Page Reviewed / Updated – Nov. 27, 2022

Program Description

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.

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
  • Light housekeeping

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

Eligibility Guidelines

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 they must require the level of care that is provided in a nursing home. Also, 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 from April 2022 through March 2023 is $963 per month. Married couples are allowed a slightly higher monthly income of $1,297. (These figures are equivalent to 85% of the Federal Poverty Level.) Further, there is a $5,301.85 asset limit for individual seniors who want to enroll in MO HealthNet. Married couples are allowed up to $10,603.70 in assets. Some assets are considered exempt (non-countable) and include one’s home (given the applicant or their spouse lives in the home and the equity value is not greater than $636,000), 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 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

Transportation that is essential, such as for medical appointments and shopping for groceries is also a program benefit.

As mentioned before, family members or friends can be hired as personal caregivers, except for spouses and legal guardians. As of January 2022, caregivers are paid an hourly rate of approximately $11.15 per hour.

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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 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 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

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