During New York’s 2025 CDPAP transition, thousands of consumers chose not to remain in CDPAP and instead moved to Personal Care Services, commonly called PCA Home Care. By May 2025, New York State reported that approximately 75,000 consumers had opted to transition from CDPAP to Personal Care Services.
If you are currently using CDPAP and wondering whether PCA might be a better fit, the most important thing to understand is that switching is not simply changing payroll companies. CDPAP and Personal Care Services are different Home Care models with different caregiver rules, training requirements, supervision and permitted tasks.
Quick Answer: Can You Switch From CDPAP to PCA in New York?
Yes. A Medicaid member can potentially move from CDPAP to Personal Care Services if PCS is appropriate and authorized for the person’s needs.
New York State advises that a consumer switching between the programs may need a new authorization for services, including an updated Person-Centered Service Plan and plan of care. Any required authorization should be addressed before the change takes effect to reduce the risk of a gap in Home Care.
Your existing CDPAP caregiver also cannot automatically become your PCA. The caregiver must separately meet Personal Care Aide relationship, training, employment and agency requirements.
What Changes When You Leave CDPAP for PCA?
The biggest change is who manages the caregiver.
Under CDPAP, the consumer or designated representative recruits, trains, schedules and supervises the personal assistant. The consumer is responsible for directing the care and arranging backup coverage.
Under Personal Care Services, the caregiver is a trained Personal Care Aide employed by a licensed Home Care agency. The agency manages employment, payroll, training requirements, administrative supervision and staffing responsibilities.
| CDPAP | PCA / Personal Care Services |
|---|---|
| Consumer-directed | Agency-delivered |
| Consumer recruits and manages PA | Licensed agency employs PCA |
| No PCA certification required | PCA training or approved competency pathway required |
| Broader caregiver relationship rules | More restrictive relationship rules |
| PA may perform authorized skilled tasks | PCA has a narrower scope of practice |
| PPL processes CDPAP payroll | Home Care agency processes payroll |
Can Your Current CDPAP Caregiver Become Your PCA?
Possibly, but it depends heavily on the relationship between the caregiver and the person receiving care.
CDPAP generally allows more relatives to serve as paid personal assistants. Eligible adults can potentially include adult children, siblings, friends and other relatives, subject to the program’s restrictions.
New York’s traditional Personal Care Services rules are more restrictive. Medicaid payment for PCS cannot be made to the patient’s spouse, parent, son, daughter, son-in-law or daughter-in-law. Other relatives may potentially qualify when all applicable requirements are satisfied.
So if your current CDPAP personal assistant is your adult son or daughter, switching to PCA generally means that person cannot simply continue as your paid PCA.
For more information about CDPAP relationships, see our CDPAP caregiver requirements.
Does a CDPAP Caregiver Need Certification to Switch to PCA?
A CDPAP personal assistant does not need PCA or HHA certification simply to work in CDPAP. The consumer or designated representative is responsible for training and supervising the PA.
PCA Home Care is different. Someone hired as a Personal Care Aide must meet New York training and competency requirements.
Standard PCA basic training consists of at least 40 hours through an approved New York Personal Care Aide Training Program. People with qualifying previous training or experience may instead qualify for an approved competency evaluation pathway.
Training, required evaluations, health documentation and agency onboarding should be completed before changing services if you are trying to keep the same eligible caregiver.
Will Your Home Care Tasks Change?
They can.
CDPAP personal assistants can perform authorized Personal Care, Home Health Aide and certain skilled nursing tasks when properly trained and directed by the consumer or designated representative.
A PCA has a narrower permitted scope. Depending on the person’s care needs, moving from CDPAP to Personal Care Services may mean that some tasks currently performed by the PA cannot be performed by a PCA.
This is particularly important when the consumer requires health-related tasks or skilled care. The services needed should be reviewed before changing programs rather than discovering after the switch that the new caregiver cannot perform an essential task.
Considering PCA Home Care?
