What the CDPAP Changes in New York Actually Mean (and What to Do About It)

If you or someone you care about uses CDPAP to stay independent at home, you’ve probably heard the buzz: New York is changing the program. Not a small tweak. We’re talking about a total overhaul—moving from hundreds of local fiscal intermediaries (FIs) to one statewide company, Public Partnerships (PPL).

Here’s what’s going on, what it means for you, and what you actually need to do about it—whether you're a consumer, caregiver, or run an agency.

First, a Quick Refresher: What’s CDPAP?

CDPAP stands for Consumer Directed Personal Assistance Program. It’s a Medicaid-funded program that lets patients—called consumers—hire and manage their own caregivers. That could be a friend. A cousin. Even your daughter. Unlike traditional home care, you decide who comes into your home and when, and your caregiver can do things agency aides aren’t allowed to—like give medications or do wound care.

It’s personal. It works. And for over 250,000 New Yorkers, it’s the reason they’re still at home and not in a facility.

So What Changed?

Last year, lawmakers passed a plan to scrap the patchwork system of 600+ FIs and replace it with a single statewide one. Their argument? Too much waste, not enough oversight, and a ballooning $8–9 billion price tag.

Starting April 1, 2025, every CDPAP consumer and personal assistant must be registered with Public Partnerships (PPL), a private company based in Massachusetts. Your local FI—whether a community org, mom-and-pop shop, or big nonprofit—will be gone unless they’re subcontracting under PPL.

This is already in motion. The switch is happening now.

The State’s Logic

Here’s what Albany says this will fix:

• Cost savings. Hochul’s team claims this move will save $500 million a year.
• Consistency. One FI, one rulebook.
• Fraud prevention. Some FIs were sloppy. A few were indicted.

On paper? Sure, streamlining makes sense. In reality? It’s going to be bumpy.

So... What Do I Actually Need to Do?

If You’re a CDPAP Consumer (Patient or Family):

• You need to enroll with PPL. Now. Not in March. Not in April. Now.
• Your caregiver needs to enroll too.
• If you don’t switch in time, your care could stop.

The official deadline is March 28, 2025. There’s a short grace period in April, but that’s risky. During the grace period, caregivers have to track hours manually, and paychecks might be delayed.

Bottom line: Don’t wait. Don’t assume someone else is handling it. Call PPL. Use a facilitator if you need help.

If You’re a CDPAP Caregiver (Personal Assistant):

This transition means new paperwork, a new payroll system, and a new company cutting the checks—but your job still exists, and the consumer is still your boss. Here’s what to expect:

• You stay employed if your consumer transitions to PPL. That’s the key. Stick with them.
• You’ll need to fill out onboarding paperwork for PPL—W-4, I-9, health documents, etc.
• You’ll start using PPL’s electronic timekeeping system (Time4Care app or phone check-in).
• Pay and benefits should remain the same. Wage parity and minimum wage laws still apply.
• No background check is required unless your consumer asks for one. The law hasn’t changed.
• You don’t need to get certified. CDPAP still allows non-licensed aides, including family members.

Optional Path: You can choose to become a certified Personal Care Aide (PCA). This isn’t required, but if your consumer exits the program—or you want to pick up more work—you’ll need a PCA certificate to work for a traditional home care agency. Some agencies and training centers are already offering this certification for CDPAP caregivers looking to expand their options. Before making this transition, it's essential to research your state's specific programs and requirements. Consulting with a local Medicaid office or a social worker can provide guidance tailored to your situation.

If you want to stay in home care long-term, PCA training might be worth considering.

What About the Agencies and FIs?

If you run or work for a Fiscal Intermediary: the model is gone. Most FIs will be shut down unless they subcontract with PPL as a facilitator. Those that do continue won’t be allowed to run payroll, manage timesheets, or handle compliance. They’ll only help with paperwork and support.

If you’re not a facilitator, you’ll need to wind down your CDPAP operations and transfer your consumers. Some agencies are already doing this. Others are still fighting it in court—but the April 1 handoff is happening.

If you’re a home care agency with a CDPAP division, you’ve lost that line of business. You may pick up a few consumers who choose to leave CDPAP altogether, but don’t expect a major swing—most CDPAP users prefer the program and are trying to stick with it.

Timeline (As of April 15, 2025):

• March 28 – Enrollment deadline for consumers and caregivers to switch to PPL.
• April 1 – PPL becomes the only legal FI in the state.
• April 30 – Grace period ends. After this, if you're not enrolled with PPL, you’re out.
• May 1 – CDPAP must run fully through PPL. All services, payments, and compliance handled by them.

What’s Staying the Same?

• Consumers still pick their caregiver.
• Caregivers can still do skilled tasks (like insulin shots or suctioning).
• Consumers still run the day-to-day care.
• Family members can still be paid to provide care.
• No licenses or certifications are required.

So if someone tells you “CDPAP is over,” they’re wrong. What’s over is local fiscal intermediaries running the show.

Will This Be a Mess?

Maybe. Pennsylvania tried the same thing with PPL. They had tech glitches, missed paychecks, and lost consumers. New York says it’s prepared. We’ll see.

The safer bet: Assume hiccups. Have a backup plan. Document everything.

Eligibility Rules: A Quick Note

CDPAP eligibility is getting tighter.

New applicants generally need help with two daily activities. People with dementia need help with one. If you’re already in the program, you’re likely fine. But new assessments are being done by a third-party company hired by the state—not your plan. That can mean stricter evaluations.

If you're getting reassessed or applying, be prepared. Have your medical records ready. Bring someone with you to the visit. Don’t assume the assessor knows your needs.

The Bottom Line

CDPAP isn’t ending. It’s just changing who runs the back office.

For consumers: sign up with PPL. Help your caregiver do the same. Ask for help if you need it.

For caregivers: stay the course. Get your paperwork in. And if you want to hedge your bets, look into PCA certification as a way to stay in the industry no matter what happens next.

For agencies and FIs: this is the end of an era. Make the transition as smooth as you can for your clients. It matters.

The state can centralize payroll. It can cut costs. But it can’t replace the relationships at the center of this program. CDPAP works because of the trust between patients and their caregivers. That hasn’t changed.

As long as that bond holds, CDPAP’s heart is still intact.