Program Description
Consumer Directed Attendant Services (CDAS) is a Medicaid entitlement program available through Maine’s state Medicaid. (Medicaid in Maine is more commonly referred to as MaineCare.) CDAS provides personal or attendant care services to Medicaid recipients in their homes or certain group living environments, as long as personal care services are not already being provided.
Under CDAS, the adult children of aging parents can be paid to provide caregiving services.
Under this program, participants are empowered to select, hire, train, and manage their own care providers instead of having 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.
It is the intention of this program to help individuals remain living in their homes by providing care services in that environment instead of requiring individuals to move into nursing home residences. As mentioned previously, consumers are able to select their own personal care providers, with certain family members being among those who are eligible to be paid caregivers. Parents and spouses are not able to be hired, but the adult children of aging parents could become paid caregivers provided they are not also the legal representative of their parent.
Eligibility Guidelines
General Requirements
- 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.
Applicants must also be financially eligible for MaineCare. Financial eligibility looks at both an applicant’s income and their countable assets.
Financial Requirements
Income Limits
In 2023, single senior applicants have a monthly income limit of $1,215. Married applicants are allowed up to $1,644 a month. This amount is equivalent to 100% of the Federal Poverty Level (FPL).
Asset Limits
The asset limit for a single person is $10,000. Married applicants are allowed $15,000 in assets. Countable assets do not include one’s home if the applicant lives in their home or has intent to return to it. Also exempt are personal items, furniture, and a car.
Over the Financial Limits?
Being over the asset limit does not mean automatic disqualification from CDAS. Strategies exist to help families meet the asset requirements. However, it is extremely important that one does not give away cash or other countable assets in an effort to lower one’s assets to the allowable asset limit. Doing so may violate Medicaid’s look back period and can result in a penalty, delaying needed Medicaid benefits.
For applicants who have income over the limit, Maine offers an alternative pathway to eligibility for “medically needy” persons. Medically Needy individuals have high medical expenses that they cannot afford to pay even though they have income over the limit mentioned above. This is a determination made by the state. It may be advantageous to consult with a private Medicaid expert prior to pursuing 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. Participants are reassessed periodically to ensure their needs are continuing to be met. Services can include any or all of the following:
- Assistance with their Activities of Daily Living (ADLs), such as bathing, personal hygiene, dressing, mobility and transfer assistance, eating, and using the toilet; and assistance with their Instrumental Activities of Daily Living (IADLs), such as grocery shopping, meal preparation and clean up, housekeeping, laundry, and assistance with money management (up to 28 hours per week)
- Assistance with health maintenance activities, such as medication administration, physical / occupational activities, and catheterization
- Care Coordination Services / Case Management (up to 18 hours / year)
- Skills training for the individual hired as a Personal Care Attendant (up to 14.25 hours / year)
Personal care can be provided to individuals residing at home or in the home of a loved one.
How to Apply / Learn More
The CDAS Program is run by the Maine Department of Health and Human Services; persons 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.
