Eight real steps, in order, with realistic timelines for each. No skipped steps, no vague "contact your caseworker" hand-waving.
The process starts with your county MDHHS Adult Services office — not an online application. This is where you'll request a Home Help assessment for your loved one and get pointed toward next steps specific to your county.
If your loved one isn't already on Medicaid, that application happens through MI Bridges and needs to be in motion before Home Help services can be approved. If they're already enrolled, this step is just a confirmation.
An MDHHS Adult Services Worker visits the home in person and completes the Adult Services Comprehensive Assessment (MDHHS-5534) — documenting exactly which ADLs and IADLs your loved one needs help with. Be ready to speak honestly and specifically about daily struggles, not just diagnoses.
Based on the assessment, MDHHS documents a set number of approved monthly care hours — commonly up to 180, depending on documented need. This is the number that everything downstream is built around.
Decide between a self-directed family caregiver or a licensed provider agency. If you're weighing this decision, our family vs. agency comparison lays out the trade-offs plainly.
The chosen caregiver registers as an individual provider through the state's CHAMPS system — MiLogin account, provider enrollment application, background check. This is typically the longest step, and incomplete applications are the most common cause of delay.
Electronic Visit Verification through the HHAeXchange+ app (or a telephony line) has to be configured before caregiving hours can be paid. This is a required step, not an optional add-on.
Once everything is approved and EVV is set up, the caregiver clocks in and out for each visit, and payment follows based on verified hours at $17.13/hr. See our pay guide for exactly how that plays out month to month.
Realistic total timeline: most families should expect several weeks to a few months from first contact to a first paycheck, not an instant turnaround. The assessment scheduling and CHAMPS enrollment are usually the two steps that take the longest.
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