In the Home Help Program, some family members can be paid for the caregiving assistance they provide.
Home Help is a state Medicaid program administered by the Michigan Department of Health and Human Services (MDHHS) for elderly and disabled Michigan residents that require assistance with their daily and instrumental living activities. This program’s services include personal care, such as bathing and toileting, as well as assistance with laundry and shopping for essentials. The Home Help Program is intended to promote independence at home and delay institutionalization. Therefore, it is not available to individuals living in nursing homes, adult foster care homes, or assisted living residences.
There is a consumer direction component to this program, also referred to as participant direction or self-direction. Based on Medicaid’s Cash and Counseling model, program participants can select their own caregivers. Friends and family members (with the exception of parents and spouses) can be paid for the care they provide. The individual works with the county case manager to determine the appropriate amount of care and then is granted a budget for care instead of receiving care services directly from the state. As of January 2020, the individual caregiver rate is $11.00 / hour in the counties of Benzie, Grand Traverse, Leelanau, and Manistee. All other counties pay individual caregivers $9.65 / hour. Please note that this hourly pay rate is much less than the average national hourly rate for home care, which is $23 / hour according to Genworth’s Cost of Care Survey 2019.
Another program that might be of interest to elderly Michigan residents is Michigan Health Link. This program is for individuals who are eligible for both Medicaid and Medicare. The services provided via Home Help are also available under Health Link, as well as a variety of other long-term care services. Unlike Home Help, personal care assistance via Health Link can be provided in Adult Foster Care homes and Homes for the Aged, which are also known as assisted living facilities.
The Home Help program has functional (disability) and financial requirements. There are no age restrictions. Although the program is intended to help adults remain living at home and parents are not eligible to be paid caregivers. Thus, this program is appropriate for individuals ages 18 and over. However, the requirements that follow are relevant for those 65 and older.
Applicants must be assessed and certified by a Medicaid employee that they require assistance to perform a minimum of 1 of the 7 essential activities of daily living (found halfway down the page).
Participants must be financially eligible to receive Michigan Medicaid. There are both income and assets limits. The applicant’s monthly income cannot exceed $1,063 in 2020 and a couple’s income is limited to $1,437. These limits are set per the Federal Poverty Level (FPL) and are adjusted annually.
Single applicants are further limited to no more than $2,000 in total money, including assets that are easily converted to cash. Married applicants have a slightly higher asset limit, which is $3,000. However, some assets are not counted towards this limit. These exemptions include one’s home and vehicle, provided the applicant uses them. However, the applicant’s home equity must be valued at or below $595,000.
Medicaid also reviews the applicant’s past asset transfers back as far as 60 months. This is done to prevent individuals from simply giving away their resources to other family members, or selling them under fair market value, in order to qualify for Medicaid. This is called the Medicaid ‘Look back’ Period. Applicants found to have violated the asset transfer rules during the look back period may be subject to a penalty in their benefits. Learn more here.
Services provided under this program are determined on a case-by-case basis with a county worker. As mentioned before, the types of services typically provided are assistance with the activities of daily living and instrumental activities of daily living. These activities include:
To apply for the Home Help program, one should contact his or her Department of Health County office. An in-person assessment must take place to determine one’s level of care before the applicant can be qualified to receive services. More information is available for download about the program here. And additional information can be found on the Michigan Department of Health & Human Services’ website. Benefits start promptly once the application is approved. There are no waiting lists for this program, as it is an entitlement for those who meet the eligibility requirements.