How to Get Paid as a Family Caregiver in New York

Yes. New York can pay an adult child, sibling, friend, or some other adult relative to provide approved care through CDPAP, but it generally cannot pay the Medicaid member’s spouse, designated representative, or the parent of a member under 21 through that program.

The fastest useful question is not “Does New York pay family caregivers?” It is which program can pay this person, for this recipient, in this county? For 2026, Public Partnerships LLC (PPL) publishes minimum base wage rates of $20.65 an hour in the five New York City counties, $20.05 in Nassau, Suffolk, and Westchester, and $18.65 everywhere else in New York. Those are minimums, not a promise of the worker’s final wage or approved hours. The personal assistant’s actual base rate appears in the PPL offer letter.

The relationship decides the route. The authorization decides the hours. The written offer decides the wage. Get all three right before your household counts on caregiver income.

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Pick the Door That Can Actually Pay

New York does not have one family-caregiver paycheck. It has separate doors with separate rules.

CDPAP is the main statewide answer for many families. It is a Medicaid home-care program in which the consumer or designated representative recruits, hires, trains, supervises, schedules, and can dismiss the personal assistant. The personal assistant can perform authorized personal-care, home-health-aide, and nursing tasks. That control is the bargain: New York may fund the care, but the household accepts real employer-like responsibilities.

The CDPAP Family Rule: Who Is In and Who Is Out

Here is the clean answer.

Usually possible: an adult child, sibling, grandchild, cousin, in-law, other adult relative, friend, or neighbor, if that adult is otherwise qualified and the care plan can be delivered safely and cost-effectively. The controlling regulation allows an adult relative other than a legally responsible person, spouse, or designated representative when the conditions are met.

Not allowed as the CDPAP personal assistant:

• The Medicaid member’s spouse.
• The parent of a consumer who is under age 21.
• The consumer’s designated representative.
• A legally responsible person under the governing rule.

Do not solve a relationship exclusion by putting the same person on both sides of the timesheet. A designated representative acts for a consumer who cannot fully self-direct; that representative cannot also be the paid personal assistant. If Mom needs a representative and wants her daughter paid, one workable structure may be for another qualified person to serve as representative while the daughter applies as the assistant. The plan and administering parties still have to approve the arrangement.

The worker does not get paid merely because care is already happening. The consumer or representative must recruit enough assistants, train and supervise them, arrange backup coverage, and attest to time worked. PPL, as the statewide fiscal intermediary, handles payroll functions such as wages, required withholding, workers’ compensation, disability coverage, unemployment insurance, records, and timesheets.

Family is not the authorization. Love is not the timesheet. Existing unpaid care is not automatically approved paid work.

What CDPAP Pays in New York in 2026

PPL’s current published minimum base wage rates are county-specific. The actual base rate for a particular personal assistant is the rate in the PPL offer letter.

• Bronx, Kings, New York, Queens, and Richmond counties: $20.65 per hour minimum base wage rate.
• Nassau, Suffolk, and Westchester counties: $20.05 per hour minimum base wage rate.
• All other New York counties: $18.65 per hour minimum base wage rate.

PPL says personal assistants are paid weekly on Thursday by direct deposit or check. Its benefits package can include sick and safe leave, holiday benefits, health benefits, a 401(k), training, and Paid Family Leave, subject to the applicable rules. PPL also says rates are set, take its benefits into account, and are not negotiated worker by worker; the personal assistant’s actual base rate appears in the offer letter.

The statewide labor-law floor is a separate number. Effective January 1, 2026, New York’s minimum wage for covered home-care aides is $19.65 in New York City, Long Island, and Westchester and $18.65 in the rest of the state. The labor department includes CDPAP personal assistants in its home-care-aide definition. PPL’s published NYC and suburban minimum base wage rates are therefore not identical to the broad statutory floor.

