Home Care for ALS in Michigan: Medicaid, MI Choice and Medicare

Home care for ALS in Michigan helps a person living with amyotrophic lateral sclerosis stay safely at home as the disease progresses, with hands-on help for bathing, dressing, eating, transfers and daily routines. When the person has Medicaid, this care can be paid through Michigan Home Help or the MI Choice Waiver, often with a family member as the paid caregiver.

On this page

1. What does home care for ALS involve day to day?
2. Which Michigan programs pay for ALS home care?
3. Can a family member be paid to care for someone with ALS?
4. Where can Michigan families find ALS-specific support?
5. How does Supportive Solutions help families living with ALS?
6. When does a person with ALS need more than home care?
7. Frequently asked questions

What does home care for ALS involve day to day?

ALS progresses differently for everyone, but needs build over time and the care plan has to keep pace.

Early on

Help often starts with buttons, cooking, safe showering and rides to the ALS clinic. Fall prevention matters from the start.

As mobility declines

Transfers between bed, wheelchair, toilet and shower become central. A trained caregiver helps with transfers, repositioning, toileting, dressing and bathing, using a lift or transfer board as the physical or occupational therapist has directed.

Communication and fatigue

When speech becomes hard, many people use a speech-generating device, eye-gaze system or letter board. A good caregiver learns the person’s system, keeps devices charged and within reach, and waits for answers. ALS also brings deep fatigue, so caregivers plan around energy: bathing when rested, frequent breaks, no rushing at meals.

Later stages

Caregivers help with meals prepared as the speech-language pathologist recommends. Tube feeding, suctioning and breathing equipment are skilled tasks for nurses or family members trained by the medical team. Our caregivers provide non-medical personal care only.

Which Michigan programs pay for ALS home care?

Michigan Home Help

Home Help, run by the Michigan Department of Health and Human Services, pays a caregiver for personal care. It is based on need, not diagnosis: the person needs full Medicaid, must live in a private home, needs hands-on help with at least one activity of daily living such as bathing, dressing, eating, toileting, transferring or mobility, and needs a doctor, physician assistant or nurse practitioner to sign the medical needs form (DHS-54A). Our Home Help guide covers the steps.

Because ALS is progressive, hours approved at the first assessment often fall short. You can ask the adult services worker for a reassessment when the condition changes, without waiting for the next scheduled review.

MI Choice Waiver

The MI Choice Waiver serves adults 18 and older with a physical disability, and adults 65 and older, who meet Nursing Facility Level of Care and Medicaid financial rules. You apply through the local waiver agent, often the Area Agency on Aging. Besides personal care, MI Choice can cover specialized medical equipment and supplies, home modifications such as ramps or bathroom changes, respite for family caregivers, and supports coordination. Waitlists are possible, so apply early. Personal care usually comes through either Home Help or MI Choice, not both. See our MI Choice guide and MI Choice services.

Medicare, SSDI and ALS

ALS has special Social Security rules. People with ALS who are approved for Social Security Disability Insurance (SSDI) generally get Medicare as soon as SSDI begins, without the 24-month wait most disability beneficiaries face. The usual 5-month SSDI waiting period was also removed for ALS by a 2020 law. Start dates depend on the claim, so confirm with the Social Security Administration.

Medicare covers doctor and ALS clinic visits and may cover equipment such as power wheelchairs and speech-generating devices when medically necessary. It does not pay for ongoing personal care at home. A person can have Medicare and Medicaid at the same time.

Program	What it pays for	Who qualifies	Can family be paid?
Home Help	Personal care and related household tasks	Full Medicaid, need with at least one daily activity, private home, signed DHS-54A	Yes, except a spouse or parent of a minor
MI Choice Waiver	Personal care plus equipment, home modifications, respite	18+ with a physical disability or 65+, nursing facility level of care, Medicaid financial rules	Possible through self-determination; ask the waiver agent
Medicare home health	Part-time skilled nursing and therapy at home	Homebound, with a doctor-ordered skilled need	No
Medicare hospice	Comfort-focused care, nursing visits, equipment, some aide help, family respite	Doctor certifies a limited life expectancy, typically about six months or less	No

Can a family member be paid to care for someone with ALS?

