Home Care Nursing Hardship Waiver

The Home Care Nursing (HCN) Hardship Waiver allows parents/family foster parents of minor children, legal guardians or spouses to provide HCN services to a person who is eligible for Medical Assistance and authorized to receive HCN services.

The HCN hardship waiver applies to people who are the person’s:

  • Parent (biological and adoptive) of a minor child.
  • Legal guardian, as determined by a court of law.
  • Conservator, as determined by a court of law.
  • Spouse.

Note: Other family members may serve as a person's HCN workers without completing a hardship waiver.

Who is eligible for a hardship waiver?

To be eligible to apply for the hardship waiver, the parent/family foster parent of minor children, legal guardian or spouse must:

  • Be a registered nurse (RN) or licensed practical nurse (LPN) currently licensed in Minnesota.
  • Be employed by an HCN agency or Medicare-certified home health agency.
  • Expect to continue as the primary and/or emergency-backup caregiver without any reimbursement for those services.
  • Pass a criminal background check.
  • Be in at least one of the following situations:
    • Changed from full-time to part-time employment (that results in less compensation) to provide HCN services to the person.
    • Resigned from a full-time or part-time job to provide HCN services to the person.
    • Took a leave of absence without pay from a full-time or part-time job to provide HCN services to the person.
    • Needed to provide an adequate number of qualified nurses to meet the person’s needs because of labor conditions, specific language needs or intermittent hours of care.

Note: The HCN hardship waiver is not available for people who use consumer directed community supports (CDCS).

How do people using HCN apply for a hardship waiver?

If a person wishes to apply for an HCN hardship waiver:

  • People not using HCN through a managed care organization (MCO): The person’s HCN agency or home health agency must complete and submit the HCN Hardship Waiver Application DHS-4109 (PDF) to DHS for review and approval.
  • People using HCN through an MCO: The person’s HCN agency or home health agency must submit a request to the MCO for approval.

People may submit a question on the DSD contact form if they are unable to find information about Disability Services Division programs and services.