Starting the search for adult care services can feel overwhelming, especially if this is the first time your family has navigated Minnesota's Home and Community-Based Services (HCBS) system. Here's a plain-language walkthrough of how the process generally works and what to expect.
Step 1: Understand what HCBS covers. HCBS is an umbrella term for services that support adults with disabilities or aging-related needs in a home or community setting instead of an institution. In Minnesota, this includes supportive housing, in-home assistance with daily activities, employment support, and care coordination — all licensed and regulated under state statute 245D.
Step 2: Figure out waiver eligibility. Most HCBS services are funded through Medicaid waivers rather than paid for privately. The main ones in Minnesota are CADI (Community Access for Disability Inclusion), Brain Injury (BI), Developmental Disabilities (DD), and Community Alternative Care (CAC). Eligibility and the specific services approved are determined through your county's case management office — this is usually the first call to make if you haven't already been assigned a case manager.
Step 3: Get a needs assessment. Eligibility for waiver-funded services runs through Minnesota's MnCHOICES assessment, a visit from a certified county assessor — it is worth knowing what to expect at a MnCHOICES assessment before the day arrives, because how the conversation goes shapes what gets approved. Separately, a qualified provider can complete an assessment to understand the level and type of support needed — daily living assistance, housing, transportation, medication support, community engagement, or a combination. If the choice in front of you is between a supported apartment and support delivered at home, ICS or Individualized Home Supports? explains which is which.
Step 4: Choose a provider that fits. This is where it's worth asking direct questions: Which counties do they serve? Which waivers do they accept? How do they involve you and your case manager in the plan? What does a typical day look like for the people they support? A good provider should be able to answer all of these clearly, and should welcome you talking to your county case manager as part of the decision.
Step 5: Build the support plan together. Minnesota's 245D framework requires person-centered planning — meaning the plan is built around the individual's own goals and preferences, not a one-size-fits-all program. Expect ongoing check-ins and the ability to adjust the plan as needs change.
If you're in Ramsey, Hennepin, Dakota, Scott, Washington, Chisago, or Pine County and are just starting this process, Midway Homes Adult Care LLC offers a free assessment and can help you understand your options, whether or not you ultimately choose us as your provider. Call 612-416-8555 or reach out through midwayhomesadultcare.com.