Page Reviewed / Updated – Nov. 7, 2023

Program Description

Missouri’s state Medicaid program, referred to as MO HealthNet, offers a consumer-directed personal care assistance program. With consumer directed services (CDS), also referred to as “self-directed care,” eligible applicants can hire, train, and supervise the individual 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.

While this program is not limited to the elderly, it does assist seniors who are unable to perform routine daily activities due to illness. (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
  • Light housekeeping

This personal care assistance program is administered by the Division of Senior and Disability Services, a department of DHSS. It is available statewide.

Eligibility Guidelines

General Requirements

To be eligible for this program, applicants must meet the following requirements:

  • Be a Missouri resident.
  • Be at least 18 years of age.
  • Able and willing to direct their own care.
  • Must be physically disabled and unable to perform daily routine activities such as bathing oneself, dressing, and preparing meals.
  • Must require the level of care that is provided in a nursing home.
  • Must currently be enrolled in MO HealthNet.

Financial Requirements

In addition to the above requirements, MO HealthNet eligibility is also dependent on financial criteria.

Income Limits
As of 2023, the income limit for a single senior is $1,033 per month. Married couples are allowed a slightly higher monthly income of $1,397. (These figures are equivalent to 85% of the Federal Poverty Level.)

Asset Limits
Further, there is a $5,726 asset limit for individual seniors who want to enroll in MO HealthNet. Married couples are allowed up to $11,452 in assets. However, some assets are considered exempt (non-countable). These include one’s home (given the applicant or their spouse lives in the home and the equity value is not greater than $688,000), household items, personal goods, and a motor vehicle.

Over the Financial Limits?

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 rest of the month.

Persons unsure of their eligibility status may wish to consult with a Medicaid planning professional.

Individuals who are receiving consumer directed personal care services through MO HealthNet are not eligible to receive self-directed services via Missouri’s Division of Developmental Disabilities. 

Benefits and Services

This program provides consumer-directed personal care assistance that is non-medical in nature, in the home of eligible applicants. Assistance with a variety of ADLs and IADLs is central to this program. It may include help with the following:

  • Bathing
  • Grooming
  • Toiletry
  • Mobility
  • Medication management
  • Light housecleaning
  • Laundry
  • Meal preparation
  • Shopping for essential items
  • Essential transportation, such as for medical appointments

As mentioned before, family members or friends can be hired as personal caregivers.

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How to Apply / Learn More

The Division of Senior and Disability Services determines eligibility for the Consumer Directed Personal Care Program. If you are currently enrolled in 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 can apply by calling 855-373-9994, by downloading an application, or through the online portal.

One can learn more about the consumer-directed personal care program here