If you are exploring PCA instead of CDPAP, start by checking whether the patient and proposed caregiver fit the PCA pathway before making changes to existing care.
Family Caregiver NY screens the caregiver relationship, location, Medicaid status and patient’s long-term care needs before referring qualified cases to top, vetted licensed Home Care agencies.
Call or text 929-660-2391 if you want to discuss the situation before completing the form.
Will You Lose Your Current Home Care Hours?
You should not assume that an existing CDPAP schedule automatically transfers unchanged to Personal Care Services.
New York State specifically advises consumers that a change between CDPAP and PCS may require a new authorization, Person-Centered Service Plan and plan of care. The required authorization should be addressed before switching to help prevent a gap in services.
That does not mean switching automatically reduces your hours. It means the PCS authorization and care plan need to support the services that will be delivered under the agency-based model.
Do the New Minimum Needs Requirements Apply?
New York introduced new Minimum Needs Requirements for many people seeking Personal Care Services or CDPAP beginning September 1, 2025.
For new applicants age 21 or older, eligibility generally requires the person to be assessed as needing at least limited assistance with physical maneuvering in more than two activities of daily living.
For someone with Alzheimer’s disease or dementia, the standard can be met when the individual is assessed as needing at least supervision with more than one activity of daily living.
However, people who were authorized for PCS or CDPAP before September 1, 2025 may have Legacy Status. Those individuals are reassessed under the previous eligibility criteria rather than the new Minimum Needs Requirements while the applicable legacy protections remain in place.
Can You Switch Back From PCA to CDPAP?
Potentially, yes.
During the statewide CDPAP transition, the New York State Department of Health specifically stated that Home Care consumers who chose Personal Care Services could later register with PPL if they decided to return to CDPAP.
Returning to CDPAP still requires the consumer to meet current CDPAP eligibility and authorization requirements and to use New York’s Statewide Fiscal Intermediary.
When Might PCA Be a Better Fit?
PCA Home Care may be worth considering when the consumer prefers an agency-managed model rather than taking responsibility for recruiting, scheduling, training, supervising and arranging backup caregivers.
It may also be practical when an eligible extended relative or trusted friend wants to become a trained caregiver through a licensed Home Care agency.
CDPAP may remain appropriate when the consumer wants direct control over staffing, has an eligible caregiver who could not qualify under PCS relationship rules, or needs authorized tasks that fall outside a PCA’s scope.
Neither program is automatically better. The decision depends on the consumer’s medical needs, caregiver relationship and ability or desire to manage the caregiver directly.
Frequently Asked Questions
Can I switch from CDPAP to PCA in New York?
Yes. Consumers may potentially move from CDPAP to Personal Care Services. New York advises that a new authorization, Person-Centered Service Plan or plan of care may be required, so the transition should be coordinated before existing services end.
Can I keep my CDPAP caregiver after switching to PCA?
Possibly. The caregiver must qualify under PCS relationship rules and satisfy PCA training, evaluation, background-check and agency employment requirements. Some relatives eligible under CDPAP cannot be paid caregivers under PCS.
Does my CDPAP caregiver need 40 hours of training?
Not to work as a CDPAP personal assistant. However, if an eligible PA wants to become a Personal Care Aide, standard PCA basic training is at least 40 hours unless an approved alternative competency pathway applies.
Can my adult child continue as my PCA?
Generally, no. Adult sons and daughters may potentially serve as CDPAP personal assistants, but New York’s Personal Care Services payment rules prohibit payment to a patient’s son or daughter.
Can I return to CDPAP after switching to PCA?
Potentially. New York has stated that consumers who switched to Personal Care Services may later return to CDPAP if they meet the program’s current requirements and complete the required process with the Statewide Fiscal Intermediary.
About CDPAPHC.com: CDPAPHC.com is an independent informational resource about New York’s Consumer Directed Personal Assistance Program. We do not process CDPAP enrollment. Families exploring PCA, HHA or OPWDD services can visit FamilyCaregiverNY.com for screening and referral assistance.