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Michigan Home Care Policy and Procedure Manual

For Michigan agencies that give non-medical home care. Michigan does not license these agencies, so the manual is written for MDHHS-approved Home Help agency providers, MI Choice Waiver direct service providers and private-pay agencies. The manual has 50 policies and 56 client and agency forms, with every client form in English and Spanish, written to the Michigan Medicaid Provider Manual and Michigan laws such as adult abuse reporting (MCL 400.11a) and MIOSHA's bloodborne pathogens rules. Each policy opens with a plain-English summary and names the rule it follows, and every one is filled in with your agency's details. You get Word and PDF files to keep, and your staff sign off on their phones.

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Michigan · Home care

50 policies written to the Michigan rules, with 56 forms. Every one is filled in with your agency's details.

  • A plain-English summary first
  • The rule each policy follows
  • Word and PDF downloads, yours to keep
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Policies
50
Forms
56
Categories
13
Policy Pack · required
$700one-timeIncludes 90 days in the portal with Premium. To keep it open after that, Premium is $79 a month or $790 a year.

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3 free sample policies, shown in full for a sample agency.

MI-HC-CR-01Free sample Client rights

Client Rights and Responsibilities

Sets out the rights every client of the Agency has and the responsibilities clients are asked to meet, and how the Agency tells each client about them in writing at the start of services. Because Michigan has no home care licensing law, the rights come from the Medicaid program rules that bind the Agency (the MI Choice rights notice, the HCBS settings rule, Home Help client choice, payment in full, freedom from restraint and coercion, confidentiality) and from the Agency's own standards, which apply to every client whatever the payer. It also tells clients how to complain, grieve or appeal and where to report abuse or fraud.

Read the full policy MI-HC-ANE-01Free sample Safeguarding

Recognizing and Reporting Abuse, Neglect, and Exploitation of Adults

Requires every employee and volunteer who suspects or has reasonable cause to believe that an adult client has been abused, neglected or exploited to make an immediate oral report to MDHHS Centralized Intake for Abuse and Neglect, calling 911 first when anyone is in danger. Gives the Michigan definitions, the signs staff look for, what the report must contain, what the Agency does afterwards (including MI Choice critical incident reporting and removing an accused employee from client contact), and the confidentiality, good-faith immunity and civil fine for failing to report that the Social Welfare Act sets.

Read the full policy MI-HC-IC-01Free sample Infection control

Infection Prevention and Standard Precautions in the Home

Requires every direct care worker to use standard precautions with every client: hand hygiene, gloves and other protective equipment supplied by the Agency at no cost, respiratory hygiene, cleaning and disinfecting, safe handling of soiled laundry, waste and the client's own sharps, and safe food handling. Treats all blood and body fluids as potentially infectious (MIOSHA universal precautions), and links to the bloodborne pathogens exposure control plan and the rules on working while ill.

Read the full policy
Michigan rules

What Michigan's program rules ask your policies to cover

  • Backup when a worker cannot come. Each MI Choice participant has a service need level. When services are not delivered as planned, the backup plan starts, or family and friends are contacted, immediately for levels 1A and 1B and within 12 hours for 2A and 2B. MPM MI Choice Waiver §4.5.A
  • Supervision and in-service training. MI Choice providers supervise their staff in the home at least twice each fiscal year, with a qualified professional making the visit, and give in-service training at least twice each fiscal year. MPM MI Choice Waiver §9.12.B and §9.12.D
  • Critical incidents. For MI Choice participants, an unexpected death is reported to the waiver agency within two business days, and other critical incidents within 30 calendar days. MPM MI Choice Waiver §10.4.C
  • Abuse, neglect and exploitation. Home Help providers are mandated reporters. Suspected abuse, neglect or exploitation of an adult is reported immediately, by telephone or otherwise, to MDHHS Centralized Intake. MCL 400.11a(1); MPM Home Help §8.6.E.3
  • Electronic visit verification. A caregiver who records a visit offline connects to the internet within seven calendar days so the data is sent. MDHHS expects 85 percent of verified visits each quarter, per payer, to have no manual edits. MPM Electronic Visit Verification §2.3.A and §5.1
  • Records. Medicaid and Home Help records are kept seven years from the date of service, and MI Choice records not less than 10 years. MPM General Information for Providers §14.1; MPM MI Choice Waiver §9.18

