Federally approved EW plan, Minn. Stat. Ch. 245A, Minn. Stat. Ch. 245D, Minn. R. 9555.5105 to 9555.6265, Minn. Stat. §256B.0919, subd. 3

The information on this page applies to the home and community-based services (HCBS) adult foster care service on the Elderly Waiver (EW).

Adult foster care: Individual waiver services that provide ongoing residential care and supportive services to adults living in a home licensed as family foster care or a community residential setting (CRS). These services are individualized and based on the needs of the adult, as identified in the support plan.

Family foster care setting: A licensed family foster care setting where the license holder resides in the home.

Community residential setting (CRS): A licensed residential setting that serves adults and where the license holder does not reside. This setting typically uses a shift-staff model of support (i.e., paid staff work shifts on a 24-hour basis). In this type of setting, at least one person receives foster care or supported living services funded by an HCBS waiver program.

Institution: For the purposes of this page, “institution” means:

Prong 1 setting: Setting located in a publicly or privately owned institution. For example, the waiver service setting and the institution share the same address, share a common wall or are connected by a walkway, skywalk or other enclosed corridor.

Prong 2 setting: Setting located adjacent to a publicly owned institution. For example, the waiver service setting touches the institution or its property with no intervening parcel of land between the two settings.

Publicly owned institution: Institution financed and operated by a county, state, municipality, or other unit of government. A privately owned nursing facility is not a public institution.

The adult foster care waiver service covers the provision of protection, supervision, household services and living-skills assistance.

Household services

Household services can include training and assistance with:

Living-skills assistance

Living-skills assistance can include training and assistance with activities such as:

Not covered within the service

The adult foster care waiver service does not cover:

Services that cannot be authorized with adult foster care

If a person receives adult foster care, they cannot receive state plan or waiver services that duplicate adult foster care, such as:

Waiver resources cannot pay for room and board. The Housing Support (formerly GRH) allocation pays for room and board for eligible adults. The lead agency financial worker determines both the amount of the adult’s resources used for room and board and the Housing Support room and board payments, as applicable. For more information, refer to DHS – Housing Support.

Adult foster care providers may be licensed to serve up to five adults per home if all people who receive foster care are age 55 or older and do not have a serious and persistent mental illness or a developmental disability.

Services under all waiver/AC programs must:

Own home

For information about how to determine if a setting requires a license or qualifies as a person's own home, refer to CBSM – Requirements for a person’s own home.

When an adult lives in a licensed foster care setting, all federal, state and/or licensing agency rules and regulations must be followed.

Adult foster care is an enrollment-required service. For more information, refer to CBSM – Waiver/AC service provider overview.

Service license requirements

An adult foster care provider must have one of the following licenses or county certification:

The provider does not have to be licensed under both Ch. 245D and Ch. 245A. However, if a provider is dually licensed, the provider is required to meet the 245D licensing standards.

County certification of relatives

A county may certify a person who is exempt from licensure under Minn. Stat. §245A.03, subd. 2 to provide adult foster care to a related person on EW, according to Minn. Stat. §256B.0919, subd. 3. The person must meet all of the following criteria:

Setting license requirements

The adult foster care service can only be provided in settings licensed as an adult foster care setting under Minn. R. 9555.5105 – 9555.6265 or CRS under Minn. Stat. §245D.23 to Minn. Stat. §245D.26.

Background study

To provide adult foster care, providers must have a background study. For more information, refer to CBSM – Waiver/AC service provider overview – Required DHS background studies for direct-contact services.

Reporting

A provider licensed under 245D must report all uses of controlled procedures, emergency use of manual restraint and prohibited procedures according to Minn. Stat. §245D.06, subd. 5 to DHS via the Behavioral Intervention Report Form, DHS-5148.

Providers are prohibited from emergency use of manual restraint.

Lead agencies use the Elderly Waiver Residential Services (EW RS) Rate Tool in the MnCHOICES Support Plan to develop service plans and determine rates for EW adult foster care services. For more information, refer to DHS – EW residential services.

When adult foster care component service rates and monthly caps increase, DHS updates the rate and cap values in the EW RS Rate Tool. After the new rate and cap values take effect, people on EW access them throughout the year when the lead agency completes a new EW RS Rate Tool for a person due to:

To find a list of licensed adult foster care providers in Minnesota, refer to: