Can Michigan pay you to care for your adult child? A step-by-step guide to Home Help
Yes, once they turn eighteen. Michigan’s Home Help program is a Medicaid State Plan benefit with no waiting list, currently paying $17.13 an hour, and most families find out about it years later than they should have.
The medical needs form is the piece most families stall on, because it requires a physician visit and physicians do not volunteer it. Print the DHS-0054-a from the MDHHS forms page, bring it to the next appointment already filled out with your own notes on what your adult child needs help with, and ask the doctor to review, correct, and sign. One appointment. That form plus a MI Bridges application is the entire front end of this process.
No waiting list
Home Help is a Medicaid State Plan personal care benefit, not a waiver. If your adult child qualifies, they are entitled to it. There is no slot to wait for.
Parents qualify at 18
A parent cannot be paid to care for a minor child. When your child turns 18, you become eligible to be their paid caregiver.
Spouses cannot
A spouse cannot be a paid Home Help provider. Siblings, grandchildren, nieces, nephews, other relatives, and friends can be.
45
45 days
Your adult services worker must notify you in writing within 45 calendar days whether services are approved or denied. Put that date on your calendar when you apply.
Reassessed every 6 months
Approved cases get a home visit and comprehensive assessment every six months. Treat each one like a review that could change your hours, because it is.
The level 3 threshold
Payment is authorized only for activities assessed at level 3 or higher on the five-point independence scale. Level 3 means hands-on assistance is required.
The Home Help facts that matter
Medicaid State Plan personal care
None
$17.13 per hour, all 83 counties
Eligible provider at age 18
Not an eligible provider
45 calendar days, in writing
Home visit every 6 months
Activities scored level 3 or higher
Renee had been doing every transfer, every shower, and every medication pass for her son since he turned eighteen. She learned about Home Help at a support group when he was twenty-two. Nobody at the hospital, the school, or the CMH had ever mentioned it. Four years of the same labor, done for free, because the only place the program is advertised is inside the program.
Apply, get assessed, get paid
The order of operations
- 1Confirm your adult child has active Medicaid.
- 2Apply for Home Help through MI Bridges.
- 3Get the DHS-54A completed and signed by a physician.
- 4Complete the in-home comprehensive assessment.
- 5Enroll as a provider in CHAMPS.
- 6Set up Electronic Visit Verification and log every shift.
What to have ready for the assessment
- Medicaid ID and proof of current coverage
- Completed DHS-54A medical needs form
- Medication list with prescribers and dosing
- A written day-in-the-life description of assistance needed
- Notes on bathing, toileting, dressing, eating, transfers
- Documentation of any falls, injuries, or incidents
- Photo ID and Social Security number for the provider
- A calendar showing hours you already provide
The assessment is where the hours are decided. Describe the hardest ordinary day, not the best one, because the score is what pays.
A woman at a support group in Livonia asked me whether it was true that Michigan would pay her to care for her own son. She had been doing every transfer and every shower for four years, unpaid, while working part time to keep the lights on. It is true. It has been true the entire time. And in four years of hospitals, schools, and case managers, not one person had told her.
What Home Help is, and why the distinction matters
Michigan’s Home Help program is a Medicaid State Plan personal care benefit. That phrase is doing enormous work, so let me unpack it.
Most of the good services in the disability world live inside waivers. Waivers are capped. States decide how many slots exist, and when the slots are full, people wait. That is why there are over 600,000 people on home and community based services waiting lists nationally.
State Plan services are different. They are part of what Michigan promises every Medicaid beneficiary who meets the criteria. There is no slot count and no waiting list. If your adult child qualifies for Home Help, they are entitled to Home Help.
That is the single most important sentence in this post. Families spend years on waiver waiting lists without ever applying for the entitlement that was available the whole time.
Who can be paid, and who cannot
A parent cannot be paid to provide Home Help to a minor child. Michigan takes the position that ordinary parental responsibility covers that.
When your child turns 18, that changes. You become an eligible paid provider for your own adult child. Siblings, grandchildren, nieces, nephews, other relatives, and friends can also be providers.
