How Consumer Directed Services works

Here is the whole thing, from your first phone call to your attendant’s first paycheck. That includes the parts we do not control, so you know what to expect.

Step 1 — Request an assessment

Contact the Department of Health and Senior Services and ask for a Home and Community Based Services assessment. The referral line is 866-835-3505. You, a family member, a friend, a hospital discharge planner or a physician can all make the referral.

We can talk you through this call before you make it, and tell you what information to have ready.

Step 2 — The in-home assessment

Someone from the state comes to your home. They walk through your day with you: how you get out of bed, whether you can bathe safely, how meals happen, what you can and cannot reach.

They are working out two things. Do your needs match what a nursing home would handle? And which tasks do you need help with?

Step 3 — Your care plan is authorized

The state writes a care plan. It lists the tasks they approved and how much time each one gets. That is what your attendant can be paid to do.

Anything not on the plan cannot be billed, no matter how helpful it would be.

See which tasks are commonly authorized →

Step 4 — Choose your vendor

You pick which CDS vendor handles your services. That choice is yours alone. Not the assessor’s, not a hospital’s, not a family member’s. If you pick us, tell the state and tell us.

Step 5 — Identify and onboard your attendant

You name the person you want to hire. They fill in job and tax forms, pass a background check, and come to us for training on the job and the program rules. We handle the paperwork. You make the hiring choice.

What attendants must complete →

Step 6 — Work begins, timesheets start

Your attendant works the schedule you set, within your authorized hours. Under RSMo 208.909, you and your attendant both sign timesheets and submit them to the vendor on a biweekly basis. Missouri also requires electronic visit verification for personal care services, so visits are recorded electronically as well.

How timesheets and pay work →

Step 7 — Ongoing responsibilities

RSMo 208.909 sets out what you are responsible for once services begin:

• Supervise your attendant and verify the wages paid to them.
• Prepare and submit dual-signed timesheets biweekly.
• Notify the department within ten days of any change in circumstances affecting your care plan or where you live.
• Report significant health changes that affect your ability to direct your care.
• Report service quality problems to the vendor first, and escalate to the department if they are not resolved.
• Provide the information the vendor needs to establish employer identification, and allow required quality assurance activities including annual home visits.

How long does all this take?

Honestly, it depends on two things: when the state can visit, and how fast your attendant finishes their paperwork and background check.

We will not promise you a number of days. The slowest part is not ours to control. What we can do is start your attendant’s paperwork at the same time as the state process, so nothing waits its turn.