Updated September 3, 2026. Quick answer: partially, through Home Help Program (MDHHS), where family pay is possible but narrower than a full open hire. A spouse cannot be the paid caregiver; the federal rule against paying a “legally responsible relative” still applies here.
How Michigan pays a family caregiver
| Program | Home Help Program (MDHHS) |
|---|---|
| Can a family member be paid? | Partial. “Do not pay Home Help services to: A responsible relative (a spouse caring for a spouse or a parent caring for a minor child). … A minor (17 and under). … Fiscal intermediary (FI).” |
| Can a spouse be paid? | No. “A spouse who is separated from a spouse cannot be the individual paid to provide Home Help services.” |
Why the spouse question is different
Federal Medicaid rule treats a spouse (and a parent paying for a minor child) as a “legally responsible relative”, someone already assumed to owe the care for free, so paying them is barred by default. A state has to build an explicit exception into its waiver or state-plan option to pay a spouse at all; the rule for any other relative (an adult child, a sibling, a grandchild) is looser and usually allowed. That is why the two rows above can carry different answers on the same page.
The going rate
$17.13/hour. “Effective January 1, 2026, the Home Help individual caregiver rate will be $13.73 plus a $3.40 pass-through, totaling $17.13 per hour.”
How it works
The client applies through their local county MDHHS/adult services office; a worker interviews the client and chosen caregiver, and the caregiver (who may be an adult child, sibling, other relative, or friend, but not a spouse or the parent of a minor) must enroll as a Medicaid provider and pass a criminal-history screen before being paid, with the client as legal employer.
What this doesn’t answer
MDHHS has proposed a new MI Choice waiver benefit called “Coordinated Caregiving” (structured family caregiving) for live-in family caregivers with an anticipated 7/1/2026 effective date and an ~$80.80/day stipend-based rate, but only the pre-implementation notice was found, not confirmation it is operational, so it is not represented as live in this page. Current Home Help/MI Choice waitlist status and the exact monthly hour cap were not verified this session.
Sources
- MDHHS Adult Services Manual ASM 135, Home Help Caregivers
- MDHHS Adult Services Manual ASM 138, County Rates (eff. 1-1-2026)
- MDHHS Home Help: Individual Caregivers
Read September 3, 2026.
Same question, other states: Minnesota · Mississippi.
Related: the private-pay caregiver-agreement rule · the household-employee tax rules once you’re being paid · what family caregiving actually costs unpaid.
General information drawn from each state’s own Medicaid agency and public program materials, not legal, tax or financial advice. Medicaid self-direction programs are administered state by state and change by budget cycle and waiver renewal; this page cannot see your own state’s current program status or your family’s eligibility. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.