Minnesota’s home and community-based waivers


Minnesotans with disabilities or chronic illnesses who need certain levels of care may qualify for the state’s home and community–based waiver programs.

Medicaid home and community-based service (HCBS) waivers afford states the flexibility to develop and implement creative alternatives to placing Medicaid-eligible persons in hospitals, nursing facilities or Intermediate Care Facilities for Persons with Developmental Disabilities (ICFs/DD). HCBS waivers allow states to put together various service options that are not available under regular Medical Assistance. These service options are available to persons in addition to services covered by MA. Generally, these services are targeted to people with specific needs or diagnosis.

The Minnesota Department of Human Services (DHS) recognizes the importance of helping people live where they choose with appropriate services that assure their health and safety.

In 1999, the United States Supreme Court in the Olmstead v. L.C. decision interpreted the Title II of the American with Disabilities Act (ADA) to include supporting people with disabilities in the most integrated setting possible. The decision applies to people of any age who have a disability. The Olmstead v. L.C. decision played an important role in the expansion of consumer-directed services in Minnesota as well as in other states.

Corresponding with the Olmstead v. L.C. decision, President Bush, in February 2001, announced the New Freedom Initiative. The New Freedom Initiative is a comprehensive plan that represents an important step in working to ensure that Americans have the opportunity to learn and develop skills, engage in productive work, make choices about their daily lives and participate fully in community life.

What are the home and community-based waiver programs available in Minnesota?

Minnesota has chosen to enter into a number of waiver agreements in order to provide Minnesotans with more choice in their services. There are some differences in the services available in each waiver and the amount of money that a person can use to purchase supports. Home and community-based waiver programs available to persons who meet the eligibility criteria include:

  • Alternative Care is a program that supports certain home and community-based services for older Minnesotans, age 65 years and over, who are at risk of nursing home placement and have low levels of income and assets (AC is administered by the DHS Aging and Adult Services Division)
  • Brain Injury (BI) Waiver for persons with acquired or traumatic brain injuries who need the level of care provided in a nursing facility that provides specialized (cognitive and behavioral supports) services for persons with brain injury or neurobehavioral hospital level of care
  • Community Alternative Care (CAC) Waiver for chronically ill and medically fragile persons who need the level of care provided in a hospital
  • Community Access for Disability Inclusion (CADI) Waiver for persons with disabilities who require the level of care provided in a nursing facility
  • Developmental Disabilities (DD) Waiver for persons with developmental disability or related condition who need the level of care provided in an Intermediate Care Facility for Persons with Developmental Disabilities (ICF/DD)
  • Elderly Waiver (EW) for people over the age of 65 years who require the level of care provided in a nursing facility (EW is administered by the DHS Aging and Adult Services Division)
  • Because each of the waiver programs was written to meet federal guidelines, each program includes:

  • • Eligibility requirements specific to the type of disability
  • • Funding parameters and limits
  • • Separate county and/or state policies
  • • Service menus
  • What are the criteria for participation in Minnesota’s home and community-based waivers?

    Each home and community-based waiver program requires certain questions be asked about services:

  • • Are the services necessary to ensure the recipient’s health, welfare and safety?
  • • Will the services address skill development and/or skill maintenance?
  • • Is the service covered by any other funding source, such as, MA state plan services, private health care coverage, Medicare, education or Vocational Rehabilitation Service?
  • • Have all options been assessed and does this option meet the individual desires, needs and preferences of the person?
  • • Is the cost of the service considered reasonable and customary?
  • How can I apply for a waiver program in Minnesota?

    You can apply for waiver programs at your local county social services agency. Eligibility for all waiver programs is determined through a screening process. The DHS Disability Services Division administers the BI, CAC, CADI and DD waiver programs. The DHS Aging and Adult Services Division administers the Elderly Waiver (EW) waiver program.

    For more information, contact your local county agency (PDF).

    Let us know if you are unable to find information about Disability Services Division programs and services. E-mail DHS.Dsdtahelp@state.mn.us.

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