Page Reviewed / Updated – Feb. 22, 2024

Program Description

The Alternative Care Program (AC) helps approximately 4,000 Minnesota seniors who are at risk of nursing home placement to remain living at home or in the home of a caregiver. The program provides a wide range of care services and non-care support to seniors and their caregivers. These services can include personal care, respite, transportation assistance, and home delivered meals. This is a non-Medicaid program intended to prevent or delay Medicaid-funded nursing home placements for seniors.

In the AC Program, family members can be hired as paid caregivers for their loved ones.

Under the Alternative Care Program, participants have the option of self-directing some of the care services they receive. This option is referred to as Consumer-Directed Community Supports. It means the care recipient can choose from whom they receive care.

Family members, including adult children, can be hired and paid to care for their aging parents. Minnesota is also one of the few states in which a spouse can be hired. However, spouses are limited to providing “personal assistance services.” Family members seeking to be employed must enroll as official care providers with the state, and a fiscal intermediary is used to manage payments.

Eligibility Guidelines

General Requirements

The Alternative Care Program has eligibility requirements related to both the functional ability of the senior and their financial situation. Participants must:

  • Be a resident of Minnesota.
  • Be 65 or older.
  • Assessed and found to have the need for nursing home level of care.

Financial Requirements

  • An individual cannot be financially eligible for Medicaid, also called Medical Assistance in Minnesota. (Individuals who qualify for Medicaid should be eligible for similar services through Minnesota Medicaid.)
  • An applicant’s combined income and assets must be less than the cost of 135 days of nursing home care.
  • The needed services must cost less than 75% of what Medicaid would pay for similar services.
  • Have no other way to pay for services.

Benefits and Services

The care supports and services provided under the Alternative Care Program differ by county and by the needs of the individual.

During enrollment, each individual is assessed to determine his or her specific care needs. Services may be provided free of charge, but some participants may be required to pay a co-payment. Co-payments are based on a sliding scale. Individuals may be provided with any of the following services, some of which are open to consumer direction.

  • Adult day care
  • Caregiver training
  • Case management services
  • Chore services
  • Companion services
  • Counseling
  • Durable medical equipment
  • Environmental accessibility adaptations (home and vehicle)
  • Home health aides
  • Home-delivered meals
  • Homemaker services
  • Medical equipment and supplies
  • Nutrition services
  • Personal care services
  • Personal emergency response systems
  • Respite care (in-home and out-of-home)
  • Skilled nursing
  • Transportation assistance (non-medical)

Adult foster care and assisted living care services are not included in the Alternative Care range of senior services. For individuals who are looking for help with the cost of their residential care, the Elder Waiver does include financial assistance for assisted living and foster care.

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How to Apply / Learn More

The Minnesota AC Program is managed by the county social services offices. One can contact a Long-Term Care Consultation Intake worker or call the Senior LinkAge Line at 800-333-2433.

Additional program information can be found here.