Home Help vs. Community Living Supports (CLS): What's the Difference?

Home Help and Community Living Supports (CLS) get confused constantly, and for good reason — both can involve a family member getting paid to help with daily tasks. But they run through entirely different parts of Michigan's Medicaid system, with different rules, different administering agencies, and different limits on enrollment.

Home Help: a state-plan entitlement

Home Help is a Medicaid state-plan personal care benefit administered directly by MDHHS. It has no enrollment cap and no waitlist — anyone who meets the Medicaid and functional eligibility criteria can be approved, regardless of how many other people are already enrolled statewide. An MDHHS Adult Services Worker determines your approved hours.

CLS: a waiver service, not a standalone program

Community Living Supports isn't its own program — it's a category of service authorized through a Medicaid waiver, most commonly the MI Choice Waiver (for older adults and adults with physical disabilities) or the Habilitation Supports Waiver and similar waivers coordinated through your county Community Mental Health (CMH) agency (typically for people with intellectual or developmental disabilities). Unlike Home Help, these waivers are capped programs with a set number of statewide slots and can carry regional waitlists.

Who manages your case

This is the clearest practical difference. Home Help cases are managed by your local MDHHS office and an Adult Services Worker. CLS and other waiver services are managed by a Supports Coordinator, typically through a MI Choice Waiver Agency (often a local Area Agency on Aging) or your county CMH — a different point of contact entirely, with a different intake process.

Can a family member get paid through CLS too?

In many cases, yes — CLS also allows consumer-directed hiring in some models, similar in spirit to Home Help's self-direction option. But the enrollment process, the agency you'd work with, and the specific rules about who can be hired vary by waiver and by CMH, so it's not a simple copy-paste of Home Help's rules.

Bottom line for families

If your family member is Medicaid-eligible and needs personal care help, Home Help is usually the faster, less complicated path to a paid family caregiver arrangement. CLS and other waiver services tend to come into play when someone needs a broader range of services — respite, home modifications, skilled nursing coordination — beyond what Home Help covers, or when they meet a nursing-facility level of care.