Home Care for Adults With Disabilities in Michigan: Programs That Pay

Home care for adults with disabilities in Michigan is paid for mainly through Medicaid. Four programs matter: the Home Help program (MDHHS), the MI Choice Waiver, the Habilitation Supports Waiver, and Community Mental Health services. Each one can fund in-home support, and each one allows a family member to be the paid caregiver under certain rules.

On this page

1. Which programs pay for home care for disabled adults in Michigan?
2. Home Help: personal care for any age
3. MI Choice Waiver: more services for higher needs
4. Habilitation Supports Waiver: developmental disabilities
5. Community Mental Health: the front door for developmental disability and mental illness
6. Can a family member be paid to care for an adult with a disability?
7. How to get started
8. Disability home care across Michigan
9. Frequently asked questions

Which programs pay for home care for disabled adults in Michigan?

Michigan has no single “disability home care program.” The right one depends on the type of disability, the level of need and the person’s age.

Program	Who it serves	Who runs it	Family caregiver can be paid?
Home Help	Any age with Medicaid and a need for help with ADLs	MDHHS county office	Yes, as an individual provider through CHAMPS
MI Choice Waiver	Adults 18+ who meet nursing-facility level of care	Area Agencies on Aging and waiver agents	Yes, through the self-determination option
Habilitation Supports Waiver	Adults and children with a developmental disability	Community Mental Health (CMH)	Yes, in many cases, through self-determination
Community Mental Health services	Developmental disability or serious mental illness with Medicaid	County CMH via regional PIHP	Depends on the service and arrangement

Home Help: personal care for any age

The Home Help program, run by the Michigan Department of Health and Human Services (MDHHS), is the most direct route to paid in-home help. It is not a seniors-only program. An adult of 25 with a spinal cord injury qualifies the same way an 80-year-old does.

To qualify, the person must:

• Have active Michigan Medicaid
• Need hands-on help with at least one activity of daily living, such as bathing, dressing, toileting, eating, transferring or mobility
• Have that need confirmed on a medical needs form by a doctor, physician assistant or nurse practitioner
• Live in their own home or a family member’s home, not a licensed facility

An MDHHS adult services worker visits the home, scores each task, and approves a monthly number of hours. The person then picks their caregiver, who enrolls in CHAMPS, passes a background check and logs visits with Electronic Visit Verification. Read the full eligibility rules in who qualifies for Home Help in Michigan.

MI Choice Waiver: more services for higher needs

The MI Choice Waiver serves adults 18 and older who would otherwise qualify for a nursing home but want to stay in the community. It fits when the person needs more than personal care: supports coordination, home modifications, respite, adult day services or private-duty nursing.

You apply through your regional Area Agency on Aging or waiver agent, not the MDHHS county office. A nurse and social worker assess level of care, and there is a state-set income and asset test. Slots are limited, so some regions keep a waiting list.

Under MI Choice’s self-determination option, the person controls a budget and can hire their own caregiver, including a family member, through a fiscal intermediary. Our MI Choice Waiver guide explains the process, the waiting list and the paid family caregiver rules.

Habilitation Supports Waiver: developmental disabilities

The Habilitation Supports Waiver (HSW) is Michigan’s Medicaid waiver for people with a developmental disability who would otherwise need an intermediate care facility. It funds services such as:

• Community living supports (help with daily tasks and community activities)
• Respite care for the family
• Supports coordination
• Medical equipment and home modifications
• Supported employment

You apply through your county Community Mental Health Services Program (CMH). HSW slots are capped statewide, so CMH prioritizes the greatest need and keeps a waiting list. Without a slot, many of the same services can still be funded through regular CMH Medicaid services.

Community Mental Health: the front door for developmental disability and mental illness

Michigan delivers Medicaid specialty services for adults with developmental disabilities or serious mental illness through regional Prepaid Inpatient Health Plans (PIHPs) and county CMH agencies. If your adult child or sibling has autism, an intellectual disability or a serious mental illness, CMH is where in-home support starts.

After intake and a person-centered planning meeting, CMH writes an individual plan of service that can include in-home community living supports, respite, skill building and case management. Under self-determination, the family manages the budget and hires staff directly, with a fiscal intermediary handling payroll.

Home Help and CMH services can run at the same time, as long as they cover different hours and tasks: Home Help for bathing and meals, CMH for community outings and skill building, for example.

Can a family member be paid to care for an adult with a disability?

Yes, in each program, though the rules differ.

• Home Help: A parent, sibling, spouse, other relative or friend can be the individual provider after a background check, CHAMPS enrollment and EVV setup. Legal guardians should confirm with MDHHS whether any restriction applies.
• MI Choice: Family members can be hired under self-determination. Spouses and guardians face extra scrutiny, so ask the waiver agent before planning around it.
• HSW and CMH: Family members are often paid as community living supports staff under self-determination, with limits on spouses and, for minors, parents. Your supports coordinator can confirm what your county allows.

Payments to a caregiver who lives in the same home may be treated as difficulty-of-care payments under IRS Notice 2014-7 and excluded from federal income tax; see the IRS guidance or a tax professional. Enrollment steps for family caregivers are on our become a paid caregiver page.

How to get started

1. Confirm Medicaid. Many adults with disabilities already have it through SSI; working adults may qualify under Freedom to Work. Use our Medicaid eligibility check or apply through MI Bridges.
2. Identify the need. Hands-on daily tasks point to Home Help. Higher medical needs point to MI Choice. A developmental disability or mental illness points to CMH.
3. Make the first call. MDHHS county office for Home Help; Area Agency on Aging for MI Choice; county CMH for HSW.
4. Complete the assessment. Describe every task the person cannot do alone.
5. Enroll the caregiver. Background check, CHAMPS or fiscal intermediary paperwork, and training.

Disability home care across Michigan

Supportive Solutions Homecare serves adults with disabilities in Detroit, Dearborn, Warren, Sterling Heights, Ann Arbor, Flint, Lansing and Grand Rapids. We enroll family caregivers in Home Help and work in English, Arabic and Spanish. Learn more on our disability home care page.

Frequently asked questions

Can a person with a disability under 65 get Home Help?

Yes. Home Help has no minimum or maximum age. Any Michigan Medicaid recipient who needs hands-on help with at least one activity of daily living, confirmed by a medical provider and an MDHHS assessment, can qualify. Adults with physical disabilities, developmental disabilities, brain injuries and chronic illness are all served.

Will Medicaid pay for caregivers in the home?

Yes. Michigan Medicaid pays for in-home caregivers through Home Help, the MI Choice Waiver, the Habilitation Supports Waiver and Community Mental Health services. The caregiver can be an agency worker or, in most cases, a family member. Each program has its own assessment and its own rules for approving hours.

Can I be paid through MI Choice to care for a loved one?

Yes. Under the MI Choice self-determination option, the participant manages a budget and can hire a family member as a paid caregiver through a fiscal intermediary. Spouses and legal guardians may face restrictions, so confirm with the waiver agent. The participant must first be enrolled and meet nursing-facility level of care.

Can a parent be paid to care for an adult child with a disability?

Yes. Once the child is 18, a parent can be the paid Home Help provider if the adult child has Medicaid and an approved assessment. Parents can also be paid as community living supports staff under a CMH or HSW self-determination arrangement in many counties. Ask the supports coordinator about any local limits.

Is there a waiting list for these programs?

Home Help does not have a waiting list; it is an entitlement for anyone who qualifies. The MI Choice Waiver and the Habilitation Supports Waiver both have limited enrollment slots, so waiting lists exist in many regions. Applying to Home Help first gives the family paid help while a waiver slot opens.