What your attendant can help with

Your authorized care plan is the controlling document. DHSS assesses which activities you need help with and allots time for each. Below is what the program commonly authorizes — but your plan, not this page, decides what your attendant may be paid to do.

Personal care

Mobility and physical support

Household tasks

Essential transportation

Transportation is authorized when it is essential — medical appointments, grocery shopping and errands, school, or employment. This is not a general chauffeur service; the trip has to serve one of those purposes.

What is not covered

• Skilled nursing tasks — injections, sterile wound care, IV therapy, tube feeding management.
• Physical, occupational or speech therapy.
• Medical assessment, diagnosis or clinical decision-making.
• Care for people other than you — your attendant is not the household’s helper.
• Heavy home maintenance, yard work, or major cleaning projects.
• Anything not in your authorized care plan.

Medication is a common grey area. Attendants may generally provide reminders and help you physically manage containers, but administering medication is a clinical act. Ask your case manager where the line falls in your specific plan.

How task time is worked out

The assessment does not hand out hours in a lump. It works through the tasks you need help with and estimates the minutes each one takes per day, then adds them up. That is why a specific, concrete account of your day matters so much at the assessment — “I need help bathing” produces a smaller allocation than a description of what actually happens when you try to get into the tub.

It also explains something that puzzles families: why a care plan can authorize help with bathing but not with the shopping, or the reverse. Each task is assessed on its own, and the plan is the sum of the ones that were approved.

Tasks your attendant may not do for other people

This one causes genuine friction, so it is worth stating plainly. Your attendant is authorized to help you. They are not the household’s cleaner. Cooking a meal you will eat is authorized; cooking for four is not. Doing your laundry is authorized; doing the family’s is not. Light housekeeping in the rooms you use is authorized; cleaning the whole house is not.

Attendants find this awkward to enforce, particularly when they are also a family member living in the same house. If you are the consumer, you can make it much easier by being the one who says it out loud first.

If your needs change

Care plans are not permanent. If you have declined, had a hospital stay, or your circumstances have shifted, you can ask DHSS to reassess. Missouri law requires you to report significant changes within ten days anyway — and a reassessment is how an outdated plan gets corrected.