Questions a surveyor may ask

Every policy lists questions a surveyor may ask about it, so your staff can practice the answers. A few from this manual:

What is this participant's service need level, and what happens if her caregiver calls in sick an hour before the shift? MI-HC-SP-02Scheduling, Missed Visits, and Backup Plans Who calls Centralized Intake: the caregiver, or the office? Does the caregiver have to ask permission first? MI-HC-ANE-01Recognizing and Reporting Abuse, Neglect, and Exploitation of Adults Show me the Michigan State Police check and the reference checks for your three newest workers, with the date each first entered a participant's home. MI-HC-HR-02Criminal History Checks, Reference Checks, and CHAMPS Caregiver Enrollment What was your percentage of visits without manual edits last quarter, for each payer? MI-HC-BUS-03Electronic Visit Verification If an ice storm closes the roads tomorrow, which participants do you serve first, and how do you know? MI-HC-EP-01Emergency Preparedness and Continuity of Services
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Browse all 50 policies

Search by title, policy number or rule. Open any policy to see its summary, the rules it follows and what is inside.

All 50 policies

Client rights4

MI-HC-CR-01Free sample Client Rights and Responsibilities Sets out the rights every client of the Agency has and the responsibilities clients are asked to meet, and how the Agency tells each client about them in writing at the start of services. Because Michigan has no home care licensing law, the rights come from the Medicaid program rules that bind the Agency (the MI Choice rights notice, the HCBS settings rule, Home Help client choice, payment in full, freedom from restraint and coercion, confidentiality) and from the Agency's own standards, which apply to every client whatever the payer. It also tells clients how to complain, grieve or appeal and where to report abuse or fraud. MPM MI Choice Waiver §9.9 MI-HC-CR-02 Nondiscrimination, Language Access, and Effective Communication Sets out how the Agency prevents discrimination against clients and applicants for services, gives free language assistance to people with limited English proficiency, and communicates effectively with people with disabilities, as Section 1557 of the Affordable Care Act (45 CFR Part 92) requires of an agency paid by Medicaid. It covers the nondiscrimination notice and the notice of available language help, qualified interpreters and translators (never minors, and adults only in the narrow cases the rule allows), auxiliary aids and reasonable modifications, the Section 1557 Coordinator, discrimination grievances, and training. 45 CFR Part 92 MI-HC-CR-03 Client Choice, Representatives, Consent, and Advance Directives Sets out how the Agency supports each client to make their own choices about their services, how it identifies and works with representatives (guardians, patient advocates, agents under a power of attorney and people the client chooses to involve), how it obtains and records consent to services and to sharing information, and how it handles advance directives, do-not-resuscitate orders and MI-POST forms. No rule requires a non-medical home care agency to give advance directive information; the Agency's practice on advance directives is its own standard. MPM Home Help §1.1 MI-HC-GRV-01 Complaints and Grievances Gives every client, representative, family member and member of the public a simple way to complain to the Agency, in any form and language, without fear of retaliation, and sets the Agency's own time frames to acknowledge and resolve complaints. Because Michigan has no licensing complaint office for non-medical home care, it also tells clients where else they can go: MI Choice participants to their waiver agency's grievance and appeal process, Home Help clients to their adult services worker and the administrative hearing process, and anyone to the civil rights, privacy, fraud and abuse reporting routes. It covers the Section 1557 grievance procedure and the complaint log. MPM MI Choice Waiver §11.1