Often, yes. Under Home Help the person with ALS chooses their caregiver, and an adult child, parent of an adult, sibling, grandchild, other relative, friend or neighbor can be paid. The caregiver enrolls in CHAMPS, records visits through EVV and is paid for the approved hours. See how paid family caregiving works.

For many ALS families the main caregiver is a husband or wife, and a spouse cannot be a paid Home Help provider. An adult child or another relative can be the paid provider while the spouse keeps helping. MI Choice self-determination has its own rules about who can be hired, so ask the waiver agent what applies to you. Our article on whether a spouse can be paid explains the options, and respite care can give a spouse regular breaks.

Where can Michigan families find ALS-specific support?

The ALS Association Michigan Chapter has a care services team that helps people with ALS and their families. It runs equipment loan programs that can include wheelchairs, lifts and communication devices, plus support groups and local referrals. Contact them early, since equipment can take time to arrange.

How does Supportive Solutions help families living with ALS?

• We check eligibility and help you apply for Medicaid if needed.
• We prepare you for the Home Help or MI Choice assessment, and we are an enrolled MI Choice Waiver provider.
• We handle CHAMPS enrollment, EVV setup and paying the caregiver. The first paycheck typically arrives about 30 days after approval.
• We place background-verified, MDHHS/CHAMPS-enrolled caregivers, choosing only trained caregivers whose certifications match the person’s condition and needs, including transfer and lift needs.
• We request reassessments as ALS progresses and help with appeals if hours are denied or cut.

New inquiries get a response within 24 hours, and our dedicated team of associates is available every day from 8 AM to 8 PM. We speak English, Arabic and Spanish and serve all of Michigan. See disability home care and how it works.

When does a person with ALS need more than home care?

• Skilled care at home: Medicare home health can send nurses and therapists for skilled needs when a doctor orders it. See home care vs home health care.
• End-of-life care: hospice provides comfort care, nursing visits, equipment and family support at home.
• Round-the-clock needs: if needs exceed what home can safely meet, a nursing facility may be the right step.

See all conditions in our care by condition hub.

Frequently asked questions

Does Medicaid pay for home care for ALS in Michigan?

Yes, when the person has Medicaid and needs hands-on help with daily activities, which most people with ALS do as the illness progresses. Michigan Home Help pays a caregiver for personal care. The MI Choice Waiver covers personal care plus extras such as equipment, home modifications and respite for people who meet nursing facility level of care.

Can I get paid to care for my parent with ALS?

Usually, yes. An adult child can be the paid Home Help provider for a parent who has full Medicaid and needs help with at least one daily activity. You enroll in CHAMPS, record visits through EVV and are paid for the approved hours. Siblings, other relatives and friends can also be paid.

Can a spouse be paid as a caregiver for someone with ALS?

Not through Home Help. Michigan does not allow a spouse to be the paid Home Help provider. Another relative or friend can be paid while the spouse keeps helping. MI Choice self-determination has its own rules about who can be hired, so ask the waiver agent what applies in your case.

Does Medicare cover home care for ALS?

Medicare covers doctor visits, much medical equipment, home health for skilled needs, and hospice. It does not pay for ongoing personal care such as daily bathing and dressing. People with ALS who qualify for SSDI generally get Medicare without the usual 24-month wait; confirm timing with the Social Security Administration.

What should we do when ALS care needs increase?

Ask for a reassessment as soon as the person needs noticeably more help, for example after losing the ability to transfer or feed themselves. Write down what has changed and how long tasks now take. Supportive Solutions helps families request reassessments and appeal if hours are not increased.

Can a home caregiver use a Hoyer lift for someone with ALS?

A trained caregiver can help with transfers and use lift equipment the way the person’s physical or occupational therapist has directed. That includes the right sling and, where advised, two people. Skilled tasks such as suctioning, tube feeding or ventilator care are handled by nurses or by family members the medical team has trained.