"Am I an employee or a contractor?" is a more important question than it might sound, because it determines how your pay is taxed, whether you're covered by workers' compensation, and what protections apply if something goes wrong with payroll.
The short version: mostly W-2, not 1099
In Michigan's Home Help structure, caregivers are generally treated as W-2 employees rather than 1099 independent contractors, whether they're hired through a provider agency or working under self-direction with a Fiscal Intermediary. This matters because W-2 status means payroll taxes are withheld automatically, and in the agency-employed case, workers' compensation coverage typically applies.
Provider agency: the agency is your employer
When you're hired as an agency employee, the agency handles W-2 payroll, tax withholding, and any applicable employer obligations — the same as any traditional employer would. You receive a standard W-2 at year-end.
Self-direction: the Fiscal Intermediary is the payroll processor
Under self-direction, the Medicaid recipient is technically your employer, and a Fiscal Intermediary handles the mechanics of payroll on their behalf — typically still resulting in W-2 wages rather than 1099 income, though the FI is the one issuing that paperwork, not the family directly.
What to verify before you start
If you're evaluating self-direction with a specific Fiscal Intermediary, it's worth confirming directly how they classify and report caregiver pay before you start — practices can vary between FIs. For the agency-employed path, this is one of the things the agency confirms upfront as part of onboarding, not something you have to chase down later.
Check current rules before you act. Home Help requirements, forms, and payment procedures can change. Use MDHHS Home Help guidance as the final source for current program details.