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.