Minnesota currently has a TEFRA program and four HCBS 1915(c) waivers that serve children. All programs waive parent income. See this Home and Community-Based Service Waivers overview for general information. Minnesota also has a 1915(k) Community First Services and Supports (CFSS) program that provides in-home services. Minnesota plans to expand this program to include both personal care and state-plan home and community based services.

Minnesota has charged a “parent fee” for its programs, including its TEFRA program, for decades. These parent fees ended effective 6/30/23.

Minnesota Advocacy Organizations:

Last updated 9/25/23

Programs in Minnesota

  • Target Population: Children who would otherwise require care in an institution with any type of disability, including medical, developmental, intellectual, or psychiatric conditions.
  • Ages: 0-18
  • Levels of Care: Intermediate Care Facility, Nursing Facility, Hospital
  • Income Waiver: Yes, the program is based on the child’s income only.
  • Waiver Type: TEFRA
  • Spots: unlimited
  • Expiration Date: NA
  • Description: Provides Medicaid coverage only.
  • Online State Information: MN TEFRA
  • How to Apply: Apply online at MNSure or follow the directions on this page.
  • Waiting List: none
  • Advocacy/Support Group: Minnesota Disability Support Group

Also called CAC Waiver

  • Target Population: Children and adults with physical or other health disabilities. Persons must be medically fragile or technology dependent and require a hospital level of care. Children with lesser disabilities should apply for the CADI Waiver.
  • Ages: 0-64
  • Levels of Care: Hospital
  • Income Waiver: Yes, the waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 1133
  • Expiration Date: 3/31/2028
  • Description from medicaid.gov: Provides adult day service, caregiver living expenses, case management, homemaker, prevocational services, respite, extended home care nursing, extended home health care, extended personal care assistance, 24-hour emergency assistance, chore services, community residential services, consumer directed community supports (CDCS): environmental modifications & provisions, CDCS: personal assistance, CDCS: self-direction support activities, CDCS: treatment and training, CDCS: integration and support, CDCS: individual-directed goods and services, CDCS: support planning, CDCS: financial management services, CDCS: environmental modifications – home modifications, CDCS: environmental modifications – vehicle modifications, crisis respite services, day support services, employment development services, employment exploration services, employment support services, environmental accessibility adaptations – home modifications, environmental accessibility adaptations – vehicle modifications, family residential services, family training and counseling, home delivered meals, independent living skills (ILS) therapies, individualized home supports, integrated community supports, night supervision services, positive support services, specialist services, specialized equipment and supplies, transitional services, and transportation services to individuals with other disabilities ages 0-64 years who meet a hospital level of care.  This waiver operates with a concurrent 1915(b)(4) authority.
  • Online State Information: Community Alternative Care Waiver
  • Official Federal Information
  • How to Apply: Apply at your local Human Services agency.
  • Waiting List: none
  • Advocacy/Support Group: Minnesota Disability Support Group

