Practical assistance for people with disabilities,
with an end goal of independent living.

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Independent at Home
Consumer Directed Services

Paraquad’s Consumer Directed Services (CDS) is a Medicaid-based program that provides personal care attendant services to individuals with disabilities, enabling them to live with greater independence in the community, rather than in a nursing home.

Paraquad’s Consumer Directed Services (CDS) is a Medicaid-based program in which adults with disabilities hire, schedule, and manage their own personal care attendants.

Personal care attendants assist with tasks of daily living such as bathing/showering, toileting, obtaining medication, meal preparation and cleanup, housekeeping/laundry, essential transportation, etc., thus enabling them to live with greater independence at home and in the community, and not in a nursing home.

Who is eligible to be a Paraquad CDS participant?

To qualify for Paraquad’s Consumer Directed Services in Missouri, a person must be:

  • 18 years of age or older with a disability

  • Has or is eligible for Medicaid

  • Capable of living independently with the services of a personal care attendant, and able to direct needed care to that attendant.

  • Has a level of care need as determined by the Missouri Department of Health & Senior Services

We Pay $15.50 Per Hour

To learn more about CDS scheduling, please call us at 314.289.4266 or contactus@paraquad.org

Why join/switch to Paraquad's CDS Program?

  • Paraquad performs ongoing background checks and pays all attendant wages and taxes via Medicaid reimbursement.

  • An attendant can be a friend or family member (excluding spouse or anyone under the age of 18).

  • We pay $15.50 per hour. Contact us for help in your home at 314-289-4200.

  • Founded in 1970, Paraquad has vast experience in managing its CDS program and staying current with government regulations.

  • Each CDS participant receives dedicated customer service - a personal case manager who phones on a monthly basis, visits at least once on an annual basis, and strives to assist with independent living needs that go beyond personal care services.

  • By joining Paraquad’s CDS program, participants have greater access to other Paraquad programs including peer mentoring, employment, advocacy, and the Stephen A. Orthwein Center, Paraquad’s state-of-the-art fitness center.

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Customer Directed Services FAQS

  • The program provides people with disabilities with CDS caregivers who provide assistance in the following areas. Participants may qualify for some or all of these services.

    Bathing
    Dressing
    Grooming
    Toileting
    Ostomy/colostomy hygiene
    Obtaining medication
    Transferring
    Range of motion
    Meal preparation, feeding and cleanup
    Housekeeping, laundry
    Errand transportation (shopping, paying bills/banking, picking up medication)

    You will also receive personalized attention from your CDS specialist, who will assist you with defining your independent living goals, navigating CDS scheduling and identifying resources that meet your needs and expand your knowledge.

  • To qualify for Consumer Directed Services in Missouri, each participant must:

    Be eligible for MO HealthNet (Medicaid).

    Be 18 years of age or older.

    Be able to direct his or her own care.

    Be physically disabled.

    Be capable of living independently with the services of a personal care attendant.

    Require at least a nursing facility level of care.

    The Missouri Department of Health and Senior Services (DHSS) (or its designee) will assess people who meet the minimum qualifications to see if they are eligible for assistance via a CDS caregiver. If a person is eligible, DHSS and the potential participant will create a care plan that outlines the type(s) of service(s) the person will be approved to receive from a personal care attendant through the Consumer Directed Services program in Missouri.

  • If you meet the minimum qualifications, please visit our Get Services page or call (314) 289-4200. An intake specialist will complete a preliminary screening and refer you to DHSS for an assessment. Someone from our attendant services department will then help you get your personal care attendant prepared for employment.

  • Program participants are permitted to hire up to four CDS caregivers. An attendant can be any qualified caregiver chosen by the CDS program participant, including a family member (other than a spouse).

    A CDS program participant is the legal employer of his or her personal care attendant. Participants are responsible for interviewing, hiring, scheduling, directing and, if necessary, firing an attendant. Personal care attendants do not work for Paraquad.

    Personal care attendants must pass a background check through the Family Care Safety Registry (FCSR) and the Employee Disqualification List. Attendants must also complete an employee eligibility check using E-Verify through the U.S. Department of Homeland Security. Paraquad completes all required background checks.

    If requested, Paraquad will provide support and assistance and training to participants of Consumer Directed Services in Missouri.

  • All prospective CDS caregivers must visit Paraquad prior to being employed by a CDS program participant. When an attendant visits our facilities, he or she must present:

    A current, original state-issued photo ID.

    An original Social Security card.

    Cash or money order for $15.55 (one-time fee) to cover FCSR registration costs.

    If an attendant is already listed on the FCSR, please bring only a current, original state-issued photo ID and original Social Security card.

  • A personal care attendant cannot begin working as part of Consumer Directed Services in Missouri until the participant has been assessed by DHSS and approved to receive service(s). A participant must also be trained by Paraquad to become a legal employer. The participant will then receive instructions on how to train their attendant to clock in and clock out, and will be given a start date for a CDS caregiver to begin working.

  • The CDS program is funded by MO HealthNet (Medicaid). Participants who receive Medicare or have private insurance are not eligible for the CDS program.

    A participant must be eligible to receive MO HealthNet (Medicaid) in order for a personal care attendant to be paid.

    Verified and approved attendant services are billed to MO HealthNet (Medicaid) in accordance with the care plan authorized by DHSS.

    As part of Consumer Directed Services in Missouri, attendants are paid by money received from a participant’s MO HealthNet (Medicaid) account for authorized care plan service(s) provided to the participant.

  • As of July 20, 2025, all active CDS caregivers are paid at the rate of $15.50 an hour.

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