Understanding Minnesota Waivers — CADI, BI, DD, and Elderly Waiver
What Are Minnesota Waivers?
Minnesota's home and community-based service (HCBS) waivers are Medicaid-funded programs that allow people to receive long-term care services in community settings rather than in institutional facilities like nursing homes. These waivers "waive" certain Medicaid rules to give people more flexibility in where and how they receive care.
For families and case managers, understanding waiver programs is essential because they are the primary funding mechanism for many types of residential care — including assisted living, adult foster care, and other community-based housing options.
The Major Waiver Programs
Minnesota operates several waiver programs, each designed for a specific population. The four most relevant to residential care placements are CADI, BI, DD, and the Elderly Waiver.
CADI — Community Alternative Care
The Community Alternative Care (CADI) waiver serves adults and children who have physical disabilities or chronic medical conditions and would otherwise require care in a hospital or nursing facility.
Who qualifies: Individuals under 65 who meet a hospital or nursing facility level of care due to a physical disability, chronic illness, or complex medical needs.
What it covers: CADI funds a broad range of services including residential care (assisted living and adult foster care), personal care assistance, homemaker services, respite care, adaptive equipment, and environmental modifications.
Why it matters for placements: CADI is one of the most commonly used waivers for residential placements. Many adult foster care and assisted living providers accept CADI funding. When searching for a provider, always confirm CADI acceptance before proceeding.
BI — Brain Injury Waiver
The Brain Injury (BI) waiver supports individuals of any age who have sustained a brain injury and need ongoing community-based services.
Who qualifies: Individuals with a documented traumatic or acquired brain injury who meet a nursing facility or neurobehavioral hospital level of care.
What it covers: The BI waiver covers residential services, structured day programs, prevocational services, supported employment, crisis respite, and specialized therapies. It also funds training for caregivers and family members.
Why it matters for placements: Brain injury care requires specialized training and environments. Not all residential providers have experience with BI waiver residents, so it's important to identify providers who specifically serve this population. Check the Capacity Track directory and filter by providers who accept BI waiver funding.
DD — Developmental Disabilities Waiver
The DD waiver serves individuals with developmental disabilities who need residential and community support services.
Who qualifies: Individuals with a diagnosed developmental disability (such as intellectual disability, autism spectrum disorder, or other conditions originating before age 22) who meet an institutional level of care — specifically, an Intermediate Care Facility for Persons with Developmental Disabilities (ICF/DD) level of care.
What it covers: The DD waiver funds residential services (primarily adult foster care and supported living), day training and habilitation, respite care, assistive technology, in-home support, and crisis intervention services.
Why it matters for placements: DD waiver placements are often coordinated through county case managers and may involve specialized providers. Many adult foster care homes are specifically licensed and staffed to serve DD waiver recipients.
Elderly Waiver (EW)
The Elderly Waiver is Minnesota's largest HCBS waiver program, serving older adults who need long-term care services in community settings.
Who qualifies: Adults 65 and older who meet a nursing facility level of care and are eligible for Medical Assistance (Minnesota's Medicaid program).
What it covers: EW covers assisted living services, adult day services, homemaker support, personal care, chore services, home-delivered meals, and caregiver support. It is the primary waiver used for assisted living placements for older adults.
Why it matters for placements: The Elderly Waiver is the most common funding source for assisted living placements in Minnesota. Most assisted living facilities accept EW funding, though coverage amounts vary by assessed need level.
How to Apply for a Waiver
The waiver application process follows a general path regardless of which waiver you're applying for:
Step 1: Contact Your County
Reach out to your county's human services or social services department. You can also contact a managed care organization if the individual is enrolled in one. They will assign a case manager or assessor.
Step 2: Complete an Assessment
A certified assessor conducts a Long-Term Care Consultation (LTCC) to determine the individual's level of care needs. This assessment establishes whether the person meets the institutional level of care required for waiver eligibility.
Step 3: Determine Financial Eligibility
Waiver programs are funded through Medical Assistance, so the individual must meet income and asset requirements. The county financial worker will review eligibility as part of the application process.
Step 4: Develop a Care Plan
Once approved, the case manager works with the individual and their family to develop a community support plan that outlines which services will be funded and how they'll be delivered.
Step 5: Find a Provider
With an approved waiver and care plan, the next step is finding a residential provider that accepts the specific waiver type, has availability, and meets the individual's care needs.
Waitlists and Timelines
Some waiver programs — particularly the DD waiver — may have waitlists due to limited funding allocations. CADI and Elderly Waiver tend to have shorter processing timelines, but approval still takes several weeks to months depending on the county and complexity of the case.
Start the application process as early as possible, especially if a transition from a hospital, nursing facility, or family home is anticipated.
Finding Waiver-Accepting Providers
One of the biggest challenges after securing waiver approval is finding a provider with both the right care capabilities and current availability. The Capacity Track directory is built to help solve this problem — providers list their accepted waiver types alongside real-time capacity information, so case managers and families can quickly identify viable placement options without calling dozens of providers.
Search the provider directory to find Minnesota residential care providers with current openings who accept CADI, BI, DD, or Elderly Waiver funding.