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Am I Eligible for CAP/DA?

Community Alternatives Program for Disabled Adults (CAP/DA) 

CAP/DA is a Medicaid Waiver program that allows the elderly and adults with disabilities to receive their care in their own home, or the home of a caregiver. Medicaid Waivers are intended to keep people out of institutions. The Waivers also provide long-term services not usually covered by Medicaid. You can qualify for CAP/DA if you have a medical condition that causes physical difficulties more than anything else, or if you have Alzheimer’s or dementia.   

How do I qualify for CAP/DA?

You may qualify for the CAP/DA program if you are at risk for going to a nursing facility, or are a current resident in one.   

Here are some examples of needs that might qualify you for CAP/DA:

  • You need care from a registered nurse or nursing assistant for several hours of a day.  
  • You need a nurse to administer drugs, including infusion of fluids because you are dehydrated or need nasogastric or gastronomy feedings.  
  • You require dialysis as part of your treatment plan.  
  • You need assistance in bathing, eating, toileting, dressing, transfer and walking.
  • You need Respiratory Therapy.  

To request CAP/DA, you must also be low income. Your family’s income is not considered. You can also be over the Medicaid income limit and still qualify for CAP/DA Medicaid. In that case, you will have to pay a deductible based on your income.   

CAP/DA Waiver Services

The CAP/DA Waiver provides services that are not covered by regular Medicaid. These services include:  

  • Adult day health, a structured day program with nursing supervision  
  • Personal care aide (but not 24 hour care)  
  • Skilled nursing  
  • Meal preparation and delivery  
  • Supplies, incontinence products and nutritional supplements  
  • Home modifications and Assistive Technology  
  • Non-Medical Transportation  
  • Community Transition and Integration Services  

Other considerations

In order for this program to work for you, you must have family, friends, or volunteers to help you in your home when paid supports are not there. Or you must be able to be in your home alone safely during those times.   

There is a waitlist for CAP/DA services, so it is important that you apply to be put on that list as soon as possible. To apply, use this directory to contact the Local Lead Agency for your county.   

Read more about this program

 

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