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In-Home Waiver Help: Elderly Waiver and Alternative Care

Minnesota does not run a separate in-home-only waiver -- the Elderly Waiver covers in-home services too, with Alternative Care as a pre-Medicaid bridge program.

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Short answer

Minnesota does not split "assisted living" and "in-home" into separate waiver programs the way some states do. The same Elderly Waiver (EW) that pays for services inside assisted living also covers in-home personal care, homemaker services, home health aide visits, and related supports for Medical-Assistance-eligible seniors assessed as needing a nursing-facility level of care.

Alternative Care: the pre-Medicaid bridge

For seniors who need EW-equivalent help but are not yet Medical-Assistance-eligible, Minnesota funds a second, state-only program: Alternative Care (AC). It offers a nearly identical service array and cost cap to EW, specifically designed to delay or prevent a Medicaid spend-down or a premature nursing home placement.

Who administers it

Both programs are set at the state level by DHS and administered locally through county and Tribal human services agencies, coordinated regionally through Trellis, the Twin Cities' Area Agency on Aging, and the Senior LinkAge Line (1-800-333-2433).

Free help in your area. Trellis, the Twin Cities Area Agency on Aging, and the Senior LinkAge Line (1-800-333-2433) cover the entire metro at no cost. Read the full explanation →

Questions families ask

How is the ombudsman different from filing a complaint with MDH?

The ombudsman (1-800-657-3591) is an independent, resident-directed advocate who works to resolve individual concerns and disputes on a resident's behalf, while MDH's Office of Health Facility Complaints (651-201-4200) is the state regulator that investigates a facility's compliance with licensing law and can issue correction orders or other enforcement action.

Can the ombudsman help with a discharge or eviction dispute at an assisted living facility?

Yes — resolving disputes over involuntary discharge, transfer, or eviction from an assisted living facility or nursing home is a core part of the Minnesota long-term care ombudsman's role, and residents or their representatives can contact OOLTC at 1-800-657-3591 for help navigating an eviction notice or appeal.

Who can advocate for a resident who has no family nearby in the Twin Cities?

The Minnesota Office of Ombudsman for Long-Term Care (1-800-657-3591) advocates for any resident of a licensed facility regardless of whether family is involved, and Trellis, the metro's Area Agency on Aging, can connect isolated seniors with care coordination and other supportive services through the Senior LinkAge Line (1-800-333-2433).

Does a resident need a lawyer to file an ombudsman complaint in Minnesota?

No. Contacting the Minnesota Office of Ombudsman for Long-Term Care at 1-800-657-3591 is free and does not require an attorney — the office exists specifically to provide free advocacy and complaint resolution for long-term care residents and their families.

How do I report abuse or neglect at a Twin Cities facility?

Call the Minnesota Adult Abuse Reporting Center (MAARC) at 1-844-880-1574, a statewide line staffed 24/7, to report suspected physical, sexual, or emotional abuse, financial exploitation, or neglect of a vulnerable adult anywhere in Minnesota, including all seven metro counties. MAARC routes the report to the correct county or Tribal agency for investigation. Call 911 first if someone is in immediate danger.

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