Self-Direction and FMS in New York

All states: self-direction map

New York self-direction at a glance

Last verified against state sources: 2026-10-13.

Which Medicaid programs in New York offer self-direction?

New York has two main Medicaid self-direction programs: the Consumer Directed Personal Assistance Program (CDPAP) and OPWDD Self-Direction. CDPAP is for people of any age who need help with daily activities or skilled nursing tasks. OPWDD Self-Direction is for people with intellectual and developmental disabilities. Both let the person hire and manage their own workers, but only OPWDD Self-Direction also gives the person a budget to manage.

• Consumer Directed Personal Assistance Program (CDPAP): the services are also called Consumer Directed Personal Assistance Services (CDPAS). It serves Medicaid members of any age who are chronically ill or physically disabled, who need help with daily activities or skilled nursing tasks, and who can direct their own care or have a designated representative do it. The New York State Department of Health runs it. Services are authorized by the local department of social services or by the member's Medicaid managed care or Managed Long Term Care (MLTC) plan. The consumer has employer authority but not budget authority: the plan or local district authorizes a number of hours, and there is no individual budget for the consumer to manage.
• OPWDD Self-Direction: an option within the OPWDD Home and Community Based Services (HCBS) Waiver, a 1915(c) waiver. It serves people with intellectual and developmental disabilities who are eligible for OPWDD services and enrolled in the waiver. The New York State Office for People With Developmental Disabilities (OPWDD) runs it. The person can have both employer authority and budget authority.

Employer authority means the person recruits, hires, schedules and supervises the workers. Budget authority means the person also manages a set amount of money. On its self-direction providers page, OPWDD says a person builds a Self-Direction Budget within a Personal Resource Account, and a person who hires their own staff also sets staff pay within that budget. A Support Broker helps the person with the budget and with their Circle of Support.

Since September 1, 2025, adults 21 and over who are new to CDPAS or Personal Care Services must meet Minimum Needs Requirements. The Department of Health's CDPAP page describes them as needing at least limited physical assistance with more than two activities of daily living, or supervision with more than one for people with a dementia or Alzheimer's diagnosis. People who were already authorized on that date keep the earlier criteria.

New York also has a Community First Choice Option (CFCO) in its State Plan for members who need an institutional level of care and live in their own or a family member's home. We did not find a separate self-directed employer model, budget model or FMS organization for CFCO.

Who handles financial management services (FMS) in New York?

In CDPAP, one company handles financial management services for the whole state: Public Partnerships LLC (PPL), the Statewide Fiscal Intermediary. Since April 1, 2025, PPL is the only organization authorized to provide CDPAP fiscal intermediary services, so every CDPAP consumer works with PPL and does not choose among vendors. OPWDD Self-Direction is a separate system that uses certified nonprofit Fiscal Intermediary agencies.

New York's term for an FMS organization is fiscal intermediary (FI). A fiscal intermediary handles the payroll side of self-direction: it processes wages, benefits and withholdings and keeps the employment records. New York does not use the terms fiscal employer agent or agency with choice. Its own wording is that the CDPAP fiscal intermediary acts as joint employer.

• CDPAP, who does what: the consumer or designated representative recruits, hires, trains, supervises and terminates the personal assistants. The Statewide Fiscal Intermediary processes wages, benefits and withholdings.
• CDPAP, legal employer: the Department of Health's MLTC Policy 25.03 says the fiscal intermediary acts as the joint employer of the personal assistants, citing state regulation 18 NYCRR 505.28. PPL's own CDPAP FAQ calls PPL the Employer of Record for personal assistants, while the consumer or designated representative makes the hiring decision.
• CDPAP, facilitators: PPL subcontracts with facilitators, including Independent Living Centers, that help consumers with enrollment and with EVV training and compliance. Billing, payroll and benefits are handled only by the Statewide Fiscal Intermediary.
• CDPAP, how PPL is paid: the State Fiscal Year 2024-25 Enacted Budget authorized the Commissioner of Health to contract with a single Statewide Fiscal Intermediary. PPL bills the Department a single negotiated per member per month rate for the administrative part of the work.
• OPWDD Self-Direction: Fiscal Intermediary agencies are certified nonprofit providers of OPWDD HCBS Waiver services. They handle billing and payment of approved goods and services, fiscal accounting and reporting, and Medicaid and corporate compliance. OPWDD says services are provided under a co-employment model.

Two OPWDD points could not be confirmed. We did not find a readable state list of the OPWDD Fiscal Intermediary agencies or a count of them. We also did not find, on a page we could read, a statement of who the employer of record is for staff a person hires under OPWDD Self-Direction. OPWDD points to its Provider Directory for Fiscal Intermediary profiles. Ask OPWDD or the person's Support Broker for the agencies that serve a given area.

On pay, PPL's FAQ says the CDPAP personal assistant base rate rose by $0.55 an hour on January 1, 2026. It lists minimum base rates of $20.65 in New York City, $20.05 in Nassau, Suffolk and Westchester, and $18.65 in the rest of the state.

Who can be a paid caregiver under self-direction in New York?

In CDPAP, a friend or family member can be the paid personal assistant, with three exceptions. The personal assistant cannot be the consumer's spouse, the consumer's designated representative, or the parent of a CDPAP consumer under age 21. PPL's FAQ says the move to a single Statewide Fiscal Intermediary did not change these rules.

