OPWDDServices in New York

OPWDD stands for the Office for People With Developmental Disabilities. It is a New York State agency that coordinates and funds services for individuals with developmental disabilities, including intellectual disability, cerebral palsy, autism spectrum disorder, epilepsy, Down syndrome, Prader-Willi syndrome, and other neurological impairments. The agency was established to help individuals with I/DD live richer, more independent lives in their communities.

Applications for OPWDD services must be submitted by a Care Coordination Organization (CCO). Individuals and families cannot apply directly on their own. The first step is to contact a CCO in your area or your borough's Developmental Disabilities Regional Office (DDRO). You can find a full list of CCOs statewide at opwdd.ny.gov/find-care-manager. Cottage Home Care can help connect you with the right CCO and assist with Medicaid enrollment as part of the process.

Per the February 2026 OPWDD eligibility fact sheet, the individual must have a diagnosed developmental disability as defined under NY Mental Hygiene Law Section 1.03(22), the disability must have originated before age 22, it must be expected to continue indefinitely, and it must constitute a substantial handicap to the person's ability to function in society. Active New York State Medicaid and NYS residency are also required to access most OPWDD-funded services. OPWDD makes the eligibility determination through its regional DDROs, not home care agencies like Cottage.

Most OPWDD services are funded through the Medicaid HCBS 1915(c) Waiver. For individuals with active Medicaid who are OPWDD-eligible, home care services through an approved provider like Cottage Home Care carry no out-of-pocket cost. Families with Medicaid do not pay for authorized HHA services. If a family's income is above the 2026 Medicaid income limit of $1,836 per month for a single person (per MAPDR-01, May 14, 2026), a Pooled Income Trust may be an option to maintain eligibility.

OPWDD care management is provided by Care Coordination Organizations (CCOs), not by home care agencies. For New York City residents, the main CCOs are Advanced Care Alliance (ACA), Care Design NY, and Tri-County Care. A full statewide list is available at opwdd.ny.gov/find-care-manager. Cottage Home Care is a direct care provider that delivers HHA staffing after the CCO has secured authorization from OPWDD.

Through the OPWDD Self-Direction program, individuals and families may choose their own support workers, including friends or family members who live outside the home. These workers must complete required training before they can be paid. Legally married spouses cannot serve as paid caregivers under Self-Direction. Families interested in Self-Direction should speak with their CCO or regional OPWDD office to attend an information session before enrolling.

The OPWDD Medicaid waiver is formally known as the OPWDD Comprehensive Home and Community-Based Services (HCBS) 1915(c) Waiver. It is a federal Medicaid waiver approved by CMS that authorizes community-based habilitation services for OPWDD-eligible individuals. Services covered include community habilitation, day habilitation, respite, supported employment, and residential habilitation, and several others. Enrollment requires both OPWDD eligibility and active Medicaid.

If an OPWDD-eligible individual does not receive any OPWDD services for a continuous period of one year, this may be considered a "break in OPWDD services." After a break, eligibility may need to be re-established through the Front Door process, which can be time-consuming. Maintaining at least some form of active OPWDD service prevents this. Contact OPWDD at 1-866-946-9733 or your regional DDRO with questions about your specific situation.