Completed strategies

The direct care workforce shortage has been a problem for many years, so you might wonder what has been tried to resolve this issue. DHS, other state agencies, the Minnesota Legislature and governor and community partners have designed and implemented many initiatives to address the direct care workforce shortage. The following are some examples of initiatives that have been completed or have resources for ongoing implementation:

  • The Minnesota Department of Employment and Economic Development (DEED) and local partners manage regional CareerForce centers to help employers and job seekers make connections. They also host Workforce Wednesday discussions for employers and provide a variety of other supports to employers and job seekers. 
  • DEED worked with partners to develop materials that explain for job seekers the many different types of direct care jobs and how to apply for them.
  • Family Residential Services provides work-from-home opportunities for caregivers.
  • High school students can now receive elective credits for working in direct care. Visit Minn. Stat. 124D.475 for details.
  • The Dual Training Pipeline Grant program provides structured on-the-job training and funding for course instruction for a few different types of direct care jobs that require certification, some college coursework or similar training.
  • Many service rates were increased on several occasions (e.g. 2024, 2025 and 2026) and give employers more funding so they have the opportunity to raise care professional wages or offer additional benefits.
  • Minn. Stat. 256B.85 requires agency-providers to use a minimum of 72.5 percent of revenues generated by the Medical Assistance payment for Community First Services and Supports (CFSS) to support care professional wages and benefits.
  • To encourage longer retention of direct care professionals, DHS and partners supported the development of employee-owned cooperative service provider businesses owned by care professionals: see HCBS Workforce Development Grant.
  • DHS and partners developed a self-checklist tool for employers to assess their workplace and to provide ideas for recruitment and retention: Recruitment and retention in supports for Minnesotans with disabilities: An assessment guide and toolkit, DHS-7306 (PDF).
  • Mobile Crisis Mental Health Services provide support to care professionals and people receiving services during crises and offer training for professionals to prevent crises. DHS also offers free technical assistance from the External Program Review Committee when care professionals need assistance in reducing challenging behavior. Additionally, there are disability waiver services, as well as other services and programs, that can provide support and training for care professionals when they are supporting someone who engages in challenging behaviors.
  • The Minnesota Legislature and governor passed legislation requiring all employers to offer earned sick and safe time for employees. While this was not specific to the care professional industry, it helps ensure that those professionals have the same benefits as other professions.
  • Minnesota encourages the use of support technology through many initiatives, which can help reduce reliance on care professionals or help care professionals complete job tasks more efficiently or safely. Some resources for this include:
  • Community First Services and Supports (CFSS) now allows people who use that service to have their spouse or parent of a minor to fulfill paid caregiver hours when they meet certain requirements (parents of adults could already serve as caregivers).
  • The Minnesota Aging Pathways supports family caregivers at little or no cost.
  • DHS and partners have distributed one-time grant funds, such as bonuses, to direct care professionals through several initiatives.
  • DHS and partners have distributed several grants to employers to help them build workforce capacity.
  • The Disability Waiver Rate System exception process allows provider agencies to request higher rates to support people with exceptional needs, which can be used to pay higher direct care professional wages. Visit Minn. Stat. 256B.4914, subd. 14 and 14a, and Minn. Stat. 256S.191 for details.
  • The Minnesota Nursing Facility Employee Scholarship Program provides funding for Minnesota Medicaid-certified nursing facilities to offer scholarships for nursing facility staff that want to pursue educational opportunities in the field of long-term care.
  • Some care professionals can receive a higher wage through the personal care assistance (PCA) enhanced rate opportunity. DHS expanded this program in 2022 to include care professionals supporting people who need 10 or more hours of PCA services a day.
  • The service rates for most programs receive annual inflationary adjustments so employers can raise wages each year.
  • Gov. Walz activated the National Guard during the Covid-19 pandemic to provide support in long-term care facilities that experienced staffing shortages. An emergency staffing pool for other employers also helped provide essential services during that time.
  • The Nonemergency Medical Transportation (NEMT) Transit Pass reduces demand for care professional services by providing people using services a monthly public transit pass when they are well-served by public transit.
