The Michigan Home Help Program is the state's most-used pathway for paid family caregiving. It's a Medicaid state-plan personal care benefit, an entitlement with no waitlist, that covers help with daily activities in the home and pays the caregiver directly through MDHHS. For 2026, the individual caregiver rate is $17.13 per hour.
Home Help is often the first program families learn about when looking into paid caregiving in Michigan. It's also often confused with the MI Choice Waiver, which is a larger, more complex program with a waitlist. This guide explains exactly what Home Help covers, who qualifies, who can be hired (and who can't), what you get paid, and how to apply.
What Home Help Is
Home Help is a Medicaid state-plan personal care benefit administered by MDHHS Adult Services. Under federal rules, it operates as a state plan personal care service (grouped with other 1915(i)-style state plan HCBS programs in policy discussion).
Two structural features matter most:
- It's an entitlement, not a waiver. Every Medicaid-eligible adult who meets the functional criteria is served. There is no cap and no waitlist. This is the single biggest difference from MI Choice, which has capped enrollment and regional waitlists.
- Coverage is narrower than MI Choice. Home Help covers personal care with ADLs and select IADLs. It does not cover home modifications, adult day programs, respite facilities, meals on wheels, medical equipment, or skilled nursing. If you need that broader set of services, MI Choice is the program.
For many Michigan families, Home Help is the right fit on its own. For others, Home Help is the bridge program while an MI Choice application works through the system.
Who Qualifies
Home Help has two eligibility gates: Medicaid status and functional need.
Medicaid Status
The applicant must already be eligible for Michigan Medicaid. Most Home Help recipients are on one of these pathways:
- Aged, Blind, or Disabled (ABD) Medicaid (the typical pathway for seniors 65+)
- Nursing Home Medicaid (for a resident transitioning back home)
- MI Choice Waiver (Home Help can wrap around MI Choice in limited cases; usually you pick one)
- Dual-eligibles (people with both Medicare and Medicaid)
If you're not yet on Medicaid, you'll apply for Medicaid and Home Help together.
Functional Need
A MDHHS Adult Services Worker conducts a home visit and completes the DHS-1183 Adult Home Help Services Assessment. The assessment scores the applicant's need for help with:
- Activities of Daily Living (ADLs): bathing, dressing, grooming, toileting, transferring, eating, mobility.
- Instrumental Activities of Daily Living (IADLs): meal preparation, medication reminders, light housekeeping, laundry, shopping.
Based on the assessment, the worker authorizes a weekly budget of service hours. Typical authorizations range from a few hours per week for someone needing help with a couple of ADLs up to roughly 40 hours per week for someone needing substantial daily support. Higher hour needs usually steer families toward MI Choice instead.
What Home Help Covers
Home Help is about the tasks of daily life, not medical procedures.
Covered:
- Bathing and personal hygiene
- Dressing and grooming
- Toileting and continence care
- Eating and feeding assistance
- Transferring (bed to chair, chair to toilet)
- Mobility assistance inside the home
- Meal preparation
- Medication reminders (not administration of prescriptions, which is a skilled nursing task)
- Light housekeeping related to the applicant's living area
- Laundry
- Shopping for essentials
- Some companionship as part of other tasks
Not covered:
- Skilled nursing (wound care, injections, tube feeding): covered by Medicaid home health or private duty nursing instead
- Physical, occupational, or speech therapy
- Home modifications, ramps, grab bars: covered by MI Choice
- Adult day programs: covered by MI Choice or private pay
- Respite at a facility: covered by MI Choice
- Transportation (except incidental to a task like shopping)
- Companionship-only services without personal care
Who Can Be Hired as a Home Help Caregiver
This is the question families ask most. Home Help lets the participant pick their own caregiver from a wide pool, but there are firm rules about who is eligible.
Can be hired (must be 18 or older, pass background checks, and enroll in CHAMPS):
- Adult children
- Adult grandchildren
- Adult siblings
- Nieces and nephews
- Aunts and uncles
- In-laws
- Friends and neighbors
- Professional independent caregivers
- Home care agency workers (where the agency is CHAMPS-enrolled)
Cannot be hired under Home Help:
- Spouses. This is a hard rule in Home Help. If you need a spouse caregiver paid by Medicaid, the pathway is the MI Choice Waiver Self-Determination Option, which does permit spouses.
