CDCS Minnesota: Consumer Directed Community Supports Explained

CDCS Minnesota: Consumer Directed Community Supports Explained

Consumer Directed Community Supports (CDCS) gives Elderly Waiver and Alternative Care participants something rare in Medicaid programs — a self-directed budget they control. Instead of receiving pre-assigned services from county-selected providers, your parent decides what to spend their authorized funds on: hire family caregivers, pay for home modifications, purchase adaptive equipment, or combine services in whatever configuration works best.

How CDCS Differs from Standard Elderly Waiver Services

Under the standard Elderly Waiver delivery model, a Care Coordinator builds a service plan and authorizes specific services from licensed providers. CDCS flips this by giving the participant their total authorized budget as a lump allocation they manage themselves.

Standard Elderly Waiver: County assigns services → licensed agencies deliver → participant has limited choice over providers and scheduling.

CDCS within Elderly Waiver: Participant receives authorized budget → hires workers directly, purchases services, funds home adaptations → manages spending through a fiscal support entity.

The total budget amount is the same either way — it's based on the MnCHOICES assessment. CDCS just gives the participant control over how those dollars are allocated.

Who Qualifies for CDCS

CDCS is available to anyone currently enrolled in:

• The Elderly Waiver (65+ with Nursing Facility Level of Care and Medical Assistance)
• The Alternative Care program
• Other HCBS waiver programs (Brain Injury, CADI, DD)

Your parent doesn't need to re-qualify — they simply choose CDCS as their service delivery option during care plan development or at any annual reassessment.

What You Can Spend CDCS Funds On

The flexibility is broad but not unlimited. Eligible expenditures include:

• Personal care workers (family members, friends, or hired aides)
• Environmental Accessibility Adaptations (ramps, grab bars, widened doorways, roll-in showers)
• Assistive technology and adaptive equipment
• Homemaker and chore services
• Respite care
• Transportation to community services
• Adult day services
• Fiscal support entity fees (required administrative cost)

Each expenditure must relate to a need identified in the MnCHOICES assessment and documented in the CDCS spending plan.

Hiring Family Members Under CDCS

CDCS allows participants to hire spouses, adult children, and other family members as paid caregivers. But it imposes stricter limits than CFSS:

Spouse hourly caps: A paid spouse is limited to 60 hours per seven-day period across all combined CDCS and CFSS programs.

Parent caps: A single parent caring for their child is capped at 60 hours/week. Two parents are each capped at 40 hours/week (80 combined).

Rate ceilings: Hourly rates for family workers cannot exceed the DHS-established Level 4 (standard) or Level 4 Complex CFSS rate limits. Rates include wages, benefits, and payroll taxes.

Scope restriction: Paid caregivers can only provide personal assistance services directly tied to assessed ADL dependencies. Standard spousal or parental obligations (typical housework, child transport) cannot be billed.

All wages are reported as W-2 taxable income through the fiscal support entity.

The Spending Plan

Every CDCS participant must develop a written spending plan that details:

• Which services and goods will be purchased
• Who will provide paid services and at what rate
• How the budget allocates across categories
• Contingency plans for worker absences

The spending plan requires approval from the participant's lead agency (county or tribal human services). It's reviewed annually at reassessment and can be amended mid-year if needs change.

CDCS vs. CFSS Budget Model

Both offer self-direction, but they serve different populations:

If your parent qualifies for the Elderly Waiver and wants maximum flexibility — especially for home modifications and equipment — CDCS is the stronger option. If the primary need is paid family caregiving with fewer administrative requirements, CFSS Budget Model is simpler.

Our Minnesota Home Care Navigation Guide includes the CDCS spending plan template, budget allocation worksheet, and a side-by-side comparison of self-directed options to help families choose the right model for their situation.

See more Minnesota guides →