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Texas Community Attendant Services (CAS) Program

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.

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 receive “cash and counseling” and 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; they can be paid to provide attendant care services. Sometimes this means that an elder’s current unpaid family caregivers can become paid contractors. Close relatives and legal guardians, however, are typically excluded from this option.

While this model of program is often referred to as Cash and Counseling, the name is slightly misleading. The CDS option requires the use of a fiscal intermediary that actually receives the money from the state and pays the care providers following authorization of payment by the program participant.