Minnesota's CFSS program lets a spouse or the parent of a minor be the paid support worker, within hour and task limits, in either of its two models. Add the Elderly Waiver, respite grants, and VA benefits.

If you are caring for an aging parent, a spouse, or an adult child with a disability in Minnesota, the hard part is rarely whether help exists. It is knowing what is there and where to start. This guide maps every major caregiver program in the state for 2026.

You don't have to figure this out alone, and you don't have to fund all of it from your savings.

In This Guide

Minnesota Caregiver Programs at a Glance

Program What It Offers Who Qualifies Cost to You
CFSS (agency or budget model) Pay a support worker, including a spouse (up to 60 hours in seven days) or parent of a minor; budget-model pay at least $20.00 an hour People living in the community on Medical Assistance, an MA waiver, Alternative Care or some MinnesotaCare, with an eligible assessment Paid by the person's health care program; an MA spenddown or Alternative Care fee can apply
CDCS (Elderly Waiver / waivers) Self-directed individual budget for services Waiver or Alternative Care participants choosing CDCS Paid from the individual budget; an MA spenddown or Alternative Care fee can apply
NFCSP (Title III-E) Information, help getting services, counseling, training, respite, limited supplemental services Caregivers of adults 60+ or of a person with Alzheimer's or a related disorder; respite only if the person needs substantial help with daily activities or supervision for a cognitive impairment that creates a safety hazard Ask your Area Agency on Aging
VA PCAFC Monthly stipend to the Primary Family Caregiver, who can be a spouse Veteran with a 70%+ VA rating who needs 6+ months of in-person care and is in VA health care; VA decides through an application VA benefit; VA treats the stipend as non-taxable
VA Aid and Attendance Pension up to $29,093/yr to veteran; caregiver paid from it Wartime veteran or surviving spouse under net-worth limit No fee for claim help from a County Veterans Service Officer

How to Get Started With Minnesota Caregiver Programs

If your family is not yet enrolled in Minnesota's Medical Assistance, that is the first door for the Elderly Waiver and one route into the paid-caregiver programs below. Here is the order to work through.

1
Step 1

Apply for Medical Assistance

The Elderly Waiver requires Medical Assistance, Minnesota's Medicaid program. CFSS is open to people on Medical Assistance, an MA waiver, Alternative Care or some MinnesotaCare, and CDCS runs under the waivers and Alternative Care., Apply using the MNsure online application, or with a paper application at your county or tribal servicing agency: the MNsure paper form (DHS-6696), or the MHCP Application for Certain Populations (DHS-3876) for households in which everyone fits one of its listed groups, such as being 65 or older, blind or disabled, or 21 or older with Medicare and no children under 19 at home.

2
Step 2

Request a MnCHOICES assessment

Ask your county or tribal nation to schedule a MnCHOICES assessment, which determines whether the person meets the nursing home level of care the Elderly Waiver and Alternative Care require. CFSS also requires an assessment that finds the person eligible, so ask the county which one applies.,

3
Step 3

Choose your program and pay model

Once you are assessed, decide between the CFSS agency-provider and budget models, or Consumer-Directed Community Supports under the Elderly Waiver, and name the family member you want paid. Your lead agency or care coordinator sets this up.

4
Step 4

Veterans: start with VA caregiver support

If your loved one is a veteran enrolled in VA health care, call the VA Caregiver Support Line at 1-855-260-3274 first, weekdays from 8 a.m. to 8 p.m. Eastern. The VA caregiver programs are separate from Medicaid.

Programs That Pay Family Caregivers

Community First Services and Supports (CFSS)

CFSS is a Minnesota health care program that replaces personal care assistance (PCA) and the Consumer Support Grant. DHS began implementing it on October 1, 2024, and people move over from PCA at their yearly reassessment. To use CFSS, the person must live in the community rather than a facility, be able to direct their care (or have a representative who can), be enrolled in Medical Assistance, an MA waiver, Alternative Care or, for some people, MinnesotaCare, have an assessment that finds them eligible, and not be using the Family Support Grant. The person receiving services has a say in choosing their support worker, and CFSS makes a notable allowance: a spouse or the parent of a minor may serve as the paid support worker, in either model. In the budget model, a family employing a spouse or parent takes on the same employer duties as any other CFSS employer, including training, setting pay and following the union contract., Minnesota sets the worker rules out plainly. A spouse or parent of a minor can be paid only for tasks beyond what is considered ordinary responsibility, a spouse for up to 60 hours in a seven-day period, and in the budget model their total compensation, including wages, benefits and payroll-related taxes, cannot exceed the CFSS unit rate. No worker can be paid to provide CFSS to a person if they are that person's CFSS representative or paid legal guardian, and no worker may be paid for more than 310 CFSS hours a month. From Jan. 1, 2026, CFSS budget-model and PCA Choice workers must be paid at least $20.00 an hour, rising in steps to $22.90 for a worker with more than 10,000 hours of PCA or CFSS experience; employers may pay more. Confirm documentation requirements with your lead agency or financial management services provider. For the full rules, see our guide to CFSS family caregiver pay in Minnesota.

