How to Talk to a Doctor About the DHS-54A Medical Needs Form
A key part of applying for Michigan’s Medicaid Home Help Program is having a doctor complete the DHS-54A Medical Needs form. This form confirms that the person applying needs help with daily tasks and outlines which services are medically necessary.
But many caregivers aren’t sure how to ask the doctor to fill it out or what information is most important. This guide will help you have a clear, confident conversation with your doctor — and avoid delays in the application process.
📄 What Is the DHS-54A Form?
The DHS-54A Medical Needs form is a document that must be completed by a licensed medical provider. It is used by the Michigan Department of Health and Human Services (MDHHS) to determine:
What medical conditions affect the person’s ability to function
What Activities of Daily Living (ADLs) the person needs help with
Whether the need for care is temporary or long-term
Without this form, the application for the Home Help Program cannot move forward.
🧑⚕️ Who Can Fill Out the Form?
The form must be completed by one of the following:
Primary care physician
Specialist (e.g., neurologist, psychiatrist)
Nurse practitioner or physician assistant (if authorized)
The provider must have a valid license and be familiar with the applicant’s health and limitations.
🗣️ How to Talk to the Doctor
When scheduling the appointment, you can say:
“I’m applying for Michigan’s Medicaid Home Help Program for in-home caregiver support. They require a medical needs form (DHS-54A) confirming that I/my family member needs help with daily tasks like bathing or dressing. Could you complete it?”
At the visit, be clear and honest about the person’s needs. You can explain:
What specific help is provided daily
Any mobility or safety concerns
Memory, behavior, or medication issues that affect independence
✅ Tips for Success
1. Bring the form with you.
Download it from michigan.gov and print it out, or request a copy from your Adult Services Worker (ASW).
2. Highlight ADLs.
Ask the doctor to focus on the person’s ability to:
Bathe
Dress
Eat
Walk or transfer
Use the toilet
Manage medication
These tasks are the basis for approval.
3. Be specific.
General statements like “needs some help” aren’t enough. Encourage the doctor to write details such as:
“Requires full assistance with lower body dressing due to balance issues.”
“Needs supervision due to short-term memory loss and disorientation.”
4. Check for completeness.
Before leaving, make sure the form is signed, dated, and every section is filled out — including diagnosis, expected duration, and ADL limitations.
🛠 What If the Doctor Won’t Fill It Out?
Some providers may not feel comfortable completing the form if:
They don’t see the person regularly
They’re unfamiliar with the program
In that case, you can:
Schedule with a primary doctor or provider who knows the person well
Ask your ASW for help identifying another medical provider who can assist
Request that the doctor review home care or caregiver logs to better understand daily needs
🧭 Final Thoughts
The DHS-54A form is one of the most important parts of your Home Help Program application. By clearly explaining the situation to your doctor and making sure the form is filled out properly, you can avoid delays and improve your chances of getting approved for services.