In New York City, Nassau, Suffolk, and Westchester, Medicaid-reimbursed home-care work can also carry wage-parity obligations through a combination of wages and supplemental benefits. The employer must provide a wage notice at hiring and when the rate changes, and the pay statement must identify required wage-parity information. Ask for the PPL offer letter and pay notice. Read the cash wage and benefits separately.

Do not confuse the Medicaid service rate with your paycheck

New York’s 2026 CDPAP reimbursement schedule lists basic statewide-fiscal-intermediary service rates of $27.34 in New York City, $26.46 in Nassau/Suffolk/Westchester, and $24.73 in the rest of the state. Those are official service reimbursement rates, not the personal assistant’s hourly take-home wage. The same schedule has different hard-to-serve and live-in rates, which is another reason not to lift one large number from the table and call it caregiver pay.

Your household math is:

written hourly wage × authorized hours actually worked = gross wages before deductions.

Do not multiply by 24 hours a day. Do not use the reimbursement rate. Do not assume the hours you currently provide will all be authorized.

Who Qualifies for CDPAP Now

The recipient must have Medicaid, a stable medical condition, and a need for help with daily activities or skilled care that the program can authorize. The person must be able to self-direct or have a designated representative who can carry the responsibility.

New York added a minimum-needs gate effective September 1, 2025. In the covered adult populations, a person generally must need at least limited physical help with more than two activities of daily living. A person with dementia or Alzheimer’s disease may instead qualify by needing at least supervision with more than one activity of daily living. The rule does not apply to PACE participants, and New York describes transition protection for certain people who were already authorized, receiving services, or continuously enrolled in specified managed long-term-care coverage by the effective date.

That is not a diagnosis-only test. Document what happens during bathing, dressing, toileting, eating, transferring, walking, medication tasks, and skilled care. “Needs help” is weak. “Cannot transfer from bed to toilet without hands-on support and falls without it” gives the assessor something concrete to evaluate.

For 2026, New York’s official long-term-care Medicaid table shows a $1,836 monthly income allowance and $33,038 resource allowance for a single community-based home-care applicant; its applicant-with-spouse row shows $2,489 monthly income and $44,796 in resources. These are not universal limits for every Medicaid category or household. Do not give away assets or stop after an online calculator says “over income.” Ask the Medicaid office how the correct eligibility category, spousal rules, or spenddown treatment applies to the recipient.

Apply in This Order

1. Establish Medicaid through the right local door

New York City residents use the Human Resources Administration Medicaid process; for the general application route, call HRA at 718-557-1399. Residents outside New York City can use their local department of social services, while some eligibility categories apply through NY State of Health. The separate 1-888-692-6116 helpline appears in the state’s spousal resource-and-income allowance instructions; it is not the general NYC application number.

2. Request the independent assessment

For an initial personal-care or CDPAP assessment, call the New York Independent Assessor Program at 1-855-222-8350; TTY is 1-888-329-1541. An authorized representative may call for the applicant only when that representative is already on file with NYIAP.

The initial process requires all three of these components: an independent assessment performed by a qualified registered professional nurse, a medical examination, and a practitioner order. The local social services district or Medicaid managed-care organization then reviews the record, develops the plan, and authorizes the amount, frequency, and duration of services.

For a proposed plan averaging more than 12 hours per day, the district or managed-care organization must obtain and consider the independent review panel’s recommendation before authorization. A fair-hearing decision or court may order authorization, and a temporary plan above 12 hours may be used while the recommendation is pending when necessary to meet timing requirements, including an immediate-needs case. The panel recommendation must be considered, but it is neither an automatic approval nor an automatic denial.

3. Get the service authorization before doing payroll math

The district or managed-care organization can authorize only services actually needed and covered by the plan, and an authorization period may run no longer than 12 months before the next required action. Ask for the approved tasks, weekly hours, effective date, and authorization owner in writing.

