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CASA - Community Alternative Systems Agency


The Community Alternative Systems Agency [CASA], located in the Division of Long Term Care is staffed by employees of the Erie County Department of Social Services and Jewish Family Service. CASA's primary function is to determine the appropriateness and necessity for Medicaid Long Term Care services and develop suitable care plans for community based elderly and/or disabled individuals in Erie County to remain as independent as possible.

Eligibility Requirements:

A person must meet certain program eligibility requirements to become a part of the CASA system:

  • Must be a resident of Erie County.
  • Must be financially eligible for New York State Medicaid.
  • Must obtain a physician's medical order indicating a need for home care services.
  • If eligible and/or enrolled in Managed Care, they must receive services from the Managed Care plan.

A team of Medicaid eligibility workers located within the CASA services division interview new applicants for Medicaid who are looking specifically for Home Health Care Services. They also do the annual financial eligibility reviews for each Medicaid home care recipient.

Access and Coordination Team:

The Access and Coordination Team [ACT] is a multi-dimensional unit designed to help consumers access appropriate community services within the Long-term Care System. ACT is committed to the coordination of quality care, community education, and the most efficient use of Medicaid resources. ACT is responsible for receiving, reviewing, and processing all new referrals for home care services.

ACT referral process -

A referral for CASA services can be made by calling 858-2323. The best time to call is between 9:00 a.m. and 1:00 p.m.

  • The referral source will speak with the Intake Social Services Team Worker [SSTW]. The SSTW makes sure that the client is not already active with CASA, then checks the New York State system for Medicaid eligibility and for Managed Care enrollment.
  • If the potential client is not currently Medicaid active, the caller will be directed to the CASA Medicaid Unit or another appropriate agency for assistance.
  • The caller will be transferred to an ACT nurse or caseworker who will ask case-specific questions to identify needs and determine if CASA is the most appropriate program. If CASA is not the most appropriate program, the individual will be referred to the proper agency or agencies within the Long Term Care System - including Managed Long Term Care (MLTC).
  • For referrals that are accepted, ACT will follow-up with additional telephone calls and request medical orders. The ACT nurse will also send reminder letters to the physicians to expedite the process. Once medical orders are received, the referral is sent to one of the CASA assessment teams to complete a community evaluation by making a home visit.

Getting Eligibility Established:

After assessing the client's needs CASA arranges for home care services for its clients. CASA clients may receive:

  • Personal care aide services, which provide assistance with personal hygiene, including bathing and dressing, assistance with ambulation, etc.
  • Environmental aide services, which cover assistance with household chores, meal preparation, shopping, laundry, and similar activities.
  • Private duty nursing services, if continuous skilled nursing assistance is warranted.

Consumer Directed Personal Attendant Program [CDPAP]:

If a client qualifies for CASA services, they may also be eligible for assistance through the Consumer Directed Personal Attendant Program, a unique program which allows clients to recruit, hire and supervise their own aides. Consumer directed attendants may also perform skilled nursing tasks under the consumer's direction.

Other Services:

CASA is responsible for the prior approval of several Medicaid long-term care services to ensure the most appropriate, least-restrictive setting and access to home-based care.

Additional Information:

For more information about CASA services, please call:

Access and Coordination Team [ACT]
Monday - Friday
8:30 a.m. - 5:00 p.m.
[716] 858-2323