CFSS offers two models:

  • Agency-provider model: the person selects an agency that serves as the workers' employer, handling hiring, training, supervision, and payroll.
  • Budget model: the person is the employer of their own workers and has a budget, rather than service units, to recruit, hire, train, and supervise them. The person selects a financial management services (FMS) provider to help with payroll.

CFSS also provides a worker training and development budget.

Consumer-Directed Community Supports (CDCS)

CDCS is a self-direction option available under each of Minnesota's HCBS waivers (including the Elderly Waiver) and under the Alternative Care program. It lets the participant use an individual budget to purchase the services and supports that meet their assessed needs, including paying a family caregiver., On the Elderly Waiver, DHS defines a relative as a parent, child, sibling, niece or nephew, grandparent, aunt or uncle by blood, marriage or adoption, and a relative may be paid under CDCS if they meet all of DHS's criteria, among them that they are not otherwise responsible to provide the care, are qualified to provide the service, and are not enrolled as a Medical Assistance provider for that service. A spouse can be paid only for CDCS personal assistance, for up to 60 hours in a seven-day period counting CFSS and CDCS hours together.

To use CDCS under the Elderly Waiver, the person must first qualify for Medical Assistance. For seniors, the Medical Assistance asset limit is $3,000 for an individual and $6,000 for a couple, plus $200 for each dependent. In most cases the home and one car don't count, though a $752,000 home equity limit applies in specific situations; someone whose income runs above the limit can still qualify through a medically needy spend-down. The Elderly Waiver then has three more tests: the person must be 65 or older, meet nursing home level of care on a MnCHOICES assessment scheduled by your county or tribal nation, and need services the waiver can provide for less than the cost of nursing home care.,

Alternative Care is the pre-Medicaid version of that path. It serves people 65 and older whom a MnCHOICES assessment finds need a nursing-facility level of care, who have income and assets insufficient to pay for 135 days of nursing facility care, and who are not yet financially eligible for Medical Assistance; unlike a waiver, an AC participant may be asked to pay a fee toward their services. On Alternative Care, the lead agency may let a relative provide personal care if it finds relative hardship, for example that the person's care caused the relative to resign from a paying job, cut work hours or take a leave of absence with lost wages, or incur substantial care-related expenses.

For the full guide to paid pathways: How to Get Paid as a Family Caregiver in Minnesota.

Respite Care Programs

Elderly Waiver Respite

Respite is a covered Elderly Waiver service, listed alongside adult day services, family caregiver services and CDCS. If your loved one is on the Elderly Waiver, ask the care coordinator to include respite in the service plan.

NFCSP Grants Through Minnesota's Area Agencies on Aging

The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, makes grants to states, and the services are delivered by Area Agencies on Aging or the providers they contract with. It funds information for caregivers, help getting services, counseling, support groups and training, respite, and limited supplemental services. It serves family and other informal caregivers of people 60 and older or of a person of any age with Alzheimer's disease or a related disorder, plus some relatives 55 and older raising a child or caring for an adult with a disability. Respite is narrower than the rest: it is available only when the person you care for cannot do at least two daily activities without substantial help, or, because of a cognitive or other mental impairment, needs substantial supervision because they behave in a way that poses a serious health or safety hazard. Call Minnesota Aging Pathways at 1-800-333-2433, the statewide referral line.

For the full respite guide: Respite Care in Minnesota.