Also called CADI Waiver

  • Target Population: Children and adults with physical or other health disabilities that would otherwise require nursing facility care. These individuals are less medically fragile and disabled than those on the Community Alternative Care Waiver.
  • Ages: 0-64
  • Levels of Care: Nursing Facility
  • Income Waiver: Yes, the waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 46,772
  • Expiration Date: 9/30/2025
  • Description from medicaid.gov: Provides adult day service, caregiver living expenses, case management, homemaker, prevocational services, respite, extended home care nursing, extended home health care services, extended personal care assistance services, 24-hour emergency assistance, adult companion services, adult day service bath, adult foster care, child foster care, chore services, community residential services, consumer-directed community supports (CDCS): community integration and support, CDCS: individual-directed goods and services, CDCS: personal assistance, CDCS: support planning, CDCS: financial management services, CDCS: self-direction support activities, CDCS: environmental modifications – vehicle modifications, CDCS: environmental modifications and provisions, CDCS: environmental modifications – home modifications, CDCS: treatment and training, crisis respite, customized living, day support services, employment development services, employment exploration services, employment support services, environmental accessibility adaptations – home modifications, environmental accessibility adaptations – vehicle modifications, family residential services, family training and counseling, home delivered meals, housing access coordination, in-home family supports, independent living skills (ILS) therapies, ILS training services, individualized home supports, integrated community supports, night supervision services, personal support services, positive support services, specialist services, specialized equipment and supplies, transitional services, and transportation services to individuals with physical or other disabilities ages 0-64 years who meet a nursing facility level of care.  This waiver operates with a concurrent 1915(b)(4) authority.
  • Online State Information: CADI
  • Official Federal Information
  • How to Apply: Apply at your local Human Services agency.
  • Waiting List: none
  • Advocacy/Support Group: Minnesota Disability Support Group
  • Target Population: Children and adults developmental or intellectual disabilities.
  • Ages: all ages
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: Yes, the waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 30,604
  • Expiration Date: 6/30/2027
  • Description from medicaid.gov: Provides 24-hour emergency assistance, adult day service bath, adult day service, assistive technology, caregiver living expenses, case management, consumer directed community supports (CDCS): community integration and support, CDCS environmental modifications (home modifications), CDCS environmental modifications (vehicle modifications), CDCS environmental modifications and provisions, CDCS financial management services, CDCS individual-directed goods and services, CDCS personal assistance, CDCS self-direction support activities, CDCS support planning, CDCS treatment and training, chore, community residential services, crisis respite, day support services, day training and habilitation, employment development services, employment exploration services, employment support services, environmental accessibility adaptations (home modifications), environmental accessibility adaptations (vehicle modifications), extended personal care assistance services, family residential services, family training and counseling, home delivered meals, homemaker, independent living skills therapies, individualized home supports, integrated community supports, night supervision services, positive support services, prevocational services, respite, specialist services, specialized equipment and supplies, transitional, and transportation services to individuals with intellectual disabilities or developmental disabilities ages 0 or older who meet an ICF/IID level of care.  This waiver operates with a concurrent 1915(b)(4) authority.
  • Online State Information: DD Waiver
  • Official Federal Information
  • How to Apply: Apply at your local Human Services agency.
  • Waiting List: none
  • Advocacy/Support Group: Minnesota Disability Support Group
  • Target Population: Children and adults with brain injury.
  • Ages: 0-64
  • Levels of Care: Nursing Facility, Hospital
  • Income Waiver: Yes, the waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 1137
  • Expiration Date: 3/31/2026
  • Description from medicaid.gov: Provides adult day service, caregiver living expenses, case management, homemaker, prevocational services, respite, extended home care nursing services, extended state plan service, extended home health care services, extended personal care assistance services, 24-hour emergency assistance, adult companion services, adult day service bath, adult foster care, child foster care, chore services, community residential services, consumer directed community supports (CDCS): self-direction support activities, CDCS: environmental modifications and provisions, CDCS: personal assistance, CDCS: treatment and training, crisis respite, customized living, day support services, employment development services, employment exploration services, employment support services, environmental accessibility adaptations, family residential services, family training and counseling, home-delivered meals, housing access coordination, in-home family supports, independent living skills (ILS) therapies, ILS training services, individualized home supports, integrated community supports, night supervision services, personal support services, positive support services, specialist services, specialized equipment and supplies, structured day program, transitional services, transportation for individuals with brain injury, ages 0-64.
  • Online State Information: Brain Injury Waiver
  • Official Federal Information
  • How to Apply: Apply at your local Human Services agency.
  • Waiting List: none
  • Advocacy/Support Group: Minnesota Disability Support Group

Additional Information

  • CAC and CADI Waivers – Nursing Services: Parents/guardians who are nurses may be paid for care of minor children per the regulations in the Waiver Application-CAC and Waiver Application-CADI. “Spouses, legal guardians, family foster parents (not corporate foster parents) and parents of minor children may receive a hardship waiver to be paid to provide extraordinary services that require specialized nursing skills when the following criteria are met: 1) The service is not legally required of the parent, spouse, or legal; 2) The service is necessary to prevent hospitalization of the participant; and 3) One of the following hardship criteria are met: (i) the parent, spouse, or legal guardian resigns from a part-time or full-time job to provide the service; or (ii) the parent, spouse, or legal guardian goes from a full-time to a part-time job with less compensation to provide the service; or (iii) the parent, spouse, or legal guardian takes a leave of absence without pay to provide the service; or (iv) because of labor conditions, special language needs, or intermittent hours of care needed, the parent, spouse, or non-paid legal guardian is needed in order to meet the medical needs of the participant. The home care nursing hardship waiver is not available when a participant is using consumer directed community supports. The spouse, legal guardian, family foster parent or parent of a minor must be a nurse licensed in Minnesota and pass a criminal background study in accordance with Minnesota Statutes, Chapter 245C. Individuals must have a current RN or LPN license with the State of Minnesota and be employed by a home health care agency….The number of hours shall not exceed 50 percent of the total approved nursing hours, or eight hours per day, whichever is less, up to a maximum of 40 hours per week. The service shall not be covered if the home health agency, case manager, physician, advanced practice registered nurse, or physician assistant determines that the home care nursing care provided by the spouse, legal guardian, or parent of a minor is unsafe.”
  • CAC, CADI, DD, and BI Waivers – Personal Care Services: Minnesota will pay parents/guardians of minors through its Consumer Directed Community Supports. This program pays parents to care for their children in the home, along with others chosen by the family. See also this page for more information on regulations. Parents/guardians may be paid for providing personal care services only through the Consumer Directed Community Support program per the regulations in their respective waiver applications. “The parents (as defined above) of minor children and spouses may not provide more than 40 hours of service in a seven-day period. For parents of minor children and spouses, 40 hours is the total amount per family regardless of the: number of parents (as defined above), combination of parent(s) of minors and spouse, or number of children who receive CDCS.”
  • Paid parent caregiver for those over 18 is widely available in most programs in Minnesota.