Home care agencies NYC and New York State: how it works
Every home care agency in New York is regulated by the New York State Department of Health. The word families hear most — "agency" — covers two different licenses, and knowing which one you're dealing with tells you what it can do and who pays for it. That's true of home care agencies in New York City and upstate alike.
| LHCSA (Licensed Home Care Services Agency) | CHHA (Certified Home Health Agency) | |
|---|---|---|
| What it provides | Home health aides, personal care aides and nursing, by the hour | Part-time, intermittent skilled nursing, therapy and aide services |
| Regulated by | NYS Department of Health license | NYS Department of Health, and certified for Medicare |
| Who pays | Private pay, Medicaid (often through a managed care plan), long-term care insurance | Medicare, Medicaid, private insurance |
| Typical use | Ongoing daily help — bathing, dressing, meals | Recovery after a hospital stay, doctor-ordered |
Most families looking for new york home care for daily help end up with a LHCSA. CHHAs are what a hospital means when it arranges home health care at discharge. For the general difference, see home health vs. home care.
HHA agency NYC: home health aide agencies explained
An "HHA agency" is what New Yorkers call an agency that employs home health aides — almost always a LHCSA. A home health aide NYC agencies send has completed state-approved training and can help with personal care and some health-related tasks under nurse supervision. A home health aide agency NYC families hire should tell you the aide's schedule, who supervises them and who covers when they're sick.
The same checks apply to every home health aide New York agencies place, and to home health agencies NYC hospitals refer you to: confirm the license on NYS Health Profiles, ask whether they take your Medicaid plan, and get rates and minimum shifts in writing. Our home health aide guide explains what an aide can and can't do, and how to choose a home care agency has the full question list.
If you want home health care NYC doctors order after a hospital stay, you're looking for a CHHA — home health care agencies NYC hospitals work with are listed on Care Compare with star ratings. For home health NYC patients need longer-term, the case usually moves to a LHCSA.
Home care agencies Brooklyn (Kings County)
Brooklyn is Kings County. For home care, Brooklyn has more agencies than many states, so the work is vetting, not finding. Home care services Brooklyn agencies offer range from a few hours a week to live-in care; a home health aide agency in Brooklyn and an HHA agency Brooklyn families know by word of mouth should both pass the same license check.
There's no official ranking of the best home care agency in Brooklyn. Ask neighbors, check enforcement history on NYS Health Profiles and interview any home health aide agency Brooklyn relatives recommend. A home health aide Brooklyn agencies place should have state training. If the person who needs care has Medicaid, a relative can be paid through CDPAP instead.
Home care agencies Bronx, NY
The Bronx is Bronx County. Home care agencies Bronx families use are licensed by the same state department as everywhere else, so the NYS Health Profiles search works here too. For home care, Bronx families on Medicaid usually get hours through a managed long-term care plan; ask any of the home care agencies Bronx, NY-based whether they contract with your plan.
Home health care Bronx, NY hospitals arrange at discharge comes from a CHHA. For ongoing home care, Bronx NY residents more often use a LHCSA — a home health aide agency Bronx NY families hire, or a home health aide Bronx NY agencies assign. Or they use CDPAP to pay a relative. For home care Bronx NY families pay privately, get the hourly rate and minimum shift in writing.
Home care Queens, NY
Queens is Queens County. Home care Queens, NY families arrange looks like the rest of the city: LHCSAs for daily help, CHHAs for skilled care, and CDPAP for a paid relative. Home care agencies in Queens often serve particular language communities, which matters — ask whether the aide will speak the language spoken at home.
The best home care agency in Queens is the one that answers the vetting questions clearly and has a clean enforcement record. Home health care Queens hospitals order is usually short-term. An HHA agency Queens families use, and a home health aide Queens agencies send, should both be verifiable online. For home care Queens-wide, the same state tools apply to all home care agencies Queens residents consider.
Home care in Manhattan (New York County)
Manhattan is New York County. Home care agencies in Manhattan include many private-pay-only agencies that don't take Medicaid, so ask early. A private home care agency in Manhattan may offer 24-hour or live-in care; compare both setups in 24-hour home care and live-in caregivers.
