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245D Waivered Services

Accra is a Basic 245D licensed provider of Individualized Home Supports without Training, Respite, Homemaker and Night Supervision Services


245D Waivered Services

Champions Of Homecare Podcast: 245D Title Card

Accra is a 245D licensed provider of respite, homemaker, Individual Community Living Support (ICLS) services, Individual Home Supports (IHS) without training, IHS with training, and night supervision services. For each 245D service, clients select a trusted, qualified worker suited for their needs, while for IHS with training, a qualified staff is matched to the client to meet their needs. In all services, an assigned 245D Accra Service Coordinator will work with the client and county case manager to set up and administer 245D Waivered Services.

Accra also administers Caregiver Living Expenses, which provide a reimbursement of certain expenses, such as rent and food, incurred by an unrelated caregiver who is living in the same household as an individual receiving waivered services and providing approved services.

Look through our program descriptions below to discover all of the ways Accra is helping Minnesotans live full lives:

Service Overview

Individualized Home Supports Without Training

Individualized Home Supports Without Training services provide support, assistance and supervision to adults or children who live in their own homes. A staff person provides direct supervision, cueing, guidance, instruction, assistance with activities of daily living, or assistance with coordinating and attending community living activities. Individualized Home Supports Without Training services can be provided in the person’s own home or community.

Individualized Home Supports Without Training was created through the State of Minnesota Waiver Reimagine project, and it combines the previous services of Personal Support and Adult Companion.

Individualized Home Supports Without Training services are available to people on the:

Individualized Home Supports Without Training FAQ
Service Overview


Respite is a short-term care service intended to provide a break to an individual’s primary caregiver. Respite may be provided in the individual’s home or the respite provider’s home.  This service is available under various payment options including, Medical Assistance Home and Community Based Services (waiver programs), and private pay.

Respite FAQ
  • How does Respite work?  How long can my Respite breaks be?

    Respite is intended as a break for the client’s Primary Caregiver(s). Depending on the number of Respite hours available, this break could be, for example, for a few hours, or even an entire weekend, including overnights.

  • Does this mean my Respite staff could work overtime?
    While Respite staff are not allowed to work overtime on a consistent weekly basis, Accra does recognize that, based on the intention of the service (a break for the Primary Caregiver), there may be times when a respite staff member is needed to cover a longer than typical break. Your assigned Accra 245D Service Coordinator will help you understand when overtime is an option under Respite Services.
Service Overview

Homemaker Services

Homemaker Services range from light household cleaning and laundry to assistance with home management and activities of daily living. Home Management includes:

  • Meal prep
  • Shopping for food, clothes and supplies
  • Simple household repairs
  • Arranging for transportation

Homemaker Services are available under various payment options, including Medical Assistance Home and Community Based Services (waiver programs) and private pay.

Homemaker Services FAQ
  • What is the difference between Basic Homemaker Services and 245D licensed Homemaker?

    Basic Homemaker Services are not a 245D licensed service, and they allow for a staff person to assist with cleaning and laundry.  

    There are two types of 245D licensed Homemaker Services:

    • Homemaker/Home Management Services allow for a staff person to assist with cleaning; laundry; meal prep; shopping for food, clothes and supplies; simple household repair; and arranging for transportation.
    • Homemaker/Assistance with ADLs allows for a staff person to assist with cleaning, laundry, and assistance with some physical care.
  • Is there a different hiring process for Basic Homemaker and 245D licensed Homemaker Services?

    Yes. While all Accra Homemaker employees must complete an Accra employee application and pass a state required background check, only Homemakers working under the 245D license are required to complete an additional 245D Employee Training Packet.

  • How does a person qualify for Homemaker Services on a Waiver?

    There are two scenarios where a person may qualify for Waivered Homemaker Services:

    • The person is unable to manage the general cleaning and household activities of their own home.
    • The Primary Caregiver(s) who is regularly responsible for these activities is unable to manage them or is temporarily absent.  
Service Overview

Night Supervision Services

Night Supervision is a non-preventative service consisting of overnight assistance and monitoring provided by a staff in the client’s home when the client has an assessed need in one of the following covered service areas:

  • Assistance with activities of daily living (ADLs)
  • Assistance with instrumental activities of daily living (IADLs)
  • Implementation of positive support programming and transition plans
  • Reinforcement of skill development supports

Night Supervision FAQ
Service Overview

Individual Community Living Supports (ICLS)

Individual Community Living Supports (ICLS) offers assistance and support for old adults who need reminders, cues, intermittent/moderate supervision, or physical assistance to help them remain in their own homes. Individual Community Living Supports covers assistance and support for eligible people 65 years and older in the following service categories:

  • Active cognitive support
  • Adaptive support service
  • Activities of daily living (ADLs)
  • Household management
  • Health, safety and wellness
  • Community engagement

Individual Community Living Supports (ICLS) services are available to people on the:

Individual Community Living Supports (ICLS) FAQ
Service Overview

Caregiver Living Expenses

The Caregiver Living Expenses program provides a reimbursement of certain expenses – specifically rent and food – incurred by a caregiver who is living in the same household as an individual receiving waivered services and providing approved services. Caregiver Living Expenses are available to people on either the Developmental Disabilities (DD) Waiver or the Community Access for Disability Inclusion (CADI) Waiver.

Caregiver Living Expense FAQ
Service Overview

Personal Support

Personal Support consists of non-medical care, assistance and supervision provided in the individual’s home or community. This one-on-one service is intended to increase the individual’s independence and involvement with community activities.

On January 1, 2021, the State of Minnesota launched Phase One of the Waiver Reimagine Project. As a result of this change, Personal Support services were merged into a new service called Individualized Home Supports Without Training. Use the navigation bar on the left to learn more about Individualized Home Supports Without Training.

The best thing is that Accra has given me the opportunity to be the primary caregiver of my son. It brings me peace of mind knowing he is being taken care of properly between me and my son, James, as well as some added income.

Pam Julin

Pam Julin

245D Waivered Services

How to Get 245D Waivered Services


Obtain a Home and Community Based Services (HCBS) Waiver


Connect with a social worker

  • Discuss and select which HCBS Waiver best meets your needs
  • Discuss and select services from your specific HCBS Waiver service menu

Contact Accra

  • To contact Accra, call 866-935-3515 or email
  • Once Accra hears from you or your social worker, we will conduct a 245D Waivered Services intake meeting
  • Select and hire your chosen Direct Support Staff