Minnesota Health Care Programs

1.4.1 Interstate Residency Agreements

Minnesota has the following agreements with other states in regards to state residency.

North Dakota Agreement

Minnesota and North Dakota have an interstate agreement that governs state residence for people who reside in one state and enter a skilled nursing facility in the other state. The agreement applies only to skilled nursing facilities (sometimes referred to as nursing homes). It does not apply to any other type of living arrangement such as assisted living, boarding homes or medical hospitals. It does not apply to home and community-based waiver services.

Under the agreement, a North Dakota resident who moves to a Minnesota nursing facility from North Dakota is not a Minnesota resident:

for 24 months following the date of admission if the person has no community spouse living in North Dakota and was not placed in the facility by North Dakota, or until a Minnesota county, tribal or state servicing agency assumes responsibility for the person’s care, whichever comes first.
for at least 24 months following the date of admission and indefinitely as long as the person has a community spouse living in North Dakota, unless a Minnesota county, tribal or state servicing agency assumes responsibility for the person’s care after the 24 months.
for at least 24 months following the date of admission if the person was placed in the facility by North Dakota and indefinitely, unless a Minnesota county, tribal or state servicing agency assumes responsibility for the person’s care after the 24 months.

A Minnesota resident who moves to a North Dakota nursing facility from Minnesota is a Minnesota resident:

for 24 months following the date of admission if the person has no community spouse living in Minnesota and was not placed in the facility by Minnesota, or until a North Dakota state or county agency assumes responsibility for the person’s care, whichever comes first.
for at least 24 months following the date of admission and indefinitely as long as the person has a community spouse living in Minnesota, unless a North Dakota state or county agency assumes responsibility for the person’s care after the 24 months.
for at least 24 months following the date of admission if the person was placed in the facility by Minnesota and indefinitely, unless a North Dakota state or county agency assumes responsibility for the person’s care after the 24 months.

Interstate Compact on Mental Health and State Operated Services

The Interstate Compact on Mental Health (the Compact) is an agreement between most states, including Minnesota, which allows a state to transfer a person directly from a state-operated treatment facility in their state to a state-operated treatment facility in another state. The purpose of the Compact is to enable a family member of a person who meets certain criteria to request that the person receive treatment closer to the family member. People are not transferred under the Compact for the purpose of short-term hospitalization with the intent that they will be returning to the state. Transfer means the person wants to transfer to another state for continued treatment and to remain in the receiving state.

The Minnesota Department of Human Services (DHS) has a Compact Coordinator who facilitates transfers under this agreement.

A person, under this agreement, who is in a Minnesota state-operated treatment facility who is transferred to a state-operated facility in another state, is a resident of the receiving state. The person is no longer a Minnesota resident.
A person, under this agreement, who is in a state-operated facility in another state who is transferred to a Minnesota state-operated facility, is a Minnesota resident.
Prior to authorizing a transfer under the Compact, the Compact Coordinator obtains agreement from the affected county or tribe to accept financial and social service responsibility for the person.

Interstate Compact on the Placement of Children

The Interstate Compact on the Placement of Children (ICPC) is an agreement among all 50 states that governs states' responsibility when sending children across state lines for the purpose of placement in foster care, adoptive homes, group homes and residential treatment centers. See the MHCP State Residency for Adoption Assistance and Foster Care policy for more information.

Interstate Compact on Adoption and Medical Assistance

The Interstate Compact on Adoption and Medical Assistance (ICAMA) is a federal contract between Minnesota and other states designed to prevent and overcome barriers to interstate adoptions and to coordinate services for adopted children with special needs. Under ICAMA children, from another state, who receive Title IV-E adoption assistance are automatically eligible for MA when they move to Minnesota. Children who receive non-Title IV-E adoption assistance through an agreement that includes health care coverage, are automatically eligible for MA when they move to Minnesota. Not all states provide automatic MA for non-Title IV-E adoption assistance children, even if the state is a part of ICAMA. Those states which extend MA coverage to interstate agreements through reciprocity under the Consolidated Omnibus Reconciliation Act of 1985 (COBRA), also known as COBRA-Reciprocity, will provide MA to non-Title IV-E adoption assistance children who move there from another state. See the COBRA and COBRA-Reciprocity chart on the Association of Administrators of the Interstate Compact on Adoption and Medical Assistance (AAICAMA) website for a state by state listing. See the MHCP State Residency for Adoption Assistance and Foster Care policy and MA Northstar Care Adoption Assistance subchapter for more information.

Legal Citations

Code of Federal Regulations, title 42, section 435.403

Minnesota Statutes, section 256B.056, subdivision 1

Minnesota Statutes, section 256L.09