For Minnesota families caring for a parent or spouse 65 or older who needs nursing-home-level care, the Elderly Waiver and Alternative Care programs can pay family members to provide it at home.,, Their consumer directed community supports (CDCS) option gives your parent a budget to hire people they choose, including family., Minnesota Elderly Waiver CDCS family caregiver pay starts with a MnCHOICES assessment through your county or tribal nation.

Who Can Be Paid Through the Elderly Waiver and Alternative Care?

The Elderly Waiver (EW) requires Medical Assistance, Minnesota's Medicaid program. Minnesota's Alternative Care (AC) covers many of the same services for people 65 and older not yet financially eligible for Medical Assistance.

Your relationship Can you be paid? The condition
Adult child or other relative, EW Yes Meets the relative criteria
Adult child or other relative, AC Yes, with conditions CDCS; personal care needs lead agency approval
Spouse, EW Only if CDCS personal assistance (60 hours in 7 days) or adult foster care
Spouse, AC Ask the lead agency Not stated in our sources (see FAQ)
Family (non-professional) guardian or conservator Only if Meets the criteria; via a provider agency, or CDCS personal assistance only
Professional guardian or conservator No Not for any waiver service

How Minnesota Elderly Waiver CDCS Pays a Family Caregiver

CDCS can turn the care you already give into a paid job: the Minnesota Department of Human Services (DHS) says it lets your parent "Hire people they know, such as family, friends and neighbors." CDCS isn't a way onto a waiver; your parent must qualify for EW or AC first, then manages an individual budget, writes a community support plan, and acts as the employer, hiring and supervising workers with help from a financial management services (FMS) provider.

DHS warns the state may claim against the estate of someone who received Medical Assistance on or after age 55, or their spouse's estate. See estate recovery and HCBS waivers.

The Rules for Relatives on the Elderly Waiver

For an adult child, this list decides whether you can be paid. DHS defines a relative as a parent, child, sibling, niece or nephew, grandparent, aunt or uncle, by blood, marriage or adoption. Relatives and non-professional legal guardians and conservators of adults may be paid for any waiver service, including CDCS, if they are all of these:

  • Related to, or guardian or conservator for, only one person or one family of siblings.
  • Not otherwise responsible to provide the care or service.
  • Qualified to provide the service.
  • Employed by a qualified provider to provide it (not required under CDCS).
  • Not enrolled as a Medical Assistance provider with Minnesota Health Care Programs for that service.
  • Not a controlling entity of an enrolled Medical Assistance provider where the guardian or conservator gains financially.

Even then, EW can't pay relatives for caregiver living expenses, case management, or individualized home supports (with family training), or pay a primary caregiver (relative, legally responsible individual, or non-professional guardian or conservator) for chore, homemaker or respite meant as their own relief.

The Rules for Paying a Spouse

Under Elderly Waiver CDCS, a paid spouse may work up to 60 hours in seven days, counting CDCS and Community First Services and Supports (CFSS) hours together, only if the person is dependent in at least one activity of daily living, and not for tasks a spouse would typically do, such as house cleaning, meal preparation and laundry. Our spouse guide covers every Minnesota program.

Alternative Care: Who Qualifies and When a Relative Can Be Paid

Among DHS's AC requirements, your parent must be 65 or older, meet nursing facility level of care on a MnCHOICES assessment, and have income and assets insufficient to pay for 135 days of nursing facility care. They can't be on AC while on Medical Assistance, or with income at or below 120% of the Federal Poverty Guidelines and assets at or below Minnesota's current $3,000 Medical Assistance asset limit.

If you've cut hours or left a job for your parent's care, this rule is for you. For AC personal care, Minn. Stat. 256B.0913 lets the lead agency authorize a relative who meets the relative hardship requirements, or who meets the criteria and is the responsible party under a service plan a qualified professional supervises. Under that Minnesota statute, relative hardship for AC personal care means your parent's care makes you resign from a paying job, cut hours or take leave and lose wages, incur substantial client-related expenses, cover authorized but unstaffed direct care time, or meet special needs the service plan doesn't.

Becoming Your Parent's Adult Foster Care Provider

Under Minn. Stat. 256B.0919, a county may certify a relative to provide EW adult foster care to a related person 65 or older if the relative meets Minnesota's adult foster care rules and would suffer financial hardship: a substantial loss of income from resigning from, or taking unpaid leave from, a full-time job. Alternative Care doesn't cover adult foster care.

What Minnesota Elderly Waiver CDCS Family Caregiver Pay Looks Like

It's fair to want a number before you cut back at work, but our sources publish no hourly CDCS wage: each worker's pay comes out of your parent's individual budget, so ask the lead agency what that budget is.

IRS Notice 2014-7 lets a caregiver exclude qualified Medicaid 1915(c) waiver pay from federal gross income only when the person cared for lives in the caregiver's home. For Minnesota's Families with Children and Adults coverage, the Medical Assistance manual likewise counts waiver pay to a non-live-in caregiver in adjusted gross income, but not pay to a live-in one. Ask a tax professional, and see whether Medicaid caregiver payments are taxable.

How to Start

1
Step 1

Call your county or tribal nation

for a MnCHOICES assessment, or to ask about applying for Alternative Care.,

2
Step 2

Apply for Medical Assistance if needed

, since the Elderly Waiver requires it: see how to apply for Minnesota Medicaid.

3
Step 3

Choose CDCS

, write the community support plan, pick an FMS provider, and name the family caregiver under the rules above.,

4
Step 4

Stuck?

Call Minnesota's Aging Pathways line at 800-333-2433, weekdays 8:00 a.m. to 4:30 p.m.

Frequently Asked Questions

Can my dad be paid to care for my mom on Alternative Care?

Our sources don't say whether AC's relative hardship rule covers a spouse. But AC covers CFSS, which DHS says also allows a spouse to be paid, so ask the lead agency about that route.,

What if my parent becomes eligible for Medical Assistance while on Alternative Care?

Minnesota's Alternative Care (AC) can serve your parent for up to 60 days while their Medical Assistance application is pending. Then ask the lead agency about the Elderly Waiver.,

Can my parent give money to family before applying for Alternative Care?

AC uses Medical Assistance's transfer penalty policy, and no one can get AC or Medical Assistance during a penalty period. Ask the county before moving your parent's money.

Learn More

CaregiverHow to Get Paid as a Family Caregiver in MinnesotaHow to get paid to care for a family member in Minnesota in 2026: CFSS budget and agency models that pay a spouse or parent, plus CDCS and VA options. CaregiverHow to Get Paid to Care for Your Spouse in MinnesotaCan you get paid to care for your spouse in Minnesota? Yes, within limits, through CFSS or CDCS, plus the VA. See the hour cap, pay floor and how to apply. CaregiverCaregiver Programs in MinnesotaEvery caregiver program in Minnesota: CFSS paid pathways (spouses can be paid), Elderly Waiver, respite, NFCSP grants, VA benefits, and taxes for 2026.

Find personalized help getting paid to care for a parent in Minnesota at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.