The core idea behind self-direction is that the Medicaid recipient chooses who provides their care — and Michigan doesn't require that person to be related by blood or marriage. A longtime friend, a neighbor who's been helping informally, or another trusted adult can enroll as the paid individual provider.
Non-relative caregivers are allowed
Beyond the two groups Home Help explicitly excludes — spouses, and parents of minor children being cared for — the program is largely relationship-agnostic. What matters is that the care recipient trusts and has chosen this specific person, and that the person can pass the standard background check and complete CHAMPS enrollment.
How this differs from being a family caregiver
Practically, nothing changes about pay, hours, or the EVV requirement. The one place it can come up is during the MDHHS-5534 assessment — the caseworker may ask more questions to confirm the relationship and the arrangement's stability, simply because it's less immediately obvious than a parent-child relationship. That's a normal part of the process, not a red flag.
What MDHHS looks for in a non-relative provider
The same things it looks for in any provider: reliability, the ability to meet the documented care needs, and a clean background check. There's no requirement to prove a certain length of friendship or provide character references beyond what's part of standard enrollment.
Friend caregiver vs. licensed agency
If a friend or neighbor isn't available or willing to take on paid caregiving, a licensed home care agency is the other path — and can pay up to $23/hr since the agency bills at a higher contracted rate. Our family caregiver vs. agency comparison breaks down that trade-off in more detail.