- Parents of minor children (except in specific circumstances).
- The participant's legally authorized representative cannot also be the paid worker; these roles have to be separated.
- Anyone who fails a criminal background check under MDHHS rules.
- Anyone under 18.
This is one of the most consequential facts to get right when planning. A family planning for a spouse to be the primary paid caregiver in Michigan needs MI Choice, not Home Help. A family where an adult daughter will be the paid caregiver can use Home Help immediately, with no waitlist.
What Home Help Pays in 2026
The 2026 Home Help individual caregiver rate is $17.13 per hour, effective January 1, 2026. This is Michigan's $13.73/hour minimum wage plus a $3.40 pass-through built into the Home Help rate structure.
The rate applies to independent (individual) caregivers the participant hires directly. Agency-based Home Help is reimbursed at a different rate schedule set by MDHHS.
Caregivers are paid through CHAMPS (the Community Health Automated Medicaid Processing System), which handles:
- Enrollment as a Medicaid provider
- Direct deposit of payments
- W-2 wage reporting and employer tax withholding
- Time-sheet submission and visit verification
Once enrolled, caregivers submit their hours (typically through the MI Time phone or web tool, which also handles Electronic Visit Verification under the 21st Century Cures Act) and MDHHS pays them directly. The participant does not write checks.
A note on taxes: Home Help wages are W-2 income. Caregivers are employees. In certain situations where the caregiver lives in the same home as the care recipient, IRS Notice 2014-7 allows the wages to be excluded from federal gross income. This is a significant tax planning point; talk to a tax preparer familiar with Notice 2014-7 before the first tax year.
Thinking about signing up as a Home Help caregiver for a parent? Chat with Brevy and we'll walk you through eligibility, enrollment, and how to coordinate with Medicaid and MI Choice.
How to Apply
Home Help applications run through the county MDHHS office, usually in parallel with a Medicaid application if the applicant is not yet on Medicaid.
- If not already on Medicaid: apply for Medicaid through MI Bridges (newmibridges.michigan.gov) or an MDHHS-1171 paper application. Indicate interest in Home Help on the application.
- Request an Adult Services Worker referral. Your Medicaid caseworker can trigger the referral. If you're already on Medicaid, you can call your county MDHHS office directly.
- Home visit. An MDHHS Adult Services Worker visits the applicant's home (or sometimes the hospital room before discharge) and completes the DHS-1183 Adult Home Help Services Assessment. This typically takes 60 to 90 minutes. A family member should be present if possible.
- Medical certification. A physician or advanced-practice provider completes the MDHHS-6200 Medical Needs Form (the successor to DHS-54A for the 2026 program year).
- Service authorization. The Adult Services Worker writes a service plan with weekly hours and specific tasks authorized. The participant receives a copy.
- Hire a caregiver. The participant (or their representative) identifies who they want to hire. The caregiver enrolls in CHAMPS: provider application, background checks, training on time reporting.
- Services begin. Once enrollment is complete (typically 2 to 4 weeks), services start and the caregiver submits hours through MI Time.
Total timeline from application to first paycheck: typically 6 to 10 weeks. Faster than MI Choice; slower than you'd like.
Home Help vs. MI Choice: When to Use Which
| Feature | Home Help | MI Choice Waiver |
|---|---|---|
| Entitlement? | Yes, no waitlist | No, capped at ~20,543 slots |
| Services covered | Personal care only (ADLs, basic IADLs) | Personal care plus 20+ other services |
| Home modifications | No | Yes |
| Adult day health | No | Yes |
| Respite | No | Yes |
| Home-delivered meals | No | Yes |
| Private duty nursing | No | Yes |
| Spouse can be paid caregiver | No | Yes (under Self-Determination Option) |
| Other family caregivers paid | Yes (children, grandchildren, siblings, nieces/nephews, friends) | Yes (under Self-Determination Option) |
| Typical hours authorized | Few hours/week up to ~40/week | Customized plan, often higher |
| Assessment tool | DHS-1183 | LOCD |
| Functional threshold | Lower (ADL needs) | Higher (NFLOC) |
| Who administers | MDHHS Adult Services Worker | Regional Waiver Agency |
Use Home Help when: You need paid personal care and don't need the broader service menu. The caregiver will be an adult child, sibling, or friend. You don't want to wait.
