Minnesota Disability Waiver Program: Types, Applying, and CDCS

Minnesota’s disability waiver programs are Medical Assistance–funded services that let people with disabilities and older adults get care at home or in the community instead of in a nursing home, hospital, or intermediate care facility. The state runs four disability waivers — CADI, DD, BI, and CAC — plus the Elderly Waiver and Alternative Care program for people 65 and older. Together they serve roughly 70,000 Minnesotans.¹ You enter any of them the same way: by asking your county or tribal human services office for a MnCHOICES assessment.²

Every waiver requires two things: eligibility for Medical Assistance (Minnesota’s Medicaid program) and a documented need for the level of care an institution would provide, paired with your choice to receive that care in the community instead.³ Which waiver fits depends on your age, your disability, and how intensive your care needs are.

CADI Waiver

The Community Access for Disability Inclusion waiver is the broadest of the four. It serves children and adults under 65 who have a disability and need the level of care a nursing facility provides. You must be certified as disabled by the Social Security Administration or Minnesota’s State Medical Review Team, and your support needs must go beyond what standard Medical Assistance covers.⁴

Covered services include residential supports, customized living, employment services, respite care, home modifications, assistive technology, day programs, and case management.⁴

DD Waiver

The Developmental Disabilities waiver is for people with a developmental disability or related condition, as defined in Minnesota Rule 9525.0016, who need the level of care provided in an Intermediate Care Facility for persons with developmental disabilities.⁵ Unlike CADI, the DD waiver requires a 24-hour plan of care and daily interventions.⁶

Services include community residential supports, day programs, employment services, habilitation, assistive technology, crisis respite, and positive support services.⁵

BI Waiver

The Brain Injury waiver serves people under 65 with an acquired or traumatic brain injury, or a degenerative neurological condition with cognitive impairment, provided the condition is not congenital. You must score at Level IV or above on the Rancho Los Amigos Levels of Cognitive Functioning Scale and have significant cognitive or behavioral problems related to the injury. The required level of care is that of a nursing facility providing specialized brain injury services or a neurobehavioral hospital.⁷

CAC Waiver

The Community Alternative Care waiver is the smallest and most medically intensive. It serves chronically ill and medically fragile children and adults under 65 who need a hospital level of care. You must require professional nursing assessment or intervention multiple times during a 24-hour period and have health needs that are predictable but carry the potential for life-threatening changes.⁶ Annual medical documentation confirming ongoing treatment needs is required.⁸

Elderly Waiver and Alternative Care

If you are 65 or older, the four disability waivers above do not apply. Two separate programs cover you instead. The Elderly Waiver serves Minnesotans 65 and older who are eligible for Medical Assistance and need nursing facility–level care but choose to remain in the community. Alternative Care fills the same role for people 65 and older who are not yet financially eligible for Medical Assistance but would qualify within 135 days of entering a nursing facility. Both cover services like adult day care, homemaker assistance, home-delivered meals, respite care, environmental modifications, and case management.⁹

How to Apply

Every waiver runs through the same door. Contact your county or tribal human services office and request a MnCHOICES assessment. You can request one even if you are not currently enrolled in Medical Assistance.²

The MnCHOICES assessment is a free, in-person evaluation, usually conducted in your home by a certified assessor. It covers your general health, your ability to perform daily tasks, and the support you already receive from family or friends.¹⁰

The timeline is set. Once you request the assessment, the county must send an assessor within 20 calendar days.² The assessor identifies which waiver or program you may qualify for. Within 40 days of the assessment, you receive a written community support plan that details your care needs and lays out your service options.¹⁰ The county also verifies your financial eligibility for Medical Assistance. If you’re approved, a case manager helps you choose providers and build a support plan, which is reviewed at least once a year.

If you are denied, you have the right to appeal. You can also request a reassessment if your circumstances change, and your case manager can help you look at whether a different waiver would fit better.

