How to Apply for CDPAP in New York When Your Child Has a Birth Injury

When a child needs ongoing care at home after a birth injury, many New York families look into whether they can get paid for the caregiving they’re already doing.

The Consumer Directed Personal Assistance Program, known as CDPAP, is a New York Medicaid program that lets eligible individuals choose their own personal assistant instead of working with an agency-assigned aide.

It’s a genuinely useful program for many families, but there’s one rule that trips people up more than any other: a parent generally cannot be paid as the personal assistant for their own child under age 21. This guide explains exactly who can be paid, how the application process works, and what other family members and pathways are actually available to you.

What CDPAP Is and Why It Matters After a Birth Injury

CDPAP allows a Medicaid-eligible individual to direct their own care and choose who provides it, rather than having an agency assign a rotating set of aides. For a child, the parent or legal guardian typically serves as the person directing the care plan, deciding what tasks are needed, when, and how they’re performed.

The personal assistant carrying out that hands-on care, however, is subject to specific eligibility rules under New York law, and this is where families most often get the wrong impression.

Who Can Actually Be Paid as the Personal Assistant

Under New York Social Services Law § 365-f(2)(c) and 18 NYCRR § 505.28(b)(11), a personal assistant can be almost any friend or family member the consumer chooses, with three specific exceptions: the consumer’s spouse, their designated representative, and, this is the one that matters most here, the parent of a consumer under the age of 21.

This isn’t a gray area or something that varies by county; it’s a direct, current rule confirmed on the New York State Department of Health’s own CDPAP program page.

Here’s what that means in practice for a family caring for a child with a birth injury:

• A parent cannot be paid as their minor child’s CDPAP personal assistant, no matter how well-documented the child’s medical need is or how much hands-on care the parent is already providing.

• Once the child turns 21, a parent can become eligible to serve as the paid PA. This exception was added specifically by Chapter 511 of the Laws of 2016, which the New York State Department of Health clarified in an official Medicaid Update notice was meant only to expand who could serve as an aide for adult children, not to change the underlying rule for minors.

• Non-parent relatives and friends can be paid PAs for a child of any age. Grandparents, aunts, uncles, adult siblings, and family friends are all eligible, and living in the same household as the child doesn’t disqualify them.

• A designated representative cannot simultaneously serve as the paid PA, regardless of the consumer’s age. If a parent is serving as the child’s representative for directing care, that same parent cannot also be the paid assistant.

If someone has told you a parent can be paid to care for their own young child under CDPAP, it’s worth asking exactly which program they meant, since this is one of the most commonly misunderstood points in the entire system.

What Self-Directed Care Means in Practice

A core requirement of CDPAP is that the consumer be able to direct their own care, or have a representative who can direct it on their behalf.

For a child, the parent or legal guardian usually serves as that representative, making decisions about care tasks, scheduling, and training, separate from whoever is actually hired as the paid PA. Directing care means being involved in what assistance is needed and how it’s performed; it doesn’t require the representative to physically perform the care themselves.

How CDPAP Differs From Other Options

CDPAP is distinct from traditional home health aide services, where a Medicaid-enrolled agency hires, trains, and supervises the aide directly. Under CDPAP, the consumer or their representative recruits, hires, trains, and manages the personal assistant.

It’s also different from New York’s Early Intervention program, which serves children under age three with developmental delays or disabilities through therapies like physical, occupational, and speech therapy, not personal care assistance. A child can be eligible for both programs at once, since they operate under separate eligibility and funding rules; enrollment in one doesn’t affect eligibility for the other.

CDPAP is not a settlement fund, special needs trust, or litigation-related benefit. It’s a Medicaid program with its own application process, entirely independent of any legal claim or financial recovery related to a birth injury.

If You Specifically Want a Parent to Be Compensated

Given the age-21 restriction, some families look for other ways a parent can be compensated for caregiving while the child is young. A few genuine avenues worth asking about:

• New York Paid Family Leave provides job-protected, partially paid leave from a parent’s own employer to care for a family member with a serious health condition. It’s not a Medicaid caregiver wage and it’s time-limited, but it’s a real, separate benefit worth checking into for the period right after a diagnosis or a medical crisis.

