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Understand how New York Medicaid home care works today, including LHCSA services, CDPAP changes, eligibility, and how your family caregiver may get paid to care for you at home.
This guide explains how New York Medicaid home care works today, how LHCSA and CDPAP compare, who may qualify, and how FreedomCare helps families understand their options.
If you’re caring for a parent, spouse, or loved one at home in New York, you already know how overwhelming it can be. Between managing medications, coordinating appointments, and handling the physical demands of daily care, it’s easy to feel like you’re doing it all alone. Many families are already providing this care every day without realizing that, through certain Medicaid home care programs, it may be possible to get paid as a family caregiver.
New York’s Medicaid home care system has gone through significant changes in recent years, and it can be confusing to figure out which programs still exist, what you qualify for, and how to access the Medicaid home care services available to New York residents.
Whether you’re exploring home care options for the first time, trying to understand the shift from CDPAP to LHCSA, or wondering whether Medicaid rules allow family caregivers to get paid to provide support, FreedomCare is here to help you make sense of it.
Medicaid home care in New York is designed to help people who need ongoing support with daily activities, things like bathing, dressing, eating, and getting around safely, receive that care at home instead of in a nursing facility. For most people, that’s exactly where they want to be: in their own home, surrounded by people they trust.
The Bottom Line: New York Medicaid home care now most often routes through LHCSA-based services, while CDPAP remains available but has changed significantly.
The state offers several pathways to home care through Medicaid, but the two you’ll hear about most are LHCSA-based services and CDPAP. There are also waiver programs for specific populations. Here’s what you need to know about each one and how FreedomCare fits into the picture.
LHCSA stands for Licensed Home Care Services Agency. It’s a type of home care organization licensed and regulated by the New York State Department of Health that provides personal care, home health aide services, and skilled nursing support to people in their homes. For most New York Medicaid recipients today, LHCSA is the primary pathway to receiving home care.
The Bottom Line: LHCSA is the licensed-agency model that provides certified aides, care coordination, nurse supervision, payroll, scheduling, and compliance support.
FreedomCare operates as a licensed LHCSA in New York, which means we employ certified caregivers, including Personal Care Aides (PCAs) and Home Health Aides (HHAs), who deliver hands-on support to Medicaid recipients. Through our LHCSA program, we match patients with trained aides and coordinate the care plan, payroll, scheduling, and ongoing supervision so families don’t have to navigate it alone.
If you’re receiving Medicaid and need help with activities of daily living, a New York LHCSA like FreedomCare is likely the most straightforward path to getting a qualified caregiver in your home.
For years, many New York families relied on CDPAP as their main route to home care. But the state has been restructuring its Medicaid home care system, and LHCSA-based services have become the primary model for most recipients. This shift is part of broader reforms focused on accountability, caregiver quality, and program oversight across NY Medicaid long-term care.
The Bottom Line: LHCSA-based services became the primary model as New York moved toward more oversight, caregiver quality standards, and agency coordination.
What does this mean for you? If you’re new to Medicaid home care in New York, LHCSA is most likely the program your health plan will direct you toward. And if you’re transitioning from CDPAP, an LHCSA like FreedomCare can help you continue receiving care from someone you trust, with added structure and support.
To receive home care through an LHCSA in New York, you generally need to meet Medicaid, assessment, and care-need requirements.
The Bottom Line: LHCSA eligibility generally requires Community Medicaid, ADL needs, NYIAP assessment, MLTC enrollment for many adults, and meeting minimum needs requirements.
The Minimum Needs Requirements now require that you be assessed as needing at least limited assistance with more than two activities of daily living, or, if you have a dementia or Alzheimer’s diagnosis, at least supervision with more than one ADL. These standards were tightened in 2025 to ensure resources go to those with the greatest need.
Not sure if you qualify? Whether you’re looking for a Medicaid paid caregiver in New York or exploring your eligibility for the first time, FreedomCare can walk you through the process step by step. Call us at 888-730-2654 to check your eligibility.
Yes, CDPAP is still an active Medicaid program in New York. The Consumer Directed Personal Assistance Program (CDPAP) lets you choose your own caregiver, including a family member, friend, or someone you trust, and direct the care yourself. However, the program has undergone major changes, and access looks very different than it did even a year ago.
The Bottom Line: CDPAP still exists, but all participants now work through PPL as the single statewide Fiscal Intermediary.
CDPAP New York was, for many years, the program that families turned to when they wanted to keep caregiving personal. Unlike traditional agency-based care, CDPAP put you in control of who provides your care, when they work, and how they help you. It allowed hundreds of thousands of New Yorkers to hire family members or trusted friends as paid caregivers, and it became a lifeline, especially for multigenerational families and communities where cultural understanding and trust matter deeply.
The Bottom Line: CDPAP historically gave families the most direct consumer control over who provided care and how that care was delivered.