4. Enroll the consumer and worker with PPL

PPL is New York’s required statewide fiscal intermediary for CDPAP. Its New York contact number is 1-833-247-5346. Complete every enrollment task PPL assigns to the consumer and proposed assistant. Do not treat a form-submission date as a payable start date.

5. Follow the actual timekeeping clock

PPL’s current program instructions say the assistant submits time by Saturday at 11:59 p.m. and the consumer approves it by Sunday at noon for timely weekly processing. Time beyond the authorization is not made payable by entering it on a timesheet. Keep the authorization, offer letter, start notice, time records, and pay statements together.

There is no single responsible office called “Medicaid” once a case is moving. NYIAP conducts the independent assessment. The district or plan decides and authorizes. PPL handles fiscal-intermediary payroll. Call the owner of the stuck step.

When OPWDD Is the Better Door

If the care recipient has an intellectual or developmental disability, start with OPWDD eligibility and the Front Door, not a generic CDPAP sales line. OPWDD lists 1-866-946-9733 for the Front Door and explains that eligibility, care-management enrollment, Medicaid home-and-community-based-services steps, and the service plan come before self-directed services.

OPWDD Self-Direction can give the person employer authority to hire, schedule, supervise, and dismiss staff under a co-employment structure. Budget authority uses a personal resource account and approved self-direction budget, with a fiscal intermediary handling billing and payment.

But OPWDD does not copy CDPAP’s family rule. Its published self-direction guidance allows some relatives to be paid staff only when the worker is at least 18, is not a parent, legal guardian, spouse, or adult child including an in-law, does not live with the person, is not performing an ordinary family function, and provides an authorized service that would otherwise need another provider. The fiscal intermediary is the employer of record and reviews staffing, timesheets, budget compliance, and payments.

There is no honest statewide OPWDD caregiver wage to print here. Ask the care manager and fiscal intermediary for the service title, approved units, compensation rate, employer-of-record arrangement, and written start date.

Four Alternatives When CDPAP Does Not Fit

Paid Family Leave: a bridge from your own job

New York Paid Family Leave can cover care for a spouse, domestic partner, child, stepchild, person in legal custody, parent, stepparent, parent-in-law, grandparent, grandchild, or sibling with a serious health condition. In 2026, the benefit can replace 67% of the employee’s average weekly wage for up to 12 weeks, capped at $1,228.53 per week. This is temporary insurance through the employee’s job, not permission to bill Medicaid for family care.

VA PCAFC: a monthly stipend for an approved primary caregiver

PCAFC can recognize a caregiver who is at least 18 and is the eligible Veteran’s spouse, child, parent, stepfamily member, extended family member, or a person who lives full time with the Veteran. The Veteran must meet VA conditions that include a VA disability rating of at least 70%, VA enrollment, and a need for at least six months of continuous in-person personal care. An approved Primary Family Caregiver may receive a monthly stipend, and the Veteran and caregiver apply together using VA Form 10-10CG online, by mail, or in person.

Veteran-Directed Care: a local budget with hiring authority

Veteran-Directed Care gives an eligible Veteran a flexible service budget and may allow the Veteran to hire a family member or neighbor. Availability and covered services vary by location; enrollment in VA health care, clinical need, and local program availability matter. Ask the Veteran’s VA social worker which New York site administers the program.

Local aging services: useful help, not a statewide family wage promise

EISEP provides coordinated nonmedical services for a person who is at least 60, needs help with at least one activity of daily living or two instrumental activities of daily living, can be maintained safely at home, and is not eligible for the same services through Medicaid. State guidance allows Area Agencies on Aging to offer a consumer-directed model, but adoption is local. Ask the county office whether it offers that model, which relatives it permits, who acts as fiscal intermediary, whether there is cost sharing, and what rate applies. Until the local office answers, do not count it as a family paycheck.

