I/DD Waivers in Minnesota

All states: Medicaid disability services map

Minnesota I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in Minnesota?

The Minnesota Department of Human Services (DHS) runs I/DD home and community services. DHS is also the state Medicaid agency, which Minnesota calls Medical Assistance (MA), and its Disability Services Division oversees the Developmental Disabilities (DD) Waiver. Counties and Tribal Nations act as lead agencies: they arrange assessments, provide or contract case management and authorize services.

• Minnesota Department of Human Services (DHS): sets the rules for the DD Waiver, licenses providers under Minnesota Statutes chapter 245D (the home and community-based services, or HCBS, license) and pays waiver claims.
• Lead agencies: the county human services agency or Tribal Nation where the person lives. This is the front door for families.
• Case management: every DD Waiver participant gets a case manager, provided directly by the county or by a vendor under contract with it, under Minn. Stat. 256B.092. A private agency with a financial interest in other services in the person's support plan may not also be that person's case manager. DD case management follows Minnesota Rules 9525.0004 to 9525.0036, often called Rule 185, and case managers need 20 hours of training a year.

What Medicaid waivers and programs serve people with I/DD in Minnesota?

Minnesota has one 1915(c) waiver mainly for people with I/DD: the Developmental Disabilities (DD) Waiver. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. The DD Waiver serves children and adults of any age, and House Research reports 25,215 participants in 2024 and an estimated 26,377 in 2025.

• Developmental Disabilities (DD) Waiver (1915(c), CMS control number 0061.R08.00): serves people with a developmental disability or related condition who are eligible for Medical Assistance based on disability, need the level of care given in an intermediate care facility for persons with developmental disabilities (ICF/DD), need daily support with a 24-hour plan of care, and choose community services instead of an ICF/DD. The CMS waiver listing shows it also runs under a concurrent 1915(b)(4) authority. Services include community residential services, family residential services, integrated community supports, individualized home supports, day support services, prevocational services, adult day services, employment exploration, development and support services, in-home, out-of-home and crisis respite, night supervision, homemaker, 24-hour emergency assistance, positive support services, crisis supports, case management, transportation, home and vehicle modifications and assistive technology. Services can be given in the person's own home, a family home, a family foster home or a provider-run residential home. House Research estimated 2025 DD Waiver spending at about $2.73 billion.
• Consumer Directed Community Supports (CDCS): the self-directed option inside the DD Waiver. The person or family manages a budget and hires their own workers, with a financial management service handling payroll.
• Community First Services and Supports (CFSS): a state plan personal care benefit under Minn. Stat. 256B.85 that began October 1, 2024 and replaces Personal Care Assistance (PCA) and the Consumer Support Grant. It is open to people with any disability, and many DD Waiver participants use it alongside the waiver. It has an agency model and a budget model, where the person directs their own workers.

Minnesota's other disability waivers serve other groups and share the same service menu and rate system: Community Access for Disability Inclusion (CADI), Community Alternative Care (CAC) and Brain Injury (BI). The institutional option the DD Waiver is an alternative to is the ICF/DD.

Does Minnesota pay for I/DD services through managed care?

No. DHS pays DD Waiver services fee-for-service, which means the state pays each claim directly. People who are certified blind or disabled do not have to join a health plan. Adults 18 to 64 may choose to join Special Needs BasicCare (SNBC), a Medicaid health plan for people with disabilities, but their waiver services still stay outside the plan.

• Waiver services are carved out: under Minn. Stat. 256B.69, home and community-based waiver services are excluded from the health plan benefit for people with disabilities, so plan members get them the same way as people who are not in a plan.
• Voluntary enrollment: the DHS eligibility policy manual lists people certified blind or disabled as exempt from mandatory managed care, with SNBC as an option for ages 18 to 64.
• Who coordinates services: the county or Tribal Nation lead agency and the person's case manager, not a health plan.

Is there a waiting list for I/DD services in Minnesota?

No. DHS says Minnesota eliminated the waiting lists for the DD, CADI, CAC and BI waivers in 2016. Instead, when a person is found to need the DD Waiver, the lead agency must approve funding within specified timelines. Families who think a request is moving too slowly can ask their county or Tribal Nation where it stands.