Support, Training, and Key Contacts

The Minnesota Aging Pathways line, formerly the Senior LinkAge Line, is Minnesota's aging-network information and assistance service, delivered by the state's Area Agencies on Aging and open Monday through Friday from 8:00 a.m. to 4:30 p.m. If your loved one is already enrolled in CFSS, CDCS, or a waiver, the lead agency or care coordinator is your key contact for adjusting the service plan, including adding Elderly Waiver respite or setting up a paid family support worker.,

Minnesota Aging Pathways Statewide information and assistance line delivered by Minnesota's Area Agencies on Aging; open Monday through Friday, 8:00 a.m. to 4:30 p.m. 1-800-333-2433 mn.gov/senior-linkage-line
VA Caregiver Support Line VA's national line for caregiver help, support and referrals, open weekdays from 8 a.m. to 8 p.m. Eastern. It is not a crisis line: anyone in crisis should call 988 and press 1. 1-855-260-3274 www.caregiver.va.gov
Minnesota Department of Veterans Affairs The statewide front door for veterans' benefits. Your County Veterans Service Officer helps you pursue federal VA benefits, and Minnesota law bars that officer from charging a fee. 1-888-546-5838 (LinkVet) mn.gov/mdva

VA Caregiver Benefits in Minnesota

Veterans enrolled in VA health care in Minnesota have access to caregiver support programs that are separate from Medicaid.

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran. VA treats the stipend as a non-taxable benefit. The caregiver must be at least 18 and either a family member, including a spouse, or someone who lives full time with the veteran (or is willing to). VA lists four starting requirements for the veteran: a VA disability rating (individual or combined) of 70 percent or higher, a discharge or medical discharge date, a need for at least six months of continuous in-person personal care, and enrollment in VA health care. Meeting them is a first screen, not approval: you and the veteran apply together, and VA decides eligibility through its application process. Primary Family Caregivers may also receive other VA caregiver support benefits, including CHAMPVA health coverage if they don't already qualify under another health plan and at least 30 days of respite care a year; Primary and Secondary Family Caregivers can both get mental health counseling and caregiver training.

The stipend is built from the federal GS-4, Step 1 annual rate for the veteran's locality, divided by 12, then multiplied by a factor set under 38 CFR 71.40(c)(4)(i). Which factor applies turns on whether the veteran qualifies under the current program or as a legacy participant or legacy applicant:

  • Current program: 0.625, or 1.00 when VA determines the veteran is unable to self-sustain in the community.
  • Legacy participant or legacy applicant: the factor comes from the sum of the veteran's 2019 clinical ratings instead, with no self-sustain determination required. That sum pays 1.00 at 21 or higher, 0.625 at 13 to 20, and 0.25 at 1 to 12.
  • Both routes: a veteran who qualifies under each is paid at whichever factor is higher, so a legacy Minnesota household whose 2019 ratings totaled 21 or more reaches the full 1.00 on the rating sum alone, without any self-sustain finding. A legacy participant's stipend also cannot fall below what the caregiver was eligible for the day before October 1, 2020, as long as the veteran stays at the address VA has on record. The legacy rules end October 1, 2028.

Veteran-Directed Care (VDC) is for veterans who need personal care services and help with daily activities. The veteran, or a representative, manages a budget for services and, with a counselor's help, hires their own workers, who can include a family member or neighbor. ACL lists VA Minneapolis Health Care, the St. Cloud VA Medical Center and the Fargo VA Medical Center as approved VDC sites for Minnesota, but availability is still decided locally, so confirm with your VA social worker or Caregiver Support Coordinator.

VA Aid and Attendance Pension

Wartime veterans and surviving spouses who meet VA's pension rules, have a need for aid and attendance (such as needing another person's help with bathing, feeding or dressing), and have countable assets and income under the net-worth limit ($163,699 in 2026) may receive the Aid and Attendance pension. VA sets these as maximum annual rates: a single veteran with Aid and Attendance receives up to $29,093 a year; a veteran with one dependent up to $34,488 a year. These are ceilings, not payments: VA pays the rate less the household's countable income, divided by 12 and rounded down to the dollar for the monthly check. The pension goes to the veteran, who can use it to pay a family caregiver.

The Minnesota Department of Veterans Affairs is the statewide front door, and your County Veterans Service Officer helps you pursue VA benefits; Minnesota law makes it unlawful for that officer to charge a fee.

VA Caregiver Support Line: 1-855-260-3274

Taxes for Minnesota Caregivers

IRS Notice 2014-7

If you live in the same home as the person you care for and are paid through a Medicaid program, your wages may be excluded from federal gross income under IRS Notice 2014-7. The notice is written for payments under a Medicaid home and community-based services waiver (a section 1915(c) waiver). For other Medicaid programs, the IRS says the treatment depends on the nature of the payments and the program's design, so don't assume your CFSS or CDCS wages qualify. If you have a separate home of your own, the exclusion doesn't apply. Talk to a tax preparer familiar with the rule before filing.

