Medicaid is a federal program that helps provide health services to low income individuals. The program is administered in different ways by each U.S. state. Therefore, it’s important to know how to sign up for Medicaid in your own state.


Included in Medicaid is an option for Consumer Directed Services (CDS). This is a program that allows people to pay caregivers for the services which allow them to continue to live in their homes despite illness, age, or disability.


Below, we’ve compiled information about how Missouri handles Consumer Directed Services, including caregiver tasks and eligibility requirements.


What is a CDS caregiver?

In the state of Missouri, those who are eligible for Medicaid and who are disabled or too ill to care for themselves can also take advantage of a program called Consumer Directed Services.


This Medicaid-based program allows consumers to remain in their homes and communities instead of being moved to an institution. It does this by allowing a person of the client’s choosing to receive compensation for providing essential support services. These caregivers can be an acquaintance or even certainly family members.


While many caregivers in the U.S. help their loved ones with daily tasks without pay, the CDS program lets some of them earn income for their services. In Missouri, the average pay rate is between $10 and $11 per hour for CDS caregiver pay.


However, it’s important to make sure to follow all Medicaid rules when a caregiver is hired as all states investigate potential incidents of Medicaid fraud.


Missouri’s Division of Senior and Disability Services

In Missouri, home-based care services are run through the state’s Division of Senior and Disability Services (DSDS). They make sure Medicaid-eligible people get the care they need. These people include:

–          People who are over 60

–          Adults with disabilities between the ages of 18 and 59


Missouri’s Medicaid program was expanded on October 1, 2021 to include adults ages 19-64 who are not disabled but who meet certain income qualifications. However, access to the CDS program is still limited for this group, so you will need to double check your eligibility.


The state of Missouri’s Medicaid system can be confusing because the DSDS runs two similar programs: In-home services (IHS) and consumer-directed services (CDS). These two programs provide slightly different services, so it’s important to talk to someone about the program you are eligible for.

–          In-home services (IHS) are available to people with a physical disability and do not include coverage for tasks performed by licensed medical professionals.

–          Consumer Directed Services (CDS) allows people who are able to understand and direct their own care to hire an attendant to help them do daily tasks.


For information regarding eligibility criteria for both in-home services or consumer-directed services, contact DSDS at 866-835-3505.


What are some tasks of a caregiver?

In general, the responsibilities of a CDS caregiver consist of a wide range of health management and other personal care tasks. Each caregiver’s duties will look different and will depend on the client’s needs, abilities, and resources.


If you are a caregiver, you may need to perform (or assist with) the following tasks for a client:

–          Preparation of nutritious meals and assistance with eating

–          Bathing and grooming

–          Light housekeeping, including dusting, trash duties, dishwashing, and changing bed linens

–          Laundry and ironing

–          Essential shopping and errands

–          Keeping track of medications and reminding clients to take them

–          Assisting with personal hygiene

–          Incontinence care

–          Assistance with using mobility devices and keeping medical equipment clean

–          Transportation to and from medical appointments

–          Monitoring vital signs


Missouri’s CDS program maintains a list of rights and responsibilities for participants that you can find here. It also explains what a client is responsible for when it comes to hiring and monitoring their caregiver. Because this program pays for care that is “consumer directed,” the client must be able to hire and manage their caregiver.


Why would someone need a caregiver?

Not every Medicaid recipient is eligible to hire a caregiver through the program, and not all loved ones are eligible to be paid through CDS. The purpose of a caregiver is to allow a client who would otherwise not be able to care for themselves to remain in their own homes and communities instead of moving to an assisted living facility. Therefore, spouses are not considered outside caregivers who are eligible for payment.


Caregivers are not housekeepers or people who run errands for convenience. However, they may do certain chores occasionally as part of their larger job of providing personal care to clients.


Those who need caregivers typically fall into one of the following categories:

–          Those recovering from a serious illness or surgery

–          Those at risk for falling and injuring themselves without supervision

–          Clients currently being cared for by a spouse or someone else who is not eligible to act as an official CDS caregiver and want to give them a break by hiring auxiliary care

–          Those who need an escort to doctor appointments

–          Those who require another person to encourage and help them be more active or mobile

–          Those who need bathroom assistance or other incontinence care

–          Those are who bedridden


In other words, caregivers who are funded by Medicaid are there to take care of clients who are unable to care for themselves without assistance. A person’s health status or disability will require documentation before Medicaid approves any payment for a home caregiver.


What are the qualifications to receive CDS?

In Missouri, you must first be eligible for Medicaid to qualify for Consumer Directed Services. This program is administered by the Missouri Department of Social Services’ MO HealthNet Division.


If you’re not sure if you qualify for Medicaid or need help applying, you can contact the Family Support Division and they assist you with your application.


Eligibility for Medicaid in Missouri

The first step to participating in the CDS caregiver program is to be eligible for MO HealthNet, Missouri’s name for Medicaid.


Your eligibility for this state-specific Medicaid program will primarily depend on your age, income, and health needs. The following groups may be eligible:

–          Seniors (age 65 and older)

–          Parents or caretakers with a child (under age 19)

–          Children (from birth -18)

–          Women (age 18-55) with no health insurance

–          Pregnant women (including unborn child)

–          Women (under age 65) with breast or cervical cancer

–          People with disabilities

–          Blind or visually impaired adults


Eligibility for Missouri’s CDS program

Just because you are eligible for Medicaid in Missouri does not mean you are also eligible for CDS caregiving services. In order to take advantage of Missouri’s CDS program, you must also meet the following qualification:

–          Be 18 years of age or older

–          Be able to direct his or her own care

–          Be physically disabled

–          Be capable of living independently with the services of a personal care attendant

–          Require at least a nursing facility level of care


Over 20% of people in the U.S. currently act as caregivers to an adult or child with special needs. Not only are many of them unpaid for this work, but 61% also have jobs outside of their caregiving duties. Consumer Directed Services allow this work to be compensated.