• The OPWDD Comprehensive Waiver, for children with intellectual or developmental disabilities who meet an institutional level of care, offers its own self-directed services model with different rules than CDPAP. Whether a specific birth-injury-related condition qualifies depends on the child’s functional profile, so this is worth raising directly with a Medicaid or OPWDD-focused benefits counselor.

• If your child has another adult relative willing to serve as the CDPAP personal assistant, that person can be paid even while you continue directing the care plan as the representative.

Who May Be Eligible for CDPAP

Eligibility depends on two things: the child’s Medicaid status, and a documented need for personal care assistance.

Medicaid enrollment

The child must be enrolled in New York Medicaid. Families not yet enrolled should contact their local Department of Social Services or apply through the New York State of Health marketplace.

Medicaid eligibility for children can be based on household income, disability status, or other qualifying criteria. If your household income would normally be too high to qualify, it’s worth reading our guide on New York’s Children’s Medicaid waiver when a parent’s income is too high, since a child’s own disability-based eligibility often doesn’t depend on parental income the way standard Medicaid does.

A child who’s been approved for Supplemental Security Income based on a birth injury diagnosis may also have an easier path to Medicaid, and in turn to CDPAP, so it’s worth exploring both routes.

Documented care needs

Once Medicaid eligibility is confirmed, the child generally needs a documented medical or functional need for help with daily activities, such as feeding, bathing, dressing, mobility, or medication management, that traces to the effects of the birth injury.

A nurse or other qualified professional typically conducts a functional assessment to determine the level of care needed and how many hours may be authorized. As of September 1, 2025, updated Minimum Needs Requirements apply to Medicaid recipients age 21 and older seeking CDPAP or Personal Care Services, as well as to anyone 18 or older enrolling in a Medicaid Advantage Plan or Managed Long Term Care Plan; a benefits counselor or your Medicaid managed care plan can confirm how this applies to your child’s specific situation.

How to Start the CDPAP Application

Step 1: Confirm Medicaid coverage. Verify the child is enrolled in New York Medicaid, and confirm whether they’re in Medicaid fee-for-service or a managed care plan, since this affects which office handles the CDPAP application.

Step 2: Request the required assessment. Once Medicaid coverage is confirmed, request a functional or medical assessment through the local Department of Social Services or the Medicaid managed care plan. A nurse or social worker typically reviews the child’s medical history, current abilities, and care needs to determine hours that may be authorized.

Step 3: Gather medical records and care documentation. Before the assessment, gather medical records from the birth hospitalization or NICU stay, discharge summaries or hospital care plans, letters or evaluations from treating physicians or therapists, and any existing service authorizations. Having this ready helps the assessment move more smoothly.

Step 4: Complete registration and hiring paperwork. Once approved, register the personal assistant with Public Partnerships LLC (PPL), the current statewide fiscal intermediary for CDPAP, which handles timesheet processing, paychecks, and employment tax withholdings. Both the representative and the personal assistant must complete registration forms and provide required documentation.

Step 5: Finish required training and onboarding. The consumer or representative is responsible for training the personal assistant in the specific care tasks required, such as feeding techniques, mobility assistance, or medication administration. Some tasks may require additional training depending on complexity and the child’s medical needs.

What Documents Families Usually Need

Requirements vary somewhat, but families generally need proof of the child’s Medicaid enrollment, medical records or physician documentation supporting the need for personal care.

The completed functional assessment, identification for both the representative and the proposed personal assistant, employment eligibility verification for the assistant, and any additional forms required by PPL or the Medicaid plan.

Ask the Medicaid plan, local district, or PPL for a complete document checklist early to avoid delays.

What Happens After Approval

Once approved and registration is complete, the personal assistant can begin providing care and submitting timesheets.

The functional assessment results in an authorization for a set number of hours per week or month; the assistant submits timesheets, and PPL processes payment based on those hours.

Confirm the current payment rate and submission process directly with PPL, since rates and procedures can change.

What to Do if the Request Is Delayed or Denied

If an application is delayed or denied, request additional information from the Medicaid plan or local district about why, and what would resolve it. This might mean additional medical documentation, a re-assessment, or clarification of care needs.