In 2025, New York made a sweeping change to how CDPAP is administered. The state eliminated the network of over 600 community-based Fiscal Intermediaries (FIs) that had previously managed CDPAP payroll and administration. In their place, the state designated a single statewide Fiscal Intermediary: Public Partnerships LLC (PPL).
The Bottom Line: CDPAP’s main change is administrative: PPL replaced prior Fiscal Intermediaries, and participants must be registered with PPL to continue care and caregiver pay.
This transition has been challenging for many families. Some caregivers experienced delayed payments. Others struggled with the registration process or had difficulty reaching support. Legal challenges were filed, including lawsuits and a temporary restraining order in April 2025. Despite the turbulence, the state has continued moving forward with the consolidation.
As of early 2026, the transition is largely complete. If you’re currently enrolled in CDPAP, you are required to work with PPL as your Fiscal Intermediary. Your eligibility and services should remain intact, but you must be registered with PPL to continue receiving care and to ensure your caregiver gets paid.
CDPAP may still be the right choice for some families, especially when the person receiving care wants to directly manage care and hire a specific caregiver.
The Bottom Line: CDPAP may still fit if you want to self-direct care, hire a specific caregiver, meet Medicaid requirements, and can work within the PPL system.
CDPAP may still be the right choice for you if:
If you’re unsure whether CDPAP or LHCSA is the better fit, FreedomCare can help. We support families through both pathways and can explain the trade-offs in plain language so you can make the right decision for your family.
Understanding the differences between New York’s home care programs, including MLTC vs LHCSA, CDPAP, and Medicaid waivers, can feel overwhelming. These comparison tables break it down so you can see which option may work best for you.
The Bottom Line: LHCSA is now the main Medicaid home care model for many New Yorkers, while CDPAP remains a consumer-directed option with more limited access and new administration.
Primary program: LHCSA is now the primary Medicaid home care model in New York for most recipients. It provides certified caregivers, nurse supervision, and agency coordination through licensed providers like FreedomCare.
Secondary program: CDPAP remains available as a consumer-directed option, but access is more limited following the 2025 restructuring. It allows you to choose and manage your own caregiver, including family members.
| Program | Authority | Can Pay Family? | Spouse Eligible? | Who It Serves | Application Process |
|---|---|---|---|---|---|
| LHCSA | State Plan + MLTSS | Limited, family member must become certified PCA/HHA | No, spouses cannot serve as certified aides under LHCSA | Adults and seniors | Medicaid + NYIAP assessment + MLTC/plan coordination |
| CDPAP | State Plan | Yes, family members may serve as personal assistants | Limited and program-dependent | Adults and children | Medicaid + minimum needs + PPL registration |
| Personal Care Services | State Plan | No direct family hire in most cases | No | Adults with ADL needs | Medicaid assessment and plan approval |
| Medicaid Waivers | HCBS waiver authority | Limited and waiver-specific | Varies | Specific populations | Program-specific assessment and enrollment |
We know this is a lot of information. If you’re feeling unsure about which direction to go, that’s completely normal. Here’s a simple way to think about it:
The Bottom Line: Choose LHCSA for agency coordination and certified care; choose CDPAP if you want to self-direct and can work within the PPL structure.
Most New York Medicaid recipients today receive home care through LHCSA-managed pathways. This reflects the current direction of New York Medicaid operations, ensures continuity of coverage, and aligns with the state’s long-term care reforms.
Choose LHCSA if you want a licensed agency to coordinate your care, prefer having a certified caregiver, and want someone to handle the administrative side—payroll, scheduling, nurse visits, and compliance. If you have a family member who wants to become a Medicaid paid caregiver in New York, FreedomCare offers free certification training so they can get started quickly.
Choose CDPAP if you, or someone you designate, want to directly manage your care, hire a specific person you trust, and are comfortable working within the PPL system. Keep in mind that CDPAP’s administrative structure has changed significantly, and some families have found the transition challenging.
If you’re transitioning from CDPAP to LHCSA, FreedomCare makes it as easy as possible. We help your current caregiver get certified, handle the paperwork, and make sure there’s no gap in your care. Many families who’ve made this switch tell us they appreciate the added stability and support.
New York Medicaid home care rules have changed, and many families are understandably confused about what still exists, who can be paid, and whether they can keep the caregiver they trust.
The Bottom Line: CDPAP has not disappeared, not all family caregivers qualify automatically, and FreedomCare can help families transition without losing trusted care.
CDPAP has not disappeared, but access is limited. It is still a Medicaid program in New York. What changed is how it’s administered—all participants now work with PPL instead of their previous Fiscal Intermediary.
Not all family caregivers qualify for payment. Under LHCSA, your family member needs to be certified as a PCA or HHA, and FreedomCare offers this training for free. Under CDPAP, family members can serve as personal assistants, but spouse eligibility is limited and program-dependent.
Not with FreedomCare. We work with your current caregiver to help them get certified and continue providing your care. The goal is continuity, keeping the person you trust by your side.