Use MI Choice when: You need home modifications, adult day health, respite, or other non-personal-care services. The caregiver will be a spouse. You qualify for nursing-facility level of care.
Use both: In limited circumstances, a family can get Home Help started today and transition to (or add) MI Choice later. Ask your MDHHS worker about coordination.
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. For spousal caregiver pay, you need MI Choice.
"Home Help is the same as a home care agency." It's different. Home Help is a Medicaid benefit that directly employs an individual (or contracts with an enrolled agency) to provide personal care to a specific Medicaid-eligible participant. Traditional private-pay home care agencies operate on different contracts and rates.
"Home Help caregivers work under the table." They're W-2 employees. MDHHS issues W-2s. Skipping reporting risks both the caregiver's wages and the participant's Medicaid eligibility.
"I have to move my parent to my house to get Home Help." No. Home Help serves the participant wherever they live, including their own home, a child's home, or an assisted living or adult foster care facility (though Home Help won't pay room and board).
"Home Help replaces Medicare home health after a hospital stay." It doesn't. Medicare covers short-term, skilled home health after a qualifying hospital stay. Home Help is long-term personal care that Medicare does not pay for. They can run in parallel.
Frequently Asked Questions
The 2026 individual caregiver rate is $17.13 per hour, effective January 1, 2026. This is Michigan's $13.73/hour minimum wage plus a $3.40 pass-through built into the Home Help rate structure. Agency-based Home Help is reimbursed at a different rate schedule set by MDHHS.
No. Spouses cannot be hired as caregivers under Home Help — this is a hard rule. For paid spousal caregiving in Michigan, the pathway is the MI Choice Waiver Self-Determination Option (SDO), which does permit spouses. Adult children, grandchildren, siblings, nieces/nephews, in-laws, and friends can all be hired under Home Help.
No. Home Help is a Medicaid state-plan entitlement, meaning every Medicaid-eligible adult who meets the functional criteria is served. There is no cap and no waitlist. This is the single biggest difference from MI Choice Waiver, which is capped at roughly 20,543 slots with regional waitlists.
If not already on Medicaid, apply for Medicaid through MI Bridges (newmibridges.michigan.gov) or an MDHHS-1171 paper application and indicate interest in Home Help. Request an Adult Services Worker referral. A worker visits the home and completes the DHS-1183 Adult Home Help Services Assessment. A physician or APP completes the MDHHS-6200 Medical Needs Form. The worker authorizes a service plan, the participant hires a caregiver, and the caregiver enrolls in CHAMPS. Total timeline: typically 6-10 weeks.
Home Help caregivers are W-2 employees, and wages are reported through CHAMPS. However, under IRS Notice 2014-7, when the caregiver lives in the same home as the care recipient, the wages may be excluded from federal gross income. This is a significant tax planning point — talk to a tax preparer familiar with Notice 2014-7 before the first tax year.
Related Terms
- Consumer Directed Services (CDS): The national term for self-directed Medicaid caregiving programs like Home Help.
- Activities of Daily Living (ADLs): The functional measures used in the DHS-1183 assessment.
- HCBS waiver: MI Choice is a 1915(c) waiver; Home Help is a state plan benefit, not a waiver.
- Nursing Facility Level of Care (NFLOC): Home Help does not require NFLOC; MI Choice does.
Learn More
- Michigan Medicaid Programs for Seniors (Hub)
- How to Apply for Michigan Medicaid
- MI Choice Waiver Program
- How to Get Paid as a Family Caregiver in Michigan
- Michigan Caregiver Programs (Complete Directory)
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 tax advice. IRS Notice 2014-7 tax treatment is situation-specific. Michigan Home Help rates, forms, and eligibility rules change each program year. Always verify current details with your MDHHS Adult Services Worker, your county MDHHS office, or a tax professional. Brevy is not a law firm, financial advisor, or healthcare provider.