Directing Your Own Services Through CDCS

Every Minnesota waiver includes an option called Consumer Directed Community Supports, which lets you run your own services rather than receive them through an agency. Under CDCS, you design your services, set your schedules, and hire your own workers — including family members such as parents and spouses.¹¹

You receive an individualized budget based on your assessment. You can spend it on workers, assistive technology, home or vehicle modifications, supplies, and non-traditional supports. The trade-off is responsibility: you develop your own community support plan, act as your workers’ employer, and monitor your spending. A Financial Management Services provider handles payroll and employer paperwork.¹¹

Waiting Lists

Long waits used to be the biggest barrier in this system. That is no longer the case. After the Olmstead Plan’s waiting list goals took effect in May 2014, Minnesota eliminated active waiting lists for the CAC, CADI, BI, and DD waivers by 2016.¹² As of 2025, no active waiting lists exist for any of the four disability waivers. For the DD waiver, DHS tracks “timely funding approvals” instead, requiring lead agencies to approve funding within 45 days for people with institutional exit, immediate, or defined needs.¹³

What’s Changing

Two shifts and one recent round of cuts are worth knowing about before you apply.

PCA Is Being Replaced by CFSS

Community First Services and Supports is replacing the legacy Personal Care Assistance program and the Consumer Support Grant. DHS began implementing CFSS on October 1, 2024, and everyone must transition by September 30, 2027.¹⁴

CFSS is available to people enrolled in Medical Assistance, an MA waiver, or Alternative Care. Compared with PCA, it offers more flexibility: you can pay spouses and parents of minor children as support workers, you get a dedicated worker training budget of $1,272.96 per year, and you can purchase goods, services, and personal emergency response systems.¹⁵ You choose between an agency provider model, where an agency employs your workers, and a budget model, where you are the employer and manage funds through a Financial Management Services provider.¹⁴

Waiver Reimagine

DHS has been working on a restructuring called Waiver Reimagine that would consolidate the four disability waivers into two, move everyone to an individualized statewide budget, and expand self-directed control.¹⁶ The 2025 legislature delayed implementation to no earlier than January 1, 2028.¹⁷ For now, the four waivers described above are the ones you apply to.

2025 Budget Cuts

The 2025 special session produced roughly $275 million in cuts to long-term care waivers, driven by a projected $6 billion state budget shortfall for the 2028–2029 biennium.¹⁸ A few of the changes may affect what you can access:

Effective January 1, 2026, individualized home supports with training are capped at six hours per day, with no more than three consecutive hours at a time.¹⁹
Rate exceptions for high-needs individuals were reduced.¹⁸
Annual inflation increases under the Disability Waiver Rate System were capped at 4% of the Consumer Price Index, down from 6%.¹⁸
The asleep rate for night supervision was reduced.¹⁸

The same session added a 5% reimbursement rate increase for providers of personal care services to people receiving 10 or more hours of support per day, and waivers began covering adaptive swimming lessons for children under 12 with autism.¹ Direct support workers received a 40-cent hourly raise effective January 1, 2026, with another planned for 2027.¹⁷

If any of this matters for your situation, your case manager or a Disability Hub MN advocate can walk you through how a specific change affects your plan.

1
MPR News. Cuts to Unique Disability Waiver Program Leave Questions for Disabled Minnesotans
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Help Me Connect Minnesota. MA-Waiver Program
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Minnesota Department of Human Services. Home and Community-Based Services Waivers
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Minnesota Department of Human Services. CADI Waiver
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Minnesota Department of Human Services. DD Waiver
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Minnesota House of Representatives. Home and Community-Based Services Waiver Programs
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Minnesota Department of Human Services. Brain Injury Waiver
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Minnesota Department of Human Services. CAC Waiver
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Minnesota Department of Human Services. Elderly Waiver and Alternative Care
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Disability Hub MN. Deciding if a Waiver Is Right for You
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Minnesota Department of Human Services. Consumer Directed Community Supports
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Minnesota Department of Human Services. Waiver Program Waitlist
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Minnesota Department of Human Services. DD Waiver Waiting List Standards
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Minnesota Department of Human Services. Community First Services and Supports
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Minnesota Department of Human Services. CFSS Transition Information
16
Minnesota Department of Human Services. Waiver Reimagine
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Minnesota House of Representatives. Human Services Finance Bill
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Minnesota House of Representatives. Human Services Finance Bill Special Session
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Minnesota Council on Disability. 2025 Legislative Updates