Waiver Description
Maryland’s Community Personal Assistance Services (CPAS) program is part of the state Medicaid plan. Services are provided in the eligible individual’s home or community residence. Participants are able to select the caregiver who provides those services (called self-direction), or the care provider is selected by the program’s administration team. Under the self-direction option, adult children of the aging individual can be hired as paid caregivers; however, spouses cannot. In either case, the CPAS program pays for care.
Maryland’s Community Personal Assistance Services was formerly known as the Medical Assistance Personal Care program. Community Personal Assistance Services assists chronically ill, frail elderly, or disabled people in staying in their own homes. This is done by granting personal support with basic daily living tasks, such as bathing, dressing, eating, and going to the bathroom. The individual providing care must be an approved personal care provider, certified in first aid and CPR, and supervised by a registered nurse case monitor.
CPAS is administered county-by-county, and the Maryland Department of Health and Mental Hygiene manages the budget and directs the program.
Eligibility Guidelines
Community Personal Assistance Services serves disabled and senior individuals who qualify for Medicaid. There are both physical and financial criteria when determining eligibility.
General Requirements
Functional Criteria
Applicants must require hands-on care with a minimum of one of their Activities of Daily Living (ADLs). Their abilities must be at the point where, should they not receive assistance, they are at risk for placement in a nursing home. However, an institutional level of care is not a requirement of CPAS. During the application process, a county registered nurse case monitor performs an assessment of care needs.
Note: For seniors who require personal care assistance and meet a level of care consistent with what is provided in an institutional setting, the Maryland Community First Choice Program may be of interest.
Financial Requirements
Income Limits
For applicants age 65 and older, this program has very low income limits. As of 2023, a single applicant is limited to a monthly income of $350. Married couples are each allowed $392.
However, applicants with income over the limit are still able to qualify if they have medical and / or care costs that are high relative to their income. In simple terms, income can be spent on medical bills, Medicare premiums, and long-term care, and once an individual has spent his or her income down to the income limit, he or she can qualify for Medicaid. This is often referred to as a “medically needy pathway” or a “spend down program.”
Asset Limits
For 2023, Maryland limits the value of an individual’s countable assets to $2,500. Several items are not counted toward the asset limit, including the value of one’s home (up to an equity value of $688,000 in 2023) and other personal items. If married, assets are considered jointly owned, and married couples, regardless of if just one spouse is an applicant, are limited to $3,000 in assets.
*Please note that in addition to the income and asset limits above, applicants who receive SSI automatically qualify for Medicaid.
Over the Financial Limits?
The financial side of Medicaid eligibility is complicated. Persons unsure of their eligibility should consult with a Medicaid professional adviser prior to application. Read more.
Benefits and Services
The following benefits / services are available through CPAS.
- Personal Assistance – help with ADLs, such as dressing, eating, and mobility
- Nurse Monitoring – registered nursing oversight of personal care provider services
- Supports Planning – assistance planning for and obtaining supports to aid independence
In addition to the above services, participants of the CPAS program may receive other services provided by Medicaid. This includes doctors’ appointments, hospital care, pharmaceutical drugs, home health care, durable medical equipment, disposable medical supplies, laboratory services, as well as mental health services.
*Make note, services cannot be provided in an assisted living facility, but can be provided in an adult foster care home.
How to Apply / Learn More
To seek assistance through the Community Personal Assistance Services program, one should contact Maryland Access Point at 844-627-5465. One can also call Medicaid’s Long-Term Care and Waiver Services at 410-767-1739.
To learn more about the program, a fact sheet can be found here. Additional, but very limited information is available on the Department of Health’s Long Term Services and Supports website.
