HCN Hardship Waiver: An option that allows parents of minor children, family foster parents of minor children, legal guardians or spouses to provide HCN services to a person who is eligible for Medical Assistance (MA) and authorized to receive HCN services.

Legally responsible individual: An individual who is the person’s:

Spouse: Anyone to whom a person is legally married.  

HCN services: For information about services provided through the Hardship Waiver, refer to CBSM – HCN.

To apply for the HCN Hardship Waiver, the individual providing HCN services must meet all the following criteria:

1. Provide services to a person who is not using consumer directed community supports (CDCS).

2. Be a spouse or legally responsible individual.

3. Be a registered nurse (RN) or licensed practical nurse (LPN) currently licensed in Minnesota.

4. Be employed by either:

5. Expect to continue as the primary and/or emergency back-up caregiver without any reimbursement for those services.

6. Pass a criminal background check.

7. Be in at least one of the following situations:

Services provided under the HCN Hardship Waiver are covered if they are:

DHS will not reimburse HCN services authorized and provided under the HCN Hardship Waiver if the case manager, ordering practitioner (i.e., physician, advanced practice registered nurse or physician assistant) or HCN agency determines the HCN services:

HCN services provided through the HCN Hardship Waiver cannot exceed 50% of the total authorized nursing hours billed to MA or eight hours per day, whichever is less, up to a maximum of 40 hours a week (seven consecutive days), regardless of the number of people who receive HCN services at the same residence.

Services not through a managed care organization (MCO)

The HCN agency or home health agency is responsible to submit HCN Hardship Waiver Application, DHS-4109 (PDF) to DHS for review. DHS will review within 30 days. If all eligibility criteria are met, DHS will approve the request as of the date of receipt of the application or the start date of HCN services, whichever is later.

Services through an MCO

If the person is enrolled in an MCO that covers HCN, the provider submits a request to the MCO. The MCO is responsible to review eligibility for the HCN Hardship Waiver.

Additional resources