Minnesota is always changing and growing. Future challenges are expected as more Minnesotans need to access our state system of long-term services and supports (LTSS). To prepare for these challenges, opportunities are being pursued to strength services and supports by making them more accessible, sustainable and safe.
LTSS are important for many of our family members, friends, neighbors and coworkers. Minnesota is building an LTSS system that is available to everyone who needs it, at every stage of life.
Recommendations for the future are seen in the changes being made. Adjustments to programs and services, as well as larger scale system transformations, reflect the overall mission that people in Minnesota thrive and experience high-quality human services.
The following principles provide more information about how this mission will be achieved through the LTSS system:
Affordability and access
Minnesotans can easily access services regardless of income, race/ethnicity, language, or location.
Choice of setting and provider
A person-centered approach allows Minnesotans to choose services and supports that will best fit their needs regardless of their preferences or values. This requires a well-trained and well-compensated workforce available in all types of care settings.
Safety and quality
Safeguards are in place to protect from abuse or neglect. Services and supports are monitored and measured to ensure high-quality outcomes without disparities.
Support for caregivers - family, friends and neighbors
Those who are caregiving are recognized for their work and their needs are addressed so they have access to information, training, and respite or breaks.
Integration of services and community
Minnesotans can coordinate their medical and behavioral care while receiving appropriate social services within their chosen community.
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 is replacing personal care assistance (PCA) and the Consumer Support Grant (CSG).
Minnesota’s Adult Protective Services (APS) Operational Plan sets a 5 year path for adult protective services at the state and local levels. Minnesota’s plan includes mission, vision, operating principles, and goals for APS to help guide programs, evaluation, and resources. The plan builds on the Vulnerable Adult Act Redesign and consultant recommendations to develop guiding principles for service response for adults referred to counties by the Minnesota Adult Abuse Reporting Center (MAARC).
The Civil Monetary Penalty (CMP) Initiative consists of projects that are funded through CMPs. CMPs are fines assessed to Nursing Facilities that are out of compliance with federal Medicaid regulations governing facility operations. These monies must be utilized to fund projects that protect or improve the health, welfare, or safety of the residents of MN Nursing Facilities.
Consumer-Directed Community Supports (CDCS) is a service option available through the home and community-based services (HCBS) waivers. This option gives people greater control, flexibility, and responsibility to manage and direct their services and supports. An increasing number of people choose CDCS so they can do things such as: Customize their services, hire and fire staff, and purchase goods and services.
The 21st Century Cures Act requires providers of personal care, including personal care assistance (PCA) and some waiver services and home health care providers to use electronic visit verification (EVV) to document that people are receiving the services that are billed to the state. Minnesota has fully implemented EVV and the EVV system has been fully certified by the Centers of Medicare & Medicaid Services (CMS).
Positive supports, crisis respite and specialist services are often collectively referred to as “intervention services.” It is difficult for many people to access these services because of a lack of providers or because they are ineligible for waiver services. Sometimes service quality needs improvement. There are many reasons for these issues. DHS is exploring options for service improvements with the goal of preventing unnecessary hospitalizations, incarcerations, service terminations and other negative outcomes people have experienced when they do not have access to the services they need.
MnCHOICES is a computer application used by counties, tribal nations and managed care organizations (MCOs) to support their assessment and support planning work for Minnesotans who need long-term services and supports (LTSS), regardless of age, type of disability or service needs. Agency staff, including certified assessors, care coordinators and case managers, who work with people of any age with a disability or anyone in need of long-term services and supports use MnCHOICES to discuss their preferences and the supports they need to live a good life.
This report provides outcomes of the Home and Community-Based Services (HCBS) Workforce Development Grant program, which was created to attract and retain direct care professionals who provide home and community-based services for people with disabilities and older adults. Progress updates for each initiative are included, along with recommendations for doing similar work in the future, if opportunities arise.
Effective Jan. 1, 2025, the 2023-2025 collective bargaining agreement between Service Employees International Union Healthcare Minnesota and Iowa (SEIU) and the state of Minnesota established minimum wages, also known as wage floors, based on direct support workers' experience delivering personal care assistance (PCA) and Community First Services and Supports (CFSS) services.
