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Alternative Care (AC)

Page posted: 10/1/03

Page reviewed: 8/28/14

Page updated: 7/18/18

Legal authority

Minn. Stat. §256B.0913


Alternative Care (AC): State-funded program that funds home and community-based services for people age 65 years and older who require the level of care provided in a nursing home, choose to live in the community and are not yet financially eligible for Medical Assistance.


The AC program promotes community living and independence with services and supports designed to address each person's individual needs and choices.


To be eligible for the AC program, a person must choose to receive community services and:

  • • Be a Minnesota resident
  • • Be a U.S. citizen or U.S. National
  • • Be able to pay a fee (if applicable)
  • • Be age 65 or older
  • • Be assessed by a long-term care consultation (LTCC) to need nursing facility level of care
  • • Have a community support plan that can reasonably assure health and safety, within the individual budget established by the person's case mix classification
  • • Have income and assets to sustain no more than 135 days of nursing facility services
  • • Have no other payor for needed community-based services
  • • Not be currently eligible for Medical Assistance
  • The AC program may serve people who are financially ineligible for 60 days while they apply for Medical Assistance. See the following eligibility worksheets:

  • AC Program Eligibility Worksheet, DHS-2630 (PDF) for an unmarried person, married couple when both may choose the AC program or married person whose spouse is on EW or live in a nursing facility
  • AC Program Eligibility Worksheet, DHS-2630A (PDF) for a married person who has a community spouse.
  • Covered services

    The following services are covered under the AC program. For a service-specific policy page, select a service from the list:

  • Adult companion services
  • Adult day services
  • Adult day services bath
  • Case management
  • Case management aide
  • Case management conversion (for conversion from a nursing facility)
  • Chore services
  • Consumer directed community supports
  • • Discretionary services
  • Environmental accessibility adaptations
  • Family adult day services (FADS)
  • Family caregiver services (includes training and education, coaching and counseling with assessment and memory care)
  • Home-delivered meals
  • Home health services (including home health aide, nursing, skilled nursing visit and tele-homecare)
  • Homemaker
  • Individual community living supports
  • Nutrition services
  • Personal care assistance
  • Personal emergency response systems (PERS)
  • Respite care, in-home and out-of-home
  • Specialized equipment and supplies
  • Transportation (non-medical).
  • Secondary information

    The AC program covers many of the same services covered under the Elderly Waiver (EW). AC covers the following services that are not covered by EW:

  • • Conversion case management (for conversion from a nursing facility)
  • • Discretionary services
  • • Nutrition services
  • • Relative hardship waiver.
  • Non-covered services

    The AC program does not cover services:

  • • Available through other funding sources and third party payers
  • • Available under Medical Assistance
  • • For residential placements such as foster care, customized living and residential care.
  • Additional resources

    CBSM – Elderly Waiver
    CBSM – Rate methodologies for AC, ECS and EW service authorization

    CBSM – Waiver/AC service provider overview

    MHCP Provider Manual – Elderly Waiver and Alternative Care programs

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