What is Consumer Directed Personal Assistance (CDPA)?
CDPA allows Medicaid recipients (Consumers) in need of personal care, home health and nursing services to recruit, hire, train, supervise their own Personal Assistants (PAs), and if necessary terminate employment. CDPA gives people with disabilities more control and independence by empowering them to manage their home care in a way that works best for them.
Who can use CDPA?
To use CDPA, a person must be:
• Eligible for Medicaid
• Eligible for home care services, personal care services, or private duty nursing
• Self-directing or have a Designated Representative (DR) who is willing and able to assume the roles and employer responsibilities associated with self-direction.
**A self-directing Consumer is defined as: "A Consumer who is capable of making choices regarding the Consumer's activities of daily living and the type, quality and management of his or her consumer directed personal assistance; understand the impact of these choices; and assumes responsibility for the results of these choices." (10 NYCRR 505.28(b)(9))
CDChoices does NOT determine CDPA eligibility or a Consumer's ability to self-direct his/her CDPA.
If I decide to use CDPA, what are my responsibilities?
You or your Designated Representative will recruit, interview, hire, train, schedule, supervise and terminate employment of your Personal Assistant(s). This gives you full control over:
- Who you work with
- Who comes into your home
- What time of day someone is in your home
- How tasks are performed
You will need to:
- Complete the appropriate employment paperwork for each Personal Assistant you hire.
- Follow your plan of care, directing your Personal Assistant to perform only the tasks listed.
- Approve time sheets verifying your Personal Assistant(s) worked the hours listed and performed the task approved on the plan of care.
- Make sure you have backup Personal Assistants scheduled, in case your primary Personal Assistant is ill or on vacation.
What does CDChoices do?
CDChoices is a Fiscal Intermediary for Consumers who use CDPA. This means we help you, the employing Consumer, by handling the following so you don't have to worry:
• Processing payroll for your PAs, including withholdings for taxes and Social Security
• Monitoring the completion of the required annual Health Assessments and all required employment documents
• Coordinating workers compensation, disability, unemployment and other PA benefits
We also provide you with the support and resources you need to keep your service running smoothly such as:
• Peer Mentoring
• DVD and Print Library
• Consumer and PA Special Events
• Confidential online recruitment tool (PAChoices.com)
How quickly can I hire a Personal Assistant once I’m referred to CDChoices?
There are steps that need to happen before you hire someone, but hiring can happen very quickly, especially if you already know who you want to hire as your Personal Assistant (PA). Once CDChoices receives your referral, a Program Associate immediately contacts you to set up an orientation meeting to explain what paperwork needs to be filled out and what is expected of you as an employer. Generally, the orientation happens within a few days of our contacting you and we always work to accommodate your schedule.
There are state and federal requirements- such as a health assessment- that need to be completed before a Consumer can schedule a PA to work. But once we have received the required paperwork and health assessment, your PA can start working right away.
I’ve never hired or trained my own Personal Assistant. Do you have any resources that can assist me with these tasks?
In the Consumer Guide, which you’ll receive once you start to use our service, you can find tips and suggestions on interviewing and training someone to be a Personal Assistant (PA). To help you find potential candidates, CDChoices has created a website, PAChoices.com, which can be used as a recruitment tool. You can also speak to CDChoice’s Peer Mentor, Margie. Margie uses CDPA herself and has been specially trained to provide ideas on recruitment, interviewing and checking references so you can find the perfect PA for you. Margie can also provide suggestions and information on best practices for dealing with supervisory matters.
We also have many resources at CDChoices for teaching someone how to train a PA, including books, DVDs, CDs, and audiotapes. Consumers are welcome to visit us at our office to look over our lending library, or we can mail out a selection. All of our materials will also be available for your use on our website after you log into your Consumer account.
How many Personal Assistants can/should I hire?
You can employ as many Personal Assistants (PAs) as you want, as long as you don’t schedule more than one of them to work at the same time. You cannot schedule them to work more total hours than the county or managed care organization has authorized you to use per week. You should employ enough PAs so you have back-up staff in case one of your regular PAs is on vacation or out sick. You must notify CDChoices each time you hire a new PA. Each PA must complete some state and federal Medicaid requirements before you can schedule him or her to work.
What do I do if I feel like my Personal Assistant isn’t performing the roles and responsibilities that we discussed?
As the employer, there are many strategies you can use to manage your employees. CDChoices has several different types of resources, such as books, DVDs, and CDs, that can help you learn how to communicate with your PAs. In addition, you can contact Margie, CDChoices’s Peer Mentor, to discuss a plan for better managing your employees. Keep in mind it is up to you, as the employing Consumer, to make sure your PAs are appropriately performing the tasks you require of them. CDChoices does not take any part in the disciplining or terminating PAs.
If you choose to terminate a PA's employment, you’ll need to let your Program Associate know. She will then complete the appropriate paperwork.
There are times when I need to go into the hospital for a few days. Can my Personal Assistants still work for me when I’m in the hospital?
No, your Personal Assistants (PAs) can’t work for you while you’re in the hospital (or any other institutional setting) unless you pay them privately. Since Medicaid will already be paying for you to be in the hospital and receive the hospital’s care, the state does not allow for your PA to care for you between the time you’re admitted and the time you’re discharged. Your PA may, however, work for you until you’re admitted into the hospital, and they may resume working for you as soon as you’re discharged.
Can I ask my family members to be my Personal Assistant?
It depends. New York State law states any adult can be hired as a Personal Assistant (PA) so long as he or she is NOT the Consumer’s spouse, Designated Representative or someone who is legally responsible for the care and support of the Consumer. According to the Department of Health, this means parents of adult Consumers (21 years or older) can be hired to work as a PA. Parents of Consumers who are younger than 21 years of age will still not be able to be hired as a PA. Depending on the policies of your County Department of Social Services or your managed care organization, family members who live with you may be excluded from being paid as a PA. Please check with your caseworker or service coordinator before you attempt to hire a family member as your PA.
What can I ask my Personal Assistant to do for me?
When the Department of Social Service or your managed care plan performs your assessment, a plan of care is created for you. This plan outlines what tasks the Personal Assistant (PA) can perform for you. Medicaid will only approve payment for work completed toward those specified tasks. If you have any questions about what tasks your PA is allowed to do, please check with your caseworker or service coordinator to make sure a task is approved before assigning it to a PA.
How do I look for a job as a Personal Assistant?
You can visit PAChoices.com and create a profile as a potential Personal Assistant. Once your profile is active, you’ll be able to search for prospective Consumers. You can limit your search by location (including nearness to a bus line), gender, language, and schedule. PAChoices.com also allows Consumers to search for job candidates, so make sure your profile is complete and accurate so you’re easy to find.