How the Michigan Home Help Program Pays You to Care for a Loved One

Michigan's Home Help Program pays individual caregivers $17.13 an hour in 2026 to give a family member on Medicaid hands-on help with daily activities.1 The Michigan Department of Health and Human Services (MDHHS) runs it with Medicaid funding, and the person receiving care chooses and employs the caregiver, who can be an adult child, another relative, or a friend, but not a spouse.

Home Help is often the first program families find when they look into paid caregiving in Michigan, and it is often confused with the MI Choice Waiver, a 1915(c) waiver with a limited number of slots and a waiting list when it is at capacity. This guide explains what Home Help covers, who qualifies, who can be hired (and who cannot), what it pays, and how to apply.

What Home Help Is

MDHHS "administers the Home Help program and provides personal care services to individuals who need hands-on assistance with activities of daily living (ADLs) and assistance with instrumental activities of daily living (IADLs)." Medicaid funds the program, and MDHHS will not authorize payments if the client's Medicaid eligibility is inactive.1

Two features matter most:

• The client is the employer. The client, not the State of Michigan, hires the caregiver and has the right to fire them. MDHHS sets who can and cannot be paid, and checks every caregiver before payment starts.1
• The service list is narrower than MI Choice's. Home Help is personal care. MI Choice offers a longer list of home- and community-based services in addition to regular State Plan coverage, including Community Living Supports, adult day health, respite, home-delivered meals, environmental accessibility adaptations such as ramps and grab bars, nursing services, and a personal emergency response system.2

For many Michigan families, Home Help is the right fit on its own. To see how it fits alongside the state's other pay, respite, and support options, start with the Michigan caregiver pillar guide.

Who Qualifies

Home Help eligibility turns on three things: Medicaid status, the need for hands-on help, and whether a responsible relative can provide the care.1

Medicaid Status

The applicant must be eligible for Michigan Medicaid. Medicaid funds Home Help, and MDHHS will not authorize payments if the client's Medicaid eligibility is inactive.1 If your family member is not yet on Medicaid, the Medicaid application comes first (see How to Apply below).

Functional Need

An MDHHS Adult Services Worker completes the Adult Services Comprehensive Assessment (form MDHHS-5534), which MDHHS calls "the primary tool for determining a client's need for services." An in-person, face-to-face contact with the client in their place of residence is required.1

Home Help is for people who need hands-on assistance with ADLs. Adaptive equipment does not disqualify someone: if a person uses adaptive equipment for an ADL and would need hands-on care without it, they must be ranked a level 3 or greater on the functional assessment, and they are eligible for Home Help.1

The worker stays involved after approval, contacting the caregiver at the six-month review to verify that the client is receiving services.1

Responsible Relatives

This is the eligibility rule families most often miss. MDHHS defines a responsible relative as a spouse caring for a spouse or a parent caring for a minor child, and "responsible relatives must be unable or unavailable for the client to be eligible to receive Home Help services." So a married parent whose spouse is able and available to provide the care may not qualify, whoever the family hoped to hire.1

If a responsible relative's own disabilities prevent them from providing care, MDHHS bulletin MMP 26-09 requires that the disabilities be documented and verified by a medical professional on an MDHHS-6200 or DHS-54A. Married individuals who are separated must verify that they no longer live in the same home.1

What Home Help Covers

Home Help is personal care: hands-on assistance with activities of daily living and assistance with instrumental activities of daily living, for someone whose assessment shows the need.1

If the person you care for needs more than personal care, MI Choice's covered-services list is the place to look. It includes adult day health, chore services, community transportation, environmental accessibility adaptations, home-delivered meals, nursing services, private duty nursing and respiratory care, respite, specialized medical equipment and supplies, and supports coordination.2

Who Can Be Hired as a Home Help Caregiver

"The client has the right to choose their Home Help caregiver(s)," within firm limits set by MDHHS.1

What every caregiver must meet. The Adult Services Worker decides whether a caregiver qualifies in an in-person, face-to-face interview with both the client and the caregiver. The caregiver must:1

• Be 18 years or older
• Be able to follow instructions, perform the services required, and handle emergencies
• Have adequate physical health, know when to seek help in an emergency, and be dependable
• Undergo and pass a criminal history screen before providing personal care services and before being paid
• Present picture identification
• Be willing to take part in available training programs if necessary
• Be enrolled in CHAMPS

