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Family caregiver coaching and counseling with assessment – AC and EW

For other family caregiver services available under the Alternative Care (AC) and Elderly Waiver (EW) programs, see CBSM – Family caregiver services.

Page posted: 2/15/17

Page reviewed:

Page updated:

Legal authority

Federally approved Elderly Waiver Plan, Alternative Care (AC) program (Minn. Stat. §256B.0913)


Family caregiver coaching and counseling with assessment: An individualized, person-centered service intended to equip the caregiver with knowledge, skills and tools to become a stronger caregiver capable of self-directed care.

Covered services

This services covers time spent with the caregiver providing coaching and counseling.


This service covers:

  • • An assessment of the caregiver’s needs, preferences and strengths
  • • Development of a person-centered plan with goals for the caregiver
  • • Coaching provided to the caregiver, such as active listening, championing and reframing
  • • Ongoing support to reach established goals.
  • Depending on the caregiver’s goals, the provider and caregiver may work on:

  • • Communications skills (e.g., assertiveness)
  • • Developing an informal support network
  • • Disease management
  • • Education about caregiving stages and roles
  • • Finding resources
  • • Problem solving
  • • Self-care (e.g., stress management or depression)
  • • Techniques to manage family dynamics or difficult behaviors.
  • Coaching may also include:

  • • Family meetings
  • • Memory care consultation.
  • Counseling

    This service also covers counseling (i.e. a professional consultation) to help a caregiver make decisions and solve problems related to his or her caregiving role. Counseling may include:

  • • Assessment
  • • Conflict resolution
  • • Development of an individualized approach and plans
  • • Family counseling
  • Problem solving or guidance directly related to caring for the person.
  • Non-covered Services

    This service does not cover:

  • • Materials
  • • Preparation time
  • • Travel.
  • Secondary information

    The lead agency must document all coaching and counseling services in the person’s support plan.

    The caregiver does not need to live at the same address as the person to receive coaching and counseling services.

    The person’s caregiver(s) can receive up to 12 hours (or 48 units) of coaching and counseling services in a 365-day period.

    Provider standards and qualifications

    Family caregiver coaching and counseling with assessment is a DHS enrollment-required service. For more information, see CBSM – Waiver/AC service provider overview.

    Eligible providers

    The following providers may provide family caregiver coaching and counseling with assessment:

  • Caregiver consultants
  • • Gerontologists
  • • Health educators
  • • Memory care consultants
  • • Nutritionists
  • • Pharmacists
  • • Physicians
  • • Public health nurses
  • • Registered nurses
  • • Rehabilitation therapists
  • • Social workers.
  • The following organizations also may provide family caregiver coaching and counseling with assessment:

  • • Care or support-related organizations (e.g., nonprofit social service organizations, voluntary or faith-based agencies, state and local chapters of chronic disease organizations such as the Alzheimer’s Association)
  • • Home care agencies.
  • Additional provider requirements

    A family caregiver coaching and counseling with assessment provider must have at least one year of experience providing either:

  • • Home care or long-term care services to older adults
  • • Training, education or counseling to caregivers of older adults.
  • Caregiver consultants

    In addition, a caregiver consultant must:

  • • Complete the caregiver coaching basic training, developed by the Minnesota Board on Aging (MBA)
  • • Participate in continuing education offered by the MBA or Area Agencies on Aging (AAA), including education on cultural diversity.
  • Authorization, rates and billing

    Before delivering services, the provider must submit a service description and plan to the lead agency for approval.

    Based on this information and the person’s needs, the lead agency determines if it will authorize the service. If it authorizes the service, the lead agency keeps supporting documentation in the person’s file.

    The lead agency authorizes family caregiver coaching and counseling with assessment at the state-established, 15-minute rate. For more information, see:

    Additional resources

    CBSM – Family caregiver services
    CBSM – Family caregiver training and education

    CBSM – Family memory care

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