Once a family member is approved for the CADI waiver, a new person appears in your life: the case manager. They call, they schedule visits, they send paperwork to sign. But most families are never told what the role actually is, what the case manager is required to do, or what they can ask for.
If you search for "CADI case manager," you'll mostly find job postings. This guide is written for the family on the other side of the table.
The rules below come from Minnesota DHS's Community-Based Services Manual and from Minnesota Statutes § 256B.49. Program rules change. Always confirm the details for your situation with your county or tribal nation.
Who assigns the case manager
For the CADI waiver (and the BI, CAC and DD waivers), case management is arranged by the county of financial responsibility or the enrolled tribal nation, according to the DHS Community-Based Services Manual page on waiver case management (updated 7/24/26). Minnesota law calls a county, or a tribe or health plan under contract with the state, a lead agency (Minn. Stat. § 256B.0911, subd. 10).
Your case manager may work directly for the county, or for a private agency the county contracts with. DHS calls the second arrangement "contracted case management."
What the case manager is required to do
Minnesota law spells out the job. Under Minnesota Statutes § 256B.49, subdivision 13, case management for CADI includes:
- Finalizing the person-centered written support plan within the timelines DHS sets.
- Telling you about service options, including all of the waiver service options, not just the ones the county uses most.
- Helping identify potential providers, including employment and financial management providers.
- Helping you access services and appeals.
- Coordinating, evaluating and monitoring the services in the plan.
The DHS manual adds the practical duties. Case managers must develop the support plan with the person, review and update it annually with the person, and make sure providers deliver services as written in that plan.
In plain terms, the case manager is the person who turns an assessment into a plan, connects the plan to real providers, and checks that what's on paper is actually happening.
What the case manager is not
This part surprises many families.
The case manager doesn't provide the hands-on services. They don't do personal care, cook meals or provide overnight supervision. Those come from providers like a 245D-licensed agency.
A private agency can't be your case manager if it profits from your other services. Section 256B.49, subdivision 13(d), says case management "must not be provided to a recipient by a private agency" that has a financial interest in other services in the person's support plan. This conflict-of-interest rule exists so the person helping you choose providers isn't steering you toward their own.
That includes us. Midway Homes is a service provider, not a case management agency, so we can't be the case manager for anyone we serve. Be cautious of any private agency that offers to be both.
How often they must visit
For CADI, BI, CAC and DD waiver participants, the DHS manual sets a minimum of two face-to-face visits with the person within each 12-month period. The annual reassessment may count as one of those visits. DHS notes that lead agencies have had to meet these minimum face-to-face requirements since November 1, 2023.
Two visits a year is a floor, not a target. If your family member's needs are changing quickly, after a hospital stay, a move or a change in behavior, it's reasonable to ask for more contact.
What a good working relationship looks like
You won't find these in a statute, but families who get the most out of case management tend to do a few things:
- Get direct contact information. You should know how to reach your case manager and who covers when they're out.
- Keep a copy of the current support plan. It's the document providers are held to. If a service isn't in it, it usually isn't authorized.
- Bring problems early. If a provider is missing shifts or a need isn't being met, tell the case manager in writing. Monitoring services is part of their job.
- Prepare for the annual review. That's when the plan changes. The same advice in our guide on what to expect at a MnCHOICES assessment applies: describe the hard days honestly, not the good ones.
- Ask about every option. The case manager is required to inform you of all waiver service options. If you've heard of a service, such as respite, homemaking or Integrated Community Supports, ask whether it fits.
What if it isn't working?
The DHS manual says Minnesota's Olmstead Plan and transition protocol "require that each person has choice, including choice of case management." It also says a person may request a new case manager or provider, and the lead agency "must engage collaboratively with the person to discuss the available options."
In practice, the choices depend on which case management options are available in your county. You may not get any agency you want, but you're entitled to have the conversation.
To start, contact your county or tribal social services office and say you'd like to discuss changing case managers. Put the request in writing and keep a copy. If a service is denied, reduced or ended, the written notice you receive explains your appeal rights and deadline under Minnesota Statutes § 256.045. Read it the day it arrives, because the deadlines are short.
If the problem is the service provider rather than the case manager, that's a separate process, and your case manager is the person who helps you through it. Our guide on how to change waiver providers in Minnesota walks through it step by step.
Where Midway Homes fits
Case managers and providers work side by side. Once a case manager has written a support plan, a 245D-licensed provider like Midway Homes Adult Care delivers the services in it. If you're still deciding who that should be, our questions to ask a 245D provider can help you compare. If you're not yet sure your family member qualifies, start with CADI waiver eligibility in Minnesota.
Midway Homes Adult Care LLC is a Minnesota 245D-licensed provider serving Ramsey, Hennepin, Dakota, Scott, Washington, Chisago and Pine counties. If you've got a support plan and you're looking for a provider, or you just want help making sense of what your case manager told you, call 612-416-8555. If we're not the right fit, we'll tell you.