Who MDHHS will not pay as a Home Help caregiver:

• A spouse caring for a spouse, including a spouse who is separated: "a spouse who is separated from a spouse cannot be the individual paid to provide Home Help services."
• A parent caring for their own minor child.
• A minor (17 and under).
• A fiscal intermediary.
• A caregiver who is incarcerated.
• A guardian with a permissive exclusion.
• Someone who is also receiving Home Help. An individual providing Home Help services cannot be a Home Help recipient at the same time.1

"The Home Help payment may be terminated if the individual caregiver fails to meet any of the caregiver criteria."1

Family Members, Live-In Caregivers, and Guardians

MDHHS's Home Help page says the client can choose "an individual caregiver (family member or friend who is at least 18 years old) or an agency provider." The limits are narrower than many families assume:4

• An adult child can be paid as a family member 18 or older. MDHHS does not name adult children specifically, and it does not bar them.
• A parent caring for an adult child can be paid. Only a parent caring for a minor child is barred; MDHHS's manual notes that parents caring for an adult child do not have FICA withheld.
• A live-in caregiver can be paid. MDHHS's manual says live-in caregivers employed by the Home Help client or agency provider are exempt from electronic visit verification (EVV), with the exemption approved by MDHHS where the home is the caregiver's permanent and primary residence.
• Shared households get fewer IADL hours. Where other adults live in the home, assessed hours for instrumental activities (except medication) are cut by one half, unless the case clearly documents that the client's IADLs are done separately.
• Guardians: a guardian with a permissive exclusion cannot be the paid caregiver. MDHHS's manual does not otherwise say whether a legal guardian may be paid, and it does not address a power of attorney as a paid caregiver, so ask the Adult Services Worker.4

Planning turns on the responsible-relative rule. A family where a spouse would be the paid caregiver cannot use Home Help for that.1 MI Choice is a narrow alternative, not a workaround: its self-determination option bars a spouse as a paid worker, but a spouse may be paid as a Community Living Supports provider hired through a network home care agency, and only when the participant requires extraordinary care and the arrangement is in the participant's best interest.5 A family where an adult daughter would be the paid caregiver, and no spouse is able and available to provide the care, can ask for a Home Help assessment now.

What the Michigan Home Help Program Pays in 2026

"Beginning with January 1, 2026 services, the Home Help individual caregiver rate will increase to $17.13 per hour," up from $15.88. MDHHS bases the rate on the $13.73 hourly state minimum wage plus the current $3.40 hourly direct care worker wage increase.1

The client is the employer, with the right to hire and fire the caregiver, and the caregiver must be enrolled in CHAMPS and have passed the criminal history screen before Home Help can pay them.1

MDHHS also publishes a Home Help agency provider rate of $27.00 an hour ($23.60 plus a $3.40 pass-through). That is what the program pays an agency for agency-provided care, not a wage an agency caregiver earns.1

How many hours. The Adult Services Worker's assessment sets the hours, and MDHHS's manual states no fixed overall weekly or monthly cap. Instrumental activities do carry monthly maximums: 5 hours for shopping, 6 for light housework, 7 for laundry, and 25 for meal preparation. When assessed hours go above 179.59 a month (Expanded Home Help Services), the worker must request central MDHHS approval.4

A note on taxes: IRS Notice 2014-7 treats certain payments for personal care under a state Medicaid section 1915(c) home and community-based services waiver as difficulty-of-care payments that can be excluded from the caregiver's federal gross income, but only when the care is given in the caregiver's own home and the person receiving care lives there. A caregiver who keeps a separate home where they live cannot exclude the payments. Even where it applies, it is an exclusion from federal gross income, not the same as tax-free: whether the pay is subject to Social Security and Medicare taxes depends on whether you are an employee of an agency, an employee of the person you care for, or an independent contractor.6 For a Medicaid program that is not a 1915(c) waiver, the exclusion is not automatic: the IRS says the answer depends on the nature of the payments and the purpose and design of the program, so ask a tax professional how your Home Help pay is treated.6

How to Apply for the Michigan Home Help Program

Home Help needs active Medicaid, so a family member who is not yet on Medicaid applies for it first. A request for Medicaid can be made in person, by mail, by telephone, by email, or online through MI Bridges.3

