Personal Care Assistance in Missouri: What CDS Covers

If you or a family member needs help with everyday tasks like bathing, dressing or getting around the house, Missouri's Consumer Directed Services (CDS) program is one way to get that help paid for through Medicaid. In CDS, the participant chooses and manages their own caregiver, called a personal care attendant, instead of being assigned one by an agency. This page explains what kinds of personal care the program covers, who qualifies and what it does not cover. Details come from the Missouri Department of Social Services and the Department of Health and Senior Services.

What Personal Care Tasks Does CDS Cover?

The state describes Missouri's CDS State Plan Personal Care as including, but not limited to:

• Personal care: bathing, grooming, dressing and personal hygiene
• Toileting: ostomy or catheter hygiene, bowel or bladder routines and general toileting help
• Health-related help: using transfer devices, mobility help, prostheses, passive range of motion, manual assistance with medications and treatments, and cleaning and maintaining equipment
• Housekeeping: cleaning, dusting, bed linens, laundry and trash
• Meals: meal preparation, help with eating and washing dishes
• Transportation: essential shopping and errands, and trips to school or work

What a particular participant can receive depends on their care plan. The plan is written by the state (the Division of Senior and Disability Services, or a designee) after an assessment, and services are authorized in 15-minute units.

Who Qualifies?

The state's policy lists these requirements for CDS participants:

• Be at least 18 years old
• Have a physical disability, meaning loss of, or loss of use of, all or part of the body's neurological, muscular or skeletal functions to the extent that the person needs another person's help with routine tasks
• Be able to direct their own care (more on this below)
• Have active Medicaid and an appropriate Medicaid eligibility code
• Meet nursing facility level of care
• Not have been previously involved in Medicaid fraud

Living in a nursing facility, a residential care facility or an assisted living facility licensed by the state makes a person ineligible for CDS.

What "Directing Your Own Care" Means

CDS participants are the employer of their attendant. The state expects participants to be able to supervise the attendant, verify the wages paid to the attendant, use Electronic Visit Verification correctly, report changes to the state, and report problems with the quality of care. If someone cannot do these things, the state looks at other options, including agency-based personal care services.

Who Can Be the Caregiver?

Participants choose their own attendant. The attendant can be a family member, with two exceptions: the attendant cannot be the participant's spouse or legal guardian. The attendant also cannot be someone who was previously involved in Medicaid fraud or who is a current CDS participant.

What CDS Does Not Cover

According to the state's policy, CDS does not pay for:

• Services whose main benefit is to the whole household
• Tasks that household members would reasonably be expected to share or do for one another, unless the task goes beyond what's typical for a household member without a disability
• Any task that must be performed or trained by a licensed professional, such as skilled nursing or physician-ordered therapies

How CDS Is Paid For

CDS is funded through Medicaid. The participant chooses a vendor that is enrolled as a CDS provider with Missouri Medicaid. The state pays the vendor on the participant's behalf, and the vendor pays the attendant through payroll.

How HomeTeam Can Help

HomeTeam is a Missouri Consumer Directed Services (CDS) vendor based in Ballwin. CDS is a Medicaid program that lets eligible participants choose their own caregiver, including a family member in many cases, and HomeTeam handles the payroll and paperwork. If you're not sure whether you or a loved one qualifies, call HomeTeam at (314) 863-5987 and we'll explain your options.

Common Questions

Can a family member be my caregiver in CDS?
In most cases, yes. Spouses and legal guardians cannot be the attendant. See Can a Family Member Be Paid to Be a Caregiver in Missouri?

What if I can't direct my own care?
The state will look at other services, such as agency-based personal care. Ask your state case worker or your local Area Agency on Aging.

How do I apply?
See Missouri CDS Eligibility and How to Apply. To learn how the program works overall, see How Missouri CDS Works.

Sources

• Missouri Department of Social Services, MO HealthNet: Consumer Directed Services Enrollment Information
• Missouri Department of Health and Senior Services, HCBS Manual 3.25: Personal Care Assistance, State Plan, Consumer-Directed Service Model (revised January 2026)