  • The College of Direct Support offers free or low-cost training for care professionals.
  • DHS sought and received federal approval to lift the 40 hours per week care professional limit for Consumer Directed Community Supports (CDCS), Consumer Support Grant (CSG) and Home Care Nursing (HCN) services so care professionals that need to work overtime are now able to.
  • Within Minn. Stat. 256B.4914, the competitive workforce factor is now included in wage assumptions, which is a percentage component added to the care professional’s base wage assumption. This provides more funding to employers so they may offer higher wages. 
  • The Culture of Safety critical incident review process supports teams in conducting incident reviews and works to shift Minnesota away from a culture of blaming care professionals for incidents to a culture of supporting professionals and understanding the many factors that often contribute to the occurrence of incidents. 
  • Consumer Directed Community Supports (CDCS) became available on all waivers in 2004. CDCS gives people flexibility in service planning and allows them to direct their own services, including hiring and managing direct care professionals. For people who receive services through a home and community-based services (HCBS) waiver, with the exception of the Elderly Waiver (EW) or Alternative Care (AC) program, if their needs exceed their budget, they might be eligible for the CDCS budget exception, which could increase their CDCS budget by up to 30%. This allows more funds to be available for support needs, including staffing needs.
  • Certified nursing assistants (CNAs) from other states can complete an interstate endorsement form to work as a CNA in Minnesota, rather than having to retake classes.
  • Many Community First Services and Supports (CFSS) care professionals can now receive an enhanced rate of pay based on their years of experience: PCA and CFSS tiered rates and wage floors.
  • For people with developmental disabilities or related conditions, there are several services designed to help people increase their independence by learning new skills. Some examples are the individualized home supports with training service and employment support services. Additionally, Minnesota statutes require service providers to give people opportunities:
    • For the development and exercise of functional and age-appropriate skills.
    • For self-sufficiency as well as developing and maintaining social relationships and natural supports.
    • To develop and maintain essential and life-enriching skills and abilities. 
  • Care professionals providing CFSS budget model, CDCS or CSG services must receive 1.5 times their normal rate of pay for all hours worked on nine holidays, such as Memorial Day and New Year’s Day.
  • Care professionals providing CFSS budget model, CDCS or CSG services must be paid any unused paid time off earned, up to 120 hours, when the professional stops providing services.
  • The Nursing Home Workforce Standards Board has authority to establish minimum employment standards through Minn. Stat. 181.213. So far, the board has established holiday pay of time and a half for state holidays and a general minimum wage of $19/hour for nursing home care professionals, $22.50/hour for CNAs, $23.50/hour for TMAs and $27/hour for LPNs. The holiday pay standard is in effect now and the minimum wages will be effective 30 days after the federal government approves the State Plan Amendment (SPA) for nursing home rates.   
  • A Minnesota Caregiver Retirement Fund Trust was established under Minn. Stat. 179A.54, subd. 12 for the purpose of creating, implementing and administering a retirement program for individual providers of direct support services working under a collective bargaining agreement. 
  • More people are now able to offer out-of-home respite services for children under Minn. Stat. 245D.13 because of new exemptions and alternative ways of qualifying as a care provider.
  • Minn. Stat. 177.253 and Minn. Stat. 177.254 were updated to ensure Minnesota workers are allowed restroom and meal breaks. While this change was not specific to care professionals, it does help to ensure those workers have the same rights as other professions.
  • MnCHOICES initial assessments are now valid for 365 days, an increase from 60 days, giving people more time to complete tasks necessary for finding a care professional and reducing the amount of paperwork for all involved parties.
  • Paid leave allows Minnesota workers to care for themselves or family members as needed. Service providers were given $20 million in fiscal year 2026 to reimburse them for costs incurred to implement the program. While the paid leave program is not specific to care professionals, it does help to ensure those workers have the same rights as other professions. It also helps families reduce the need to hire other paid caregivers.
  • DHS published plain language background information on service rates and employee compensation regulations to help inform conversations about care professional compensation.