Home care services for adults with autism (and for anyone living with developmental disabilities or special needs) can be difficult to find and can be costly – up to $25 per hour on average. However, if you live in New York State and qualify for Medicaid, it is possible for you to be paid as your autistic child’s full-time caregiver if they are over 21.
Read on for more details on how this is possible.
- Yes, if your adult child is over 21 and covered by Medicaid, you can get paid to care for them through the New York State Department of Health’s CDPAP program.
- CDPAP allows your disabled child to receive personal assistance care and/or health services tailored to their needs, and to hire a trusted family member or friend as their paid caregiver.
- In order to apply for CDPAP, your child will need to undergo a social and nursing needs assessment and fill out forms such as an application and acknowledgement of caregiver responsibilities. Once enrolled, it’s recommended that your child works with a fiscal intermediary for payroll needs and other financial help services.
Can You Get Paid to Care for Your Autistic Child in New York?
The short answer is yes, it is possible for you to get paid to care for your autistic child in New York, if your child is 21 or over and you qualify for the CDPAP program. Read on to learn more.
What is CDPAP?
The New York State Department of Health’s Consumer Directed Personal Assistance Program (CDPAP) provides services to chronically ill or physically disabled individuals who need either skilled nursing or assistance with daily tasks. Beneficiaries of this government program have the freedom to choose their own caregivers, so friends and family are often hired and paid through the program. A fiscal intermediary handles payroll, benefits administration, and compliance with local laws and regulations.
What Are the Requirements?
Beneficiaries of CDPAP must be residents of New York State, qualify for New York State Medicaid, and currently be receiving (or be qualified to receive) long-term home care services, as determined by the Department of Social Services.
To have eligibility for the Medicaid program in New York State, you must either meet certain low-income requirements (below $14,580 annually for a single person) or fall under certain eligible populations with resources below certain levels. Eligible populations include children, pregnant people, single individuals, families, and individuals certified as blind or disabled.
To qualify for CDPAP, if your child is over 18, they must undergo a community health assessment and clinical appointment, both administered by the New York Independent Assessor (NYIA). This will determine whether your child can appropriately participate in the program.
If your child is under 18, they must receive a Physician’s Order for Services from their doctor and send it to the local services district. Then, the local services district will be authorized to complete the same community health assessment in order to determine if CDPAP is right for your child.
What Are the Benefits of CDPAP?
CDPAP allows your child to receive personal assistance tailored to your needs, to hire whomever you choose as your caregiver, and to receive as many caregivers as authorized by your service provider.
You’ll have a fiscal intermediary to handle paperwork and payroll needs, but will still be able to oversee the caregiver’s time sheets and number of hours and make decisions about the nature of your child’s care.
What is the Process for Becoming a CDPAP Caregiver to My Autistic Child?
If you would like to be hired as your autistic child’s official paid caregiver through CDPAP, there are steps you can take to do so. Read on for more details.
Managed Medicaid vs. Standard Medicaid
In addition to its standard program Medicaid offers a Managed Care program. When you are enrolled in a managed care plan, you select one regular doctor (called a primary care practitioner (PCP)) who will be solely responsible for your care and for coordinating any necessary referrals to specialists.
Typically, it is required that you select specialists and hospitals for necessary procedures from a pre-approved managed care network. With managed care plans, healthcare providers are paid directly, so you won’t need to pay out-of-pocket for covered services or submit claim forms for visits to in-network doctors.
Most managed care plans also offer health education classes, and some provide transportation to and from appointments.
On the other hand, the standard Medicaid health insurance plan in New York includes regular exams, immunizations, doctor and clinic visits, relevant medical supplies and equipment, lab tests, X-rays, vision care, dental care, in-home nursing, hospital stays and emergencies, and prescriptions.
With the standard care plan, you are not confined to your PCP’s associated network of specialists, but you are more likely to be charged a copay at the time of each visit.
As part of the CDPAP process, your child will be assessed for both social and nursing needs. Upon the receipt of a signed physician’s order, a member of the social services district staff (specifically, a registered nurse or certified home care services agency for the nursing assessment) will arrange for this assessment.
The social assessment includes a discussion of your child’s needs and preferences, an evaluation of current informal support from friends and family members, and how your child feels about the current state of those informal support services.
The nursing assessment includes a review of the physician’s order, your child’s primary diagnostic code, an evaluation of the care tasks needed (personal care, home health aide, and skilled nursing tasks), an evaluation of the medical supplies and equipment necessary, recommendations for the authorization of services, a formal CDPAP Plan of Care, and an evaluation of whether your child or a designated representative is capable of supervising and directing care.
Certain forms are required to apply for the CDPAP program. This includes a signed physician’s order, a formal medical request for home care, a CDPAP application, and a formal consumer (or designated representative) acknowledgment of roles and responsibilities.
Choosing the Caregiver
CDPAP allows your family to hire virtually anyone, including parents of children, as an adult beneficiary’s caregiver. This means that if your child is 21 or older, yes, this can be you! (as long as you are not the child’s healthcare proxy). Caregivers must also be at least 18 years of age or older.
Siblings can care for each other, and children can care for parents. The only family members that are not included in this program are spouses. Otherwise, you may hire any loved one, trusted friend, or neighbor as your child’s caregiver, or opt to find a skilled nurse through an agency.
Find a Fiscal Intermediary That’s Right for You
Once you’re enrolled in CDPAP, it’s a good idea to work with a fiscal intermediary to handle payroll and benefits administration and to ensure that you’re compliant with local laws and regulations.
You can work with a fiscal intermediary through an agency that offers CDPAP-related services. When choosing who to hire, look for an established provider with experience, who does business in your language and operates from a location that’s accessible to you.