Raising a child with a developmental disability in New York often means a lot of moving parts. There is OPWDD, a Care Manager, a Life Plan and a full schedule of supports. Even so, many families need more hands-on help at home. Pediatric home care can fill that gap. A trained aide helps your child with bathing, dressing, meals and daily routines, alongside your child's OPWDD services.
This guide explains how pediatric home care fits with OPWDD services for children, what an aide does, how it is usually paid for and how to choose a provider. City Choice Home Care Services is a Licensed Home Care Services Agency in New York and an OPWDD-approved provider. We serve families across Manhattan, Brooklyn, Queens, The Bronx, Staten Island and Westchester.
01What Is Pediatric Home Care?
Pediatric home care is hands-on support for a child, delivered at home by a trained aide. For children with developmental disabilities, that usually means help with bathing, dressing, eating, toileting, moving safely and staying supervised. In New York City, a certified Home Health Aide provides this care, and Medicaid often covers it for eligible children.
Home care is personal and practical. It is not a program your child attends. The aide comes to your home and works around your child's routine. That might mean mornings before school, afternoons after the bus drops off, or evenings when bath time and bedtime need two sets of hands.
02How Home Care Fits With OPWDD Services for Children
The Office for People With Developmental Disabilities (OPWDD) oversees services for New Yorkers with developmental disabilities. If your child is eligible, a Care Manager from a Care Coordination Organization (CCO) works with your family. Together, you build a Life Plan. That plan lists your child's goals and the supports needed to reach them.1,2 In New York City, three CCOs serve most families: Advance Care Alliance, Care Design NY and Tri-County Care.6
Children enrolled in the OPWDD Home and Community Based Services (HCBS) Waiver may receive services such as Community Habilitation, respite and Self-Direction.3 OPWDD services for children like these help with skills, independence and family breaks. Home care adds something different: steady, hands-on help with your child's personal care.
Can My Child Get Home Care and OPWDD Services at the Same Time?
Yes, in many cases. OPWDD services such as Community Habilitation and respite focus on skills, goals and family breaks. Home care covers hands-on daily care, like bathing, dressing and feeding. The two can work side by side when they are planned so they do not overlap. Your child's Care Manager helps coordinate, and Medicaid authorizes the hours.
How Is Community Habilitation Different From Home Care?
Community Habilitation is an OPWDD waiver service that helps your child build skills, such as daily living, travel training and community inclusion, based on goals in the Life Plan. Home care is different. An aide gives direct, hands-on help with personal care so your child is safe and comfortable at home. Many families use both for different needs.
Your Care Manager Is Your Partner
Your Care Manager coordinates your child's supports across systems. That includes OPWDD services, medical care and behavioral health care.2 So if you add home care, let your Care Manager know. They can record it in the Life Plan and help keep everyone on the same page. It also helps avoid schedules where two workers show up for the same hour.
Related Study/Source: New York State's overview of the OPWDD Comprehensive Waiver notes that every waiver participant receives care coordination through a CCO or Health Home. It also notes that waiver participants cannot be enrolled in a Managed Long Term Care (MLTC) plan at the same time.4
03Who Pediatric Home Care Helps
Pediatric home care helps children whose disability affects everyday tasks. Families often reach out when daily care is taking more time than one or two parents can give. OPWDD serves people with conditions such as:
- Autism spectrum disorder
- Intellectual disability
- Cerebral palsy
- Down syndrome
- Epilepsy and other neurological conditions
A diagnosis alone does not set the care plan. What matters is what your child needs help with each day. One child may need full help with bathing and toileting. Another may need someone close by for safety while eating or moving around the apartment.
Signs Your Family Could Use More Help at Home
- Personal care takes up most of your mornings or evenings.
- Your child needs close supervision for safety for long stretches.
- One parent handles care alone while the other works.
- Siblings are missing out on time and attention.
- You feel worn down, even with respite in place.
None of these signs means you are failing. They mean your family's needs have grown. Home care is one way to meet them.
04What a Pediatric Home Care Aide Does
An aide's tasks follow your child's plan of care. Families usually ask about these areas of support:
- Bathing, grooming and oral care
- Dressing and changing
- Toileting and incontinence care
- Meals, feeding support and snacks
- Safe movement, transfers and positioning
- Supervision for safety during daily routines
- Following the routines your child already knows
- Medication reminders, when the plan allows
Routine matters for many children with developmental disabilities. A good aide learns your child's cues, preferences and calming strategies. They follow your lead. You know your child best, and the aide should treat you that way.
Why Consistency Matters
Children often do better with familiar faces. When the same aide comes each week, your child has time to build trust. Ask any agency how it handles consistent scheduling and what happens when your regular aide is out.
At City Choice Home Care Services, home health aides are background-checked and trained through a New York State Department of Health-approved program. Families can ask to have their child matched with a consistent aide, so the same familiar face shows up each week.
05Common Misconceptions About Home Care and OPWDD
"Our child has OPWDD, so we can't get home care."
Not true in many cases. OPWDD services for children and Medicaid home care cover different needs. Many children have both. The key is planning them so the hours do not overlap.
"Home care will replace our OPWDD services."
