St. Louis County helps people who are over the age of 65 or have a disability find life-enhancing services. Our goal is to increase independence, health, and safety so that people can live in their communities as independently as possible.

DHS requests public comments on amendments to Elderly Waiver plan

Minnesota Department of Human Services sent this bulletin at 08/14/2026 01:32 PM CDT
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Minnesota Health Care Programs (MHCP)
Waivers

Aug. 14, 2026

DHS requests public comments on amendments to Elderly Waiver plan

The Minnesota Department of Human Services (DHS) requests public comments on fall 2026 amendments to the elderly waiver (EW) plan before submitting the amendments to the Centers for Medicare & Medicaid Services for approval. Submit comments to AASD.Publiccomments@state.mn.us by 4 p.m. Saturday, September 12, 2026.

Review the DHS requests public comments on EW plan amendments Aging and Adult Services Division eList announcement for more information.

MnCHOICES

About MnCHOICES Assessments

The MnCHOICES assessment allows for anyone of any age with a disability to access the support services needed to stay in their home. MnCHOICES helps make decisions about long-term services that help individuals thrive in their communities.  Public health nurses and social workers assess individuals in-person to learn more about your needs, goals and choices to determine what services and help you might qualify for.

If you or a loved one need assistance at home, a MnCHOICES assessment is required to determine what long-term care programs and services are best for you. Even if you are not eligible for public benefits, a certified assessor can assist you in understanding what services, accommodations, and resources exist. Follow the steps below to get started.

For more information, please see MnCHOICES brochure from DHS.

Step One: Request a MnCHOICES Assessment

To Schedule your free assessment, call 218-726-2366

Step Two: Complete a MnCHOICES Assessment

 

A certified assessor will complete a MnCHOICES assessment in your home or another location if preferred. Family and friends are welcome to join you during the assessment. Please be aware assessments may take approximately two hours to complete. 

Step Three: Eligibility

Following the MnCHOICES assessment, a certified assessor will review supports and services you may be eligible for based on assessment outcomes. Services can vary for individuals under 65 or over 65.

Services for people under age 65

DHS Intellectual Disability/Rule 185 Case Management
 
Brain Injury (BI) Waiver
 
Community Access For Disability Inclusion (CADI) Waiver
 
Community Alternative Care (CAC) Waiver
 
Consumer Support Grant (CSG)
The Consumer Support Grant program is a state-funded alternative to Medicaid home care services of home health aide, personal care assistance and/or private duty nursing. Medicaid services are paid for with a combination of state and federal money. The Consumer Support Grant Program allows eligible consumers to convert the state portion of payments for specific home care services into a cash grant. The monthly cash grants replace fee-for-service home care services payments. With county assistance, consumers can manage and pay for a variety of home and community-based services. The CSG program gives consumers greater flexibility and freedom of choice in service selection, payment rates, service delivery specifications and employment of service providers. Parents, spouses, family members, trusted neighbors or friends can be paid for service, as well as employees of traditional home care provider agencies. Consumers may choose the participant employer option and act as the employer of their direct support workers. For more information, please see Participant Employer Options.
 
 
Family Support Grant (FSG)
The Family Support Grant (FSG) program provides state cash grants to families of children with certified disabilities. The goal is to prevent or delay out-of-home placement of children with disabilities and promote family health and social well-being by providing access to family-centered services and supports.
 

Community First Services and Supports (CFSS, formerly PCA)

Community First Services and Supports (CFSS) is a Minnesota health care program that offers flexible options to meet the unique needs of people. CFSS allows people greater independence in their homes and communities. CFSS will replace personal care assistance (PCA) and the Consumer Support Grant (CSG).

DHS will begin implementing CFSS on Oct 1, 2024. View the Timeline tab for more information about the implementation.

CFSS will cover the same main services as PCA:

  • Activities of daily living, such as eating, bathing, grooming and transferring
  • Health-related tasks
  • Instrumental activities of daily living, such as shopping, cooking, laundry and assistance with self-administered medications
  • Observation and redirection of behavior.
The eligibility requirements for CFSS will be the same as PCA. A person eligible for PCA will also be eligible for CFSS unless they have a change in their condition. The person must:
  • Live in the community and not a facility such as a skilled nursing home.
  • Be able to direct care or have a representative who can direct care on their behalf.
  • Be enrolled in one of Minnesota’s health care programs: Medical Assistance (MA), an MA waiver, the Alternative Care program and some people on MinnesotaCare.
  • Have an assessment that determines they are eligible.
  • Not be using the Family Support Grant.
 

Services for people over age 65

Alternative Care (AC)
 
Essential Community Supports (ECS)
 
Elderly Waiver (EW)
 
Community First Services and Supports (CFSS, formerly PCA)

Community First Services and Supports (CFSS) is a Minnesota health care program that offers flexible options to meet the unique needs of people. CFSS allows people greater independence in their homes and communities. CFSS will replace personal care assistance (PCA) and the Consumer Support Grant (CSG).

DHS will begin implementing CFSS on Oct 1, 2024. View the Timeline tab for more information about the implementation.

CFSS will cover the same main services as PCA:

  • Activities of daily living, such as eating, bathing, grooming and transferring
  • Health-related tasks
  • Instrumental activities of daily living, such as shopping, cooking, laundry and assistance with self-administered medications
  • Observation and redirection of behavior.
The eligibility requirements for CFSS will be the same as PCA. A person eligible for PCA will also be eligible for CFSS unless they have a change in their condition. The person must:
  • Live in the community and not a facility such as a skilled nursing home.
  • Be able to direct care or have a representative who can direct care on their behalf.
  • Be enrolled in one of Minnesota’s health care programs: Medical Assistance (MA), an MA waiver, the Alternative Care program and some people on MinnesotaCare.
  • Have an assessment that determines they are eligible.
  • Not be using the Family Support Grant.
 
 
Consumer Support Grant (CSG)
The Consumer Support Grant program is a state-funded alternative to Medicaid home care services of home health aide, personal care assistance and/or private duty nursing. Medicaid services are paid for with a combination of state and federal money. The Consumer Support Grant Program allows eligible consumers to convert the state portion of payments for specific home care services into a cash grant. The monthly cash grants replace fee-for-service home care services payments. With county assistance, consumers can manage and pay for a variety of home and community-based services. The CSG program gives consumers greater flexibility and freedom of choice in service selection, payment rates, service delivery specifications and employment of service providers. Parents, spouses, family members, trusted neighbors or friends can be paid for service, as well as employees of traditional home care provider agencies. Consumers may choose the participant employer option and act as the employer of their direct support workers. For more information, please see Participant Employer Options.
 

Paying For Services

MnCHOICES assessments are completed free of charge. During your assessment visit, a certified assessor will discuss state and federal-funded programs an individual may be eligible for and funding sources that may assist with the cost of these services. A disabled child that is not eligible for Medical Assistance may qualify for TEFRA as a supplement for payment of home care services. Private pay options can also be arranged for eligible services. 

Do I qualify for Medical Assistance? Click here

Contact

Request a MnCHOICES 
Assessment

Phone: 218-726-2366

Disability Hub
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Minnesota Aging Pathways

Links to service providers by area and helpful information.

Minnesota Aging & Disability Resources

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