Consumer Directed Services (CDS)
The Consumer Directed Services (CDS) Program is available for Missouri Medicaid recipients and private-pay individuals with physical disabilities. This program is at no cost to the consumer. It allows consumers to hire their own personal care attendant and manage assistance with activities of daily living (ADL). The attendant can be a relative of the consumer.
Consumer Directed Services (CDS) include State Plan Personal Care, which encompasses, but is not limited to:
- Personal Care: Bathing, grooming, dressing, and personal hygiene
- Toileting: Ostomy or catheter hygiene, bowel and/or bladder routine, general toileting activities
- Health: Use of transfer devices/mobility aids/prostheses, passive range of motion exercises, manual assistance with medications, treatments, and cleaning and maintenance of equipment
- Housekeeping: Cleaning, dusting, changing bed linens, laundry, and trash removal
- Meals: Meal preparation and/or assistance with eating and washing dishes
- Transportation: Essential shopping/errands, school, or employment-related travel
- Independent Living Waiver (ILW): Offers additional services beyond the State Plan Personal Care program, including case management, personal care, environmental accessibility adaptations, and specialized medical equipment and supplies to a limited number of eligible consumers
- Nurse Visit: Medication setup
- Case Management
Some consumers may have to pay a spend down*
Spouses may not provide care through the CDS program.**
A spouse can work for their spouse if they have the SFW and certain restrictions apply. .***
Home and Community-Based Services Program (HCBS)
The Home and Community-Based Services (HCBS) Program provides personal care assistance to seniors and adults with disabilities, enabling them to remain in their homes rather than move to nursing facilities. The In-Home Services (IHS) program, also known as Home and Community-Based Services (HCBS), is similar to the Consumer Directed Services (CDS) program, but unlike CDS, you do not need to self-direct your own care. You may also have a family member working for you. In-home services (IHS) are provided at no cost to you. If your income exceeds the limit, ask about the Miller Trust program.
In-home services (IHS) include:
- Personal Care: Assistance with activities of daily living
- Homemaking: General assistance with housekeeping
- Chores: Short-term, intermittent tasks necessary to maintain a clean, sanitary, and safe home environment
- Advanced Personal Care: Services related to activities of daily living, specifically when such assistance requires the use of devices or procedures due to altered body functions
- Authorized Nurse Visits: Maintenance or preventative services provided by a registered nurse (RN) or a licensed practical nurse (LPN) under the supervision of an RN (must be authorized in conjunction with another service)
- Respite: Temporary relief for the caregiver of a dependent adult
- Basic: Services provided to participants with non-skilled needs
- Advanced: Services for participants with special care needs requiring a high level of oversight
- Nurse: Services for participants with skilled nursing needs
- Case Management: Coordination and oversight of services
In-home personal care workers cannot be family members of the recipient for whom personal care is to be provided. A family member is defined as a parent, sibling, child by blood, adoption or marriage; spouse; grandparent or grandchild.
Consumers might have to pay a spend-down fee*
Veteran Assist Care
The Veteran Assist (VA) “Aid & Attendance” benefit is available for wartime veterans or their surviving spouses who meet certain medical and financial requirements. In 1952, Congress passed Title 38 of the Veterans Affairs (VA) Code, authorizing benefits for veterans. One of these benefits is the Non-Service Connected Pension, which includes the “Aid & Attendance” pension benefit. Despite being available for over 60 years, this pension is not widely known or understood. Gentle Hands Home Care has years of experience successfully assisting veteran families in applying for and receiving this pension. The VA benefit is free to you, but an honorable discharge is required.
Veterans Home Care can provide personal care assistance, including:
- Help with bathing
- Help with dressing
- Medication reminders
- Transportation
- Meal preparation
- Transferring to and from bed
- Personal care
- Respite care
- Light housekeeping
- Laundry
- Companionship
- Additional services, including assistance in accessing other community resources to improve your quality of life
The “3 M’s” VA requirements are:
- Military Service: Minimum 90 days of active duty with at least one day during wartime and an honorable discharge
- Medical Needs: Non-service-connected disability requiring assistance with activities of daily living
- Money (Financial Limitations): Limited resources relative to medical expenses
Healthy Children and Youth Program
The Healthy Children and Youth Program (HCY) provides service coordination and authorization for medically necessary services for MO HealthNet recipients with special health care needs from birth to age 21. Service coordination includes assessments through home visits and linking individuals to services and resources that enable them to remain in their homes with their families. Authorized services may include in-home personal care, in-home nursing care, and skilled nursing visits. Special Health Care Needs (SHCN) Public Health Nurse Service Coordinators monitor services through assessments, regular home visits, medical records, and care plan reviews.
Service Coordination includes:
- Evaluation and assessment of needs
- Identifying and accessing service providers
- Service plan development and implementation
- Coordination of services through resource identification and referral
- Family support
- Assisting in establishing a medical home
- Transition planning
- Prior authorization of medically necessary services, including:
- Private duty nursing
- Advanced personal care
- Personal care aide
- Skilled nursing visits
- Authorized Registered Nurse visits
- Administrative case management
Please note that a family member is not allowed to care for the participant.
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