Minnesota nursing facilities have been able to contract with DHS to earn performance-incentive Medical Assistance (MA) payments (PIPP) of up to 5 percent of the operating payment rate. The incentive payments are time-limited rate adjustments. DHS has implemented the 16th round of performance-based incentive payments.
Semi-independent living services include training and assistance in managing money, preparing meals, shopping, hygiene, and other activities needed to maintain and improve the capacity of an adult with a developmental disability to live in the community. A goal of SILS is to support people in ways that help them achieve their goals and direct their own lives.
Waiver Reimagine is the name of ongoing work DHS is doing to make system-level improvements to Minnesota’s four disability waiver programs. For people who receive services and families, the Waiver Reimagine project will:
Make it easier for people and families to describe the services they want
Provide information about services and budgets to give people more choice and control over planning services and supports
Provide equitable access to services and funding across waiver programs regardless of disability and in which county or tribal nation a person lives
Increase options to self-direct services, use technology and remote supports as alternative support options
People with disabilities, older Minnesotans, and people with mental health care needs struggle to receive the care they need due to a nation-wide shortage of direct care professionals. Visit the Direct care workforce shortage in Minnesota webpage for resources, data, and other information about the shortage and ways to address it.
Minnesota’s Multisector Blueprint for Aging is a new plan for the future to make sure all our state’s residents are included, valued, and given equitable opportunities to thrive, developed from collaboration and conversations with thousands of Minnesotans. As our state's population grows older, the Blueprint guides us as we reimagine our communities as more age-inclusive places on every front - from housing and transportation to social connection and financial security.
The Minnesota Legislature passed the assisted living licensure law in Minnesota Statutes, chapter 144G. The law established regulatory standards for the provision of housing and services in assisted living facilities and assisted living facilities with dementia care to help ensure the health, safety, well-being and appropriate treatment of residents. The law also authorized the Minnesota health commissioner to adopt rules for all assisted living facilities that promote person-centered planning and service delivery and optimal quality of life, and to ensure resident rights are protected, resident choice is allowed and public health and safety are ensured.
The Minnesota Department of Human Services (DHS) is using the Culture of Safety systemic critical incident review model to review critical incidents, such as medication errors and wheelchair safety incidents. DHS is using the Culture of Safety model to:
To improve the quality of life and community participation/contribution of people with disabilities
To develop a robust and proactive response to critical incidents dedicated to accountability, learning and improvement of Minnesota’s systems, rather than assessing blame
To move beyond surface level understandings of how systems fail to an understanding of how various parts of a system worked together to influence undesirable outcomes
To develop recommendations for systemic changes to Minnesota’s home and community-based services system
Minnesota is an Employment First state, committed to the belief that all people with disabilities have the right to pursue fulfilling, competitive, and integrated employment. The Minnesota Employment First Policy was first adopted in 2014 by the Minnesota Olmstead Office to guide state agencies in making employment the first and expected option for working-age individuals with disabilities. This approach prioritizes competitive, integrated employment—such as full-time, part-time, or self-employment in typical workplace settings—at at least minimum wage, alongside employees without disabilities. In 2020, this commitment was further solidified when the Minnesota Legislature enacted the Employment First Policy into law, affirming that Minnesotans with disabilities can work, want to work, and must be offered the opportunity to earn competitive wages before being offered other services or supports. The Minnesota Department of Human Services (DHS) continues to champion this approach in its planning, service delivery, and system change efforts.
Minnesota Department of Human Services offers options that give people more control over the services and supports they receive. These options include higher rates or budgets for eligible support workers. These include:
The Minnesota Legislature authorized rate and budget increases for some home and community-based services. The service rate and monthly budget increases went into effect on January 1, 2025.
Own Your Future aims to make Minnesotans aware of the importance of planning now to identify personal and financial options to meet their future long-term needs. The stakeholder group for this initiative help develop policy reforms for financing long-term care.
As mandated under the Older Americans Act, every four years, the Minnesota Board on Aging submits a State Plan on Aging to the Administration on Community Living (ACL). This plan covers the period of October 1, 2023 to September 30, 2027.
The purpose of the State Plan on Aging is to document achievements and planned activities related to the state's long-term supports and services planning efforts, provide a state framework for activities related to programs/activities/services to Older Adults, and provide assurances to ACL that the provisions of the Older Americans Act will be followed.