• CDPAP: friends and relatives can be hired, including adult children and parents of adult consumers, as long as the person is not the spouse or the designated representative. A parent cannot be the paid personal assistant for a child under 21.
• CDPAP hours and overtime: PPL's FAQ says overtime is allowed when it is needed for continuity of care and is paid at 1.5 times the regular rate. It is subject to plan or local district limits and to Department of Health guidance, which recommends at least one personal assistant for every 40 authorized hours. PPL pays only for hours within the consumer's service authorization.
• OPWDD Self-Direction, Support Brokers: family members who live in the same household as the person, or who are the person's parents, may not be paid as Support Brokers. They may serve unpaid if trained.
• OPWDD Self-Direction, self-hired staff: OPWDD's detailed rules are in its Self-Direction Guidance for Providers, a PDF we could not read. We did not confirm which relatives may be paid as staff.

Does EVV apply to self-directed workers in New York?

Yes. Electronic visit verification (EVV) applies to CDPAP and to listed in-home services in the OPWDD waiver. The Department of Health's EVV FAQ says providers and fiscal intermediaries cannot opt out. In CDPAP, personal assistants record their time in PPL's Time4Care mobile app or on PPL's telephony line.

• CDPAP, how time is recorded: PPL offers two EVV-compliant methods, the Time4Care app and a telephony line (1-833-278-3959). Consumers approve hours in PPL@Home, in Time4Care or by phone. PPL treats manual entries, later edits and late submissions as not meeting EVV standards.
• CDPAP, deadlines: PPL's FAQ says time entries are due by 11:59 p.m. Eastern Time on Saturday and approvals by noon Eastern Time on Sunday. Paper timesheets are limited to personal assistants with an approved exception.
• CDPAP, the EVV Scorecard: PPL's EVV page describes a Time4Care scorecard that rates the last 30 days of shifts as green at 90 percent or higher, yellow from 70 to 89.99 percent, and red below 70 percent. This is PPL's scorecard, not a compliance target published by the state.
• OPWDD Self-Direction: EVV applies only to listed in-home service codes. The state's EVV billing code list includes Community Habilitation delivered through a Fiscal Intermediary (rate codes 4765 to 4768) and Respite through a Fiscal Intermediary (4764). New York uses a Choice Model for EVV, so Fiscal Intermediary agencies choose their own EVV system.

On payment, the state does not automatically deny or hold a claim that has no matching EVV record. The EVV FAQ says non-compliance can lead to a compliance review, and it can be referred to the Office of the Medicaid Inspector General (OMIG).

Three points could not be confirmed. We did not find a published EVV exemption for live-in caregivers. We did not find a statement of whether PPL delays or withholds a personal assistant's pay for a shift recorded outside its EVV methods. We also did not find an OPWDD page on EVV for self-direction. For CDPAP, ask PPL customer service at 1-833-247-5346. For OPWDD services, ask the Fiscal Intermediary agency.

What is changing next for self-direction in New York?

We did not find an upcoming, dated change to self-direction in New York as of October 13, 2026. The large changes of the last two years are already in effect. We did not find a primary source for a confirmed change to the single Statewide Fiscal Intermediary arrangement.

These recent changes are in place today:

• April 1, 2025: PPL became the only organization authorized to provide CDPAP fiscal intermediary services.
• September 1, 2025: Minimum Needs Requirements began to apply to adults 21 and over who are new to CDPAS or Personal Care Services.
• January 1, 2026: the Department of Health posted 2026 Statewide Fiscal Intermediary budgeted rates on its CDPAP reimbursement page, and PPL's FAQ reports a $0.55 an hour rise in the personal assistant base rate.
• April 1, 2026: the date by which plans were required to move CDPAP consumers with an existing signed agreement to the revised consumer agreement. We did not find a state confirmation that this was completed.
• May 27, 2026: PPL says some new CDPAP personal assistants are assigned to The IMA Group for the required health assessment, while existing personal assistants stay with Mobile Health.

For OPWDD Self-Direction we did not find an announced change. To check for anything newer, see the Department of Health's CDPAP page and OPWDD's self-direction page, or email the Department of Health at StatewideFI@health.ny.gov with CDPAP questions.

New York self-direction sources

• NYSDOH: Consumer Directed Personal Assistance Program (CDPAP)
• NYSDOH: MLTC Policy 25.03 (Statewide Fiscal Intermediary transition)
• NYSDOH: CDPAP Statewide Fiscal Intermediary reimbursement
• NYSDOH: Electronic Visit Verification FAQs
• NYSDOH: EVV applicable billing codes
• OPWDD: Self-Direction
• OPWDD: Self-Direction for providers
• PPL: New York CDPAP frequently asked questions
• PPL: CDPAP electronic visit verification

Related reading

• Self-Directed Medicaid Home Care Services in 2026
• Understanding Self-Direction and FMS
• Self-Direction Fiscal Intermediary: A Guide for Participant-Directed Care
• 5 Big Challenges in Self-Directed Care And How FMS Providers Can Solve Them
• Self-direction in every state (map)
• New York EVV requirements

Page history

• October 13, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for FMS organizations and agencies that support self-direction. If you would like to talk through your program, contact Ankota or read more about Ankota's self-direction and FMS software.