MDHHS works to a 45-day standard of promptness on a Medicaid application, and to 90 days where the application is made on the basis of disability. Federal rules let the agency miss those standards in unusual circumstances, and separately bar it from treating them as a waiting period or as a reason to deny you.3

What If You're Denied or Get Too Few Hours

If MDHHS denies Home Help or authorizes less help than you expected, you can appeal. You have 90 calendar days from the date of the written notice of case action to request a hearing, and the request has to reach the local office inside those 90 days. Hearings are conducted by the Michigan Office of Administrative Hearings and Rules (MOAHR). Keeping benefits running while you wait is a separate and narrower question: MDHHS reinstates benefits to their former level on a timely request, meaning one it receives within 10 days of the date the notice of case action was issued, and for Medicaid it must maintain benefits if you request the hearing before the action's effective date. There is no continuation when the hearing is about a denial at application, and benefits are also not restored if you say in writing that you do not want them continued, or if they were cut by a mass update required by law (unless you are contesting how they were computed).3

Home Help vs. MI Choice: When to Use Which

The two programs differ on what they pay for, how enrollment is limited, and who can be paid.1,7,2,5

MI Choice has more than one eligibility test. The table shows the functional gate, because that is what the two programs measure differently. It is not the whole test. The MI Choice chapter of the MDHHS Medicaid Provider Manual requires all three of the following: the applicant must establish financial eligibility for Medicaid services, must be categorically eligible for Medicaid as aged or disabled, and must meet functional eligibility through the online Nursing Facility Level of Care Determination. Passing the LOCD alone does not enroll anyone.7 To enroll and stay enrolled, the applicant must also require at least two waiver services, one of which must be supports coordination, have service needs that existing State Plan or other services cannot fully meet, and agree to receive MI Choice services on a regular basis, at least every 30 days.2

If a waiver agency tells you there is a waiting list, ask where on that list you stand. MDHHS enrolls from the MI Choice waiting list in four priority categories, not first come, first served: nursing facility residents who want to return home, and applicants being diverted from an imminent nursing facility admission, rank ahead of the general queue, behind only young adults aging out of Private Duty Nursing. The Provider Manual also states that the enrollment process "is not ever actually or constructively closed." Our MI Choice guide explains all four categories and what to say at screening.7

Look at Home Help when: the person you care for needs paid help with personal care rather than the broader MI Choice service list, and the caregiver will be an adult child, another relative, or a friend rather than a spouse.

Look at MI Choice when: you need home modifications, adult day health, respite, home-delivered meals, or other services beyond personal care, and the person you care for meets nursing facility level of care.

Coordinating the two: MI Choice is the funding source of last resort, so its funds must not duplicate or replace services available through the State Plan, and a qualified applicant may enroll in only one long-term services and supports program at a time.2,7 Ask your MDHHS worker and the waiver agency how the two would fit in your case.

Common Misconceptions

"My husband and I can each be paid to care for each other." Neither spouse can be paid as the other's Home Help caregiver. And because responsible relatives must be unable or unavailable for the client to qualify, a spouse who is able and available to provide the care can keep the other spouse from qualifying for Home Help at all.1 MI Choice's self-determination option bars a spouse too; its one approved spouse route is a Community Living Supports job through a network home care agency, limited to a participant who requires extraordinary care.5

"Home Help is the same as a home care agency." It is different. Under Home Help, the client, not the State of Michigan, is the employer and has the right to hire and fire the caregiver, and MDHHS will not pay a fiscal intermediary as the caregiver.1 For how agency care compares, see our guide to home care vs. home health in Michigan.

"My daughter can start getting paid the day she starts helping." Not until she qualifies. All Home Help individual caregivers must undergo a criminal history screen before providing personal care services, the screen must be completed and passed before a provider can be paid, and the caregiver must be enrolled in CHAMPS.1

Related Terms

• Consumer Directed Services (CDS): the national term for self-directed Medicaid caregiving programs, where the person receiving care chooses their caregiver.
• Activities of Daily Living (ADLs): the functional measures used in the Adult Services Comprehensive Assessment (MDHHS-5534).
• HCBS waiver: MI Choice is Michigan's 1915(c) Home and Community-Based Services waiver.7
• Nursing Facility Level of Care (NFLOC): the functional standard MI Choice requires, determined through the LOCD.7

Learn More

Find personalized help applying for caregiver pay programs in Michigan at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.