It does not. Adding an aide does not take away Community Habilitation, respite or Self-Direction. Home care sits next to those services. Your Life Plan still guides your child's goals.
"We have to change Care Managers to add home care."
You do not. Your Care Manager stays the same. A home care agency works with your existing team, not in place of it.
"Choosing a home care agency locks us in."
Families in New York can choose their providers. If an agency is not the right fit, you can talk with your Care Manager and Medicaid plan about other options. A good agency earns your trust over time.
06How Is Pediatric Home Care Paid For in New York?
For children with OPWDD services, Medicaid usually pays for pediatric home care. Children enrolled in the OPWDD waiver have Medicaid coverage. It can cover Home Health Aide services once a nurse assesses your child's daily care needs and the number of hours is approved. Families without Medicaid coverage can ask us about private pay options.
Most OPWDD services for children are funded through Medicaid's HCBS Waiver.5 Home care is a separate Medicaid benefit. Before home care starts, a nurse assesses your child's needs.7 Medicaid then approves a number of hours. If your child is in a Medicaid managed care plan, the plan usually handles that approval. Otherwise, your local Medicaid office does.
Hours depend on your child's assessed needs. Two children with the same diagnosis can get very different plans. If your family's situation changes, you can ask for a new assessment.
City Choice Home Care Services works with New York Medicaid for home health aide services. Its team can walk your family through what your child's coverage includes before care begins.
A Note on MLTC
You may see Managed Long Term Care (MLTC) mentioned on home care websites. MLTC plans serve adults. They are not how children with OPWDD services get home care, and OPWDD waiver participants cannot be enrolled in MLTC.4
07How to Choose a Pediatric Home Care Agency
What to Check First
- The agency holds a Licensed Home Care Services Agency (LHCSA) license from the New York State Department of Health.
- It accepts your child's Medicaid plan.
- It serves your borough or county.
- It has aides with experience caring for children with developmental disabilities.
Questions Worth Asking
- How do you match an aide with a child?
- Will we see the same aide each week?
- What happens if our aide is sick or on vacation?
- How do you communicate with parents about each visit?
- Will you keep our Care Manager informed when we ask you to?
What the Right Agency Feels Like
You feel heard on the first call. The agency asks about your child, not only the paperwork. It answers questions plainly and does not rush you. Most of all, it respects that you are the expert on your child.
That is the standard City Choice Home Care Services holds itself to. The agency has been licensed to provide home care in New York since 2005 and is an OPWDD-approved provider. Its home health aides care for children with developmental disabilities and complex daily needs, in homes across Manhattan, Brooklyn, Queens, The Bronx, Staten Island and Westchester.
Here is what families can expect when they work with City Choice Home Care Services:
- Home health aides who are background-checked, bonded, insured and trained through a New York State Department of Health-approved program
- Aide matching based on your child's needs, schedule, language and location
- The option to request a consistent aide, so your child sees a familiar face
- A clear walkthrough of what your child's Medicaid coverage includes
- No long-term contract
- An intake line that answers 24/7
The team also respects the plan your family already has. Home care is added alongside your child's OPWDD services, and your Care Manager stays your partner. Parents set the routine, and aides follow it. Learn more on the Pediatric Care page.
To talk through your child's daily needs, call City Choice Home Care Services at 718.645.1116 or contact the team online. There is no obligation, and your child's OPWDD services stay exactly as they are.
References
1. Office for People With Developmental Disabilities. Front Door welcome flyer. New York State OPWDD. Published February 1, 2024. Accessed November 3, 2026. https://opwdd.ny.gov/get-started/front-door-welcome-flyer-english
2. Office for People With Developmental Disabilities. Plan your services. New York State OPWDD. Accessed November 3, 2026. https://opwdd.ny.gov/access-supports/plan-your-services
3. Office for People With Developmental Disabilities. Individual eligibility and enrollment for the OPWDD HCBS 1915(c) Waiver and requests for service authorization (23-ADM-06R). Accessed November 3, 2026. https://opwdd.ny.gov/regulations-guidance/23-adm-06r-individual-eligibility-and-enrollment-opwdd-hcbs-1915c-waiver-and
4. New York State Department of Health. Overview of services available through the 1915(c) Consolidated Children's Waiver and 1915(c) Comprehensive OPWDD Waiver. April 22, 2025. Accessed November 3, 2026. https://healthweb-back.health.ny.gov/health_care/medicaid/redesign/behavioral_health/children/2025/2025-04-22_cw-opwdd_overview.htm
5. New York State Department of Health. OPWDD Home and Community-Based Services Waiver. Accessed November 3, 2026. https://healthweb-back.health.ny.gov/health_care/medicaid/program/longterm/omrdd.htm
6. Columbia University Department of Psychiatry, PROGRESS Center. What is the Office for People With Developmental Disabilities (OPWDD)? Accessed November 3, 2026. https://www.columbiapsychiatry.org/research/research-centers-interdisciplinary-programs/progress-center/families/what-office-people-developmental-disabilities-opwdd
7. AHRC Nassau. Medicaid FAQ. Accessed November 3, 2026. https://askarcnassau.com/1923/Medicaid