The nation’s #2 HCBS-rebalanced state at 84.0% — with full overtime protections, SEIU-negotiated wage floors, permanent family caregiver payment rules, and paid sick leave and paid FMLA — demonstrating what comprehensive state policy looks like.
| # | Metric | Minnesota | Status |
|---|---|---|---|
| 1.1 | BLS median hourly wage (SOC 31-1120) | $16.64/hr (mean) | Public |
| 1.2 | PHI median hourly wage (all DCW, ACS) | $15.83/hr | Public |
| 1.3 | Median annual earnings (DCW) | $25,015 | Public |
| 1.4 | MIT living wage (1 adult, 0 children) | $22.05/hr | Public |
| 1.5 | Wage gap (living wage minus BLS median) | −$5.41/hr (~$11,253/yr) | Derived |
| 1.6 | State minimum wage (2026) | $11.41 (all employers) | Public |
| 1.7 | Local minimum wage (highest city) | $16.37/hr (Minneapolis) | Public |
| 1.8 | Low-income household rate (<200% FPL) | 32% | Public |
| 1.9 | Public assistance reliance (state-specific) | Not published (32% proxy) | Proxy |
| 1.10 | Housing cost-burdened rate | 29% | Public |
| 1.11 | Uninsured rate (DCW) | 9% | Public |
| 1.12 | PHI Overall State Index ranking | 19/51 (Tier 2) | Public |
| 1.13 | Wage competitiveness vs. similar jobs | −$3.71/hr | Public |
| 1.14 | Genworth median home health aide rate | Not separately published | Gap |
| 1.15 | Genworth median NF semi-private rate | Not separately published | Gap |
| 1.16 | Family Care capitation PMPM (NH LOC) | N/A (different program) | Public |
| 1.17 | Blended HCBS avg cost (all acuity) | Not published | Gap |
| 1.18 | NF private pay monthly avg | Not separately published | Gap |
| 1.19 | HCBS-to-NF cost ratio (state-specific) | Not calculated | Derived |
| 1.20 | Exemption aggregate savings (national est.) | Same national figure | Estimated |
| 1.21 | Per-worker OT loss (50hr/wk worker) | $4,373/yr (at national median) | Derived |
| # | Metric | Minnesota | Status |
|---|---|---|---|
| 2.1 | Headline caregiver vacancy rate | 13.7–16.2% (NA, nursing asst.) | Public |
| 2.2 | Open caregiver positions | Not separately published | Gap |
| 2.3 | Available job seekers (entire labor market) | Not separately published | Gap |
| 2.4 | Annual turnover rate | >40% (PCA/HHA) | Public |
| 2.5 | Individuals denied/delayed services | Not separately published | Gap |
| 2.6 | Agencies unable to staff all hours | Not separately published | Gap |
| 2.7 | Nursing homes closed since 2016 | Not separately published | Gap |
| 2.8 | NF beds empty due to staffing | Not separately published | Gap |
| 2.9 | Total direct care workers | 138,920 | Public |
| 2.10 | New jobs projected (2022–2032) | 16,510 | Public |
| 2.11 | Total openings incl. separations (2022–2032) | 234,300 | Public |
| 2.12 | Population 75+ growth projection | +20%+ residents 65+ by 2030 | Public |
| 2.13 | Workforce demographics: % women | 81% | Public |
| 2.14 | Workforce demographics: % people of color | 38% | Public |
| 2.15 | Workforce demographics: % immigrants | 26% | Public |
| 2.16 | Health insurance offered by agencies | Not published | Gap |
| 2.17 | Family caregivers providing 80%+ of all care | Yes (comparable) | Public |
| 2.18 | Unpaid caregiver hours/economic value | Not separately published | Gap |
| # | Metric | Minnesota | Status |
|---|---|---|---|
| 3.1 | State companionship/OT exemption status | NONE: Full OT coverage (48-hr threshold) | Public |
| 3.2 | State overtime threshold | 48 hours (all home care workers) | Public |
| 3.3 | Domestic Workers Bill of Rights | Not enacted (adjacent protections exist) | Public |
| 3.4 | Paid sick leave law | Yes (eff. 1/1/2024) | Public |
| 3.5 | Paid family/medical leave | Yes (eff. 1/1/2026) | Public |
| 3.6 | Primary self-directed Medicaid program | CDCS (within DD, BI, CAC, CADI, EW waivers) | Public |
| 3.7 | Self-directed program enrollment | CDCS: Not publicly reported | Gap |
| 3.8 | Primary managed LTC program | Minnesota Senior Health Options (MSHO) | Public |
| 3.9 | Managed LTC enrollment | Not separately published | Gap |
| 3.10 | Combined HCBS enrollment | Not compiled in single figure | Partial |
| 3.11 | HCBS share of LTSS spending | 84.0% (#2 nationally) | Public |
| 3.12 | HCBS waiting lists status | Not separately published | Gap |
| 3.13 | Spouses as paid Medicaid caregivers | Yes — permanent policy (CDCS, PCA/CFSS) | Public |
| 3.14 | Parents of minors as paid caregivers | Yes — permanent (CDCS, PCA/CFSS) | Public |
| 3.15 | COVID family caregiver relaxations permanent? | Yes — enacted permanently Oct 2024 | Public |
| 3.16 | SDPC maximum wage (self-directed) | $20/hr referenced (Ramsey Co.) | Public |
| 3.17 | OT rate cap in self-directed programs | N/A (state OT law applies) | Public |
| 3.18 | IRIS/SDPC weekly hour cap | N/A (48hr OT threshold applies) | Public |
| 3.19 | Minimum fee schedule for HCBS | SEIU contract: tiered rates | Public |
| 3.20 | Wage pass-through requirement | Yes — 72% of ARPA increases to workers | Public |
| 3.21 | MCO contract wage floor provisions | Not separately published | Gap |
| 3.22 | Union representation (home care workers) | SEIU Healthcare MN (~35,000 workers) | Public |
Minnesota demonstrates what comprehensive state policy looks like: full overtime coverage (48-hour threshold), permanent family caregiver payment rules (spouses and parents), SEIU-negotiated wage floors, 72% wage pass-through of ARPA increases, and new paid sick leave and paid FMLA laws. The state is also transitioning to Community First Services and Supports (CFSS) — a modernized self-directed program launched Oct 2024.