Service delivery12

MI-HC-ADM-01 Referral, Intake, Acceptance, and Service Agreements Sets out how the Agency receives referrals, decides whether it can accept a client, and starts services under the right authority for each payer: the Home Help provider Time and Task and the signed Home Help Services Agreement (MSA-4676), the MI Choice waiver agency's work order and assessment, or the Agency's own Private Pay Service Agreement. It covers the intake record, allowed and prohibited service settings, the Home Help limits on recruiting clients and former individual caregivers, the start-of-service visit, and what the Agency does when it cannot start services. MPM Home Help §8.6.A MI-HC-DC-01 Service Changes, Suspension, Transfer, and Discharge Sets out how services change, are suspended or end: when the client chooses another provider or stops services (which a client may do at any time), when the program changes or ends the authorization, when the client goes into a hospital or facility, and when the Agency itself must suspend or discharge a client. It covers the Home Help rules on facility admission and discharge dates and the 10-business-day report to MDHHS, MI Choice suspension during hospital stays and waiver agency adverse benefit determinations, the Agency's own written notice before an Agency-initiated discharge, safe transfer to another provider, and closing the client record. MPM Home Help §4.3 MI-HC-SAF-01 Client Safety, Falls, Safe Transfers, and Prohibition of Restraints Prohibits restraints, seclusion and restrictive interventions for every client (bed rails or bed canes only where an assessed need is documented), and sets how direct care workers keep clients safe at home: a home safety check on Form MI-HC-SAF-01-A at the start of services and at supervisory visits, daily fall prevention, what to do when a client falls, safe transfers and body mechanics, fire, smoking and oxygen safety, and clients who wander or cannot be left alone. MPM MI Choice Waiver §9.5 MI-HC-SAF-02 Medical Emergencies, Changes in Condition, and Death in the Home Sets out what direct care workers do in a medical emergency (call 911 first, then the office), how they respect a client's do-not-resuscitate order under the Michigan Do-Not-Resuscitate Procedure Act, how they observe and report changes in a client's condition, and what they do if a client dies or is found dead at home. Covers the reports that follow: notice to MDHHS of a Home Help client's hospitalization or a facility stay, and MI Choice unexpected deaths reported to the waiver agency within two business days. MPM Home Help §8.2 MI-HC-SAF-03 Direct Care Worker Safety in the Home Sets out how Sample Agency, LLC protects direct care workers who work alone in clients' homes and on the road: screening a home before the first visit, check-in while working alone, travel and winter driving, aggressive behavior, harassment and the right to leave an unsafe situation after making the client as safe as possible, safe lifting, chemicals, infestations and other hazards, reporting every injury the same day, MIOSHA injury and illness recording and the 8-hour and 24-hour reports to MIOSHA, workers' compensation, and protection from retaliation. Concerns are recorded on Form MI-HC-SAF-03-A. MCL 408.1011 MI-HC-SP-01 Care Planning Within Authorized Services Sets out how the Agency turns each client's authorization into a written care plan and task list that workers follow on every visit, without ever adding tasks or time the program did not authorize. The adult services worker (Home Help) and the waiver agency (MI Choice) assess need and set the services; the Agency plans how the authorized tasks are done, with the client's preferences, safety precautions and contacts. For private-pay clients the Agency builds the plan with the client. It covers Home Help noncovered services and IADL limits, community living supports tasks that need registered nurse supervision, review and updating, and how changes are requested. MPM MI Choice Waiver §9.12.A MI-HC-SP-02 Scheduling, Missed Visits, and Backup Plans Sets out how the Agency schedules visits within each client's authorization and preferences, what happens when a worker is late or cannot make a visit, and how backup coverage is arranged so that clients who cannot be left alone are never left without help. For MI Choice participants it uses the service need levels the waiver agency assigns (1A to 3B) to decide how fast backup must start, and treats provider no-shows for participants with a critical need as critical incidents. It also covers client cancellations, visits where the client is not home, and billing only for services actually delivered. MPM MI Choice Waiver §4.5 MI-HC-SP-03 Coordination with Adult Services Workers, Supports Coordinators, and Other Providers Sets out how the Agency works with the people who authorize and oversee each client's services, the MDHHS adult services worker for Home Help and the waiver agency's supports coordinator for MI Choice, and with physicians, home health and hospice agencies and other providers. It covers the Home Help caregiver interviews with the ASW, the 10-business-day reports of changes that affect payment, observing and reporting changes in a participant's condition to the supports coordinator, cooperating with waiver agency reviewers, avoiding duplication with other services, and sharing information only as HIPAA and the MI Choice confidentiality rule allow. MPM Home Help §8.6.E.2 MI-HC-SUP-01 Supervision of Direct Care Workers and In-Home Supervisory Visits Requires a supervisor to be available to every direct care worker whenever the worker is serving a client (by telephone allowed), a Michigan-licensed registered nurse to supervise community living supports workers who perform asterisked tasks, and in-home supervision of every direct care worker at least twice each fiscal year by a qualified professional, applied to all clients as the Agency's own standard. Sets what the supervisor checks at each visit, how findings are followed up, and how visits are recorded on Form MI-HC-SUP-01-A. MPM MI Choice Waiver §9.12.B MI-HC-SVC-01 Scope of Services and Clients Served States which services Sample Agency, LLC provides and to whom: Home Help personal care (hands-on help with activities of daily living, instrumental activities of daily living and complex care tasks), MI Choice community living supports, in-home respite and chore, and private-pay companion, homemaking and personal care. Lists what each program does not cover, where services may and may not be given, the services the Agency never provides (skilled nursing, therapy, and medication administration beyond Policy MI-HC-SVC-04), and how the Agency decides that it cannot safely accept a client. MPM Home Help §2 MI-HC-SVC-02 Personal Care and Household Support Sets out how direct care workers give personal care (bathing, dressing, eating, grooming, mobility, toileting and transferring) and household support (laundry, light housework, meal preparation, shopping) safely and with dignity; explains the difference between Home Help, which pays only for hands-on help, and MI Choice community living supports, which also include reminding, cueing and guiding; covers dementia care, safe food handling, observing and reporting skin and other changes, and documenting each task. MPM Home Help §2.1 MI-HC-SVC-05 Respite, Chore, and Transportation Services Sets the standards for in-home respite (assessment before the first visit, matching the worker to the participant, an emergency notification plan for each visit, a supervisor available during the shift), chore services (heavy cleaning, yard work and snow removal only as authorized, safe use of equipment, no pest control), and transportation (who may drive clients, driver and vehicle checks, seat belts, emergencies, and what each program pays for). MPM MI Choice Waiver §4.1.N

