Six questions that decide eligibility.
Eligibility isn't one test — it's six
Families often ask for the eligibility requirement, expecting a single yes-or-no line. In reality, CDPAP eligibility is decided across six separate questions, and a person can qualify even if the answer to one or two of them isn't straightforward.
The six questions
- Is the person enrolled in Medicaid, or eligible to enroll?
- Does a physician or nurse practitioner confirm the person needs help with daily living tasks, or has a stable medical condition requiring home care?
- Is the person medically stable enough to be self-directing, or does a representative meet that requirement on their behalf?
- Is there a willing, eligible caregiver available — whether a family member or another chosen individual?
- Does the person, or their representative, have the capacity to manage caregiver scheduling and basic supervision?
- Is the requested level of care something CDPAP is designed to cover, rather than a need that requires a skilled nursing facility?
Where families get tripped up
The most common stumbling block isn't Medicaid status — it's question three, self-direction. If the person receiving care has a cognitive condition that makes independent direction difficult, that doesn't disqualify them; it shifts the requirement to a designated representative, usually a family member, who takes on that responsibility instead.
We've seen families assume a 'no' on question three means the whole application is dead. It just means we route through a representative instead — the case still moves forward.
What we check first
Our intake process runs through all six questions in the first call, specifically so families aren't surprised three weeks into an application by a requirement nobody mentioned earlier.