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Medicaid Home and Community-Based Services

Updated: Feb 7, 2019

Medicaid is a State-operated health coverage program that varies somewhat from state to state, providing health insurance coverage for low-income individuals and families. The program is funded by both state and Federal funds. The Medicaid programs often have different names by state, for example, in Kansas, KanCare is the term while in Missouri, Medicaid is called MO HealthNet. Medicaid is often confused with Medicare a Federal program which is for seniors and individuals with permanent disabilities rather than being income-based. Individuals can have both Medicare and Medicaid coverage simultaneously.

Medicaid provides long-term in-home personal care services largely as the result of a Supreme Court ruling called the Olmstead Decision regarding the Americans with Disabilities Act (ADA) and its prohibition of unnecessary, unreasonable segregation of individuals based on disability. The ruling determined a particular case but established that, as an example, requiring an individual to enter a nursing facility in order to receive covered services that could instead be provided at home for the same or less cost is unlawful under the ADA. As the ADA is a Federal law, it is applicable in all states. For more information about how Consumer-Directed versions of the program came about, visit this link:

President George H. W. Bush signing the ADA at desk outdoors with four individuals on either side, two of whom are seated in wheelchairs.
President George H. W. Bush signing the ADA into law.

Consumer-Directed Services or CDS, as it is generally referred to in Missouri where individuals hire or choose their own caregiver, can operate differently and go by a variety of names based on the state also. For example, in California, it is called IHSS or In-Home Support Services, whereas in New York it is called CDPAP or Consumer-Directed Personal Assistance Program. It can be a particularly complex process to move from one state to another while receiving/requiring these services, as individuals can only be Medicaid-eligible in one state at a time. For those moving into our coverage area in northeast Missouri from out of state, we are happy to assist and inform regarding this process. Simply call 816-822-7432, email, or visit to get started.

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