Let's start with the criterion that turns families away before they ever apply. To qualify for Minnesota's CADI waiver, a person must be assessed as needing "nursing facility level of care."
That phrase does not mean the person has to enter a nursing home, want to enter one, or ever have been in one. It is a measurement of how much support someone needs — nothing more. The entire point of the waiver is to fund that level of support while the person stays in their own home or community. People read "nursing facility" and conclude the program is not for them. It is often precisely for them.
First, a naming problem
You will find CADI written out two different ways. Current Minnesota DHS material calls it Community Access for Disability Inclusion. Older documents, archived manual pages, and plenty of still-circulating PDFs call it Community Alternatives for Disabled Individuals.
Same program. If you are comparing two sources that seem to describe different waivers, check the acronym before you worry.
The four requirements
A person must choose to live in the community, and meet all four of the following. These are not a scoring system where strength in one offsets weakness in another — all four have to be true.
1. Eligible for Medical Assistance. CADI is funded through Minnesota's Medicaid program, so MA eligibility is the foundation everything else sits on.
2. Certified as disabled. This comes either from the Social Security Administration or from Minnesota's State Medical Review Team (SMRT). One practical detail worth knowing: if the person is already certified disabled by SSA, they should not be referred to SMRT. That referral is redundant, and it adds weeks to a process that is already slow. If a worker suggests it and SSA has already made a determination, it is reasonable to ask why.
3. Under 65 at first enrollment. The age rule applies at the moment someone first opens on the waiver. It is not an expiry date — people already receiving CADI services may stay on CADI after turning 65, or move to the Elderly Waiver instead. Turning 65 does not end support; it opens a choice.
4. Assessed as needing nursing facility level of care. This is determined through a MnCHOICES assessment — the in-person visit from a certified county assessor. There is a second part to this requirement that gets overlooked: the person must also have an assessed need for supports beyond what the regular MA state plan already covers. The waiver exists to fund what standard Medicaid does not.
If you have an assessment ahead of you, it is worth reading what to expect at a MnCHOICES assessment first. How that conversation goes shapes what gets approved.
Once CADI is approved, the next decision is usually which service to use it for — ICS or Individualized Home Supports? covers the two most common options.
Not sure whether your family member meets these? We talk through this with families regularly, free and with no obligation, including when the answer turns out to be no. Call 612-416-8555.
The financial side
CADI eligibility runs through Medical Assistance, so MA's income and asset rules apply. Three things are worth understanding in principle:
- A spenddown may apply. If income is above the limit, certain medical expenses can be deducted from it, and MA covers services once income falls at or below the limit after those deductions. Being over the line on paper does not automatically mean disqualified.
- Giving away assets can backfire. Uncompensated transfers — handing property or money to someone for less than fair value — can trigger a penalty period during which MA will not pay for long-term care services, CADI included. Talk to the county or an advocate before moving assets, not after.
- A home equity limit applies.
We have deliberately not printed income or asset figures here. Those numbers change on a yearly cycle, and a stale figure in a guide like this is worse than no figure — someone reads it, concludes they do not qualify, and stops. For current amounts, use the DHS income and asset limits page, which is kept up to date, or ask your county directly.
When services can actually start
Even after eligibility is established, waiver services cannot begin until three things are complete: the assessment is finished, a care plan is developed, and MA payment eligibility for long-term care services has been determined. Families often expect support to start at approval. It starts after the plan exists.
What about waiting lists?
Honestly: it varies, and anyone who gives you a confident statewide answer is guessing.
Lead agencies manage CADI, CAC, and BI waiver authorizations together as a single budget, and those allocations are limited. Statutory enrollment caps on CADI expired in 2015, but limited local funding is a different constraint from a legal cap, and it is a real one. Whether there is a wait where you live, and how long, is a question only your county can answer. Ask them directly, and ask what the current wait looks like for someone with your family member's assessed needs rather than in general.
If you think you might qualify
Call your county or tribal human services office and request a MnCHOICES assessment. Start the Medical Assistance application and the disability certification in parallel if neither is in place — both take time, and they can run alongside each other.
Midway Homes Adult Care LLC is a Minnesota 245D-licensed provider serving adults on the CADI, BI, DD, CAC, and Elderly waivers across Ramsey, Hennepin, Dakota, Scott, Washington, Chisago, and Pine counties, with ICS supportive housing, Individualized Home Supports, respite, night supervision, and personal care.
If you are working through eligibility now, or have an approved plan and no provider yet, call 612-416-8555 for a free assessment. We are happy to help you understand the options even if you choose another provider — this process is hard enough without having to guess at it alone.