Who qualifies for Michigan Home Help, and how to apply

The short answerTo get Home Help, a person generally needs to be enrolled in Michigan Medicaid, be certified by a Medicaid-enrolled medical professional as needing care, live at home rather than in a facility, and be assessed by a State caseworker as needing hands-on help with at least one activity of daily living. Only the State makes that decision.

The requirements, in plain language

• Medicaid. Home Help is paid for with Medicaid funds. The caseworker checks the person's Medicaid status as part of the assessment. If the person is not enrolled, Medicaid eligibility has to be sorted out first.
• A medical need. A Medicaid-enrolled medical professional must certify the need for services. That professional certifies; they do not prescribe or authorize the hours.
• A home setting. The person cannot be living in a hospital, nursing facility, licensed foster care or home for the aged, or similar institution.
• A functional need. The State assessment must find that the person needs hands-on help with at least one activity of daily living (bathing, dressing, eating, grooming, mobility, toileting or transferring), ranked 3 or higher on the State's 1 to 5 scale.

What does not decide eligibility

• Not having a diagnosis list. The State looks at what the person can do, not only at a diagnosis.
• Who the caregiver is. Choosing a family caregiver does not change whether the person qualifies, although some relatives, like a spouse, cannot be paid.
• An agency's opinion. Agencies, including ours, help with paperwork but do not decide eligibility.

How to apply, step by step

1. Confirm Medicaid. If the person already has Michigan Medicaid, you are ahead. If not, apply through MDHHS, which you can start online at MI Bridges or at the county office.
2. Contact the county MDHHS office. Ask for Adult Services and say you are requesting Home Help. The county offices are listed on michigan.gov/mdhhs.
3. Get the medical certification. Ask the person's doctor or another Medicaid-enrolled medical professional to certify the need for care. The caseworker will tell you what form is used.
4. Meet the Adult Services Worker. The worker visits the home, scores each daily task and sets the tasks and time.
5. Choose a caregiver. Tell the caseworker who you want. Individual caregivers are screened and enrolled with the State, and must be interviewed in person. Or choose an agency.
6. Sign the agreement. The client and the caregiver or agency sign the Home Help services agreement before the State authorizes payment.

What to have ready

• The person's Medicaid ID, date of birth and address
• Names and contacts for their doctor and any other care providers
• A plain list of what they need help with each day, and what they can still do alone
• Photo ID for the person who will be the caregiver
• Any paperwork that shows who makes decisions for them, such as a power of attorney or guardianship

How long does it take?

There is no single answer, because several offices and people are involved: the family, the person receiving care, the doctor, the caseworker and the caregiver's screening. In practice, most of the waiting happens between steps rather than inside them, so it helps to keep track of which person or office each step is waiting on and follow up on the one that has stalled. Ask the county office what to expect for your case.

If you are turned down or approved for less than you expected

You can ask the State to explain the decision, and you have appeal rights. The notice you receive explains how and by when, and deadlines can be short, so read it as soon as it arrives. Changes in the person's condition can be reported to the caseworker, who can decide on a new assessment.

This is general information, not legal, medical or benefits advice, and we cannot tell you whether a specific person qualifies. Only the State of Michigan decides. Rules and forms change, so confirm with your county MDHHS office.