What is 245D? In Minnesota, "245D" is shorthand for Minnesota Statutes chapter 245D, the Home and Community-Based Services (HCBS) Standards. It is the set of rules a provider must follow to deliver Medicaid waiver services, such as respite, individualized home supports, community residential services, day support, and employment services, to people with disabilities and people age 65 and older. The Department of Human Services (DHS) issues the 245D license and inspects providers against the chapter.
When an agency says it is "245D licensed," it means DHS has licensed it under this chapter for one or more of the services listed in § 245D.03, subd. 1. That list splits into basic support services and intensive support services, and the category decides how much planning, assessment, and training the provider owes each person.
This guide reflects the statutes as of September 2026. For the application process, see the 245D license guide.
What chapter 245D covers
§ 245D.01 states that the chapter "may be cited as the 'Home and Community-Based Services Standards' or 'HCBS Standards.'" § 245D.03, subd. 1 gives DHS its authority: the commissioner "shall regulate the provision of home and community-based services to persons with disabilities and persons age 65 and older pursuant to this chapter."
The chapter is organized around the person receiving services rather than around a building. Its main sections are:
| Section | Subject |
|---|---|
| § 245D.03 | Which services need the license; basic vs intensive categories |
| § 245D.04 | Service recipient rights and the written rights notice |
| § 245D.05 | Health services and medication administration |
| § 245D.06, § 245D.061 | Protection standards, incident reporting, prohibited procedures, emergency use of manual restraint |
| § 245D.07, § 245D.071 | Service planning for basic and intensive services |
| § 245D.081 | Designated coordinator and designated manager |
| § 245D.09 | Staffing, orientation, and training |
| § 245D.095 | Service recipient and personnel records |
| § 245D.10, § 245D.11 | Grievance, suspension and termination, and required policies |
| § 245D.22 and following | Facility standards for community residential settings and day services |
A short history of 245D
Chapter 245D was created by Laws of Minnesota 2012, chapter 216, article 18, and built out by Laws of Minnesota 2013, chapter 108, article 8, the session law the revisor's history notes cite for most of the chapter. Licensing under the chapter took effect on January 1, 2014. § 144A.484 records that date: from January 1, 2014 to June 30, 2015 the commissioner of health enforced the chapter 245D standards for providers that also held a home care license.
Chapter 245D brought waiver services that had been regulated under separate rule chapters and waiver plan requirements under one license and one set of standards, and it has been amended in most sessions since.
Which services and waivers require a 245D license
§ 245D.03, subd. 1 ties each licensed service to the federally approved waiver plans it appears in. As of September 2026 the covered waivers are the brain injury (BI), community alternative care (CAC), community access for disability inclusion (CADI), developmental disabilities (DD), and elderly waiver (EW) plans, plus individual community living support under § 256S.13.
| Service group | Examples | Category |
|---|---|---|
| Respite and companion | In-home and out-of-home respite; adult companion services (EW) | Basic |
| Supervision and safety | 24-hour emergency assistance, personal emergency response, night supervision | Basic |
| Home support | Homemaker; individual community living support; individualized home supports without training | Basic |
| Intervention | Positive support services, crisis respite, specialist services | Intensive |
| In-home support with training | Individualized home supports with training or with family training | Intensive |
| Residential | Community residential services, family residential services, life sharing | Intensive |
| Day and employment | Day support, prevocational, day training and habilitation; employment exploration, development, and support | Intensive |
| Integrated community supports | ICS under BI and CADI, and under CAC and DD since January 1, 2023 | Intensive |
A provider holds one statewide 245D license that names each service it may deliver. Adding a service means adding a service line, which DHS is not doing during the current moratorium.
Basic vs intensive support services
Paragraph (b) of § 245D.03, subd. 1 defines basic support services as assistance, supervision, and care necessary for health and welfare that is not directed at training, treatment, habilitation, or rehabilitation. Paragraph (c) defines intensive support services as that same care plus services specifically directed toward training, habilitation, or rehabilitation.
Basic services follow the planning rules in § 245D.07: a preliminary support plan addendum within 15 calendar days and a revised addendum within 60 calendar days. Intensive services follow § 245D.071 as well, adding assessments, an initial planning meeting, a service plan with measurable outcomes, annual progress reviews, and the policy set in § 245D.11. The basic vs intensive guide lays the two tracks side by side.
