How to prepare for the Michigan Home Help assessment

The short answerThe assessment is an in-person visit by an Adult Services Worker, who scores each daily task from 1 to 5 based on how much human help the person needs. Those scores set which tasks and how many hours Home Help approves. Preparing means being ready to describe, accurately and specifically, what the person can and cannot do on a normal day.

What happens at the visit

The caseworker meets the person who needs care, usually at home, and does a functional assessment. They go through the seven personal care tasks and five household tasks, and for each one decide how much help is needed. They also check the person's Medicaid status and review the medical certification from a Medicaid-enrolled medical professional. See what Home Help pays for for the list and the scale.

Before the visit

• Medical certification. Ask the person's doctor or another Medicaid-enrolled medical professional to certify the need for care, and ask the caseworker which form is used.
• A plain task list. For each of the twelve tasks, write what the person does alone, what needs reminding, what needs hands-on help and what they cannot do even with help.
• A bad-day picture. If abilities vary from day to day, write down what a typical hard day looks like and how often those happen.
• Contacts. Doctor and other providers, plus any power of attorney or guardianship papers.
• Caregiver details. If a relative or friend will be the caregiver, tell the caseworker early, since they must be screened, enrolled and interviewed in person with a photo ID.

During the visit

• Let the person speak. They are the client. If they want help describing something, say so.
• Be specific. "She needs help with bathing" is less useful than "she cannot step into the tub and needs someone to steady her and wash her back."
• Describe the hard parts honestly. Many people downplay needs in front of a stranger. Stating how things really are is not exaggerating.
• Do not exaggerate. Overstating needs can cause problems later, and the caseworker is trained to look at what is observed as well as what is said.
• Ask about anything you do not follow. Including how the scores become hours.

After the visit

• Ask when to expect a decision and who to call if you do not hear.
• Read the notice when it arrives. It explains what was approved and how to ask for a review or appeal, and deadlines can be short.
• If the person's condition changes, tell the caseworker. A change can lead to a new assessment.

The full sequence of steps is in Who qualifies for Michigan Home Help, and how to apply.

This is general information, not legal, medical or benefits advice. The caseworker's assessment is the State's decision. Procedures change, so confirm with your county MDHHS office.