Clinical tasks2

MI-HC-SVC-03 Complex Care Tasks and Higher-Level Community Living Supports Tasks Sets out which complex care tasks (Home Help) and higher-level community living supports tasks (MI Choice) Sample Agency, LLC accepts, the three tiers the Agency uses (accepted with client-specific training, accepted only with governing body approval and registered nurse delegation, never accepted), and the steps that must be complete before a worker performs any such task: written client-specific instructions, review by the supervising nurse, training, a supervised return demonstration recorded on Form MI-HC-SVC-03-A, and ongoing supervision and re-checks. MPM Home Help §2.3 MI-HC-SVC-04 Medication Reminders and Assistance with Self-Medication Sets out what direct care workers may and may not do with a client's medications: medication reminders and cueing (MI Choice community living supports), hands-on help with taking medication (Home Help), and assistance with self-medication under written procedures reviewed by a consulting pharmacist, physician or registered nurse. Workers do not administer medication except as a complex care task the Agency has accepted under Policy MI-HC-SVC-03. Covers storage, refusals, errors and reactions, and recording each assistance on Form MI-HC-SVC-04-B. MPM MI Choice Waiver §4.1.D

Safeguarding2

MI-HC-ANE-01Free sample Recognizing and Reporting Abuse, Neglect, and Exploitation of Adults Requires every employee and volunteer who suspects or has reasonable cause to believe that an adult client has been abused, neglected or exploited to make an immediate oral report to MDHHS Centralized Intake for Abuse and Neglect, calling 911 first when anyone is in danger. Gives the Michigan definitions, the signs staff look for, what the report must contain, what the Agency does afterwards (including MI Choice critical incident reporting and removing an accused employee from client contact), and the confidentiality, good-faith immunity and civil fine for failing to report that the Social Welfare Act sets. MCL 400.11a MI-HC-ANE-02 Reporting Suspected Child Abuse or Neglect Sets how staff report suspected abuse or neglect of a child (anyone under 18) whom they meet at work, whether the child is a Home Help client or lives in or visits a client's home. Licensed nurses, social workers, counselors and the other professionals named in the Child Protection Law must make an immediate report to MDHHS Centralized Intake and a written report within 72 hours after a telephone report; as the Agency's own standard, every other employee and volunteer reports too. Covers the legal definitions, telling the person in charge, confidentiality and good-faith immunity, and the penalties for failing to report. MCL 722.623

