A caregiving program that pays a family member to care for an infirm loved one! What could be more perfect? In many cases it is but like most programs be sure to weigh the benefits and as well as the disadvantages.
Since the beginning of 2016, I have been averaging five inquiries a week on New York State’s Consumer Directed Personal Assistance Program (CDPAP) a Medicaid program that will pay a family member to care for a sibling, parent, or adult child who needs home care.
This program has gained more prominence as families are becoming more concerned about the care of frail loved ones at home. CDPAP has been in existence in New York since 2000, but over the last few months it has gained more visibility probably because many Medicaid home care agencies are now offering the program.
CDPAP offers many benefits, one of the most attractive being it allows family members to get paid for caregiving, a job they are already performing. This is particularly beneficial for individuals who have sacrificed outside jobs to care for a family member. Another appealing benefit is it permits people without caregiver training to take on the caregiver role. Agency home care aides must attend government accredited training programs that teaches them basic skills such as hygiene, nutrition and correct ways to bath, dress and toilet their clients. CDPAP hirees do not have to take these courses; their major qualification is their ability to follow the directions of the patient or an overseeing third-party.
A third benefit of CDPAP is it allows the caregiver to conduct tasks that a home health aide is not permitted to perform. Accredited aides are not permitted to perform medical tasks such as administering medications, dressing wounds, suctioning tracheostomy, or giving insulin injections. Only nurses are permitted to perform these tasks. A CDPAP aide is not restrained by these regulations. She can be instructed by the patient to perform all these duties. These three features make CDPAP an attractive solution for many families.
However there are major flaws to CDPAP. Two of the biggest drawbacks concern who determines the hours a caregiver is permitted to work, and how much she gets paid. CDPAP is first and foremost a Medicaid program, and must adhere to government protocol. Before a patient can receive CDPAP, a doctor must confirm a person requires home care. Next the family must apply to the local social security department to participate in the program. A nurse visits into the home to assess the client and determine how many hours are required. Finally Medicaid wages are low, on average $10-$12/hour. This in itself eliminates many family members who thought they could quit their day job and live off their caregiving salary.
Other downside is in the details. The program does not permit certain relations to care for family members. For instance, a spouse is not permitted to care for a spouse and a family member who takes on the role cannot be the person who signs the time card. Another disadvantage is New York’s CDPAP is designed for disabled adults. It does not cover underage children.
Finally the program is designed for the patient who can self direct his own care. CDPAP was born to assist young disabled individuals who need continual care. It made it possible for young people who were previously confined to institutional care to live more fulfilling lives in the community.
CDPAP offers many benefits for people with infirm family members, however like most programs it is not a panacea. Each family must weigh its needs and determine if it can live with the downside as well as the benefits.
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