Do you qualify for Consumer Directed Services?
Five things decide it, and you need all five. The state makes the final call, not us. But these questions will usually tell you whether it is worth asking for a visit.
The five requirements
1. You are 18 or older
CDS is for adults. There is no upper age limit. A 92-year-old and a 24-year-old qualify on the same terms.
2. You are eligible for MO HealthNet
MO HealthNet is Missouri’s Medicaid program, and it pays for CDS. If you are not signed up yet, you would need to apply first. Whether you qualify depends on your income, what you own, and your disability.
3. You have a physical disability
State law describes this as the loss, or loss of use, of nerves, muscles or bones — enough that you need help with everyday tasks.
Conditions that often qualify include spinal cord injury, multiple sclerosis, muscular dystrophy, cerebral palsy, stroke, bad arthritis, amputation, ALS and Parkinson’s. But the name of the condition matters less than what you can and cannot do.
4. You can direct your own care
People get this one wrong most often. CDS asks you to act as an employer. You decide what help you need, tell your attendant, check their hours and sign timesheets.
You do not need to be able to do any of it with your own hands. You need to be able to make the decisions and say what you want.
RSMo 208.900 leaves out people who have a guardian or conservator making their decisions. A 2009 federal court ruling limited that. So if there is a guardianship in your case, ask the state rather than assume.
5. You are assessed at a nursing facility level of care
The state checks whether your needs are at the level a nursing home would handle. That is the whole point of the program: people who could go to a nursing home get to stay in their own house instead.
What does not disqualify you
A lot of people rule themselves out for reasons that are not real rules:
- Living with family. You can live with your adult children, your parents, or anyone else and still qualify.
- Having a family member as your attendant. Encouraged, in fact — as long as they are not your spouse.
- Owning your home. Home ownership is not an asset test failure in itself for MO HealthNet purposes.
- Being employed. Working does not disqualify you, and essential transportation to a job can be an authorized task.
- Already receiving some other services. Ask — many combinations are permitted.
If you are not sure
Call us. A five-minute talk costs nothing and usually settles it. If you clearly do not qualify, we will say so and point you somewhere better. We will not start paperwork that leads nowhere.
Frequently asked questions
Who actually decides if I am eligible?
The Missouri Department of Health and Senior Services, through its Division of Senior and Disability Services. They perform the in-home assessment and authorize the care plan. A vendor cannot approve you, and any vendor who implies otherwise is misrepresenting the program. See how the assessment works.
I have a guardian. Am I automatically excluded?
Not necessarily. The statute’s exclusion language has been limited by litigation, and situations vary. Ask DHSS directly rather than assuming — call the HCBS line at 866-835-3505.
Does a mental health diagnosis disqualify me?
The program’s eligibility is built around physical disability and the ability to direct your own care. A mental health diagnosis by itself neither qualifies nor disqualifies you; what matters is physical function and decision-making capacity.
What if I qualify but do not have anyone to hire?
Tell us. We recruit attendants throughout the St. Louis area and can bring you candidates to interview. You still make the hiring decision. How choosing an attendant works.