What is the MDHHS Home Help Program?

What the program actually is

The Home Help Program is a Medicaid state-plan personal care benefit. That distinction matters more than it sounds: because it's a state-plan entitlement rather than a capped waiver, every Medicaid-eligible Michigan adult who has a documented need for hands-on help with daily activities must be offered services — there's no enrollment cap and no regional waitlist the way there is with some other long-term-care programs.

In practice, that means two things for most families: the program exists to help people stay in their own home instead of moving into a nursing facility, and — the detail that surprises most people — the person receiving care can often choose who provides it, including a family member.

Who administers it

Home Help is run by the Michigan Department of Health and Human Services (MDHHS), specifically the Adult Services division, working through local county MDHHS offices. Applications, home assessments, and hour approvals all flow through your local office; payment processing and provider enrollment happen through the state's CHAMPS system.

CarePay Michigan is an independent resource — we're not MDHHS, and we don't process applications on the state's behalf. What we do is walk you through the real process in plain language and, if it's useful, connect you with a licensed home care agency partner in your county.

What the program covers

Home Help splits into two categories of support:

• Activities of Daily Living (ADLs): bathing, dressing, grooming, mobility within the home, transferring (like bed to wheelchair), and toileting.
• Instrumental Activities of Daily Living (IADLs): light housekeeping, laundry, meal preparation, and grocery shopping for essentials.

An MDHHS Adult Services Worker documents exactly which of these your loved one needs help with during the home assessment, and that documentation is what determines approved monthly hours.

The self-direction option

This is the part almost nobody explains clearly. Home Help includes a consumer-direction (self-direction) component — the Medicaid recipient, or their authorized representative, can choose their own caregiver rather than being assigned one. That chosen caregiver can be an adult child, sibling, grandchild, or friend, and the state pays that person directly for the approved hours.

Spouses and parents of minor children generally cannot be paid caregivers under this specific program. We cover exactly who can and can't be paid, and why, on our self-direction guide.

Fiscal intermediary vs. provider agency

You'll sometimes see two different business models mentioned in this space, and they're not the same thing:

• Fiscal Intermediary (FI): in the self-directed option, the Medicaid recipient is technically the caregiver's employer. An FI just processes the payroll and tax paperwork so the caregiver gets paid correctly — the FI doesn't provide any hands-on care itself.
• Provider Agency: MDHHS approves the agency itself as the care provider. The agency's own employees — which can include a hired family member — deliver the care, and the agency bills Medicaid directly.

Neither model is "better" across the board — it depends on whether your family wants to manage the caregiving relationship directly or have an agency handle the administrative side.

How this differs from the MI Choice Waiver

Home Help gets confused with Michigan's MI Choice Waiver constantly, so it's worth being direct: MI Choice is a 1915(c) waiver program with a limited number of slots. When demand exceeds capacity, screened applicants go on a regional waitlist, and spouses can be paid caregivers under MI Choice's self-direction option — the opposite of Home Help's rule. Home Help, by contrast, has no cap and no waitlist because it's a state-plan entitlement, but it also has narrower rules on who can be a paid caregiver.

The EVV requirement

As of the 2024–2026 rollout, Electronic Visit Verification (EVV) is required for Home Help visits. In practice, this means the caregiver clocks in and out of each visit using the HHAeXchange+ mobile app or a telephony line, rather than submitting paper timesheets. It's not optional and it's not a separate program — it's simply how the state verifies that approved hours were actually worked before releasing payment. We go deeper on what to expect from EVV day-to-day in our blog guides.

What to do next

If this sounds like it could apply to your family, the practical next step is usually one of three things: check whether your loved one meets the eligibility criteria, understand what the pay actually looks like month to month, or walk through the step-by-step application process. If you'd rather just talk it through, the form below connects you with a Michigan care specialist directly.