Missouri Medicaid home care: Consumer Directed Services, personal care and how to apply

Missouri pays for personal care at home through MO HealthNet, the state's Medicaid. With Consumer Directed Services (CDS) you hire your own attendant, but the Department of Health and Senior Services (DHSS) says spouses and court-appointed guardians cannot be the paid attendant.

The programs

The MO HealthNet Division describes its Personal Care Program as medically related services designed to meet the maintenance needs of participants with a chronic, stable condition. Its page lists personal care assistance consumer-directed services among the available services. DHSS's Division of Senior and Disability Services (DSDS) authorizes home and community based services. See Consumer Directed Services in Missouri.

Missouri Medicaid Audit and Compliance says CDS is funded by Medicaid through the MO HealthNet Division and by General Revenue through DHSS and DSDS, and that services are authorized by DHSS and DSDS or its designee. It also describes an Independent Living Waiver, offered to a limited number of eligible consumers, that adds case management, personal care, environmental accessibility adaptations, and specialized medical equipment and supplies.

Eligibility for home and community based services

The DHSS manual chapter on Medicaid eligibility, revised February 2026, says applicants need:

• an appropriate Medicaid eligibility code and Medicaid benefits that reimburse for these services;
• a finding that they meet nursing facility level of care; and
• agreement to a face-to-face assessment and a person-centered care plan.

The manual says people with the Medicaid Expansion code E2 are eligible only for Consumer Directed Services. It points to other chapters for the level of care criteria and dollar limits, which we did not read, so we state none.

Who can be paid

The DHSS manual's CDS clarification says only legally responsible individuals, defined there as a court-appointed guardian or conservator, and spouses are prohibited from being an attendant in CDS. A payee may be an attendant, though the provider may want more oversight. A minor cannot be hired. An agency owner or direct employee who does certain office tasks cannot be an attendant for that agency's participants, with a narrow exception. The page does not address other relatives. A separate DHSS personal care page says that in the agency-based Personal Care program, an aide employed by the provider agency generally cannot be a family member, where family means a parent, sibling, child, spouse, grandparent or grandchild. That is a different program from CDS.

See paid family caregiver in Missouri.

How to start

1. Call the Department of Social Services on 573-751-3425, the number Medicaid.gov lists, for coverage questions.
2. Ask DHSS Senior and Disability Services for an assessment for home and community based services.
3. Ask whether you meet nursing facility level of care and whether CDS or agency-based personal care fits.

The pages we read do not describe the referral steps or give an intake phone number. Relay Missouri is 711 and TDD/TTY is 800-735-2966, according to the Department of Social Services page.

What we have not described

We did not read pages on the age and disability rules for CDS, the Independent Living Waiver's eligibility, adult day care or the programs for people with developmental disabilities, which the Department of Mental Health runs. We state no rates. Ask DSDS.

Where Carevo fits

Carevo is a connection platform and directory. We do not run these programs, assess eligibility or vouch for providers. For paid help now, see home care in Missouri, home health in Missouri, nursing homes in Missouri and developmental disability services in Missouri.

Programs in Missouri

• Consumer Directed Services (CDS): Missouri Consumer Directed Services let you hire and direct your own attendant for personal care. DHSS says spouses and court-appointed guardians cannot be the paid attendant, and a minor cannot be hired.

Find providers in Missouri

• Home care in Missouri
• Home health care in Missouri
• Nursing homes in Missouri
• Intellectual and developmental disability services in Missouri
• Paid family caregiver in Missouri