A CADI waiver is a Minnesota Medicaid program that helps people with disabilities live in their homes or communities instead of in nursing facilities. CADI stands for Community Access for Disability Inclusion, and it covers a range of services, from personal care assistance to home modifications, that make independent living possible for people who would otherwise qualify for nursing home care.
Who Qualifies for the CADI Waiver
To be eligible, you need to meet three core requirements. First, you must be under age 65 when you first open the waiver. Second, you must be certified as disabled, either by the Social Security Administration or by Minnesota’s State Medical Review Team. Third, and this is the key threshold, you must be assessed as needing the level of care that a nursing facility provides.
That last requirement trips people up because it sounds like you need to be extremely ill or immobile. In practice, “nursing facility level of care” means your medical condition or combination of conditions requires ongoing skilled support. This could include needing help with tube feedings, catheter care, medication management that you can’t handle on your own, regular monitoring of vital signs, or wound care. It can also apply if you need consistent help with daily activities like bathing, dressing, and eating due to a physical or cognitive disability. The determination is made through a screening process called MnCHOICES, where an assessor evaluates your functional needs and medical situation.
You also need to meet Medical Assistance (Minnesota’s Medicaid) financial requirements. If you’re currently working, you may qualify through a separate pathway called Medical Assistance for Employed Persons with Disabilities, which uses its own income rules and methodology rather than the standard long-term care limits.
What Services the Waiver Covers
The CADI waiver funds services that replace what a nursing facility would provide, but delivered in your home or a community setting. These generally include personal care assistance, case management to coordinate your services, respite care to give your regular caregivers a break, home and vehicle modifications for accessibility, specialized equipment, supported employment services, and customized living arrangements in assisted living or similar settings.
The specific services and number of hours you receive depend on your MnCHOICES assessment. Your support plan is built around what you actually need to live safely outside of an institution, so two people on the CADI waiver can have very different service packages.
The Self-Directed Option
One of the most flexible features of the CADI waiver is an option called Consumer-Directed Community Supports (CDCS). Instead of receiving services through an agency, you manage your own budget and decide how to spend it based on your assessed needs. You can hire the people you want to deliver your care, including parents, spouses, friends, and neighbors.
This option gives you significant control but also real responsibility. You develop your own community support plan, serve as the employer for your workers (with help from a financial management services provider), and handle hiring, training, supervising, and tracking your spending. The budget you receive is a capped annual amount based on your assessment, representing the maximum funds available for one full service period. For people who want more say in how their care is delivered and by whom, CDCS can be a good fit. For others who prefer a more hands-off approach, traditional agency-delivered services may work better.
No Waitlist for Services
Minnesota eliminated its CADI waiver waitlist in 2016 as part of the state’s Olmstead Plan goals, which focused on reducing barriers to community-based living for people with disabilities. Before that, people could wait months or longer after being found eligible before actually receiving services. Today, the CADI waiver has no waitlist, meaning that once you’re determined eligible, services can begin without a queue.
How to Apply
The process starts by contacting your county or tribal human services agency, which serves as the lead agency for waiver services. They will schedule a MnCHOICES assessment, an in-person evaluation where an assessor reviews your medical conditions, daily living needs, and current support systems. Based on that assessment, the agency determines whether you meet the nursing facility level of care standard and develops a support plan outlining the services you’ll receive.
You’ll also need to have your disability status verified. If you’re already receiving Social Security Disability Insurance or Supplemental Security Income, that documentation typically satisfies this requirement. If not, your case goes through the State Medical Review Team for certification.
If You’re Denied or Lose Services
If your application is denied or your service hours are reduced, you have the right to appeal. You must request an appeal hearing in writing within 30 days of receiving the written notice about the decision. If you disagree with the outcome of that hearing, you can take the case to district court or ask the state to reconsider, again in writing and within 30 days of the appeal decision. Keep every piece of written correspondence you receive during this process, because the 30-day clock starts from the date on the notice, not from when you read it.