How does Medicaid self-directed home care (called CDPAS in NY, don't know if elsewhere) work?

If you are approved for 40 hours a week and are disabled, hire an agency aide for the full 40 hours, that will take care of bathing, dressing, etc. Talk to the agency about spreading the 40 hours across the 7 days, instead of just 5. Use the respite, caregiving is not a job for someone who is disabled...you will have enough to do for mom when the aide is not present.

The ltmc agency you choose, like home first or whatever will have a list of home health agencies in your county that they are contracted with. Do you have poa over your mom? If you do, you can't get paid, it's a conflict of interest because cdpap is consumer directed personal assistant program and if you are the poa because she's unable to make her own choices then you are the consumer and you cant direct yourself. But if you aren't poa and she is competent, you call the agencies, see what they pay and whatever else. Here's the thing about cdpap, it's all on the consumer to hire, train and fire the aides so you cannot be cdpap and then ask the agency to send you some people. You get your own people. Then once you pick the agency, they send some paperwork and you have to get a physical and some tests like ppd and proof of vaccinations, you also need a flu shot each year. If the physical shows you can get the job done then you get the papers and tax and id forms to them, a rep from the agency comes out for your mom to sign a contract, give her some time sheets, a handbook and explain their payroll process, I take a picture of mine and email it but it might be different elsewhere. Then you can start working. You get a regular check with taxes taken out. The agency is your employer of record but you will really have no contact with them unless they mess up the check or there's a rule change, etc. then every 6 months someone will come over from both the ltmc and the hha, not on the same day but usually the same week because they put it off until the last week. They just come and check out the patient, make sure everything is ok. The hha is in and out in 5-15 minutes, the ltmc is a little longer depending on the nurse, one guy is here 5 minutes but the females actually do their jobs and are usually 30 minutes. The ltmc is there to re certify your mom and to see if the hours allotted need to be raised or lowered or stay the same. Hope this helps, I've been getting paid through this program for about 3 years so lmk if you have any more questions.