The Texas Community Care for the Aged and 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).
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 Community Care Services Eligibility (CCSE).
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:
Monthly income cannot exceed three times the Supplemental Security Income (SSI) payment. As of 2023, for a single applicant, this amount is $2,742. For married applicants with both spouses applying, the monthly income limit is $5,484.
Assets and resources (as of 2023) 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 Community Attendant Services, 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).
Texas residents who exceed these income and asset limits but still cannot afford their care costs still might qualify for this program by working with a Medicaid planning professional. They are trained to assist applicants who find themselves in this very situation and are well versed in reallocating income and assets so that it isn’t counted toward the limits. For instance, extra income can be deposited into a Miller Trust, also referred to as a Qualified Income Trust, and an Irrevocable Funeral Trust can be used to lower one’s countable assets.
In addition to case management, the following services are available via the CCAD program:
Adult Foster Care – 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 –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 – Adult day care provided up to 10 hours a 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 – 24-hour electronic monitoring for functionally impaired individuals living in socially isolated residences.
Family Care – 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 a week.
Home-Delivered Meals – Nutritious meals delivered to the individual’s home.
Residential Care – 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 – Counseling, skills training, and personal assistance services are available to help individuals live independently. This service is only available in Dallas, Tyler, Houston, and Austin.
To begin the application process for Community Care for the Aged and Disabled / Community Care Services Eligibility (CCSE), contact your local Aging and Disability Resource Center (ADRC). One can also contact the ADRC at 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 can call HHS at 512-424-6500 for more information.