Taxes, Benefits, and the Paycheck You Keep

PPL handles required payroll withholding. That means “Medicaid caregiver pay is tax-free” is not a safe blanket rule. The IRS says some Medicaid home-and-community-based waiver payments may be excluded from gross income under Notice 2014-7 when care is provided in the worker’s home, but treatment depends on the program and payment facts. The IRS also says federal employment-tax treatment can depend on whether the worker is the employee of the care recipient or another entity. Ask PPL what tax form and withholding treatment it will use, then take the actual facts to a qualified tax professional.

If the worker receives SSI, Social Security says to report gross wages and changes in earnings no later than the tenth day of the following month and keep pay stubs. Also check how wages affect SNAP, housing assistance, Medicaid, or other means-tested benefits before the first check lands.

Frequently Asked Questions

Can a wife or husband get paid through New York CDPAP?

No. The Medicaid member’s spouse cannot serve as that member’s CDPAP personal assistant. Screen Paid Family Leave and the VA programs separately because they use different relationship rules.

Can an adult daughter or son get paid?

Often, yes. An adult child can fit CDPAP’s “other adult relative” rule if the person is not also the designated representative or otherwise legally barred and all program conditions are met. OPWDD is different: its published family-staff guidance excludes an adult child, including an in-law.

Can a parent get paid to care for a child?

Not through CDPAP when the consumer is under 21. A parent caring for an adult may fit CDPAP if no other exclusion applies. OPWDD’s self-direction family-staff guidance excludes a parent, so do not transfer the CDPAP answer to OPWDD.

How much does CDPAP pay in New York City?

PPL currently publishes a $20.65 hourly minimum base wage rate for personal assistants serving consumers in the five New York City counties. That is a minimum, not necessarily the worker’s final base wage; the actual base rate appears in the offer letter. Gross weekly pay still depends on authorized hours actually worked, and deductions and benefit treatment affect the check.

Is the $27.34 New York City CDPAP rate my wage?

No. It is the 2026 basic service reimbursement rate on New York’s statewide fiscal-intermediary schedule, not the personal assistant’s wage. PPL’s published NYC minimum base wage rate is $20.65; the offer letter states the worker’s actual base rate.

Is CDPAP administered differently in New York City?

The CDPAP program and PPL fiscal intermediary are statewide, but the Medicaid application office and wage region differ. New York City applicants use HRA, and PPL publishes a $20.65 minimum base wage rate for personal assistants serving consumers in its five-county NYC region. The personal assistant’s actual base rate appears in the offer letter. The service authorization may belong to a managed-care plan or local district depending on enrollment.

Can I be paid for care I gave before enrollment?

Do not assume so. The current official sources reviewed do not establish a statewide promise of retroactive family-caregiver wages before authorization, worker enrollment, and an official start. Treat pre-start care as unpaid unless the responsible program gives a written, case-specific answer.

How long does approval take?

There is no responsible statewide number to promise. Timing depends on Medicaid status, assessment, authorization, document completion, worker enrollment, and corrections. Ask each owner for the date its step was received, what remains missing, and the escalation path. Do not budget from a competitor’s “two to four weeks” claim.

Is there a CDPAP waiting list?

The current official sources reviewed do not publish one statewide waitlist count or guarantee immediate service. Ask the district or managed-care plan about the recipient’s authorization status and ask PPL about enrollment status; those are different questions.

Can the same person be designated representative and paid assistant?

No. The CDPAP designated representative cannot also be the personal assistant. Split the roles before enrollment.

Turn Care Into Authorized Pay, Not Wishful Math

Start with four pieces of paper: the recipient’s Medicaid and program status, the service authorization, the worker’s written offer or compensation approval, and the official start/timekeeping instructions. If one is missing, the paycheck is not ready.

The relationship decides the route. The authorization decides the hours. The written offer decides the wage.

Find My Best Rate records your New York interest for HomeCare’s private beta and future rate rankings. It does not currently route your case, compare offers, select an administrator, determine eligibility, refer you, return a rate, or promise a response. For action today, call the official owner named in the section that matches your route.