What is a Fiscal Intermediary? The Complete Guide

what is a fiscal intermediary

Consumer Directed Personal Assistance Program (CDPAP) allows home care recipients to take greater control of the services they receive. However, with these advantages also come an increased level of administrative responsibilities.

This is where a Fiscal Intermediary comes in.

A Fiscal Intermediary is an organization that provides financial and administrative on the behalf of the consumer. This allows the individual to focus on their quality of care with the peace of mind that their caregiver is receiving the proper compensation and benefits for their services.

In this guide, we will review in-depth the benefits of a fiscal intermediary. If you are a home care recipient in New York State looking to take control of your personal care services, contact us today to see how we can help you.

What Types of Care Do Fiscal Intermediaries Support?

Fiscal Intermediaries support recipients of consumer-directed personal care assistance, expanded in-home services for elderly adults (EISEP), and respite care.

Consumer-Directed Personal Care Assistance

Consumer Directed Personal Assistance Program (CDPAP) is a Medicaid program that allows individuals to receive in-home health services from a caregiver of their choosing. Under this program, the consumer has the power to decide what type of services they need and who will provide them. Once these decisions are made, the fiscal intermediary steps in to handle the financial and administrative obligations.

Expanded In-Home Services for Elderly Adults

Fiscal intermediaries also support expanded in-home services for elderly adults. This program provides assistance to adults not eligible for Medicaid, are over the age of 60, and who need help completing activities of daily living, such as bathing, dressing, and eating.

Alzheimer’s Respite Care

Fiscal Intermediaries in Albany and New York state also commonly help administer the financial and administrative obligations of respite care for caregivers of those with an Alzheimer’s diagnosis. This allows individuals to select the care provider and ensure that their services are compensated while the care recipient is away from them.

Consumer Directed Personal Assistance Program (CDPAP) Services Provided by Fiscal Intermediaries

As we stated above, Fiscal Intermediaries help CDPAP consumers by fulfilling specific financial and administrative obligations involved in their care. These can include:

Payroll and Tax Withholding

One of the primary roles of the Fiscal Intermediary is to handle payroll and tax withholding for caregivers. This includes calculating hours worked, issuing paychecks, and making sure that all applicable taxes are withheld correctly.

Benefits Administration

Another key responsibility of the fiscal intermediary is to administer benefits on behalf of the consumer. This includes enrolling caregivers in health insurance plans, handling disability and workers’ compensation claims, paying out paid time off, and ensuring that all other applicable benefits are being received.

Benefits a personal care assistant may be entitled to include:

● Paid time off

● Increased holiday pay

● 401(k) retirement options

● Direct deposit options

● Life insurance

● Medical bridge insurance

● Paid initial and annual health assessments

● Healthcare and dental insurance

Compliance Assistance

The Fiscal Intermediary is also responsible for assisting the consumer with compliance. This includes help with understanding and following all applicable laws and regulations, as well as maintaining required documentation for key compliance needs, such as:

● Consumer agreement compliance monitoring

● Assessment and employment compliance monitoring

● Corporate compliance assistance

What to Look for in the Right Fiscal Intermediary

Nonprofit Structure

One of the most important things to look for when choosing a Fiscal Intermediary is that they have a nonprofit structure. This ensures that they are not motivated by profit, but rather by providing the best possible service to the consumers they serve.

Fiduciary Service for Consumers and Care Providers

The Fiscal Intermediary you choose should also offer fiduciary services for both consumers and care providers. This means that they act in the best interest of the consumer when it comes to financial decision-making and ensure that the care provider reliably receives the compensation and benefits, they are entitled to.


Another key factor to consider is whether the organization is accredited. Organizations that have been accredited by external agencies have undergone a rigorous review process to ensure that they meet the highest objective standards of quality and service.

Get Fiscal Intermediary Services for Your NY CDPAP

At CDChoices, we are committed to providing accredited and fiduciary Fiscal Intermediary services for residents across New York State. We want to help you reliably manage the financial aspects of your consumer-directed care so that you can spend more time focusing on receiving the best-quality services possible.

To learn more about how we can assist you, contact us today to get started.

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