Missouri CDS: Get Paid to Give Care

    Through Missouri's Consumer Directed Services program — part of Missouri Medicaid (MO HealthNet) — a participant hires and directs their own attendant, and that attendant may be a family member.

    Call 314-667-5951

    A Family Member Can Be the Attendant

    Under Missouri's CDS rules the attendant may be a family member — but not the participant's spouse or legal guardian. We confirm the specifics with you.

    Care for Someone You Already Help

    If you already help a relative day to day, CDS is the program through which a participant hires and directs their own attendant.

    Talk to a CDS Coordinator

    Free, no-obligation consultation.

    By submitting this form, you agree to be contacted about our services.

    Program rules and authorised hours are set by the State of Missouri, and DHSS/DSDS — not Diverse Health Services — determines eligibility. A coordinator confirms what applies to you during your consultation.

    Who can be the attendant

    In Missouri's Consumer Directed Services model the participant is the attendant's employer of record and chooses who provides their care. The Department of Health and Senior Services (DHSS) says the attendant may be a family member, but cannot be the participant's spouse or legal guardian; Missouri statute defines a personal care attendant as a person other than the consumer's spouse. Beyond that, the attendant must clear the state's background screening before program funds can pay for their hours.

    Who can be a participant is a separate question. The program sits within Missouri Medicaid (MO HealthNet); Missouri statute and DHSS describe adults with a physical disability who can direct their own care, who hold active MO HealthNet coverage and whose care needs are assessed at a nursing-home level of care. DHSS/DSDS — not Diverse Health Services — determines eligibility — through a referral and an in-person assessment, not through us.

    Screening, registry checks and orientation

    Before a family member's first paid shift, three things happen on the vendor's side:

    • Family Care Safety Registry. Vendors must make sure every attendant is registered with Missouri's Family Care Safety Registry, and state law requires the background screening to be completed before program funds are used for the attendant's work.
    • Employer orientation. The participant gets an orientation on what being the employer of record means — scheduling, supervising and signing off on the attendant's time.
    • Employment paperwork. Tax and employment forms for the attendant, kept on file by the vendor.

    Hours, timesheets and payroll

    The hours an attendant can work come from the participant's care plan, which the state authorises after its assessment. Missouri statute then sets out the paperwork: timesheets signed by both the participant and the attendant, verified by the vendor, which pays the attendant directly on the participant's behalf and makes the payroll and employment tax payments on time. The vendor also monitors how the services are going with at least one face-to-face visit a year.

    We do not publish pay figures on this site, because they are not ours to set. A coordinator explains the timesheet and payroll process in your consultation.

    Caregiver support

    Caring for a relative is work, paid or not. Our post on why respite care matters for family caregivers covers the signs of caregiver burnout and how a planned break helps both of you. If you are not yet in the program, referrals go to the state's HCBS Intake line at 1-866-835-3505; our step-by-step guide to applying explains what happens next.

    Frequently Asked Questions

    Common Questions About Paid Family Caregiving

    How Missouri's Consumer Directed Services program works for family caregivers in St. Louis.

    Missouri's Consumer Directed Services (CDS) program lets a participant hire and direct their own attendant, and the attendant may be a family member other than the participant's spouse or legal guardian. DHSS/DSDS — not Diverse Health Services — determines eligibility, through a referral and an in-person assessment; a coordinator can explain the steps.

    Under Missouri's rules the vendor collects and verifies the timesheets you and the participant both sign, pays the attendant on the participant's behalf and makes the payroll tax payments. We do not publish pay figures on this site.

    The participant, a family member or another supporter submits a referral to the state's HCBS Intake line or online form, DSDS carries out an in-person assessment, and the participant chooses a CDS vendor. Our how-to-apply guide lists each step, or schedule a call with a coordinator.

    Schedule a call with a coordinator How to apply for CDS in Missouri

    The state's referral line accepts referrals from participants, family, friends and other informal supports, so you can start the process for a parent. The assessment and the decision are the state's, and the parent, as the participant, is the attendant's employer of record.

    Already know you want CDS and need a local provider?

    Already in CDS with another vendor? You can switch

    Sources

    Program statements on this page are summarised from the official Missouri sources below. Program rules can change; the state's own pages are the authority.