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MI Choice: A Michigan Long-term Care Option


Help at Home and Independence for Katy

Katy K. is fiercely independent. Despite relying on a wheelchair because of multiple sclerosis and requiring in-home help, she does as much on her own as she can.

That includes motoring to a nearby Kroger or dollar store or the library, sometimes just to get out.

MI Choice participant Katy appreciates the independence the program makes possible

Katy says that independence and choice are her favorite part of the program.

Just over 15 years ago, Katy, 51, was informed by the Area Agency on Aging 1-B (AAA 1-B) that she might qualify for the MI Choice Medicaid Waiver program, an in-home care program for older adults and people with disabilities. Kay enrolled in the program after she had lost her job as a health unit coordinator in a local hospital and was collecting unemployment. A fellow resident in the apartment complex where she was living knew about the program and called the AAA 1-B on her behalf.

MI Choice turned out to be a perfect fit. The services it provides to Kay in the senior apartment complex where she lives in Rochester Hills enable her to stay independent, to live her life on her own terms.

The program, which has been around since 1998 under the auspices of the Michigan Department of Health and Human Services, enables older adults and people with disabilities to receive services in the home of their choice. That could be the family home, an assisted living or other licensed home that works with the AAA 1-B.

To qualify for the program, a person must meet eligibility requirements related to the level of care they need; MI Choice is considered to be an alternative to a nursing home. A participant also must also meet financial eligibility requirements (see details below.) The program does not have a deadline; it lasts as long as a person needs help.

Through the MI Choice program, Katy gets two home aides who split shifts three days a week to help wrap her legs (she has lymphedema from being confined to a wheelchair), help her to take a shower, do laundry and some light house cleaning. Katy says on the other two days she is busy with doctor appointments so doesn’t need the help.

“It’s awesome. I go to the grocery store by myself to pick up my own food. I go to the library myself. MI Choice gives me the opportunity to get out and to have the comfort of being in my own home and staying independent. I will even go two miles out of my way if I choose. I have the freedom to do what I want,” says Kay.

AAA 1-B enrolls residents from its six-county service area region (Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw counties). Other MI Choice “agents” in southeast Michigan include the Detroit Area Agency on Aging, Senior Alliance and Macomb Oakland Regional Center.

The program is available statewide (there are about 12,000 total participants in Michigan). It is a lot less expensive than nursing home care, at about $80 per day compared to about $200 per day.

Family Members Can Be Paid to Care for a Loved One

As a participant of the MI Choice program, Valerie T. receives services in the Pontiac home she shares with her husband, sister, and brother-in-law. She recently acquired a stairlift and a ramp through the program that allows her more freedom to move around.

Valerie’s main caregiver is her sister. Sharlene, 70, is what is called an “umbrella worker.” MI Choice allows relatives (not spouses) to become trained and certified as caregivers. They are reimbursed as direct care workers by a home health agency. Sharlene is required to take progress notes and to complete paperwork every two weeks that tracks her hours and activities.

That adds to long days for Sharlene. Her day starts out with making breakfast, getting Valerie out of bed, cleaning her and dressing her (with help), getting her in her chair and giving her medication. She then makes lunch, washes and changes her sister, puts her back in her chair, does the laundry. And then she starts dinner. Sharlene makes sure Valerie is hydrated and gets plenty of veggies in her diet.

“She can feed herself, but we have to watch her so she doesn’t choke,” says Sharlene. “She uses her left hand to eat. She understands us, but she may not be able to say what she wants. She’ll point to it.” That includes pointing at her wristwatch when her shows come on (the TV news and a few game shows).

Sharlene keeps herself in caregiving shape by resting, taking vitamins and eating healthy.

“It’s like, ‘Wow, I can’t believe I’m doing it,’” Sharlene says.

Shawn Mullin of Clinton Township is also a hardworking umbrella employee.

MI Choice allows family members to care for loved ones

Shawn likes that the program has options that allow her to be the paid caregiver for her aunt.

After her aunt Carol left a nursing home following years of rehabilitation from a stroke, Shawn learned that she could become her paid primary caregiver. She took the training and became certified, and over the past two years, she has provided daily cared for her aunt, who lives in a senior high rise in Mt. Clemens with Shawn’s uncle. Shawn cooks, cleans and dresses her aunt, does her laundry and the grocery shopping.

MI Choice, says Mullin, is “amazing.”

“It keeps somebody in their own home with their loved ones, where they should be,” she says.

Services Offered Through the MI Choice Program Include:

  • Personal care (help with bathing, toileting and personal hygiene)
  • Help transferring (getting into and out of bed)
  • Nursing care
  • Housekeeping/meal preparation
  • Adult day services
  • Respite care for family members
  • Transportation
  • Service/care coordination
  • Home modifications
  • Home-delivered meals
  • Personal emergency response systems
  • Relief for family caregivers
  • Specialized medical equipment and supplies

MI Choice Eligibility:

  • Be at least 65 years old or be an adult with a disability
  • Need a nursing home-level of care
  • Meet Medicaid financial eligibility criteria for the program (a single person’s income in 2022 can’t exceed $2,523 and assets of not more than $2,000, not including one’s home. Married couples can have a higher financial threshold for assets through a provision called spousal impoverishment.

Other Facts About MI Choice:

  • You can get MI Choice in your own home, the home of a loved one, or in a licensed or unlicensed assisted living community that works with the AAA 1-B.
  • A relative may be designated as a primary caregiver (and receive training and certification) and be reimbursed for providing care. Spouses are excluded.
  • After a person or their loved one calls AAA 1-B at 800-852-7795, a screening and telephone assessment will be completed (after it is safe to do so, the agency will go back to in-person assessments).

Getting Started:

To see if you qualify, call  Area Agency on Aging 1-B Information & Assistance 800-852-7795. For more information on the program, visit our In-home Services page or the Michigan Department of Health and Human Services MI Choice page.


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