Minnesota State Income Tax

Minnesota levies a progressive individual income tax with four brackets. The four rates (5.35%, 6.8%, 7.85%, and 9.85%) are set in state law and hold from year to year; what moves is the dollar amount of each bracket, adjusted for inflation annually. A full-year Minnesota resident pays Minnesota tax on all of their income, so caregiver wages, including wages paid through a Medicaid program, are subject to Minnesota income tax unless a specific provision excludes them. IRS Notice 2014-7 addresses federal income tax, so ask a Minnesota tax preparer how your state return should treat the same wages.

VA PCAFC Stipend

VA considers the PCAFC monthly stipend paid to a Primary Family Caregiver a non-taxable benefit, and because it is non-taxable, it does not earn Social Security retirement credits.

Not sure which Minnesota caregiver program fits your family? Chat with Brevy's care navigator for a personalized comparison based on your loved one's Medical Assistance enrollment, veteran status, and whether a spouse or family member would be the paid caregiver.

Frequently Asked Questions

Can I get paid to care for my spouse in Minnesota?

Yes. Under CFSS, a spouse or the parent of a minor may serve as a paid support worker, in either the agency-provider model or the budget model. Being able to hire a spouse or parent doesn't by itself make the person eligible for CFSS, so the program's usual eligibility rules still apply. A spouse can be paid only for tasks beyond ordinary responsibility, for up to 60 hours in a seven-day period, and not while also serving as the person's CFSS representative or paid legal guardian. From Jan. 1, 2026, budget-model and PCA Choice workers must be paid at least $20.00 an hour, rising to $22.90 with experience. Confirm documentation requirements with your lead agency or financial management services provider.

What is the difference between the CFSS agency and budget models?

In the agency-provider model, you select an agency that employs the workers and handles hiring, training, supervision, and payroll. In the budget model, you are the employer and have a budget, rather than service units, to recruit and hire your own workers, with a financial management services provider you choose helping with payroll.

What is CDCS?

Consumer-Directed Community Supports is a self-direction option under Minnesota's HCBS waivers (including the Elderly Waiver) and Alternative Care. It gives the participant an individual budget to purchase the services that meet their needs, including paying a family caregiver.

Can I get respite in Minnesota without Medicaid?

Possibly. The National Family Caregiver Support Program funds respite through Area Agencies on Aging, and its eligibility turns on who you care for rather than on Medicaid enrollment. Respite under it is limited to caregivers of someone who cannot do at least two daily activities without substantial help, or who, because of a cognitive or other mental impairment, needs substantial supervision because they behave in a way that poses a serious health or safety hazard. Call Minnesota Aging Pathways at 1-800-333-2433 to start.

How do I reach my Area Agency on Aging in Minnesota?

Call Minnesota Aging Pathways at 1-800-333-2433, Monday through Friday from 8:00 a.m. to 4:30 p.m. Formerly the Senior LinkAge Line, it is Minnesota's aging-network information and assistance service, delivered by the state's Area Agencies on Aging.

Learn More

CaregiverCaregiver Programs: The 50-State GuideA directory of caregiver programs in all 50 states: paid family caregiver pathways, respite, NFCSP grants, and VA benefits. Find your state's complete guide. CaregiverMedicaid Self-Direction and Consumer-Directed ServicesHow Medicaid self-direction lets a family member be your paid caregiver: employer authority, budget authority, the 1915(j) spouse rule, and how to get started. CaregiverThe National Family Caregiver Support Program (NFCSP): A Complete GuideWhat the National Family Caregiver Support Program funds, who is eligible, and how to reach respite and caregiver support through your Area Agency on Aging. 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. CaregiverRespite Care in MinnesotaA 2026 guide to respite care in Minnesota: Elderly Waiver respite, NFCSP respite via Area Agencies on Aging, CFSS family pay, adult day costs, and VA respite. CaregiverCaregiver Burnout: Signs, Stages, and How to Get SupportHow to recognize caregiver burnout, why it happens, and what actually helps, from respite care to evidence-based programs like REACH II and Powerful Tools. VA BenefitsVA Aid and Attendance in MinnesotaMinnesota VA Aid and Attendance in 2026: who qualifies, the $34,488 yearly maximum for a veteran with a spouse, how to apply, and free help from MDVA and CVSOs. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house.
Your next step Find personalized help navigating Minnesota caregiver programs 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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