1) What is the Consumer Directed Personal Assistance Service (CDPAS)?
CDPAS is a Medicaid home care service designed for those who require and are eligible to receive home care, personal care or skilled nursing services, and who wish to maintain control over who provides those services.
You must be “self-directing”, capable to make safe decisions for yourself. Or, you may name an individual who is willing and able to perform as your “self-directing other” (SDO). You, or your SDO, are in charge of directing your own home care services. You (or the SDO) are responsible for finding, interviewing, hiring, training, supervising and terminating your personal assistants.
2) Can you better define “self-directing”?
A self-directing individual is capable of making safe choices about his/her activities of daily living, understanding the impact of those choices and assuming responsibility for the results of the choices. Characteristics of a self-directing consumer would be:
- The consumer is alert, demonstrates unimpaired judgment, makes decisions that do not place the consumer or others at risk and is able to manage his/her own affairs.
- The consumer understands what to do in an emergency that threatens his/her health or safety, and can summon appropriate assistance, verbally or with the help of a device
- And, the consumer knows how to obtain assistance during times when the CDPAS is not being provided, including when services are unexpectedly interrupted due to inclement weather or personal assistant illness.
In contrast to a self-directing individual, someone who is not self-directing lacks the capability to make safe choices about his/her activities. This person does not understand the implications of those choices and cannot, or does not assume responsibility for the results of those choices. Characteristics of a NON self-directing consumer may would be:
- May be delusional, disoriented at times, have periods of agitation, or have behaviors that are inconsistent or unpredictable.
- The consumer may have tendencies to wander and/or to endanger his/her physical safety through exposure to hot water, extreme cold, misusing home appliances or equipment; or
- The consumer may exhibit other behavior harmful to him/herself or to others, such as hiding medication, taking medication without his/her physician’s knowledge, refusing or not understanding to seek assistance in an emergency.
3) What if I do not have Medicaid?
You must have Medicaid and be eligible for home care services to qualify for CDPAS. You may contact your county Department of Social Services or Human Services (DSS) or your Managed Care Organization or your Managed Long Tern Care Organization to express your interest in CDPAS.
A county representative or managed care organization representative helps you. They identify with the help of your doctor, if you qualify for this program.
If you do not have Medicaid, qualifying and applying for Medicaid can be a complicated process involving a thorough review of your income, assets, etc. Rules change frequently. It is best to work with the county department of social services to determine eligibility.
4) I have Medicaid and qualify for Home Care Services. What next?
You may call us for help. You will need to contact the county department of social services, your managed care organization or your managed long term care organization to inquire about the program. A representative will set up a time to meet to explain the program and paperwork with you more thoroughly. We can help you along the way.
There are several requirements to meet before a consumer can schedule an assistant to work within the program, so you cannot start immediately. You will also be asked to choose an agency, such as us, to work with. This agency operates as a Fiscal Intermediary.
Medical Solutions, Inc. is contracted to work in New York State with the Consumer Directed Personal Assistant Service as a Fiscal Intermediary. Once we are notified of your choice, our CDPAS Program Director will contact you to arrange a visit and get you started. Call us, and we’ll help you.
5) If I decide to use the CDPAS model, what are my responsibilities?
You, or your SDO will recruit, interview, hire, train, schedule, supervise and terminate your personal assistants which gives you control of who you work with, who is coming into your home, when they come into your home and how the tasks are performed.
You will need to ensure the appropriate employment paperwork is filled out for each worker and they are cleared to work by the Fiscal Intermediary. Our Program Director can help guide you regarding the employment paperwork.
You will follow the Plan of Care created by the registered nurse assigned to your case. The assistants are only allowed to perform tasks on the Plan of Care. You will approve your assistant’s time sheets and will ensure they are paid only for time worked. You will make sure you have back up personal assistants in case your primary assistant is ill or on vacation.
6) What are the responsibilities of Medical Solutions, Inc.?
As a Fiscal Intermediary, Medical Solutions, Inc. works with you to ensure you have a satisfactory experience with the program. On behalf of you, the employing consumer, we will process payroll for each personal assistant, including withholdings for taxes and social security. We monitor the completion of any required background checks, annual health assessment, PPD (tuberculosis skin test), and all other required employment documents. We provide Workers Compensation, Disability and Unemployment if things don’t work out. Medical Solutions, Inc. is available to provide you with support so that your program runs as smoothly as possible.
7) There are times I need to go to the hospital for a few days. Can my assistant still work for me when I’m in the hospital?
Absolutely not. If you are admitted to the hospital, your assistants are NOT allowed to work for you, unless you choose to pay them privately. Because Medicaid is already paying for your hospital care, they will not pay for your assistant to work for you while you are in the hospital. Your assistant may work for you up until the time you are admitted to the hospital.
8) Can I ask my family members to be my Personal Assistant?
It depends. New York State regulations do not allow payment for immediate family to work as personal assistants. Immediate family is defined as mother, father or spouse. Family members who live with you may also be excluded. You will need to check with your caseworker before you attempt to hire a family member.
9) What can my Personal Assistant do for me?
When assessed by the registered nurse, a Plan of Care will be developed specific to your needs. This plan will outline what tasks the assistant can perform. You cannot have your assistant paid by Medicaid while doing work that is not in your Medicaid Plan of Care. If you have questions about what tasks your personal assistant can do, please discuss with the registered nurse.
*** Medical Solutions, Inc. is a medical staffing agency that has served the Greater Rochester / Finger Lakes area since 1996 with a commitment to excellence in healthcare services. We are locally owned and operated which means you are helped by individuals living in your community that are quickly able to address your specific needs. We Truly Care.
