If you are searching for a place for an adult family member with a disability, you have probably seen three phrases used as if they meant the same thing: adult foster care, group home, and supportive housing. They overlap, but they are not interchangeable. This guide explains what each term usually means in Minnesota, where the rules come from, and which questions to ask before you choose.
"Group home" is a nickname, not a license
Minnesota's Department of Human Services (DHS) licenses small homes for adults under specific license types. The two that matter here are adult foster care and community residential setting (Minn. Stat. § 245A.11, subd. 2a names both). "Group home" is the everyday name people use for either one: a small home where several adults live and paid staff provide support.
Because the phrase is informal, always ask a provider what license they hold and which services that license covers. The license, not the nickname, determines the rules the home must follow.
What adult foster care is
Minnesota law defines foster care for adults as a program operating 24 hours a day that provides functionally impaired adults with food, lodging, protection, supervision and household services in a residence (Minn. Stat. § 245A.02, subd. 6c). Under section 245A.11, adult foster care and community residential setting licenses both have a maximum capacity of four beds, including non-staff roomers and boarders. A fifth bed is allowed only in narrow cases the statute spells out, such as a home where everyone in care is 55 or older.
Family foster care vs. a staffed home
The most useful distinction is who the license holder is and where they live.
- Family adult foster care. Minnesota law defines this as an adult foster care home that is licensed by DHS, is the primary residence of the license holder, and in which the license holder is the primary caregiver (Minn. Stat. § 245A.02, subd. 6f). Think of it as someone sharing their own home and providing most of the care themselves.
- Community residential setting. A home where a 245D provider delivers residential supports to adults, the provider owns, leases or rents the home, and the license holder does not live there (Minn. Stat. § 245D.02, subd. 4a). Hired staff provide the support. This is often what people mean by "group home."
Neither model is better in general. A family setting can feel warm and consistent; a corporate setting can offer staffing schedules and backup coverage that one household cannot. What matters is the match with the person: their support needs, their routines, and what they want their home to feel like.
Where 245D comes in
Many families run into "245D" at the same time. Chapter 245D is Minnesota's licensing framework for home and community-based services (HCBS): the services that help people live in the community. It is separate from the foster care license in chapter 245A, but the two can work together: section 245D.03 lists 245D residential services that can be provided in a family adult foster care residence. Because these rules are amended over time, confirm the current text with the provider or DHS.
Our guide to 245D supportive housing vs. adult family homes covers how those terms overlap in more detail.
Where supportive housing (ICS) fits
Integrated Community Supports (ICS) is a 245D service that combines housing with the day-to-day help a person needs, in a home-like setting. Compared with adult foster care, the main differences families notice are:
- License: adult foster care is a foster care license under chapter 245A; ICS is a service under a 245D license.
- Size: an adult foster care home is generally capped at four beds by statute; for ICS it depends on the provider and the setting.
- Focus: adult foster care centers on residential care and supervision; ICS is housing plus person-centered supports tied to the service plan.
- Who decides eligibility: for both, the county or tribal lead agency, through the person's waiver or assessment.
This is a simplification. Individual homes differ, so ask each provider to put what they offer in writing. If you are weighing ICS against in-home support, see ICS or Individualized Home Supports? and our overview of Integrated Community Supports.
How it is usually paid for
Services for adults with disabilities are commonly funded through Minnesota Medicaid and home and community-based waivers, such as CADI, BI, DD and CAC. Your county or tribal lead agency completes the assessment and decides which services are authorized, so the first step is usually the county, not the provider. CADI waiver eligibility in Minnesota walks through what that process asks for. Some homes also accept private pay. Whether a given home accepts your waiver is a question only that home can answer.
Questions to ask on a tour
- What license do you hold, and can I see it? Is this a family or corporate home?
- Is someone awake overnight, or does the home use another form of overnight supervision? (DHS can allow alternate overnight supervision only through a variance under § 245A.11, subd. 7.)
- Who is on staff, and what happens when someone is out sick?
- Which waivers do you accept, and in which counties?
- How are the person's goals written into their plan, and how often is it reviewed with the family and case manager?
- What are the resident rights in this home, and how would we raise a concern?
Our longer checklist, 15 questions to ask a 245D provider, goes deeper on what a good answer sounds like.
When adult foster care may not be the right fit
Foster care can be a good fit, but it is not right for everyone. If the person wants more independence, a home of their own with visiting supports may suit them better. If their needs are mostly medical, a different service may be needed. Your case manager can help you compare options, and you are entitled to ask for a reassessment if the plan no longer fits.
Talking with Midway Homes
Midway Homes Adult Care LLC is a Minnesota 245D-licensed provider offering Integrated Community Supports (ICS) supportive housing, Individualized Home Supports, and employment services. We are not an adult foster care provider and do not hold an adult foster care license; our ICS supportive housing is a 245D service, not foster care. If foster care is what your family member needs, your county case manager can point you to licensed foster care homes. We do not need you to know every term before you call. We will help you work out which type of setting fits your family member and what to ask your county.
Call us at 612-416-8555 for a free assessment. We serve Ramsey, Hennepin, Dakota, Scott, Washington, Chisago, and Pine counties.
This guide is general information, not legal advice. Licensing rules and waiver policies change; confirm current requirements with your county case manager or the Minnesota Department of Human Services.