Community Alternatives Program for Disabled Adults

Community Alternatives Program for Disabled Adults (CAP/DA) is a special Medicaid Program. The program is designed to make care at home a possibility for people who may be facing nursing home placement. CAP/DA uses services within the community to help families provide a less costly, more effective alternative to nursing facility care.


CAP/DA is for people 18 years of age or older who are eligible for Medicaid and live in a private residence. In order for someone to be approved for CAP/DA, he or she must be at risk of being placed in a nursing facility or he or she is a current resident of a facility who wishes to return to a private residence. He or she must also be able to show that his or her health, safety, and will being can be maintained at home within the Medicaid cost limit. He or she must have family and/or friends available to help assist with care.

Medicaid Eligibility

Medicaid eligibility and coverage differs in some respects for a CAP/DA client. Because CAP/DA is considered institutional care. Spousal income and resources do not count toward the applicant's eligibility. People over the Medicaid income limit may still qualify for CAP/DA Medicaid. The department of Social Services will determine if a person will have a deductible based on income.

Services Offered

CAP/DA exists to supplement services and support already available to an individual. Some of the services CAP/DA provides include the following:

  • In-home aide services assists with personal and simple home management tasks.
  • Waiver supplies includes oral nutritional supplements (Ensure / Glucerna) and medication dispensing boxes, and poise pads.
  • Home mobility aids includes hand held showers and grab bars, wheelchair ramps, and widening of door frames.
  • Telephone alert allows individuals to contact emergency services by pressing a button.
  • Case management social worker coordinating and monitoring needed services on a monthly basis.

Estate Recovery

Federal and State law authorize the Division of Medical Assistance to file a claim against the estate of people who receive long term care Medicaid. This means that when a recipient of CAP/DA dies, the state may seize property from their estate (such as their home) and sell it to recoup money spent on their care. An estate is subject to recovery when the resident is:

  • Age 55 or older
  • Medicaid is paying for a portion of their care in a nursing facility, or they are receiving services under the Community Alternatives Program

There are some circumstances when Medicaid will not collect the estate. For example, estate recovery will be waived if a surviving spouse continues to live on the property.

Contact Information

For questions about Medicaid eligibility or estate recovery, contact the Davidson County Department of Social Services by calling:

  • Lexington Phone: 336-242-2500
  • Thomasville Phone: 336-474-2760

Additional Program Information

Visit the Supportive Care Solutions website for more information on CAP/DA.

For general questions regarding the CAP/DA Program, please call 336-242-2290 or complete the online contact us form.