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Missouri’s state Medicaid program, referred to as MO HealthNet, offers a consumer-directed personal care program. With Consumer Directed Services (CDS), also referred to as self-directed care, eligible applicants can hire, train, and supervise, the individual(s) they choose to provide their personal care. Family members, who register as CDS providers with the Missouri Medicaid Audit and Compliance Unit within the Department of Social Services, can be hired to provide care. An exception is spouses and legal guardians.
This program is intended to help prevent the need for nursing home placement by providing at-home assistance for those who are physically disabled, and would require institutionalization, if not for this state program. Missouri defines "living at home" broadly. The definition of at home includes Level 1 and Level 2 Residential Care Facilities (more commonly referred to as assisted living residences).
While this program is not limited to the elderly, it does assist seniors who are unable to perform routine daily activities, due to illness, such as cancer and kidney failure. Those with Alzheimer’s and other similar dementias are, unfortunately, not eligible for this program. Assistance is provided with both Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Examples of these activities include eating, toiletry, mobility, cooking, shopping for groceries, and light housekeeping.
This personal care program is administered by the Division of Senior and Disability Services, a department of the Missouri Department of Health and Senior Services (DHSS), and is available statewide.
To be eligible for this program, applicants must be Missouri residents who are 18 years of age or older, and are able and willing to direct their own care. They must be physically disabled, and unable to perform daily routine activities, such as bathing oneself, dressing, and preparing meals, and must require the level of care that is provided in a nursing home. In addition, they must currently be enrolled in MO HealthNet.
MO HealthNet eligibility is dependent on the age, income, and sometimes the countable assets of the candidate. The income limit for a single or widowed senior in 2018 is $855 per month. Married couples are allowed a slightly higher monthly income of $1,151. (These figures are equivalent to 85% of the Federal Poverty Level.) Further, there is a $2,000 asset limit for individual seniors who want to enroll in MO HealthNet. Married couples are allowed up to $4,000 in assets. Some assets are considered exempt (non-countable) and include one’s home (given the applicant or their spouse lives in the home), household items, personal goods, and a motor vehicle.
Individuals who have income over the limit may still qualify via a spenddown, which works similarly to a deductible program. Participants spend their excess income on medical bills and care needs, and once they have reached the Medicaid income limit, they are able to receive personal care services via Medicaid for the remainder of the month.
Person unsure of their eligibility status may wish to consult with a Medicaid planning professional.
This program provides consumer-directed personal care assistance that is non-medical in nature, in the place of residence of eligible applicants (provided their residence is not a nursing home). Assistance with a variety of ADLs and IADLs is central to this program, and may include help with bathing, grooming, toiletry, mobility, medication management, light housecleaning, laundry, meal preparation, and shopping for essential items. Transportation that is essential, such as for medical appointments and shopping for groceries is also a program benefit.
As mentioned previously, family members or friends can be hired as personal caregivers with the exception of spouses and legal guardians. Caregivers are paid an hourly rate within a range as determined by the program participant. Most caregivers are compensated at between $9.00 and $10.50 per hour.
The Division of Senior and Disability Services determines eligibility for the Consumer Directed Personal Care Program. If you are currently on MO HealthNet, call 866-835-3505 for a pre-screening, which will take 10-15 minutes. Following the pre-screening, a home assessment will be scheduled.
If you are not currently enrolled in MO HealthNet, you must apply via DHSS. You can do so by calling 855-373-4636 or click here to download the MO HealthNet application.