Families also have the right to request a fair hearing if they believe a denial was incorrect or that authorized hours are insufficient. A benefits counselor, patient advocate, or attorney familiar with New York Medicaid can help navigate an appeal.

If Your Child Is Under 3

New York’s Early Intervention program serves children from birth to age three with developmental delays or disabilities, providing therapies rather than personal care assistance.

A child can be eligible for both Early Intervention and CDPAP at the same time, since they operate under separate criteria; families shouldn’t assume enrollment in one affects eligibility for the other.

Our guide on getting help with Medicaid, SSI, and Early Intervention walks through how these systems fit together for a young child with a birth injury.

Questions to Ask the Medicaid Plan or Local District

Before starting, it helps to ask: Is my child currently enrolled in Medicaid, and in what type of plan? What’s the first step to request a CDPAP assessment?

Who conducts it, and how long does it take? Since a parent generally can’t be paid as the PA for a child under 21, who in our family or circle could serve in that role?

What documents will we need? How many hours of care are typically authorized for a child with similar needs? What is the current PPL payment rate? What training is required before the caregiver can begin? What should we do if the application is delayed or denied?

When to Get Legal Help or Benefits Guidance

Navigating CDPAP alongside other Medicaid programs, special needs planning, or birth injury litigation can get complicated. A benefits counselor or Medicaid specialist can help with eligibility questions, documentation, and denials.

An attorney focused on special needs planning or Medicaid law can advise on how CDPAP fits into broader financial planning, especially if the child has received or may receive a settlement related to the birth injury.

Our guides on how birth injury settlements work in New York and why a first-party special needs trust often makes sense for a birth injury settlement explain how a settlement can be structured so it doesn’t interfere with ongoing Medicaid or CDPAP eligibility.

Legal help may also make sense if you believe your child’s care needs aren’t being met, authorized hours are insufficient, or the application process involves unexplained delays.

Frequently Asked Questions

Can I Be Paid to Care for My Own Child Under CDPAP?

Generally, no, not while your child is under 21. New York Social Services Law § 365-f(2)(c) and 18 NYCRR § 505.28(b)(11) specifically exclude the parent of a consumer under 21 from serving as that child’s paid personal assistant. This changes once the child turns 21. In the meantime, another adult relative or family friend can be paid to provide the care while you continue directing the plan.

If I Can’t Be Paid, Who Else in Our Family Could Be?

Almost any relative or friend other than the consumer’s spouse, designated representative, or a parent of a minor consumer. Grandparents, aunts, uncles, adult siblings, and family friends are all eligible, and living in your household doesn’t disqualify them. Many families find that a grandparent or another close relative who’s already involved in the child’s care is a natural fit for this role.

Does CDPAP Affect Our Child’s Eligibility for a Future Legal Settlement, or Vice Versa?

CDPAP and a birth injury legal claim are entirely separate systems; CDPAP eligibility doesn’t depend on whether you’re pursuing a claim, and pursuing a claim doesn’t affect current CDPAP eligibility. If a settlement is eventually reached, it’s worth planning ahead with an attorney familiar with both special needs planning and Medicaid rules, since how a settlement is structured can matter for maintaining Medicaid eligibility long-term.

What If My Child Needs More Hours Than Were Authorized?

You can request a re-assessment or ask for a fair hearing if you believe the authorized hours don’t reflect your child’s actual needs. Gathering updated medical documentation showing the specific tasks and time involved in your child’s care can strengthen that request. A benefits counselor or attorney experienced with CDPAP appeals can help you prepare it.

Can My Child Be Enrolled in Both CDPAP and Early Intervention at the Same Time?

Yes. They’re separate programs with separate eligibility rules: Early Intervention provides developmental therapies for children under three, while CDPAP provides personal care assistance for daily activities. Enrollment in one doesn’t limit or affect eligibility for the other, so it’s worth pursuing both if your child’s needs support it.

This article is for informational and educational purposes only. It is not a substitute for medical advice from your child’s healthcare providers or legal advice based on your family’s specific circumstances.