The help you need, When And
where you need it.

Providing you with Reliable quality care services while you live in the comfort of your home.

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Combined Application Form (CAF)

MFIP, DWP, SNAP, MSA, GA, GRH:
The Combined Application Form (CAF) (DHS-5223) (PDF) allows people to apply for multiple assistance programs on 1 form. Visit Link.

MA Application Steps

Find DHS 3531
Visit DHS Edocs site: https://mn.gov/dhs/general-public/publications-forms-resources/edocs/
Search DHS 3531 MA LTC application.
Complete application.
Fax or drop application to appropriate County.

Waiver Eligibility Types

CADI waiver.
BI waiver.
DD waiver.
CAC waiver.
AC-EW waiver.
To determine service eligibility, please contact your county Waiver Assessment department. Waiver assessment request contacts for all MN counties link.