Medicaid Home Health Program Allows People To Hire Their Own Aides

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VESTAL, NY (WSKG) — The demand for home health care has been growing in the past few years, and many providers have struggled to find the workers to meet it. Staffing shortages in home health, like many areas across the healthcare industry, have worsened during the pandemic.

One program involves people hiring their own home health aides, rather than depending on an agency. Consumer Directed Personal Assistance (CDPA) is a Medicaid program in which consumers set the schedule and hire and train their own aides.

Howard Struble has used CDPA since 2009. He gets about 28 hours of home care a week, around three or four hours a day.

Struble said directing his own care gives him independence. He added that many people with disabilities do not have control over the quality of their care.

“The choices get made for them. And that’s horrible,” said Struble. “Because if you’re disabled, and you don’t get to speak for yourself, then you lose your voice.”

Howard Struble speaks about Consumer Directed Personal Assistance (CDPA) at a press conference held by New York Senator Kirsten Gillibrand. (Phoebe Taylor-Vuolo/WSKG)

Struble said without the program, he might have ended up in an assisted living facility. He is disabled, and was hit by a car over the summer, causing him to need even more care to recover.

With CDPA, Struble has been able to hire his own aides, some of whom have been friends. He said it was important to him to be able to set his schedule for care, something he didn’t get to do when he used a traditional home health agency.

“I had no control over what time my aides came, how they did things, what they did,” said Struble. “I just like knowing the people that come in.”

Maria Dibble, the Executive Director of the Southern Tier Independence Center, said many people like CDPA specifically because it lets them hire people they are familiar with, such as family or friends.

“Some of the care that’s being provided is very intimate, and personal,” said Dibble. “And you really would rather have someone you know performing that care, rather than having a stranger do it.”

Many traditional home health agencies lost staff during the pandemic, but Dibble said many people using CDPA did not lose their aides.

“Most of our consumers were able to retain their workers,” said Dibble. “And that again, is because they’re people they know, they’re people they have a personal relationship with.”

However, Dibble said it can still be difficult for people to find aides for CDPA. Not everyone has friends or family who can help them, and the aides in the program are paid the same low wages that other home health workers are paid, usually around $12.50 an hour. This means that it can still be hard to find someone to do the work.