We recommend that the Missouri Department of Social Services monitor consumer-directed PCA providers to ensure compliance with the State agency's established policies and procedures such that timesheets are completed and the tasks performed are described accurately and in sufficient detail; units of service charged on timesheets do not exceed the units allowable on the recipients' plans of care; consumer-directed PCA providers maintain documentation showing that attendants are registered, screened, and employable pursuant to the FCSR; and plans of care are signed.