Caregiver rules
Who can be the paid caregiver
In CDS the consumer chooses and hires their own attendant, and it is usually someone they already know. Missouri sets a small number of hard limits. Here they are, before you get attached to a plan.
First, the person receiving care
The person receiving care stays in charge
CDS only works when the person receiving care directs their own care: choosing the caregiver, setting the schedule, and saying what help they need. Missouri law requires it, and it settles two questions families ask us often.
They have a power of attorney
That alone does not rule anyone out. It matters only if the power of attorney gives someone else the authority to make the care decisions CDS asks of the consumer. Have the paperwork handy when you call and we will look at it with you.
They have a guardian or conservator
Then Missouri law does not allow them to enroll in CDS, because someone else holds the decisions the program needs them to make. Call us anyway. We will talk through what other help may fit.
Sources: RSMo 208.900 and 208.903.1; 19 CSR 15-8.100 and 15-8.200; DHSS Home and Community Based Services Manual, Consumer Directed Services policy clarifications.
Allowed
Who can be paid
- ✓An adult son or daughter
- ✓A parent of an adult consumer
- ✓A grandchild, grandparent, sibling, niece or nephew
- ✓A friend, a neighbor, or someone from your church
- ✓An in-law, step-relative or cousin
- ✓Someone you have never met, hired from our caregiver list
Every attendant must be 18 or older, legally able to work in the US, and able to pass the background screening.
Not allowed
Who cannot be paid
-
✗
A spouse
Missouri does not allow a husband or wife to be paid as the attendant. This is program rule, not our policy, and there is no exception to apply for.
-
✗
A court-appointed guardian or conservator
Missouri does not allow a guardian or conservator to be paid as the attendant. And a person who has a guardian or conservator cannot be enrolled in CDS at all, so see the person stays in charge above.
-
✗
Anyone who fails the background screening
Missouri screens every attendant against the Family Care Safety Registry and the abuse and neglect registries. We run it, and it is the one thing we cannot work around.
The awkward one
What if the obvious person is the spouse?
It is the most common disappointment in CDS, and it is worth knowing early rather than late.
If a husband or wife is already doing all the caring, the program will not pay them. What often works instead: an adult child, a sibling, a niece or nephew, or a friend takes the paid hours for the tasks they genuinely cover, and the spouse stops carrying all of it alone.
Call us before you rule the whole thing out. We have found a workable arrangement for most families who asked, and it costs nothing to talk it through.
Talk it through: 417-218-2888