MaineCare Consumer Directed Attendant Services (CDAS) Program

Program Description

CDAS is a Medicaid entitlement program (Medicaid in Maine is more commonly referred to as MaineCare).  CDAS covers personal or attendant care provided to Medicaid recipients in their homes or certain group living environments.  Under the CDAS program, program participants are empowered to select, hire, train and manage their own care providers instead of having the state administrators select caregivers on their behalf. This consumer directed model of care is also referred to as participant direction, self-direction and cash and counseling. To avoid confusion it is worth mentioning that these services are also referred to as personal care attendant (PCA) services, or simply attendant services.

Under CDAS, the adult children of aging parents can be paid to provide caregiving services.

It is the intention of this program to help individuals remain living in their homes or "communities" ("communities" can include adult residential care homes but not nursing homes) by providing care services in those environments instead of requiring individuals to move into a nursing home residence. As mentioned previously, consumers are able to select their own personal care providers, certain family members are among those who are eligible to be paid caregivers. Parents and spouses cannot be hired however the adult children (of aging parents) can become paid caregivers provided they are not also the legal representative of the parent.

 Maine has a similar program with consumer direction for non-Medicaid eligible seniors called the Home Based Care Program.

 

Eligibility Guidelines

To be eligible for the MaineCare CDAS program, participants must be at least 18 years of age and have a permanent and verifiable disability that limits their ability to care for themselves and manage their activities of daily living. Individuals cannot reside in a hospital, nursing home, intermediate care facility or other private, non-medical, residential care facility commonly called assisted living or board and care homes. They also cannot concurrently be receiving care services from other MaineCare programs in which personal care is offered. Finally, they must be financially eligible for MaineCare. Financial eligibility looks at both an applicant’s income and their “countable assets”.

Income Eligibility – Single applicants are subjected to a monthly income limit or $2,205 in 2017. Married applicants, if one spouse does not require MaineCare, are subjected to different criteria. The applicant has the same income limits but their spouse is permitted a Monthly Maintenance Needs Allowance of $3,022.50.

Countable Asset Eligibility – The effective asset limit for a single person is $10,000 in cash and savings. Countable assets do not include one’s home if the value of their home equity is not greater than $840,000. Also exempt are personal items, furniture and a car. Assets that are held by both partners in a married couple are not exempt but $120,900 in jointly held assets can be allocated to the non-applicant spouse. This is referred to as the Community Spouse Resource Allowance. A “community spouse” is the non-applying spouse. Other strategies exist to help families meet the asset requirements.

Outside the above financial criteria, Maine also offers an alternative pathway to eligibility for “medically needy” persons. Medically Needy individuals have unusually high medical expenses which they cannot afford to pay even though they have income’s over the limits mentioned above. This is a determination made by the state. It may be advantageous to consult with a private Medicaid expert prior to pursing this approach. Learn more.

 

Benefits and Services

The exact services provided under the CDAS program are specific to the participating individual and are determined during enrollment in the program. They are re-assessed periodically to ensure their needs are continuing to be met. Participants can qualify for three different tiers of Personal Care Services (PCS) up to a maximum of 28 hours / week. PCS can include any or all of the following:

  • Assistance with the activities of daily living such as bathing, personal hygiene, dressing, mobility assistance, eating and medication administration.
  • Assistance with the instrumental activities of daily living such as grocery shopping, meal preparation and clean up, housekeeping, laundry and assistance with money management.
  • Care Coordination Services / Case Management
  • Skills training for the individual hired as a Personal Care Attendant

Personal care can be provided to individuals residing at home, in the homes of their loved ones or in certain adult residential care homes (commonly thought of as assisted living residences).  That said, Maine does put some restrictions on in which assisted living residences care can be provided. 

 

How to Apply / Learn More

The CDAS Program is run by the Maine Department of Health and Human Services; one should contact their local office. A list of offices and their contact information is available here. One can also read more about the program in the very comprehensive MaineCare benefits manual available here.