Ask Public Partnerships LLC (PPL), New York's statewide Consumer Directed Personal Assistance Program (CDPAP) fiscal intermediary, about enrollment, time entries, and payroll rules. Ask the Medicaid Managed Long Term Care plan or local district for the hour amount or an increase, because that agency sets authorized hours.
According to the NY State Department of Health statewide transition press release, PPL became the sole statewide intermediary on April 1, 2025. According to PPL's Myths vs. Facts explainer, PPL does not set authorized hours; the plan or district sets them from assessments.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- Who approves more hours?
- How does dementia need become hours?
- What should you ask PPL about pay?
- Who can direct care when memory fails?
- What if the hours fall short?
Who approves more hours?
PPL's explainer says the plan or local district turns assessment results into a weekly hour total. PPL pays within that total but cannot raise it. When supervision needs grow, call the plan care manager first.
Ask the plan for specifics that PPL cannot decide. Bring recent notes on supervision, safety, and night needs. Ask PPL to confirm aide enrollment and timesheet totals during the review. Keep logging only approved hours so pay stays clean.
- Current weekly hours and covered tasks
- What change triggers a new assessment
- What notes support more supervision time
How does dementia need become hours?
Since Sept. 1, 2025, LeadingAge NY, summarizing state policy, reports new adult applicants must show limited help with 3 or more Activities of Daily Living (ADLs). People with dementia or Alzheimer's can qualify with supervision or cueing for 2 or more ADLs plus a DOH-5821 form.
NY Health Access, from NYLAG, explains that a nurse from the NY Independent Assessor completes a Community Health Assessment with the state's UAS-NY assessment form. The assessment includes a practitioner order, then the plan uses a task-based tool to set weekly hours. FreedomCare's 2026 guide, citing the NYIA process, notes new approvals averaging over 12 hours per day need added medical review. Expect this step when you seek round-the-clock supervision for dementia.
What should you ask PPL about pay?
According to PPL Consumer Resources consumer resource page, live-in codes T1020, 2405 and 2406 pay a flat 13 hours to one aide per day. Ask PPL which code covers your case and which aide holds that slot. The same PPL resources state entries need consumer approval by Sunday noon for Thursday pay.
Ask PPL how to fix a missed approval before payroll closes. NYS Labor Law Sec. 170, via the State Senate, requires overtime at 1.5 times the rate after 40 hours in a week. Splitting high authorizations across aides can limit fatigue and disputes.
- How are weekly hours split across our aides?
- What happens when one aide nears 40 hours?
- How do we correct a wrong code or shift?
Who can direct care when memory fails?
State regulation 18 NYCRR 505.28, effective Nov. 30, 2025, allows a designated representative to direct care when the consumer cannot self-direct.
That person hires and manages aides, so a family caregiver can fill the role. Ask PPL what forms name the representative and enroll each aide. Ask how to add a backup aide for nights and weekends.
What if the hours fall short?
One state external appeal decision, published by the Department of Financial Services appeal decision, reversed a denial for dementia care. It set 12 hours per day, 7 days per week in split shifts.
That totaled 168 hours per week. Ask the plan for the denial notice and the reassessment path. Ask PPL how to keep current aides active and paid correctly while you appeal.