| # | Metric | Minnesota | Status |
|---|---|---|---|
| 4.1 | Travel time/mileage reimbursement mandate | SEIU contract covers driving time; CDCS = $0.63/mi | Public |
| 4.2 | Caregiver-to-senior ratio by county | NOT COMPILED | FOIA |
| 4.3 | Counties with zero/limited home care agencies | NOT COMPILED | FOIA |
| 4.4 | Rural broadband coverage (for EVV compliance) | 75% Greater MN; ~240K households without | Partial |
| 4.5 | EVV system & vendor | HHAeXchange (free; hybrid) | Public |
| 4.6 | EVV offline/low-connectivity accommodation | IVR telephone; no smart devices provided | Public |
| 4.7 | EVV hard launch date (personal care) | Sept 1, 2024 (enforcement) | Public |
| 4.8 | Rural vs. urban NF admission rates | NOT COMPILED at county level | FOIA |
| 4.9 | Rural nursing home closures since 2016 | Not separately published | Gap |
| 4.10 | Rural HCBS alternatives (adult day, ALF) | Not separately published | Gap |
| 4.11 | Projected NF bed shortage (statewide) | Not separately published | Gap |
| # | Metric | Minnesota | Status |
|---|---|---|---|
| 5.1 | Medicaid rate-setting authority model | County-administered; managed care optional | Public |
| 5.2 | Minimum fee schedule exists? | SEIU-negotiated rate floors | Public |
| 5.3 | Fee schedule codified in statute or budget? | Legislative + contract | Public |
| 5.4 | Wage pass-through % requirement | 72% (ARPA increases) | Public |
| 5.5 | State-level 80/20 compensation rule? | No | Public |
| 5.6 | MCO contract cycle & next renewal | Verify with DHS | FOIA |
| 5.7 | MCO workforce adequacy reporting required? | Not separately published | FOIA |
| 5.8 | IRIS IBA formula inputs reflect market wages? | N/A (different program) | Public |
| 5.9 | Premium pay structure for extended hours? | N/A (48hr OT threshold applies) | Public |
| 5.10 | State domestic service OT exemption status | No exemption | Public |
| 5.11 | Legislative path to eliminate state OT exemption? | Already eliminated | Public |
| 5.12 | Federal Medicaid loss projection (10yr) | Not separately published | Gap |
| 5.13 | Annual new cost to state taxpayers | Not separately published | Gap |
| 5.14 | State-directed payment limit impact (eff. 2028) | Not separately published | Pending |
| 5.15 | Provider tax moratorium status | Not separately published | Gap |
| 5.16 | NF staffing rule moratorium (10yr) | Applies | Public |
| 5.17 | Work requirements effective date | Dec 31, 2026 (childless adults) | Public |
| # | Metric | Minnesota | Status |
|---|---|---|---|
| 6.1 | 2013 DOL rule status (as of March 2026) | Technically in effect; enforcement suspended July 25, 2025 (FAB 2025-4) | Public |
| 6.2 | Proposed rescission rule published? | Yes — July 2, 2025 (90 FR 28976) | Public |
| 6.3 | Final rescission rule published? | No (as of March 2026) | Monitor |
| 6.4 | Chevron deference status | Eliminated — Loper Bright v. Raimondo (2024) | Public |
| 6.5 | Private litigation still viable? | Yes — 2013 rule provisions still invocable by private parties | Public |
| 6.6 | DOL estimated annual transfer (2013 RIA) | $321.8M (medium scenario, 7% discount) | Public |
| 6.7 | Adjusted current estimate | $500–700M annually | Estimated |
| 6.8 | GAO post-implementation finding | Hour caps, not cost absorption; pay did not increase; workforce declined 11.6% | Public |
| 6.9 | Familial caregiver % in self-directed programs | 50–78% nationally; CA IHSS >70% | Public |
| 6.10 | Disparate impact demographics | 85% female; 67% POC; 27% Black; 26% Hispanic | Public |
| 6.11 | CMS 80/20 Access Rule status | Finalized May 2024; faces likely rescission/non-enforcement | Public |