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Home care agencies Staten Island (Richmond County)
Staten Island is Richmond County. There are fewer home care agencies Staten Island families can choose from than in the other boroughs, and some agencies based elsewhere don't send aides there. Ask whether a home health aide agency Staten Island families are considering has aides who live on the island.
Home care Staten Island families arrange through Medicaid follows the same NYC rules and pay rates. A home health aide Staten Island agencies send should be verifiable on NYS Health Profiles like any other.
Home care Long Island: Nassau and Suffolk
Long Island's two counties are Nassau and Suffolk. Home care agencies Nassau County families use and those in Suffolk are regulated by the state, not the counties, so the same NYS Health Profiles lookup applies. Medicaid eligibility runs through each county's Department of Social Services.
For in home care, Long Island families face longer drives and fewer aides per square mile than the city, so ask any home care agency in Long Island about travel areas and backup coverage. A home health aide agency in Long Island may also staff CHHA work; home health care Long Island hospitals arrange comes from a CHHA. A home health aide Long Island agencies send and a private home care agency in Long Island that only takes private pay are both options for home care Long Island families arrange.
Searches for the best home care agencies in Suffolk County, NY turn up ads, not rankings. Use enforcement records and interviews instead. CDPAP pays $20.05 an hour on Long Island.
Home care agencies in Westchester County, NY
Westchester County has its own Department of Social Services for Medicaid. Home care agencies in Westchester County, NY range from large regional LHCSAs to small local ones; a home health aide Westchester County, NY agencies send should be listed with state training.
For CDPAP, Westchester County, NY sits in the higher downstate pay band: $20.05 an hour, the same as Long Island. Nearby Rockland and Putnam counties follow the same state rules.
Home care Buffalo, NY, Rochester, Syracuse and Watertown
Buffalo (Erie County)
Buffalo is in Erie County. Home care Buffalo, NY families arrange comes from the same two agency types. Home care agencies Buffalo, NY families consider can be checked by county on NYS Health Profiles; a home health aide Buffalo, NY agencies send should be too. CDPAP pays $18.65 an hour upstate.
Rochester (Monroe County)
Rochester is in Monroe County. Home care agencies Rochester, NY families use, home health agencies Rochester, NY hospitals refer to, in home care Rochester, NY Medicaid pays for, and a home health aide Rochester, NY agencies place all fall under the same state rules.
Syracuse (Onondaga County)
Syracuse is in Onondaga County. Ask any home care agency Syracuse, NY families consider about rural coverage if the person lives outside the city; a home health aide Syracuse, NY agencies send may travel long distances.
Watertown (Jefferson County)
Watertown is in Jefferson County, New York. Agency aides are scarcer in the North Country, so many caregivers Watertown, NY families rely on are relatives — the situation CDPAP was built for.
Private pay home care agencies New York
Private pay home care agencies New York families hire don't need a Medicaid plan's approval — you set the hours. Private home care agencies in NYC usually quote an hourly rate with a minimum shift, and separate rates for overnight, live-in or 24-hour care. Get every rate in writing, ask what happens if the aide doesn't show up, and ask whether the aide is an employee.
Before paying privately, check whether the person qualifies for Medicaid home care. Long-term care Medicaid has different rules from regular Medicaid. See private pay home care and the cost of in-home care.
Get paid to take care of family NY: CDPAP
The New York State caregiver program that pays relatives is CDPAP, the Consumer Directed Personal Assistance Program. When people search for the NYS caregiver program, the NYC caregiver program or a Medicaid caregiver program NY runs, this is almost always what they mean. The Medicaid member (or someone acting for them) hires, trains and directs their own personal assistant — who can be an adult child, grandchild, sibling or friend.
| Region | Minimum base wage |
|---|---|
| New York City (all five boroughs) | $20.65/hr |
| Nassau, Suffolk and Westchester | $20.05/hr |
| Rest of the state | $18.65/hr |
Since April 1, 2025, every CDPAP consumer and personal assistant registers with Public Partnerships LLC (PPL), the single statewide fiscal intermediary, which runs payroll. Read our CDPAP guide, the New York caregiver program, New York caregiver pay and our comparison of PPL.
So yes, you can get paid to care for a family member NY-wide, and be paid to take care of a family member NY families already help — with two limits. Spouses cannot be paid under CDPAP (see New York spousal caregiver rules), and parents cannot be paid for their own children under 21.
