Guides → New York

Getting paid to care for a parent in New York

Updated 2026-08-10 · Every figure below is dated and sourced · Rules change — confirm with the agency
The short answer: New York's door is Consumer Directed Personal Assistance Program (CDPAP), run by New York State Department of Health (Medicaid), with Public Partnerships LLC (PPL) as the single statewide fiscal intermediary since April 2025. Pay: $18.65-$20.65/hr. This is the caregiver's actual wage — the minimum base wage PPL pays the personal assistant — not a Medicaid billing rate. Effective January 1, 2026: $20.65/hr for consumers living in the five NYC boroughs (Bronx, New York, Kings, Queens, Richmond); $20.05/hr in Nassau, Suffolk, and Westchester; $18.65/hr in every other county. That was a $0.55/hr raise on January 1, 2026, in step with New York's home care aide minimum wage ($19.65/hr downstate and $18.65/hr rest-of-state for 2026). Pay is weekly, on Thursdays, by direct deposit or paper check. Overtime is time-and-a-half, but read the fine print before counting on it: PPL can only pay for the hours your parent's plan has actually authorized, and that authorization resets each week — hours you work beyond it are not paid. And seventh-day overtime (the premium for working all seven days in a week) only applies if you also worked for someone you are not related to; if you care solely for your own parent, you do not get it. Downstate "wage parity" money is not extra cash in your check. PPL says its posted rates already take its benefits into account, and the parity dollars go to safe-and-sick-leave accrual ($0.69/hr in NYC, $0.67/hr in Nassau, Westchester, and Suffolk) and then into a 401(a) retirement account once sick leave maxes out. Ignore the ~$23.81/hr "all-in NYC" number circulating on caregiver-marketing sites — PPL's posted wage table does not support it.

Who can be the paid caregiver

Adult children, siblings, in-laws, grandchildren, friends, and other relatives may be the paid "personal assistant" — no certification or license required, and the consumer hires and trains them. A relative who lives with the parent can still be paid if they moved in because the parent's care needs require it. Excluded: the spouse, the parent of a consumer under 21, and whoever serves as the consumer's designated representative. The caregiver must be legally authorized to work in the US and pass a pre-employment health assessment.

The spouse question

No. New York regulation (18 NYCRR 505.28, restated in DOH directive 11 OHIP/ADM-6) flatly bars a spouse from being the paid CDPAP personal assistant, with no exception. A spouse's only paid routes are outside Medicaid: NY Paid Family Leave (temporary, for employed spouses), Veteran-Directed Care, or VA caregiver programs if the parent is a veteran.

Waitlist reality

CDPAP is a Medicaid state plan service, so there is no waitlist — but do not read that as "everyone gets in." Since September 1, 2025 there is a hard eligibility gate ahead of any wait: a new applicant age 21 or over must need hands-on help ("limited assistance with physical maneuvering") with more than two activities of daily living — three or more. If your parent has Alzheimer's or another dementia, the bar drops to needing supervision with more than one ADL, but a doctor must sign form DOH-5821. Anyone already authorized for CDPAP or personal care before September 1, 2025 keeps "legacy status" under the old rules. Get past that gate and the remaining delay is process, not a list: Medicaid approval, the two-part New York Independent Assessor evaluation, managed-care plan authorization of weekly hours, and PPL registration typically run several weeks to a few months. One more caveat: the 2025 forced move to PPL as sole fiscal intermediary — 209,000-plus consumers and 203,000-plus personal assistants, with the old fiscal intermediaries not fully cut off until June 6, 2025 under a federal court agreement — caused registration backlogs and missed paychecks. Most of that has settled by mid-2026, but expect onboarding to be slower than advertised. Separately, county EISEP programs (non-Medicaid) genuinely do carry waitlists in many counties.