What a 245D license holder must do
Whatever the category, a 245D license holder carries a core set of duties. The 245D documentation checklist covers the records in detail; the table below is the map.
| Duty | Rule | The deadline a licensor checks |
|---|---|---|
| Give written notice of service recipient rights | § 245D.04, subd. 1 | Within 5 working days of service initiation and annually |
| Write the support plan addendum | § 245D.07, subd. 2; § 245D.071, subd. 3 | Preliminary within 15 days; revised within 60 days (basic) or assessments and planning meeting before 45 days of service or within 60 calendar days (intensive) |
| Report incidents | § 245D.06, subd. 1 | Within 24 hours to the legal representative and case manager; deaths and serious injuries also to DHS and the Ombudsman |
| Report emergency use of manual restraint | § 245D.061, subd. 5 to 8 | Written report in 3 calendar days, internal review in 5 working days, expanded support team review in 5 working days, external report in 5 working days |
| Orient and train staff | § 245D.09, subd. 4, 4a, 5 | Maltreatment reporting within 72 hours of first direct contact; program orientation within 60 calendar days; person-specific orientation before unsupervised contact; annual training |
| Keep the service recipient and personnel records | § 245D.095 | Record of current services for each person; personnel file with training dates, hours, trainer, and background study |
| Employ a designated coordinator and designated manager | § 245D.081 | Qualified individuals who oversee service delivery and evaluate the program |
Compliance note: the statute is written in deadlines, and the licensor reads dates before narrative. A service note that is complete but sits in a record with no dated preliminary addendum is still a citation.
How 245D differs from a home care license and from 245A
Three regulatory frameworks get confused with one another.
| Framework | Who issues it | What it governs | How it relates to 245D |
|---|---|---|---|
| Chapter 245A, the Human Services Licensing Act | DHS | Applications (§ 245A.04), fees (§ 245A.10), background studies (with ch. 245C), correction orders (§ 245A.06), sanctions (§ 245A.07) for every DHS-licensed program | The procedural shell around 245D; a 245D provider applies, pays, and is sanctioned under 245A |
| Chapter 245D, the HCBS Standards | DHS | Program standards for waiver services: rights, planning, training, incidents, records | The substance a 245D provider is inspected against |
| Home care license, §§ 144A.43 to 144A.4799 | Minnesota Department of Health (MDH) | Home care services such as home health aide, nursing, and medication management in the home | A separate license; § 144A.484 lets a home care provider add an HCBS designation to deliver basic support services without a 245D license |
Under § 144A.484, a home care provider "may apply to the commissioner of health for a home and community-based services designation" covering the basic support services in § 245D.03, subd. 1, paragraph (b). Intensive support services still require a 245D license from DHS. Separately, § 245D.03, subd. 2 exempts settings such as foster care and intermediate care facilities for persons with developmental disabilities, and adult day services are licensed under chapter 245A and Minnesota Rules chapter 9555 rather than 245D.
How DHS enforces 245D
Enforcement runs through chapter 245A. A licensing review is a records review first: the licensor samples service recipient records, personnel files, incident and restraint reports, and policies, and under § 245A.04, subd. 4 can observe the program in operation. DHS has committed to reviewing every licensed 245D provider at least once every three years.
When a review finds a violation that does not pose imminent danger, § 245A.06 requires a correction order that states the conditions that violate law or rule, the specific law or rule violated, and the time allowed to correct each violation. For HCBS programs with multiple sites, subd. 1a requires the order to be site-specific unless DHS has an articulable basis for applying it more broadly. A license holder can request reconsideration in writing within 20 calendar days of receiving the order; the request does not stay the order, and 245D programs are offered mediation if reconsideration is denied.
If violations are not corrected, or are serious or repeated, § 245A.07 applies. DHS can make the license conditional (reconsideration within 10 calendar days, which does stay the order), impose fines of $1,000 per maltreatment determination, $5,000 for serious maltreatment, $200 per health, safety, or supervision violation, and $100 per other violation, or suspend or revoke the license. Orders and sanctions are public on the DHS Licensing Information Lookup. The common 245D citations guide lists what those orders tend to cite.
The 2026-2027 moratorium
On December 2, 2025, DHS announced a temporary 245D licensing moratorium under § 245A.03, subd. 7a, which allows the commissioner to stop accepting applications for up to 24 months when growth in applications exceeds the determined need for service capacity. Effective January 1, 2026, DHS stopped accepting new 245D applications, stopped adding service lines, and cancelled pending applications with refunds. The expected end date is December 31, 2027. A lead agency or Tribal Nation can request an exception for a person who cannot otherwise get a needed service.
When applications reopen, the initial fee under § 245A.10, subd. 3 is $4,200 as of January 1, 2026, and DHS must act on a complete application within 90 working days. A separate Medicaid enrollment freeze that began January 27, 2026 covers several 245D services, including individualized home supports and integrated community supports, and was extended through January 27, 2027.
How Trustora helps
Trustora is one platform for 245D, ARMHS, PCA/CFSS, EIDBI, and adult day providers. For a 245D license holder, it keeps the service recipient record described in § 245D.095 with the support plan addendum, assessments, progress reviews, rights notice, incident reports, and medication records in one dated file, and the compliance engine tracks the 15-day, 60-day, 24-hour, 72-hour, and annual deadlines in this guide with gap-day alerts before a date is missed.
Personnel files hold orientation, training, and background study dates so a licensor's sample can be pulled for any period, and the one-click DHS audit binder assembles client and staff records for a licensing review. See the platform overview for the 245D workflow.