Keeping a home clean and running is hard when someone has a disability, is recovering, or is getting older, and harder still when the family member who usually handles it is worn out or away. Minnesota's waivers can pay for help with that. The service is called homemaker, and it comes in three types that cover different things.
This guide explains homemaker services using the rules in the Minnesota Department of Human Services (DHS) Community-Based Services Manual page on homemaker. Rules change, and every support plan is different, so confirm the details with your county case manager.
What homemaker services are
DHS defines homemaker as "services that help a person manage general cleaning and household activities." A homemaker comes to the person's home and does the work, while keeping an eye on the person's well-being and home safety.
Homemaker is help with the house, not a teaching service. DHS is clear that homemaker does not cover training or habilitation. If the goal is for your family member to learn to do these tasks themselves, ask about individualized home supports with training instead.
Which programs pay for it
Homemaker is covered under the Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI), Developmental Disabilities (DD) and Elderly Waiver (EW) plans. It is also available through Alternative Care (AC) and Essential Community Supports (ECS). If you're not sure which waiver your family member has, CADI waiver eligibility in Minnesota covers the most common one for adults.
Who qualifies
According to DHS, a person can get homemaker services when either of these is true:
- The person needs support to manage general cleaning and household activities.
- The primary caregiver who usually handles those activities can't manage them or is temporarily away.
When the help is about the caregiver, the caregiver rules differ by program. On BI, CAC, CADI and DD, the primary caregiver must live at the same address as the person, as their primary residence, and own or lease that home. On AC, ECS and EW, the caregiver doesn't need to live there.
The three types of homemaker service
1. Homemaker cleaning
Cleaning tasks only, such as light housekeeping and laundry, plus keeping an eye on the person's safety while in the home. The person doesn't need to be home while cleaning is done.
2. Homemaker home management
Cleaning first, plus incidental help with running the household while the homemaker is there:
- Arranging transportation
- Preparing meals
- Shopping for food, clothing and household supplies
- Simple household repairs
Cleaning must be the main service. Meals and errands are extra help during the visit, not the reason for it. The person must be home for this service. DHS allows home management to be delivered partly through remote support when it meets the remote support rules.
3. Homemaker assistance with activities of daily living (ADLs)
Cleaning first, plus incidental help with personal tasks during the visit:
- Walking and moving around
- Bathing
- Dressing
- Eating
- Grooming
- Toileting
Again, cleaning must be the main service, and the person must be home. If personal care is the main need, ask your case manager about personal care services (PCA, now becoming CFSS) instead.
What homemaker doesn't cover
Knowing the limits up front saves frustration later. According to DHS:
- No training or habilitation. Homemaker does the work. It doesn't teach it.
- No duplicates. It can't be authorized if it would duplicate another state plan or waiver service the person already gets, such as chore services or transitional services.
- Not in licensed settings. It can't be authorized for someone living in a licensed setting, such as foster care or a supervised living facility.
- Not with round-the-clock residential services. It can't be authorized for someone receiving adult foster care, community residential services, family residential services or customized living.
- ICS has a special rule. A person receiving integrated community supports (ICS) can get homemaker services only if a different provider delivers them.
Who can provide it
The licensing rules depend on the type:
- Homemaker cleaning is an "approval-option" service. Counties and tribal nations can approve vendors that meet state standards, including vendors not enrolled with DHS.
- Home management and assistance with ADLs require DHS enrollment and, unless an exclusion applies, either a Minnesota 245D license as a basic support service provider or a Chapter 144A license with a home and community-based services designation.
- Every homemaker provider needs a background study.
Homemaker is authorized in 15-minute units at a rate the state sets in advance.
How to get homemaker services
- Talk to your case manager. Describe what's not getting done at home and who has been doing it. If a caregiver is stretched thin or away, say so.
- Be specific about the type. Cleaning only, cleaning plus meals and errands, or cleaning plus help with daily tasks are three different services.
- Ask about the alternatives. If the real need is personal care or learning skills, a different service may fit better. Respite can also help when a family caregiver mainly needs time off.
- Choose a provider. Our questions to ask a 245D provider work for homemaker providers too.
Homemaker services with Midway Homes
Midway Homes Adult Care LLC is a Minnesota 245D-licensed provider, and homemaker services are one of the basic support services we offer adults living in their own homes. We serve Ramsey, Hennepin, Dakota, Scott, Washington, Chisago and Pine counties.
One honest note: because of the ICS rule above, people who live in a Midway ICS home can't get homemaker services from Midway itself. They'd need a different provider.
Call 612-416-8555 to talk through what kind of help at home would make the biggest difference. If another provider or service is a better fit, we'll tell you.