People also search for a home health aide for a family member NY-wide, a home health aide for a family member NYC agencies might employ, or a "home attendant for family member nyc" (home attendant is a long-standing NYC term for a personal care aide). You don't need to become an agency aide to be paid for caring for a relative; CDPAP pays you directly as their personal assistant, with no aide certificate. Some agencies do hire family, too — see home care agencies that hire family members.
NY Medicaid home care eligibility
NY Medicaid home care eligibility has two parts: financial eligibility for Medicaid, and a needs assessment showing the person needs help with daily activities.
- Apply for Medicaid. In New York City, through the Human Resources Administration; elsewhere, through the county Department of Social Services, or the Medicaid Helpline at 1-800-541-2831.
- Get assessed. The New York Independent Assessor (NYIA) does the initial assessment for personal care and CDPAP for most new applicants. Since September 2025, most new adult applicants must also meet new "minimum needs" rules.
- Choose your care. Many adults are enrolled in a Managed Long Term Care plan, which authorizes the hours. You can choose agency care or CDPAP.
- Register with PPL if you choose CDPAP, and start logging hours.
Want a quicker answer? Check eligibility in two minutes, or read Medicaid home care.
Best home care agency in NYC — and best paying home care agencies in NYC
Nobody publishes a reliable ranking of the best home care agency in NYC. What you can check: the license, enforcement history on NYS Health Profiles, how fast they fill a shift, and whether the same aide keeps coming. Families who search for caregiver NYC options should interview at least three.
Aides ask a different question: which are the best paying home care agencies in NYC? New York sets minimum wage rules for home care aides, and on top of that, pay depends on the agency's contracts with Medicaid plans, overtime policy and benefits. Ask for the hourly rate, differential for weekends and nights, and benefits in writing. If you're caring for your own relative, CDPAP's $20.65 NYC minimum is a useful benchmark. See caregiver jobs.
Home care NYC at a glance
Whether you want in home care NYC agencies provide, home care services NYC Medicaid plans authorize, or home care NYC families pay privately, the choices are the same:
| Option | Best for | Read more |
|---|---|---|
| LHCSA agency aide | Ongoing daily help from a trained aide | Home health aides |
| CHHA home health | Skilled care after a hospital stay | Home health vs. home care |
| CDPAP | A relative or friend as the paid caregiver | CDPAP |
| Private pay | Families who don't qualify for Medicaid | Private pay home care |
Home care New York residents use elsewhere follows the same model; other states are in home care by city, and Pennsylvania has its own guide: home care in Pennsylvania.
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Frequently asked questions
What is the difference between a LHCSA and a CHHA?
A LHCSA is a state-licensed agency that supplies aides and nursing by the hour, often for ongoing daily help. A CHHA is certified for Medicare and provides part-time skilled nursing, therapy and aide services, usually after a hospital stay.
How do I check a New York home care agency?
Search the NYS Health Profiles site by county, service or agency type. It shows the agency's license type and enforcement records. Medicare-certified agencies also appear on Medicare Care Compare.
Can I get paid to take care of my parent in New York?
Yes, if your parent has Medicaid and qualifies for home care. Through CDPAP your parent hires you as their personal assistant, and you're paid through PPL.
How much does CDPAP pay in NYC?
The minimum base wage from January 1, 2026 is $20.65 an hour in New York City, $20.05 on Long Island and in Westchester, and $18.65 in the rest of the state.
Can a spouse be paid under CDPAP?
No. Spouses cannot be hired as CDPAP personal assistants. Parents also cannot be paid for their own children under 21.
Do I need home health aide certification to be paid for caring for a relative?
Not for CDPAP. You're hired by your relative as their personal assistant. Agency jobs as a home health aide do require state-approved training.
Does Medicare pay for home care in New York?
Medicare pays for short-term skilled home health care from a certified agency when a doctor orders it. It does not pay for ongoing daily help or for family caregivers.
Sources: NYS Health Profiles: home care agencies (CHHA and LHCSA) · NYS Department of Health: CDPAP · PPL: New York CDPAP FAQs · NYS Department of Health: New York Independent Assessor Program · Medicare Care Compare. Program rules and rates change — always confirm with the program. Reviewed September 30, 2026.