Texas Community Care for Aged/Disabled: Non-Medicaid Services for the Elderly

Program Description

The Texas Community Care for the Aged / Disabled (CCAD) program is designed to allow seniors or disabled individuals who are at risk of nursing home placement to remain living at home, in the community, or in the home of a caregiver, and receive services and support in those locations. In addition to helping low-income elderly or disabled individuals reside in their homes, the goal is to prevent costly Medicaid-funded nursing home institutionalization. To achieve that goal, the program offers a suite of different services (outlined below). 

In summary, the program offers personal care at home, in foster care or in assisted living residences. It also covers services which reduce the need for personal care or supervision such as Personal Emergency Response Services (PERS). 

The CCAD Program is also referred to as Non-Medicaid Services and, sometimes by its federal funding source, Title XX Social Services. To avoid confusion, it is worth noting that Texas offers similarly named Medicaid versions of some of these programs.

 Happy Either Way: According to research, 90% of seniors want to age in their homes and yet 90% of individuals in assisted living rate themselves as happy in their communities. 


Eligibility Guidelines

Eligibility for Non-Medicaid Services and Support is determined by an individual's place of residence. For example, services differ if one lives at home, in the home of their caregiver, in adult foster care or in assisted living. Eligibility requirements common to all the programs and services include:

  • Individual must be 18+ years old
  • Monthly income cannot exceed three times the Supplemental Security Income (SSI) payment. As of 2017, for a single applicant, this amount is $2,205. For married applicants, the monthly income limit is $4,410. 
  • Assets and resources (as of 2017) for a single individual cannot exceed $5,000. For married applicants, the limit is slightly higher at $6,000. It is worth noting there are many exemptions to what is considered a countable asset (one's primary home and a single vehicle, for example)
  • Individuals must be disabled or functionally impaired to the extent that assistance is required
  • Individuals cannot concurrently receive assistance from Medicaid for the same services


Benefits and Services

In addition to case management, the following services are available via the CCAD program:

Adult Foster Care (AFC) – 24-hour assistance with the activities of daily living (eating, grooming, mobility, toiletry, etc.) provided by a household resident to no more than three individuals residing together in a shared living space. This program pays for the care services, but not for room and board.

Client Managed Personal Attendant Services - pays for personal care services but allows the care recipient to select and manage their care providers, which can include spouses. Texas offers a very similar program known as the Community Attendant Services (CAS) Program and more information is available on this page.

Day Activity and Health Services (DAHS) - adult day care provided up to 10 hours / day on weekdays during daytime hours. This may include meals and snacks, transportation, personal and nursing care assistance, and recreational activities.

Emergency Response Services (ERS) – 24-hour electronic monitoring for functionally impaired individuals living in socially isolated residences.

Family Care (FC) - assistance with the activities and instrumental activities of daily living (bathing, dressing, shopping, cooking, etc.) provided to persons living at home. A person may receive up to 50 hours of care / week.

Home-Delivered Meals (HDM) - nutritious meals delivered to the individual’s home.

Residential Care (RC) - assistance with the activities and instrumental activities of daily living (bathing, dressing, shopping, cooking, etc.) provided to persons living in assisted living residences. This program pays for the care services, but not for room and board.

Special Services to Persons with Disabilities (SSPD) and Special Services to Persons with Disabilities 24-Hour Shared Attendant Care (SSPD-SAC – only available in Houston) - additional loosely specified services designed to help individuals live independently.


How to Apply / Learn More

To begin the application process for Community Care for the Aged and Disabled / Non-Medicaid Services and Supports, contact your local Texas Department of Aging and Disability Services office. One may learn more about these programs by reviewing the online handbook. Readers should be aware that the handbook was written for case managers, not for consumers, provides considerable detail, and can be confusing.

 Texas has several other non-Medicaid programs which assist the elderly.  Read about Community Attendant Services, SAIL and the Family Support Program