The Community Attendant Services (CAS) Program is part of the Community Care for the Aged / Disabled (CCAD) Program, which offers a suite of services designed for Texas residents to assist them in living in the community, rather than require institutionalization. While most of the services provided under CCAD are not Medicaid funded, CAS is an exception and is Medicaid funded. To be very clear, CAS is only available to Medicaid recipients.
CAS is intended for seniors and disabled individuals who are functionally unable to manage their Activities of Daily Living (ADLs), which includes actions such as bathing, dressing, and mobility, without assistance. Program participants receive non-technical attendant care in their homes.
Enrolled individuals have the option of using the state agency to manage their care services or they can participate in the Consumer Directed Services (CDS) option, which means they are responsible for hiring, training, and managing their own care providers. One especially attractive component of the CDS option is that friends and some family members can be hired as caregivers. Sometimes this means that an elder’s current unpaid family caregivers can become paid contractors. Spouses and legal guardians, however, are typically excluded from this option.
There are medical and financial eligibility requirements for the CAS Program.
Functionally, individuals must be unable to perform some of their activities of daily living without assistance, such as dressing, eating, transferring, toileting or basic mobility. A medical doctor must document their need for assistance.
There are no age restrictions in order to be eligible for this program.
Financial eligibility changes annually and is calculated as a percentage of the SSI income limit.
Financially, as of 2023, individuals must have a monthly income less than $2,742. For couples when both spouses are applying, the monthly income limit is twice the individual limit, $5,484.
In 2023, an individual must have assets valued at less than $2,000. The resource limit for couples with both spouses applying is 50% higher at $3,000. Note that some assets, such as a primary home up to an equity value of $688,000, may be considered exempt.
Over the Financial Limits?
Persons with finances over these limits should consider finding Medicaid planning assistance. Persons in these situations still may be eligible for Medicaid, but just require financial expertise to help them allocate their resources appropriately. Learn more.
Medicaid has a 60-month look-back period in which all transfers within this time frame are scrutinized. Assets are not allowed to be gifted in order to meet financial requirements, otherwise the individual will be penalized with a period of Medicaid ineligibility.
Benefits and Services
CAS provides up to 50 hours a week of personal attendant services, although the average participant receives approximately 15 – 20 hours a week of assistance. Personal attendant services can be provided by a state approved agency or can be self-directed (meaning the care provider is selected by the participant). Services can include:
- Personal Care – Assistance with the activities of daily living such as bathing, dressing, eating, grooming, toileting, medication administration, mobility, and accompanying an elder to medical appointments.
- Home Management – Assistance with the Instrumental Activities of Daily Living (IADLs), such as housekeeping, laundry, meal planning and preparation, and shopping for groceries and other essentials.
How to Apply / Learn More
The CAS program is managed by Texas Health and Human Services (HHS). To apply, one should contact their local HHS office. Click here to find your local office.
One can read limited information about the program on their website.