Medicaid self-directed care
Home Help Program
Checked
- Who qualifies
-
People of any age who have Medicaid (not Medicare) and need hands-on help with at least one activity of daily living, such as bathing, dressing, eating, grooming, mobility, toileting or transferring, because of a medical condition, physical disability or cognitive impairment. If you qualify for help with an activity of daily living, you may also get help with tasks such as light housework, laundry, meals, shopping and taking medication.
If your income is too high for full Medicaid, ask the adult services unit at your local MDHHS office about Home Help for people with deductibles (spend downs). There is no maximum number of hours; your adult services worker sets them after a home visit.
Source: Home Help Program Client Handbook, MDHHS-Pub-1733 (Michigan Department of Health and Human Services, 4-24)Checked
- Can a family member be paid
-
Yes. Yes, other than a responsible relative. You choose your Home Help caregiver and are their employer. Home Help does not pay a responsible relative (a spouse caring for a spouse, or a parent caring for a minor child), anyone 17 or younger, or a fiscal intermediary.
The manual's payroll rules also cover parents who are caring for an adult child as paid caregivers. Every caregiver must enroll in CHAMPS and pass a criminal history screen before they can be paid.
Source: Adult Services Manual ASM 135, Home Help Caregivers (Michigan Department of Health and Human Services, ASB 2026-008, 7-1-2026)Checked
- Can a spouse be paid
-
No. No. A spouse caring for a spouse is a responsible relative, and Home Help does not pay a responsible relative. A spouse who is separated from you cannot be the paid caregiver either.
If your spouse is unable or unavailable to help, talk to your adult services worker about what to do.
Source: Adult Services Manual ASM 135, Home Help Caregivers (Michigan Department of Health and Human Services, ASB 2026-008, 7-1-2026)Checked
- Can a legal guardian be paid
-
Depends. Not if the guardian has a permissive exclusion. The manual says guardians with a permissive exclusion cannot be the paid individual caregiver, and so cannot sign their own MSA-119, Personal Choice and Acknowledgement of Provider Selection, form.
A permissive exclusion is a finding from the criminal history screen, such as certain felony convictions. Other caregivers with one can be hired only if the client signs the MSA-119. The manual does not address guardians without a permissive exclusion.
Source: Adult Services Manual ASM 135, Home Help Caregivers (Michigan Department of Health and Human Services, ASB 2026-008, 7-1-2026)Checked
- Pay rate
-
MDHHS publishes the Home Help pay rate by county, and the payment schedule, at michigan.gov/homehelp under Tools and Resources.
Social Security and Medicare taxes are withheld from individual caregivers' pay, and caregivers get a W-2.
Source: Home Help Program Client Handbook, MDHHS-Pub-1733 (Michigan Department of Health and Human Services, 4-24)Checked