Updated September 4, 2026. Quick answer: yes, through Consumer Directed Personal Assistance Program (CDPAP). Most adult family members can be hired and paid to provide the care. A spouse cannot be the paid caregiver; the federal rule against paying a “legally responsible relative” still applies here.
How New York pays a family caregiver
| Program | Consumer Directed Personal Assistance Program (CDPAP) |
|---|---|
| Can a family member be paid? | Yes. “a person legally responsible for an eligible individual’s care and support, an eligible individual’s spouse or designated representative may not be the personal assistant” |
| Can a spouse be paid? | No. “a person legally responsible for an eligible individual’s care and support, an eligible individual’s spouse or designated representative may not be the personal assistant” |
Why the spouse question is different
Federal Medicaid rule treats a spouse (and a parent paying for a minor child) as a “legally responsible relative”, someone already assumed to owe the care for free, so paying them is barred by default. A state has to build an explicit exception into its waiver or state-plan option to pay a spouse at all; the rule for any other relative (an adult child, a sibling, a grandchild) is looser and usually allowed. That is why the two rows above can carry different answers on the same page.
The going rate
Not published by the state in the materials reviewed this session.
How it works
Under CDPAP, a New York Medicaid member (or designated representative) directly recruits, hires, trains, and supervises their own personal assistant, who can be almost any adult relative or friend, but not the consumer’s spouse, their own designated representative, or the parent of a minor consumer. Payroll and employer-of-record functions run through a state-authorized Fiscal Intermediary, under authority of Social Services Law Section 365-f.
What this doesn’t answer
The NYS Department of Health’s own CDPAP page and clarification documents returned 403 errors and could not be fetched directly, so the spouse/family exclusion is sourced instead to the officially codified statute text as published by the NY State Senate, which is authoritative but not the DOH program page itself. A current CDPAP-specific hourly wage table could not be independently confirmed from a primary source this session, so the rate is left unverified rather than asserted from an unread document.
Sources
Read September 4, 2026.
Same question, other states: North Carolina · North Dakota.
Related: the private-pay caregiver-agreement rule · the household-employee tax rules once you’re being paid · what family caregiving actually costs unpaid.
General information drawn from each state’s own Medicaid agency and public program materials, not legal, tax or financial advice. Medicaid self-direction programs are administered state by state and change by budget cycle and waiver renewal; this page cannot see your own state’s current program status or your family’s eligibility. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.