Spouses cannot. If your adult child is married, their husband or wife cannot be the paid provider, though the family can hire someone else if the spouse is unable to provide the care.
The rate is currently $17.13 per hour, effective January 1, 2026, and it is the same in all 83 Michigan counties. That figure is built from a $13.73 direct care worker minimum plus a $3.40 pass-through allowance established under Public Act 337 of 2018.
Seventeen dollars and thirteen cents an hour to do work that a hired agency would struggle to staff at all. I am not going to pretend that is a generous wage for lifting an adult in and out of a shower. It is, however, considerably better than zero, which is what most Michigan parents of adult children are currently being paid for the same labor.
How the assessment actually works
This is where the hours get decided, so pay attention to this section more than any other.
After you apply, an adult services worker conducts a comprehensive in-home assessment. Each activity of daily living and instrumental activity of daily living is scored on a five-point scale, from 1 meaning independent to 5 meaning dependent.
Home Help payment may only be authorized for needs assessed at level 3 or greater. Level 3 is the threshold where hands-on assistance is required rather than cueing or supervision. If an activity scores a 2, it does not generate paid hours, no matter how much time it actually takes you.
Some instrumental activities carry monthly caps. Shopping is capped at 5 hours a month, light housework at 6, laundry at 7, and meal preparation at 25. Personal care activities are assessed individually, and cases exceeding roughly 180 hours a month get additional review under the enhanced services threshold.
The paperwork, in the order it happens
First, confirm active Medicaid. Home Help requires it. If your adult child does not have Medicaid, that application comes first, and adults with disabilities frequently qualify on their own income after 18 even when the family income would have disqualified them earlier.
Second, apply for Home Help. You can do this through MI Bridges at michigan.gov/mibridges, or by contacting your local MDHHS office and asking for adult services.
Third, the DHS-54A. This is the medical needs form, and a physician or approved medical professional has to complete it. This is the step that stalls families for months. Print it, fill in your own observations before the appointment, and hand it to the doctor to review and sign.
Fourth, the in-home assessment described above.
Fifth, the written determination. Your adult services worker must notify you in writing within 45 calendar days whether services are approved or denied. Write that date on a calendar the day you apply.
Sixth, if approved, you enroll as a provider in CHAMPS, Michigan’s Medicaid provider system, and set up Electronic Visit Verification. EVV is a federal Medicaid requirement, and it means each shift gets logged electronically. It is bureaucratic and it is not optional.
Seventh, reassessment every six months, with a home visit. Treat every reassessment as a review that can change your hours, because that is exactly what it is. Bring updated documentation each time.
The parts nobody warns you about
Home Help income is taxable, and being a paid caregiver can interact with your own benefits, your household income calculations, and your taxes. Talk to someone before your first payment, not after your first tax season.
Getting paid to care for your adult child does not replace the services they should be getting from the waiver system. It is a floor, not a plan. A family relying on Home Help alone still has no day program, no respite beyond what you personally provide, and no succession plan for when you cannot do this anymore.
And the reassessment cycle means you are never done. Every six months you make the case again. Keep the documentation running continuously rather than reconstructing it twice a year.
None of that is a reason to skip it. It is a reason to go in knowing what you are signing up for.
Your practical next steps
This week. Confirm your adult child has active Medicaid, and download the DHS-0054-a medical needs form from the MDHHS forms page.
At the next appointment. Bring the form already filled in with your notes and ask the physician to review, correct, and sign it. Ask for two signed originals.
The same week. Apply through MI Bridges or your local MDHHS office. Write down the date you applied and count 45 days forward on your calendar. If you have no written determination by then, call and reference the 45-day requirement by name.
Before the assessment. Write a plain description of a hard ordinary day, activity by activity, with the level of physical assistance each one requires. Hand a copy to the assessor. You are not exaggerating. You are translating your life into the scoring language the form uses, which is a skill nobody teaches you and everybody needs.
Michigan pays parents $17.13 an hour to do work the state cannot otherwise staff, and does almost nothing to tell parents the program exists. That is a communication choice, made by people with names, in an agency with a budget. Tell three families this week. That is the whole distribution system.