A Comparison of the Traditional Home Care Program VS. the Consumer Directed Personal Assistance Program

New York State currently has two models of homecare of which families and Medicaid beneficiaries can choose to use – Traditional Home Care Program, and the Consumer Directed Personal Assistance Program.  Comparing the two can get a bit confusing- think- comparing Apples to Oranges!  So Premier is here to help explain the similarities and differences.  There are actually more similarities than you may think!  Knowing the similarities and differences will enable you to make the best homecare choice for your family’s specific needs.

Similarities for Home Health Aides/Personal Assistants in both programs:

  • Must not be on OIG or OMIG Exclusions List
  • Must complete Application, Physical, PPD, Vaccines
  • Must attend Agency/FI Orientation
  • Must undergo background check
  • Must complete the Form I-9 – verifying identity and employment authorization
  • Agency/FI processes Home Health Aides’/Personal Assistants’ payroll, benefits and onboarding paperwork

Differences – Home Health Aide:

  • Must be certified as Home Health Aide and complete at least 12 hours of continuing education inservice each year
  • Drug screen required

Differences – Personal Assistant:

  • No certification needed- broadening the scope of who can be assigned as the Personal Assistant for Consumers – Neighbors, Family, Friends! Personal Assistant is trained and supervised by Consumer or Designated Representative
  • No drug screen required

Similarities for Clients/Consumers in both programs:

  • Must be Medicaid Eligible and need long term care assistance
  • Must choose and enroll in MLTCP (Managed Long Term Care Plan)
  • Must choose and enroll in Licensed Home Care Service Agency (Traditional Home Care) OR Fiscal Intermediary (Consumer Directed Personal Assistance Program)- both of which handle compliance items and payroll for the Home Health Aides/Personal Assistants. Premier is an established FI with over 25 years of providing home care services throughout 7 states.  To learn more about our mission, click here.

Differences – Traditional Home Care Program:

  • Licensed Home Care Service Agency (LHCSA) assigns Certified Home Health Aide to Client and provides replacement aides when permanent aide is unable to work.
  • LHCSA mediates any potential grievances between Client and Home Health Aide.
  • LHCSA trains Home Health Aide and provides a minimum of 12 hours of continuing education for the HHA through inservices each year. A Field Nurse Supervisor assesses HHA competency and skills at least once a year.
  • HHA can only provide a Home Health Aide level of care within their scope of practice- common examples being- assistance with client’s activities of daily living, personal hygiene, medication reminders, and light house-keeping.

Differences – Consumer Directed Personal Assistance Program:

  • Consumer or Designated Representative is responsible for hiring, terminating and coordinating schedule with the Personal Assistant. This program is appealing for many Consumers who want to be involved in coordinating their own services, and allows them to choose family members, friends or neighbors to care for them since Personal Assistants do not require certification or any special training.  There are a few exceptions of who can be Personal Assistants.  More information can be found here.
  • Consumer or Designated Representative must mediate any potential grievances between Consumer and Personal Assistant.
  • Consumer or Designated Representative is responsible for training and supervision of Personal Assistant.
  • Personal Assistant can provide medication administration, oxygen care, insulin injection, and many other advanced services, as long as Consumer or Designated Representative has accepted responsibility of training and supervision Personal Assistant.






This is intended for educational purposes only.