Help in New York

New York has one of the more generous Medicaid long-term care programs in the country, and it shows up in the details. The Consumer-Directed Personal Assistance Program (CDPAP) is unusual: eligible recipients can hire their own caregivers, including in many cases adult children or other family members, and the state pays for the hours. For families that have already been providing unpaid care, this can be a significant change. Eligibility rules are real and worth getting help with. A practical heads-up: as of April 2025, CDPAP transitioned to a single statewide fiscal intermediary (Public Partnerships LLC, or PPL), replacing the 700+ local agencies that used to administer it. Existing consumers and personal assistants had to re-enroll. If you're entering CDPAP for the first time or your family was previously enrolled, verify the current process directly — this is an area where outdated guides on the internet are common. The state expanded Medicaid in 2014. New York also runs Managed Long-Term Care plans (MLTC) for adults 21+ who need community-based long-term care; enrollment in an MLTC plan is required to access most home-care services through Medicaid. NYSOFA (the State Office for the Aging) operates NY Connects, which is the closest thing to a single front door for caregivers — they route callers to the right Area Agency on Aging based on county. Outside of New York City, the AAA network is strong; in NYC, the Department for the Aging operates a parallel system. Adult Protective Services in New York is administered by counties, not statewide. New York City residents reach APS through 311. One planning quirk: New York has historically aggressive estate-recovery rules for Medicaid long-term care. Spousal protections are decent, but the rules around the family home are nuanced. An elder-law attorney with NY experience is particularly important here.