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. Officially this option is referred to as Consumer Directed Community Supports. It means that the care recipient can choose from whom they receive care. Family members, including the adult children, can be hired and paid to care for their aging parents, if they wish to do so. 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.
Program social workers assess the participants’ homes for potential environmental accessibility adaptations. The Alternative Care Program pays for home modifications that increase accessibility or safety. Examples include the addition of a wheelchair ramp, the replacement of a shower with a handicap-accessible walk-in tub, and the addition of a stair lift.
The Alternative Care Program has eligibility requirements related to both the functional ability of the senior and their financial situation. Functionally, residents must be 65 or older, and assessed and found to have the need for nursing home care. In addition, applicants must be Minnesota residents.
An individual cannot be financially eligible for Medicaid, also called Medical Assistance in Minnesota. In order for an applicant to be considered financially eligible for the AC Program (in 2020), an individual must have income higher than $1,296 / month ($15,552 / year) or assets greater than $3,000. Individuals who have income equal to or less than $1,296 / month and assets equal to or less than $3,000 are not eligible for the AC Program. (Individuals with income and assets under these limits should be eligible for similar services through Minnesota Medicaid.) Furthermore, to be eligible for services via AC, an applicant’s combined income and assets must be less than $39,659. (This amount is the projected cost of 135 days of nursing home care, plus $3,000, which is the asset limit for Minnesota Medicaid).
The care supports and services provided under the Alternative Care program differ by county and by the needs of the individual. The average program participant receives approximately $990 / month in care services.
During enrollment, each individual is thoroughly 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 cost of up to 30% of the full cost of services. 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 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.
The Minnesota AC Program is managed by the county social services offices. For additional, but limited, program information, click here. One can contact a Long-Term Care Consultation Intake worker or call the statewide toll-free phone number to begin the application process at 1-800-333-2433.