Michigan's Home Help Program: Getting Paid to Care for a Parent at Home
Families ask us about assisted living long before they are ready for it. What they usually want, in the first conversation, is a way to keep a parent at home a while longer. Michigan has a program for exactly that, it pays a family member to do the work, and most people we talk to have never heard its name.
It is called Home Help. It is run by the Michigan Department of Health and Human Services, it is part of Medicaid rather than a separate waiver, and it changed twice this year in ways that have not filtered down to the families it affects.
What Home Help actually is
Home Help pays for personal care in a person's own home. To qualify, someone has to be eligible for Medicaid fee for service and need physical assistance with at least one activity of daily living.
Those activities are the concrete physical ones: bathing, dressing, eating, grooming, mobility, toileting, and transferring inside the home. The program also covers what the state calls instrumental activities, meaning light housework, laundry, taking medication, meal preparation, and shopping for food and medication.
Read the first list again, because it is the part that decides most applications. The standard is physical assistance. A parent who is physically capable but needs someone present for safety and reminders is a harder case than a parent who cannot get out of a chair unaided. Both situations are real and exhausting. Only one of them fits neatly inside what this particular program was built to pay for.
The part that surprises people: a family member can be paid
The client chooses the caregiver. It can be an agency, or it can be an individual, and the state's own description of an individual caregiver is a family member or friend who is at least 18 years old. The client can hire, fire, or change that caregiver at any time.
So an adult daughter who has cut her hours at work to bathe and dress her mother can, in the right circumstances, be paid to do it.
There is one exclusion that catches people, and it is worth stating plainly because families plan around the wrong assumption: the caregiver cannot be the client's spouse. A husband caring for his wife cannot be paid through Home Help for that care. A son or daughter can. A niece can. A neighbor can. A spouse cannot.
Caregivers have to enroll in the state's provider system, called CHAMPS, and pass a background check before they can be paid. That is not a formality and it takes time, so it belongs at the front of the plan rather than the end.
What changed in 2026, and why nobody told you
Two policy changes landed this year. Neither was announced in a way that reaches families, because these bulletins are written for providers.
Since May, more clinicians can sign the medical form. A Home Help application needs a medical needs certification, and the list of professionals who can complete it now includes clinical nurse specialists. If you have ever tried to get a signature from a primary care physician who is booked eight weeks out, a longer list of qualified signers is not a technicality.
Two related pieces from the same change are worth knowing. The state added Form MDHHS-6200, Adult Services Medical Needs Certification, to the forms that can be used. And for a parent who receives care through the Veterans Health Administration, a VA Form 10-10M completed by a VHA medical provider is accepted. Veteran families routinely have current VA paperwork and no recent civilian appointment, and that path is now explicit.
There is also a provision for the situation nobody plans for, which is a caregiver who becomes a patient. When a responsible relative has disabilities of their own that prevent them from providing care, those disabilities can be documented and verified by a medical professional on the MDHHS-6200 or the DHS-54A.
Since August, moving to another county no longer means starting over. This is the change that matters most to the families we meet, because it is the thing many of them are trying to do.
Under the old policy, a Home Help client who moved from one Michigan county to another had to go through an in person comprehensive assessment with an adult services worker in the new home, and payments could not be authorized for care in the new county until that happened. A parent moved from Grand Rapids to Troy to be near a daughter, and the help stopped while everyone waited for a home visit.
As of August, that in home assessment is replaced by a phone interview, and the phone interview is only required when one of two things happens: the client changes providers, or the household composition changes in a way that affects how instrumental activities are prorated.
For an adult child bringing a parent closer, that is a meaningful difference. It does not remove the paperwork and it does not mean nothing happens. It means the default is now a phone call rather than a scheduled visit that has to be arranged before anyone gets paid.
How a family actually starts this
Contact the Adult Services unit at your local MDHHS office. In our area that is the Oakland County office, and the referral gets assigned to an adult services worker in the county where the client lives, which is worth remembering if the parent has not moved yet.
The first form is the DHS-390, Adult Services Application, signed by the client or their guardian. Then an adult services worker schedules a home visit to complete the eligibility assessment.
We are deliberately not printing an income limit in this article. Home Help eligibility runs through Medicaid fee for service, the thresholds are not the same as the waiver numbers people find first, and the figure circulating on most senior care websites is several years old. A wrong number here does real damage, because a family reading that they earn too much will not apply, and the only way to find out is to apply. If you are close to any line you have read anywhere, treat that as a reason to call rather than a reason to stop.
How this differs from the MI Choice waiver
Families mix these two up constantly, and the difference is worth holding onto.
MI Choice is a waiver. It funds a broader set of services, including care in some licensed residential settings, and demand for it exceeds what the state funds, which is why applicants encounter a waiting list. We wrote about how the MI Choice waiver works in Michigan and what its numbers actually mean.
Home Help is not a waiver. It sits inside regular Medicaid and it pays for personal care in a person's own home. Different program, different application, different door.
The honest limit
We run two small adult foster care homes, so we are not a neutral party here, and we would rather say the true thing than the useful thing.
Home Help works when the need is help with specific physical tasks and there is someone willing to do them. It stops working when the need is someone awake at three in the morning, or when a parent needs eyes on them all day and the family member doing the caring is coming apart. The program pays for hours of assistance. It does not pay for a person to be there continuously, and there is a point where those two things stop being the same thing.
Plenty of families use Home Help for a year or two and then need something else. That is not a failure of planning. It is what the trajectory usually looks like, and knowing the name of the program is better than not knowing it.
If a parent needs help with bathing and dressing and there is a daughter or a son who is already doing that work unpaid, this is worth a phone call to the Adult Services unit this week.