Complete the form below to check eligibility and begin the Medicaid approval process for the Consumer Directed Personal Assistance Program (CDPAP). This program allows Medicaid recipients to hire and manage their own caregivers, including family members or friends. Providing accurate information will help ensure a smooth application process.

If the patient who requires the care cannot complete the form due to age, disability, or other reasons, a caregiver or trusted individual may fill it out on their behalf.

Patient Requirements:

  1. The patient requiring assistance must be 21 years or older.
  2. They must have a long-term health condition or disability requiring help with daily living activities.
  3. While CDPAP may be available in other states, our services are licensed exclusively for New York State residents.

Caregiver Requirements:

  1. Must be 18+ and authorized to work in the U.S.
  2. Must complete an initial health assessment.

We are committed to protecting your privacy and will use the information provided solely to determine eligibility for CDPAP.

What Happens Next?

After you submit the form:

  1. Our team will review your application promptly.
  2. We’ll contact you to discuss the status of your application, outline the following steps, and answer any questions.

If you have any questions or need assistance with the form, contact us:
📞 Call us at 718-395-6329
📧 Email us at contact@cdpaphc.com


id number
The Medicaid Client ID Number (CIN) is preferred and can be found on the front of the patient’s NYS EBT card, as shown in the example above. If you cannot locate the CIN, you may use their SSN instead.