The History of CDPAP in New York

The Consumer Directed Personal Assistance Program was founded in name in 1995. The program however has a deeper history going all the way back to the late 1970s. (1) A New York State Medicaid program, it was designed to benefit elderly and disabled individuals with stable medical conditions, by giving them the freedom to hire, train, and manage their own personal care assistants.

Those individuals the program was designed for had few options back in the late 70s with regards to the care they were given and even less control over their own care. They could be placed in overcrowded nursing homes or other low-quality institutions or have their home care run completely by a state-approved agency with little or no say over who is helping care for them. Not only did these options deprive the patients of choice, it also took away their independence and ability to direct their own care.

In 1977 a group was formed called Concepts of Independence for the Disabled. It was created by individuals being served by existing home care services in order to advocate for allowing those with disabilities to have more control over their care. More specifically, to be able to decide how they receive care and who provides that care. Soon after, a group of citizens in wheelchairs staged a protest at the New York City Board of Estimate which lead to a task force being created to find better state-run solutions for the disabled to have self-directed care. (1)

Further progress was made in 1979 when the task force created the Client Maintained Home Attendant Plan, which split the responsibilities of overseeing care between the patients/consumers and an agency. The program soon expanded at an exponential rate.

In 1992, the NYS Department of Health took over management of the home health program. They then launched the Patient Managed Home Care Program demonstration project to find ways to have the most positive and cost-saving impact. The program was a success and was renamed in 1995 to what it is currently known as: the Consumer Directed Personal Assistance Program. (1)

Participation scaled rapidly. The program had over 1,000 members by 1999. Over 75% of county Medicaid offices provided CDPAP services by 2002, and by 2008 the program had a 60% increase in enrolled members.

Soon CDPAP had become the second-fastest growing community-based program of its kind. The New York State Department of Health then approved grant funding for an outreach and expansion initiative. A training curriculum was developed, peer counselors were trained, and other measures taken all in order to assist consumers in determining whether the program was the best fit for their needs and if they met the requirements to be eligible.

Since 2012, most Managed Care and Managed Long Term Care Medicaid benefit packages have offered the program as an option of care. New York State expanded who was eligible to be a paid caregiver by 2016 which allowed parents of adult children with disabilities to act as caregivers. (1)

The program has had a meteoric rise in membership and impact on nearly every community, with every county in the State of New York required to offer CDPAP services and to educate the appropriate citizens on how they can take control of their own care.

1. “History of CDPAP.” Freedom Care NY - A CDPAP Agency - Hire Family As Paid Caregiver, 17 Apr. 2017,

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