• Funding timelines: DHS tracks whether lead agencies approve DD Waiver funding on time and gives them technical assistance on what it calls reasonable pace standards.
• Priorities in state law: Minn. Stat. 256B.092 directs counties to keep a list of people with developmental disabilities who need services they are not yet getting, and sets statewide priorities for DD Waiver funding: people leaving an institution, people in unstable living situations, people facing abuse or neglect, and people with a sudden change in need.
• Count: because there is no waiting list, DHS does not publish a count of people waiting.

How do people apply for the DD Waiver, and how are budgets set?

Contact the county human services agency or Tribal Nation where the person lives. The lead agency arranges a diagnostic evaluation and an assessment with MnCHOICES, Minnesota's statewide assessment, or a DD screening, done by a certified assessor. If the person qualifies, a case manager writes the services into a support plan and the lead agency authorizes them.

• Eligibility: according to the DHS Community-Based Services Manual, the person must be eligible for Medical Assistance on the basis of disability (certified by Social Security or the State Medical Review Team), have a developmental disability or related condition, need ICF/DD level of care, need daily support with a 24-hour plan of care, have an assessed need for habilitation (skill building), need more than the regular Medical Assistance benefit covers and choose community services over an ICF/DD.
• Assessment: MnCHOICES assessments are done by certified assessors under Minn. Stat. 256B.0911.
• Budgets and rates: today, the lead agency calculates a rate for each person and service in the state's rate system (see the rates section below). We did not find a published individual budget amount for traditional DD Waiver services. A 2026 state law calls for individual budgets in a future waiver structure, described in the last section.

What day and residential services can I/DD providers offer in Minnesota?

DD Waiver providers can offer day support, prevocational, adult day and employment services, and several kinds of residential and in-home support. Almost all of these need a DHS 245D license, either a basic support services license or an intensive support services license, under Minn. Stat. 245D.03. Adult day centers are licensed separately.

Day and employment services

• Day support services: facility or community-based day services with care, supervision and skill building. Needs a 245D intensive support services license. Billed only in 15-minute units. The case manager and team assign each person a staff ratio at least once a year under Minn. Stat. 245D.31: 1:4 for people who need total care or have frequent dangerous behavior, 1:8 for people who need only prompts or spot checks, and 1:6 for everyone else. One staff person may supervise no more than ten people.
• Prevocational services: day services that build work-related skills. Needs a 245D intensive support services license, uses the same 245D.31 ratios when facility based, and is billed per day (six or more hours of direct service) or per 15 minutes.
• Adult day services: center-based adult day care for adults with functional impairments, also used by the Elderly Waiver and Alternative Care programs. Licensed by DHS as an adult day care center rather than under 245D. The licensing rule sets a ratio of 1:8 for participants who can leave the building on their own in an emergency and 1:5 for those who cannot. On the disability waivers it is billed per day (six or more hours) or per 15 minutes.
• Employment exploration, employment development and employment support services: individual supported employment services. Need a 245D intensive support services license and are paid as unit-based services. We did not find a published staff ratio or confirm the unit size.

Residential and in-home services

• Community residential services: support in a home the provider controls, often called corporate foster care. Needs a 245D intensive support services license plus a community residential setting license. State law has a standing moratorium on new community residential setting licenses, with listed exceptions.
• Family residential services: support in a licensed family foster home, Minnesota's version of a host home. Needs a 245D intensive support services license and foster care licensing.
• Integrated community supports (ICS): support for people living in their own units in a multifamily building where the provider has a financial interest. Needs a 245D intensive support services license. ICS is under extra federal and state review (see the next section), and a 2026 state law bars new ICS licenses and new or expanded ICS settings from January 1, 2027, except by approved exception.
• Individualized home supports (IHS): support in the person's own or family home. IHS without training needs a basic 245D license, and IHS with training needs an intensive license. State law limits IHS with training to three hours in a row and six hours total a day, starting January 1, 2026 or on federal approval. We did not confirm whether federal approval has been given.
• Life sharing: a residential service listed in the 245D statute and in the 2026 list of rate system services. We did not find its start date or full service definition.
• ICF/DD: the institutional option. Residential services for more than four people with developmental disabilities, including ICFs/DD, are listed among 245D intensive services.

How are I/DD provider rates set and how do agencies enroll in Minnesota?