Worth knowing: Disqualifiers and traps: (1) The parent must be on Medicaid. New York's limits are relatively generous for people who need community long-term care, and as of August 2026 the 30-month lookback for home care has still NOT been put into effect — the Department of Health has postponed it repeatedly and has announced no start date, so plan as though it could arrive with little warning. Over-income families use a pooled-income trust or a spend-down. (2) The biggest trap is the Minimum Needs Requirement that took effect September 1, 2025 (DOH directive 25 OHIP/ADM-03). A new applicant age 21 or older must need at least "limited assistance with physical maneuvering" with MORE THAN TWO activities of daily living — three or more. If the parent has Alzheimer's or another dementia, the bar drops to needing supervision with more than one ADL, but a physician has to sign form DOH-5821 and send it to the New York Independent Assessor. Needing help with only one or two ADLs is now a flat denial, not just fewer hours. Also know that the assessor generally only counts ADLs your parent actually received help with in the three days before the assessment — paid or unpaid help both count, but it has to have happened and it has to come up at the visit. Anyone already authorized for CDPAP or personal care before September 1, 2025 keeps "legacy status" under the older, easier rules. (3) The designated representative cannot also be the paid caregiver — in families where one adult child manages everything, split the two roles or have the parent self-direct. (4) A spouse can never be the paid personal assistant. (5) The caregiver needs legal work authorization (Form I-9) and must clear a health assessment before the first paycheck: a physical exam, proof of measles/mumps/rubella immunity or vaccination, and a TB test (PPD or QuantiFERON, chest x-ray if positive), then an annual health questionnaire and TB screening after that. No certification, license, or training course is required. Recent changes: since the 2025 transition, Public Partnerships LLC (PPL) is the ONLY fiscal intermediary — any company advertising "sign up for CDPAP through us" is either an approved facilitator or out of date. Wages rose $0.55/hr on January 1, 2026, tracking New York's home care aide minimum wage. The base wage figures are solid because PPL posts them and PPL cuts the checks; treat any "all-in" hourly number higher than the posted rate as unverified, since PPL says its posted rates already take its benefits and wage parity into account.

Other doors in New York

ProgramWhat to know
Expanded In-home Services for the Elderly Program (EISEP)Non-Medicaid state program for age 60+ who are NOT Medicaid-eligible; case management and in-home aide help with sliding-scale cost share. Some counties offer a consumer-directed/direct-hire option that can pay a family member. Apply through the county Area Agency on Aging via NY Connects, 1-800-342-9871. Funding is capped — county waitlists are common.
NY Paid Family LeaveJob-protected, employment-based: an employed adult child or spouse can take up to 12 weeks at 67% of their own average wage (up to the state cap) to care for a parent or spouse with a serious health condition. Temporary income, not a caregiving wage.
Veteran-Directed Care (VDC)Available through several NY VA medical centers (e.g., Syracuse VA via ARISE, and others in partnership with local aging agencies). The veteran gets a flexible monthly budget and may hire family — including a spouse. Ask the parent's VA social worker if their VAMC participates.
VA Aid & Attendance + Program of Comprehensive Assistance for Family Caregivers (PCAFC)For veteran parents: A&A adds a monthly pension supplement that can informally pay family; PCAFC pays a monthly stipend to the caregiver of eligible service-connected veterans.
Structured family caregivingNew York has NO Medicaid structured-family-caregiving per-diem model (unlike GA/IN/CT). CDPAP's hourly model is the route.

Wartime veteran or surviving spouse in the family? VA Aid & Attendance stacks on top of state programs — see the national guide.

How to apply — step by step

  1. 1. Get your parent on New York Medicaid if not already enrolled — apply through the Local Department of Social Services (HRA in NYC) or the Medicaid Helpline 1-800-541-2831.
  2. 2. Call the New York Independent Assessor Program at 1-855-222-8350 (TTY 1-888-329-1541) to schedule the required two-part assessment (nurse assessment + independent practitioner visit) that determines eligibility for CDPAP/personal care hours.
  3. 3. Get the service authorization: your parent's Medicaid managed care / Managed Long Term Care plan (or the LDSS if fee-for-service) approves weekly hours and the consumer-directed option.
  4. 4. Register your parent as a consumer with PPL — call 1-833-247-5346, email nycdpap@pplfirst.com, or use the PPL@Home portal at pplfirst.com; name a designated representative if your parent can't self-direct (that person cannot be the paid caregiver).
  5. 5. Register yourself as the personal assistant with PPL: I-9, W-4, and pre-employment health assessment, then log hours in the Time4Care app once the start date is confirmed. Pay arrives weekly on Thursdays.

Where to start: New York Independent Assessor Program (assessment scheduling): 1-855-222-8350, nyindependentassessor.com. PPL CDPAP registration/support: 1-833-247-5346, pplfirst.com/cdpap

Do it yourself vs. get help

Free, accredited help first, always: your Area Agency on Aging (eldercare.acl.gov) walks families through these applications at no charge, and your county Veterans Service Officer files VA claims free. Where Resbit fits: if you're working a job and don't have hours for hold music, Resbit finds what your family qualifies for, fills out the paperwork down to the signature line, and does the chasing — flat $49/month, and the screener that starts it is free.

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Sources & dates checked: Program rules and payment rates change. Everything here is educational — real eligibility is decided by the agencies, based on your family's details.