Exclusive Family & Friends Caregiver Program

Frequently Asked Questions

• What is Consumer Directed Services (CDS)?

  CDS is a Medicaid-funded program that allows disabled or elderly people in Missouri to hire the caregiver of their choice to help with daily activities. This caregiver, or personal care attendant (PCA), can be a friend, a neighbor, or a family member other than a spouse or legal guardian. A PCA can help with daily chores or hygiene, including:

  • Help with cooking, cleaning the house, doing laundry, or taking medications on time.
  • Assistance with bathing, dressing, using the bathroom, or other personal hygiene tasks.
  • Support on errands or appointments, or general help with mobility.

  This service is administered by the Missouri Division of Health and Senior Services (DHSS), and it’s available to eligible adults over the age of 18. The goal of this program is to help participants live independently and choose someone they trust to provide them with care. Participants are responsible for hiring and managing their own attendants. What this means is that if you are in need of extra assistance in your home, and you qualify for CDS, you may hire your own personal care assistant. The friend or family member you hire will be compensated through Emerest.

• What does Emerest do?

  We are a homecare agency that works with Missouri’s Consumer Directed Services (CDS) program. Emerest Health pays the highest wages for CDS in Missouri and enables you to hire the caregiver of your choice. In addition to CDS, Emerest also provides other Home and Community Based Services through Missouri Medicaid, such as: In-Home Services, Independent Living Waiver (ILW) Services, and Structured Family Caregiver Waiver (SFCW) services.

• What Does Self-Directed Mean?

  Self-directed services allow the consumer to instruct the caregiver on how to give them the best possible care. Because the consumer knows exactly what they need, this model of care allows them the freedom to hire or fire whomever they choose to suit their needs. The consumer is expected to hire and train their own caregivers to help them perform daily tasks such as laundry, taking medications on time, or cooking. Also, because this is a Medicaid funded program, the consumer does not need to worry about any medical bills. Provided they meet the program qualifications listed below, this is a 100% free service.

• How Did the CDS Program Start?

  This program began in the mid-90s and underwent a few shifts and name changes to become CDS. In 1993 a program was started under the oversight of Vocational Rehabilitation. Titled Personal Assistance Services (PAS), it was funded by Medicaid and was meant to support people with disabilities. In 2005, the Missouri Department of Health and Senior Services (DHSS) took ownership of this program, renaming it Consumer Directed Services (CDS). A major reason for this change was that the program had shifted away from a focus on employment and grown into a more general personal care program that was home and community based. The DHSS offered vendors the opportunity to serve the CDS program; within 10 years, there were several companies helping to match caregivers with elderly or disabled people. In 2023, the state of Missouri reported that over 45,000 people were enrolled in the CDS program.

• What Benefits Does CDS Offer?

  We’re excited about this program because of the many benefits it offers members of our community:

  • CDS allows elderly or disabled people to remain in their own homes and communities rather than having to seek institutional care or move to an assisted living facility or nursing home.
  • The program allows people to choose caregivers that they know and trust.
  • With CDS, many family members who would be caring for their loved one anyway can get funding.
  • Because the money is provided by Medicaid, participants do not need to worry about payments at all.
  • CDS promotes healthier communities and allows elderly and disabled people to live with more independence.

  Essentially, CDS allows people to stay at home where they are most comfortable, direct their own care, and choose a caregiver they trust. Plus, the personal care assistant receives weekly compensation, which helps regular Missourians make ends meet.

• Does this service cost money?

  No! Emerest is free for all Medicaid patients. If you qualify for CDS you will not be charged any fees. This program is funded by Medicaid, so you never have to worry about paying us.