Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
Search Saved

Minnesota program

Hospital-level care at home (Community Alternative Care waiver)

A Medicaid waiver can support a chronically ill child who needs hospital-level care at home.

What it is

A Medicaid waiver can support a chronically ill child who needs hospital-level care at home.

The Community Alternative Care waiver can bring services into the home when hospital-level care is needed. It has no parental fee. The county or tribe assesses the child, and an assessment does not promise an available place.

Who can qualify
  • CAC normally opens before age 65. It requires certified disability, Medical Assistance eligibility, assessed hospital-level care, choice of community care and a support plan that protects health and safety. A relative’s home can qualify; TEFRA has a different parent-home requirement.
  • The applicant’s own income and assets are considered, rather than parents’ income.
What you get
  • Home care and support services in the approved waiver plan.
  • Case management, and respite when included in the plan, with no parental fee.
What the help includes
  • Services depend on the approved care plan. Respite is included only when the plan covers it.
  • Minnesota ended waiver parental fees on July 1, 2023.
If you decide to apply
  1. Ask your social worker to help arrange a county or tribal waiver assessment.
  2. Describe the care your child needs and ask about capacity and the route for moving directly from hospital.

Your county or tribal lead agency and hospital case manager. · Official page ↗

After you ask
  • The hospital provides medical documentation. The county or tribal lead agency completes the assessment and explains the next steps.
  • An expedited assessment is due within 15 business days. That is an assessment deadline, not a promise of approval or an available place.
Good to know

Meeting the care test does not guarantee a place. The county or tribe needs to explain current availability.

Other details
  • The county or tribal waiver team confirms available openings and any waiting-list or funding rules. A completed assessment does not guarantee an opening.
  • CAC is one waiver route. The lead agency can consider other routes, such as CADI, when their separate care-level tests fit. TEFRA is a coverage route, not approval for particular home services.
Official sources
Ask your social worker

“Could our child’s care needs qualify for this waiver, and is a place available? What are the benefits and drawbacks compared with TEFRA, and could you help request an assessment?”

Why I’m asking: I want to understand whether more support at home could be available.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for the assessment and describe the care the child needs.

Your social worker

The hospital case manager refers and supplies the medical documentation.

The care team

The oncologist documents the level of care the child needs.

Who decides
The county or tribal lead agency, on an assessment.
Ask your social worker
“Can we ask the county for a waiver assessment, and can you ask in writing what the current waiting position is?”

How to apply

First step: Ask the hospital case manager to refer you to the county for a waiver assessment.

  1. Ask the hospital case manager to refer for a waiver assessment.
  2. Ask the county in writing about current capacity and waiting.
  3. Ask for the expedited assessment route where discharge depends on it.

Official application / program page ↗

Where it starts: Ask the county or tribe for a waiver assessment; the hospital case manager can refer.

What to gather

  • Medical records showing the level of care needed
  • A description of daily care at home

How long: An expedited assessment is due within fifteen business days, which is the assessment clock, not an approval.

What a yes looks like

An assessed level of care and a service plan naming the hours.

What a no looks like, and the next move

Ask whether the no is about the level of care or about capacity, and appeal by the date on the notice.

Watch out

  • The waiver team confirms current capacity and waiting-list arrangements.
  • A hospital discharge does not by itself guarantee a waiver opening or faster funding.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Waiver services at home for a child assessed as needing hospital-level care, with no parental fee.

Covers: Home care and support services under the waiver · Case management through the county or tribe · Respite where the plan includes it

Legal protection: No waiver parental fees since July 1, 2023

What it costs the family: No parental fee.

The eligibility facts, as published

Level of care
assessed through the state assessment as needing hospital level of care
Age
Generally under age 65 when CAC opens; certified disability, MA eligibility, hospital-level care, a safe community support plan and choice of community care are required.
Income
the applicant's own income and assets

The trap: The county or tribal waiver team confirms current openings, waiting-list practice and any hospital-discharge funding route. Hospital discharge alone does not guarantee a place or faster funding.

Where I read this

← Back to your options