Gov. Eric Greitens


In his proposed budget, Missouri Gov. Eric Greitens has a critical program for people with disabilities and the elderly squarely in his crosshairs.

The program, Consumer Directed Services, was developed as an institutional diversion program, allowing a person with a disability who meets a nursing home level of care to choose to live at home and hire their own personal care attendant. The average cost of CDS for an individual is about a fourth of the average nursing home placement.

The governor’s proposed budget launched a three-pronged attack on the program. He recommended a reduction in rates, making it less likely that caregivers would ever get a raise. He suggested an artificial cap in funding for the program, the legality of which is in question. The final, and potentially most devastating recommendation, was changing the eligibility criteria for CDS and nursing homes. That recommendation would leave nearly 20,000 Missourians without any care at all, affecting people who have disabilities or are elderly who currently get help with things like bathing, toileting, getting in and out of bed and meal preparation.

Receiving services at home ensures that people stay connected with their community and maintain relationships with friends, neighbors and church or social groups. CDS is designed to curb the cost of Medicaid spending. If 20,000 people lose coverage, medical conditions will go untreated, physical functioning and health will deteriorate and risk for injury or falls due to lack of help will increase, costing Missouri millions more.

People with disabilities need their champions to take action. We are fortunate that our Legislature has supported key programs such as CDS. Legislators know their constituents with disabilities and understand some people need support to live an independent life.

Cathy Brown is the Director of Public Policy and Advocacy at Paraquad. She can be reached at or on Twitter at @Cathy__Brown.

Photo credit: Bill Greenblatt/UPI