New Yorkers caring for someone with Alzheimer's should get an updated physician certification documenting dementia and supervision needs, then apply through the New York Independent Assessor for home-care help. That certification matters because it preserves access under a lower functional threshold after the eligibility rules shifted. Personal Care helps with daily tasks at home.
CDPAP, or Consumer Directed Personal Assistance Program, lets the patient choose their own caregiver. MLTC, or managed long-term care, coordinates those services. ADLs mean activities of daily living, such as bathing, dressing, and eating.
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.
Official resources:
- Check eligibility on Nyc’s official study page — Use this page to check the study’s participation requirements.
- Check eligibility on Brevy’s official study page — Use this page to check the study’s participation requirements.
Table of Contents
- Get the dementia certification first
- How does the state assessment work?
- Who can be paid under CDPAP?
- What if income is over the limit?
- Do home-care asset transfers trigger a penalty?
Get the dementia certification first
Effective September 1, 2025, new adult applicants for Personal Care, CDPAP, or MLTC enrollment must need limited assistance with more than two ADLs. Applicants with physician-certified dementia or Alzheimer's must need supervision or cueing with more than one ADL, according to Falcon Rappaport & Berkman LLP in the firm's Medicaid home-care update.
Families should therefore ask the doctor for a current Alzheimer's or dementia certification. The letter should state the diagnosis and describe the need for supervision or cueing with specific ADLs. Without that certification, the patient faces the higher assistance threshold.
- Ask for dementia or Alzheimer's stated by name
- Ask for supervision or cueing needs tied to ADLs
- Keep a copy for the assessment and the managed-care plan
How does the state assessment work?
All home-care clinical eligibility must go through the New York Independent Assessor. It reviews medical conditions, determines care needs, and refers the patient to a managed-care plan or CASA, according to City of New York NYC311 in the NYC311 home-care guidance.
Call 855-222-8350 to schedule the assessment. Bring medications, diagnoses, and the dementia certification to the visit. Describe what happens on bad days, not only good days.
- Complete the Independent Assessor clinical review
- Receive the referral to a plan or CASA
- Follow the plan's care authorization next
Who can be paid under CDPAP?
Since April 1, 2025, every CDPAP consumer and assistant must register with Public Partnerships LLC as the single statewide fiscal intermediary for payroll. NY Health Access reports that this change replaced hundreds of prior intermediaries for about 280,000 consumers. An adult child, sibling, grandchild, friend, or neighbor can be hired and paid, including in the same home.
A spouse, a parent of a child under 21, and the consumer's designated representative cannot be paid, according to Caring Professionals in the Caring Professionals CDPAP explainer. Confirm payroll registration before shifts start. Keep assistant hours, timesheets, and supervision needs consistent with the authorized care plan.
What if income is over the limit?
In 2026, Community Medicaid for age 65+, blind, or disabled allows about $1,836 monthly income and $33,038 in countable resources for one person. It allows $2,489 income plus $44,796 resources for a couple applying together, according to LegalClarity New York in the LegalClarity Community Medicaid guide.
Income above that limit does not automatically disqualify an Alzheimer's patient. The Brevy Care Team reports that New York permits a medically-needy spenddown and pooled-income-trust route to establish eligibility. Ask an elder-law attorney or navigator which option fits the household budget.
Do home-care asset transfers trigger a penalty?
New York's 2020 law would create a 30-month asset-transfer lookback for community-based long-term care. HumanCare NY reports that the rule was still unimplemented in 2026 pending federal approval, so districts were not reviewing home-care transfers.
Nursing-home Medicaid is different. Its 60-month lookback remains fully in effect. Do not move assets before a nursing-home application without legal advice.
