What Qualifies Someone for Supervision or Redirection Hours in Michigan’s Home Help Program?
Michigan’s Medicaid Home Help Program allows for paid caregiver hours when a person needs help with Activities of Daily Living (ADLs) — like bathing, dressing, and eating. But the program also considers something called “supervision and redirection.”
This type of assistance applies to people who may not need physical help, but who are cognitively impaired and need someone to ensure their safety. Here’s how it works — and who qualifies.
👁️ What Is Supervision or Redirection?
Supervision and redirection is non-physical care that involves:
Monitoring someone to prevent unsafe actions
Helping them stay on task or re-focus
Intervening when they’re confused, disoriented, or at risk of harm
Preventing wandering, aggression, or dangerous behavior due to cognitive decline
This care is common for people with:
Alzheimer’s or other forms of dementia
Traumatic brain injury
Mental illness or developmental disabilities
📝 When Can You Request These Hours?
You can request supervision/redirection hours during the ASW home visit or on your DHS-54A Medical Needs form. However, it must be clearly documented that the individual:
Has a cognitive or behavioral diagnosis (e.g., dementia, severe memory loss, psychosis)
Poses a health or safety risk without someone present
Would be unable to manage their environment independently
Example: A person with dementia may leave the stove on, wander into traffic, or forget to take important medications — even if they can dress or feed themselves.
📄 How to Document It
To be approved for these hours, documentation must show:
A specific diagnosis affecting judgment or memory
A description of specific behaviors that require monitoring
Notes from a medical provider confirming the need for 24/7 oversight or frequent intervention
The Adult Services Worker (ASW) and MDHHS will not approve these hours unless the need is both medical and behavioral — not just based on age or general concern.
⏱ How Are These Hours Calculated?
Supervision/redirection hours are typically limited to:
2–3 hours per day
Only during times when direct ADL assistance isn’t being provided
Not meant to cover 24/7 care unless strongly justified
These hours are added on top of physical care hours (ADLs) if needed.
🚫 What Doesn’t Count
The following do not qualify for supervision/redirection under Home Help:
Leaving the TV on for company
Calling a family member to check in
Passive monitoring through security cameras
Help with managing money or errands without a cognitive diagnosis
✅ Final Thoughts
Supervision and redirection hours are available to people with serious cognitive or mental impairments, but approval depends heavily on proper documentation. Families should work with medical providers to describe the individual’s behavior honestly and clearly.