and a health assessment. PAs are paid as W-2 employees of PPL.
- Start logging hours. PAs record time through PPL's system (called Time4Care), and payroll runs on PPL's statewide schedule.
CDPAP, self-direction, or both?
Families often confuse CDPAP with OPWDD self-direction, because both involve hiring your own staff. They're separate programs that can run side by side. CDPAP flows through Medicaid home care and pays for personal assistance with daily living. Self-direction flows through the OPWDD HCBS Waiver and funds a broader individualized budget — community habilitation staff, respite, camps and classes, and approved goods and services. Many New York autism families use both: CDPAP for daily personal care hours, self-direction for community support and skill-building.
Stuck? You're not alone
The PPL transition was rocky for thousands of families, and getting un-stuck usually takes persistence rather than magic. Document every call, escalate politely, and lean on your care manager. GRSCorp hears from Capital Region families navigating this system every week — reach out and we'll point you to what worked for others.