Community Based Alternatives



Home and community-based services and supports provided to persons in their own home, an assisted living facility or in an adult foster care setting as an alternative to institutional care in a nursing facility. These services may include adaptive aids and medical supplies, adult foster care, assisted living, dental, emergency response services, financial management services, home delivered meals, minor home modifications, nursing services, occupational therapy, personal assistance services, physical therapy, prescription drugs (if not covered through Medicare), respite services, speech, hearing and language therapy, and transition assistance services.

What services are provided?

  • • Adaptive aids and medical supplies
  • • Adult foster care
  • • Assisted living
  • • Dental
  • • Emergency response services
  • • Financial management services
  • • Home delivered meals
  • • Minor home modifications
  • • Nursing
  • • Occupational therapy
  • • Personal assistance services
  • • Physical therapy
  • • Prescription drugs, unless the person is eligible for both Medicare and Medicaid
  • • Respite
  • • Speech, hearing and language therapy
  • • Support consultation
  • • Transition assistance services

Who can get services?

  • • You must be 21 or older.
  • • You must meet the medical necessity criteria for nursing home care and be at risk of being placed in a nursing home.
  • • You must be eligible for Medicaid in the community, including:
    • – being eligible for Supplemental Security Income,
    • – being eligible for Medical Assistance Only protected status, or
    • – meeting the income and resource requirements for Medicaid benefits in a nursing home (spousal impoverishment provisions apply).
  • • You cannot be enrolled in another waiver program.

Where is CBA available?

CBA is available in limited areas. Contact your local Texas Department of Aging and Disability Services (DADS) office to see if CBA is available in your area.

If CBA is available and you have experienced a catastrophic episode, which may lead to placement in a nursing home, you may apply for CBA under emergency procedures. The following are examples of a catastrophic episode:

  • • You rely on a caregiver to stay at home and the caregiver passes away or is suddenly no longer able to provide care.
  • • You must suddenly move where there is no one to help you.
  • • Any situation where you can no longer care for yourself.
  • • Adult Protective Services has identified you as being at imminent risk of nursing home placement.

If you are at imminent risk of nursing home placement, contact your local DADS office to apply for CBA.

How do I apply for services?

Call your local DADS office.