While LHCSA does include more state oversight, that oversight is designed to protect you. At FreedomCare, we still work to honor your preferences and ensure you’re comfortable with your caregiver, including helping family members get certified to care for you.
The Bottom Line: These FAQs answer the main New York Medicaid home care questions about LHCSA, CDPAP, family caregiver pay, MLTC, and getting started.
LHCSA stands for Licensed Home Care Services Agency. It’s a state-licensed organization that provides personal care, home health aide services, and nursing supervision to people in their homes. FreedomCare is a licensed LHCSA serving Medicaid recipients across New York State.
LHCSA didn’t replace CDPAP entirely, but it has become the primary model for Medicaid home care in New York as the state has restructured its programs. Many families who were previously in CDPAP have transitioned to LHCSA-based Medicaid home care services in NY, particularly through agencies like FreedomCare that make the switch simple and keep care uninterrupted.
Yes. CDPAP is still an active Medicaid program. However, it has undergone major changes. As of 2025, all CDPAP participants are required to work with Public Partnerships LLC (PPL) as the single statewide Fiscal Intermediary. The program still allows you to choose your own caregiver, but the administrative process is different than it used to be.
Yes, in many cases a family caregiver on Medicaid in NY can get paid. Through CDPAP, family members, including some spouses depending on the situation, can serve as paid personal assistants. Through LHCSA programs like FreedomCare’s, family members can become certified PCAs or HHAs and get paid for providing care, and FreedomCare covers the cost of certification training.
MLTC, or Managed Long Term Care, is a type of Medicaid health plan that coordinates your overall long-term care benefits. An LHCSA is the agency that actually provides the hands-on caregiving services. You typically need to be enrolled in an MLTC plan to receive LHCSA services if you’re 21 or older and need long-term home care in New York.
The first step is checking your eligibility. You can call FreedomCare at 888-730-2654 or visit freedomcare.com/new-york to learn more. We’ll help you understand your options, walk you through the enrollment process, and connect you with the right program for your situation.
The Bottom Line: These resources help New York families understand LHCSA, CDPAP, Medicaid, MLTC, and Activities of Daily Living.
Our guide explains how family members in New York may be able to get paid to care for a loved one through Medicaid programs and how FreedomCare helps families navigate the process.
freedomcare.com/how-to-earn-money-as-a-family-caregiver-in-new-york-stateInformation on New York’s Licensed Home Care Services Agencies, which are certified agencies authorized to provide in-home care services to Medicaid patients.
health.ny.gov/facilities/home_care/lhcsaOur guide on the Consumer Directed Personal Assistance Program, which allows New York Medicaid patients to choose and hire their own caregivers, including certain family members.
freedomcare.com/cdpapNew York’s Medicaid program, including eligibility, benefits, and healthcare services available to qualified residents.
health.ny.gov/health_care/medicaidNew York’s Managed Long Term Care program provides Medicaid-funded home care services for individuals who need help with Activities of Daily Living, allowing them to receive long-term care and support in their homes rather than in a nursing facility.
freedomcare.com/mltc-in-new-yorkActivities of Daily Living are basic self-care tasks such as bathing, dressing, eating, mobility, toileting, and personal hygiene that Medicaid and long-term care programs use to determine whether a person needs assistance and qualifies for in-home or long-term care services.
medicaidplanningassistance.org/activities-of-daily-livingThe Bottom Line: New York Medicaid home care rules, minimum needs requirements, CDPAP administration, family caregiver eligibility, and service availability can change.
The information provided on this page is for general educational purposes only and is not intended as legal, financial, or medical advice. Eligibility for New York Medicaid home care programs, including Licensed Home Care Services Agency (LHCSA) services, the Consumer Directed Personal Assistance Program (CDPAP), and Managed Long Term Care (MLTC) plans, is determined solely by the New York State Department of Health, the New York Independent Assessor Program (NYIAP), and relevant local or state agencies. FreedomCare does not determine Medicaid eligibility or guarantee enrollment in any program.
Program rules, minimum needs requirements, and administrative structures may change. Meeting eligibility criteria does not guarantee immediate access to benefits. Additionally, whether a family member or spouse can be paid as a caregiver varies strictly by program. For example, spouses cannot serve as certified aides under LHCSA, and spouse eligibility under CDPAP is limited.
FreedomCare operates as a licensed LHCSA in New York. Service availability, caregiver pay rates, benefits, and program details referenced on this page are approximate and may differ based on individual circumstances, region, and health plan enrollment. We encourage you to verify all information with your MLTC plan or the New York State Department of Health.
For the most current and accurate program information, please visit the New York State Department of Health at health.ny.gov. Nothing on this page should be construed as a promise of benefits, compensation, or program enrollment.
We’ll help you find the right program for your family.
Why Families Choose FreedomCare
We help families across New York every day.
We’ll help you find the right program for your family.
Why Families Choose FreedomCare
We help families across New York every day.
Get clear answers about New York Medicaid home care, LHCSA services, CDPAP changes, family caregiver certification, MLTC, eligibility, and next steps.