Rates come from the statewide Disability Waiver Rate System (DWRS) in Minn. Stat. 256B.4914. Lead agencies calculate each person's rate in a web-based rate tool, using four rate frameworks built from wage data and set cost values. New providers need a DHS 245D license, and DHS has limited new licenses and new enrollment in some services since late 2025.

• Four rate frameworks: residential support services, day programs, unit-based services with programming, and unit-based services without programming. The frameworks use Bureau of Labor Statistics wage data, component values and a 6.7 percent competitive workforce factor (4.7 percent for respite). Day program rates use each person's staffing ratio.
• Inflation updates: component values are updated by the Consumer Price Index on January 1, 2026 and every two years after, capped at 8 percent per update. We did not confirm whether the January 2026 updates are now in effect, because they needed federal approval of waiver amendments.
• 245D licensing moratorium: DHS announced on December 2, 2025 a temporary moratorium on new 245D licenses, and cancelled pending applications that a county, Tribal Nation or managed care organization had not named for an exception.
• Enrollment freeze: at the direction of the Centers for Medicare and Medicaid Services (CMS), DHS froze new provider enrollment in 13 high-risk service categories, including individualized home supports, integrated community supports and night supervision, for an initial six months. Enrolled providers may keep serving clients. We did not find whether the freeze has since been lifted or extended.
• Pre-payment review: Optum, a DHS contractor, reviews fee-for-service claims before payment for 14 high-risk services, including individualized home supports, integrated community supports, night supervision and adult day services. DHS says this review will become a permanent part of waiver claims processing.
• Enrollment path: we did not confirm the Minnesota Health Care Programs provider enrollment page for waiver providers. Ask DHS for the current steps after the 245D license.
• EVV for I/DD services: under the DHS electronic visit verification (EVV) page, only listed waiver codes need EVV today: in-home respite, crisis respite, individualized home supports, independent living skills, night supervision and homemaker with personal cares. Providers can use the free HHAeXchange system or a third-party system that sends data to the HHAeXchange aggregator.

What is changing next for I/DD services in Minnesota?

State law calls for Minnesota to replace its four disability waivers, including the DD Waiver, with a two-waiver structure and individual budgets on January 1, 2027 or on federal approval, whichever is later. DHS calls this project Waiver Reimagine. In its July 6, 2026 update, DHS said it cannot launch the new program by January 1, 2027 and has not set a new launch date.

• How the launch will work: DHS says the new Disability Waiver Program will start in a rolling, phased way, only after CMS approves the new waiver plans and after people receive a support range and budget range through a MnCHOICES assessment at least 12 months before launch. Ask DHS or your lead agency for the current timeline.
• Two-waiver structure: Laws 2026, chapter 121, signed May 27, 2026, keeps the requirement that DHS move to two 1915(c) waivers with an individual budget method, phased in after consulting the Olmstead Implementation Office.
• Integrated community supports: from January 1, 2027, DHS may not issue new 245D licenses for ICS or approve new or expanded ICS settings, except by approved exception. The same law adds ICS access services to the rate system on October 1, 2027 or on federal approval, whichever is later.
• More services under EVV: a 2026 law adds services such as integrated community supports, adult day, adult companion and waiver services paid by the hour or minute to the state EVV list, according to a House Research summary. DHS has not set the start dates.
• CFSS transition: people still using Personal Care Assistance or the Consumer Support Grant move to CFSS, with a transition deadline of September 30, 2027.

Minnesota I/DD sources

• CMS: Minnesota waiver factsheet (DD Waiver 0061.R08.00)
• Minnesota DHS Community-Based Services Manual: Developmental Disabilities (DD) Waiver
• Minn. Stat. 256B.092 (services for persons with developmental disabilities)
• Minn. Stat. 256B.69 (managed care, waiver services carve-out)
• Minn. Stat. 256B.4914 (Disability Waiver Rate System)
• Minnesota DHS: Waiver program waitlist
• Laws of Minnesota 2026, chapter 121
• Minnesota House Research: HCBS waivers (September 2025)
• Minnesota DHS: Electronic visit verification
• Minnesota DHS: Waiver Reimagine July 2026 update

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• Home and Community-Based Services (HCBS) Software Solutions
• I/DD services in every state (map)
• Minnesota EVV requirements

Other states that report no I/DD waiting list

California, Hawaii, Nebraska, Wisconsin. See every state on the I/DD services map.

Page history

• October 23, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.