Texas Community Care for Aged/Disabled (CCAD)

Program Description

The Texas Community Care for the Aged / Disabled (CCAD) program is designed to allow seniors and 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 that 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 non-Medicaid programs. While the majority of the services available via CCAD are Title XX services, Community Attendant Services (CAS) is not. Rather, this is a Medicaid (Title XIX) funded program and is only available to Medicaid recipients.

CCAD is currently administered by Texas’ Health and Human Services (HHS). Previously, the Texas Department of Aging and Disability Services (DADS) office administered CCAD. However, in September of 2017, the DADS agency was abolished.

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:

• Individuals must be residents of Texas. Length of residency is not considered.
• Individuals must be 18+ years old.
• Monthly income cannot exceed three times the Supplemental Security Income (SSI) payment. As of 2020, for a single applicant, this amount is $2,349. For married applicants, the monthly income limit is $4,698. 
• Assets and resources (as of 2020) for a single individual cannot exceed $5,000. For married applicants, the limit is slightly higher at $6,000. Please make note, the asset limit is different for Community Attendant Services. For this service, the asset limit for a single individual is $2,000, and for a married couple, the asset limit is $3,000. It is worth noting that 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. Assistance with arranging transportation, meal preparation, and housekeeping may also be provided. While this program pays for the care services, it does not pay for room and board.

Consumer Managed Personal Attendant Services (CMPAS) – pays for personal care services for community integration purposes, such as employment, education, and training opportunities. Care recipients are able to select and manage their care providers, which can include relatives, but not spouses, through Consumer Directed Services (CDS). Payroll and taxes are handled by a Financial Management Services Agency.

Community Attendant Services (CAS) – provides in-home personal care assistance for individuals with a medical need. Assistance with bathing, grooming, toileting, laundry, cleaning, etc. is available. CAS also allows for self-direction, meaning the program participant is able to select the caregiver of their choosing. While CAS is part of the suite of services offered by CCAD, a separate program page is maintained for CAS. As mentioned previously, unlike the other services provided under CCAD, CAS is Medicaid funded.

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 to and from the facility, rehabilitative services, 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 activities and instrumental activities of daily living (escort services, such as going to the hairstylist or a social event, help with bathing, dressing, shopping, cooking etc.) is 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 around the clock care services, but not for room and board.

Special Services to Persons with Disabilities (SSPD) – counseling, skills training, and personal assistance services is available to help individuals live independently. This service is only available in Dallas, Tyler, Houston, and Austin.

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 Aging and Disability Resource Center (ADRC). One can also contact the ADRC at 1-855-937-2372.

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. It provides considerable detail and can be confusing. In addition, one call HHS at 1-512-424-6500 for more information.