CDPAP is a Medicaid program. To qualify for services:

1. Medicaid eligibility (Community Medicaid/MLTC or Medicaid Managed Care, depending on age/disability).

2. Need for help with daily activities documented by a nurse assessment.

3. Ability to self-direct care or appoint a Designated Representative (DR) to handle hiring, timesheets, and communication with the plan/FI.

Who Can Be the Paid Caregiver?

• Usually eligible: Adult children, relatives, and trusted friends.

• Common restrictions: Spouses and parents of a minor child are generally not eligible to be paid caregivers under CDPAP. Legal guardians may have limits.

• Requirements: Caregivers must be legally allowed to work in the U.S., complete onboarding with the FI (paperwork, I-9, health screenings), and clock in/out via electronic visit verification (EVV).

What Hours Get Approved?

A nurse from your Medicaid plan (or local agency, depending on program) performs a standardized assessment of the consumer’s needs. The plan then authorizes a weekly number of hours.

• If needs increase (falls, hospitalizations, nighttime wandering, new wounds), you can request a reassessment.

• Hours can cover daytime, evening, and overnight as clinically justified.

• Some situations require an awake overnight aide for safety.

How the Money Flows (Pay, Taxes, Overtime)

• Pay rate: Set by the Medicaid plan and administered by the FI. Rates vary by region and plan.

• Payroll: The FI handles wages, withholdings, and direct deposit on a weekly or bi-weekly schedule.

• Overtime: Generally follows federal/state wage rules; your FI will explain caps and approvals.

• Out-of-pocket: If the consumer has excess income, they may need to meet a spend-down or use a pooled income trust (if applicable) to maintain Medicaid, this does not reduce the caregiver’s pay but affects the consumer’s monthly budget.

Step-by-Step: How to Apply

1) Confirm Medicaid Path

• If already on Medicaid Managed Long-Term Care (MLTC) or Managed Care, ask the plan about CDPAP and request an assessment.

• If not on Medicaid yet, start the Medicaid application (and pooled income trust setup if needed). Individual Home care can guide you.

2) Choose a Fiscal Intermediary (FI)

• The FI is your payroll and onboarding partner.

• Compare FIs on: support responsiveness, language access, direct-deposit timing, caregiver onboarding speed, and EVV app usability.

3) Nurse Assessment & Authorization

• A nurse evaluates daily needs and safety risks.

• You’ll receive approved weekly hours for CDPAP.

4) Recruit & Onboard Your Caregiver

• Pick your caregiver (family/friend).

• FI gathers documents: ID, work authorization, health forms (e.g., TB/physical per current requirements), direct deposit, and EVV setup.

• You (or your DR) review duties, boundaries, and backup plans.

5) Start Services & Track Time

• The caregiver clocks in/out with the EVV method required by the FI.

• You approve timesheets; FI processes payroll.

6) Keep Hours Aligned with Needs

• If circumstances change (new diagnosis, night needs), request reassessment.

• Maintain documentation (incidents, hospitalizations, MD notes) to support increases.

How Individual Home Care Helps

• Eligibility & paperwork: We map the Medicaid path (including spend-down/pooled trust if needed).

• Plan & FI setup: We coordinate assessments, help you pick an FI, and get onboarding right the first time.

• Care plan & hours strategy: We translate daily life into a persuasive, safety-focused care narrative for appropriate hour approvals.

On-going support: Reassessments, appeals, caregiver scheduling, and backup planning.