Minnesota Minnesota

Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


Elderly Waiver (EW)

Page posted: 10/1/03

Page reviewed: 8/28/14

Page updated: 6/30/25

Legal authority

Federally approved Elderly Waiver Plan, Minn. Stat. Chapter 256S

Definition

Elderly Waiver (EW): Program that funds home and community-based services for people age 65 and older who are eligible for Medical Assistance (MA) and require the level of care provided in a nursing home but choose to live in the community.

Purpose

EW promotes community living and independence with services and supports that address each person’s individual needs and choices. EW offers services that go beyond what is available through MA.

Eligibility

To be eligible for EW, a person must meet all the following criteria:

  • · Be a Minnesota resident.
  • · Be age 65 or older.
  • · Require the level of care provided in a nursing home as determined by a MnCHOICES assessment.
  • · Be eligible for payment of long term care under MA.
  • · Choose to live in the community instead of a nursing home.
  • · Require at least one EW service in addition to case management.
  • · Have a support plan that can reasonably ensure health and safety within the individual budget established by the person’s case mix classification.
  • · Pay a waiver obligation, if applicable.
  • Covered services

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

  • · Adult companion services.
  • · Adult day services.
  • · Adult day services bath.
  • · Adult foster care.
  • · Case management/care coordination.
  • · Case management aide.
  • · Chore services.
  • · Consumer directed community supports (CDCS).
  • · Customized living (including 24-hour customized living).
  • · Environmental accessibility adaptations.
  • · Extended home care services (including extended home care nursing, extended home health aide, extended personal care assistance [PCA]/Community First Services and Supports [CFSS] services).
  • · Family adult day services (FADS).
  • · Family caregiver services (includes caregiver training and caregiver counseling).
  • · Home-delivered meals.
  • · Homemaker.
  • · Individual community living supports.
  • · Personal emergency response systems (PERS).
  • · Respite.
  • · Specialized equipment and supplies.
  • · Transitional services.
  • · Transportation (non-medical).
  • Non-covered services

    EW does not cover services that are available through another funding source (e.g., Medicare, MA state plan services, long-term care insurance).

    Note: Older Americans Act (OAA) funding is not considered “another funding source” for this purpose because people on EW are not legally entitled to receive OAA-funded services. DHS does not require that OAA programs fund benefits that are available to a person through EW. The lead agency should authorize the service or amount of service the person needs within the limits of EW. If a person needs additional services beyond what can be authorized under EW, OAA programs may be an option for the person. For more information, refer to ACL – OAA payer of last resort.

    Secondary information

    When a person on EW needs skilled nursing visits, the county/tribal nation case manager must authorize the service on the waiver service authorization. For more information, refer to CBSM Skilled nursing visit (SNV).

    A person who is on EW may receive waiver services and MA services funded through a managed care organization (MCO). This can be through Minnesota Senior Care Plus (MSC+) or Minnesota Senior Health Options (MSHO).

    Additional resources

    CBSM – Alternative Care
    CBSM – EW conversion rates
    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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