Infection control2

MI-HC-IC-01Free sample Infection Prevention and Standard Precautions in the Home Requires every direct care worker to use standard precautions with every client: hand hygiene, gloves and other protective equipment supplied by the Agency at no cost, respiratory hygiene, cleaning and disinfecting, safe handling of soiled laundry, waste and the client's own sharps, and safe food handling. Treats all blood and body fluids as potentially infectious (MIOSHA universal precautions), and links to the bloodborne pathogens exposure control plan and the rules on working while ill. MPM MI Choice Waiver §9.20.F MI-HC-IC-02 Bloodborne Pathogens Exposure Control Plan This policy is the Agency's written exposure control plan under MIOSHA Part 554, Bloodborne Infectious Diseases. It records the exposure determination (category A and B job classifications), task-specific standard operating procedures for care in the home, universal precautions, engineering and work practice controls, protective equipment, housekeeping, regulated waste and laundry, hepatitis B vaccination within 10 working days of initial assignment, post-exposure evaluation and follow-up, training at initial assignment and at least annually, the annual review of the plan, and the medical and training records the rules require. Mich. Admin. Code R 325.70001 et seq.

Emergency preparedness1

MI-HC-EP-01 Emergency Preparedness and Continuity of Services Sets the Agency's plan for keeping clients safe and services going during emergencies such as winter storms, power outages, tornadoes, flooding, extreme heat or cold, pandemics, office or system outages and sudden staff shortages. It names the disaster coordinator, uses the MI Choice service need levels (and an equivalent priority level for Home Help and private-pay clients) to decide who is served first, requires a written emergency plan for each client and an emergency notification plan at each respite visit, and covers staff call-down, communication with waiver agencies, adult services workers and families, EVV offline use, recovery and an annual exercise. Michigan sets no emergency plan rule for non-medical home care; the plan is the Agency's own standard. MPM MI Choice Waiver §4.5

Records2

MI-HC-REC-01 Client Records, Retention, and Access Sets what goes into every client record, how records are written, stored and protected in controlled access files, how long they are kept (10 years from the date of service for MI Choice participants, at least seven years from the date of service under Michigan Medicaid and Home Help rules, and seven years from the last date of services for the Home Help Services Agreement), who may see them without the client's authorization (MDHHS, its authorized agents, the Department of Attorney General and federal authorities), how clients get copies and request amendments under HIPAA, and how records are kept safe if the Agency changes owner or closes. MPM General Information for Providers §14.1 MI-HC-REC-02 Daily Service Documentation and Worker Service Records Requires a daily service log for every visit to every client that records the tasks actually done, the time range, the date and the worker's identity and signature, so that each claim to MDHHS or a waiver agency is backed by a worker service record. Explains why time sheets and EVV clock-in data alone are not enough, how the log is checked against the MSA-1904 and waiver agency bills, how late entries and corrections are made, and that a missing record means the service is treated as not given. MPM MI Choice Waiver §9.23

Privacy3

MI-HC-PRV-01 HIPAA Privacy and Confidentiality of Client Information Makes every employee and volunteer protect clients' health information as the HIPAA Privacy Rule, the MI Choice confidentiality standard and the Home Help operating standards require: a designated privacy official, a Notice of Privacy Practices with a signed acknowledgment, uses and disclosures only for treatment, payment, operations or as the law allows, written authorization for anything else, the client's rights to access, amendment, an accounting, restrictions and confidential communications, a record of every release, workforce training, sanctions, complaints without retaliation, and six-year documentation. It also sets the everyday rules caregivers follow in clients' homes. 45 CFR §164.530 MI-HC-PRV-02 HIPAA Security and Mobile Devices Sets the HIPAA Security Rule program that protects clients' electronic information in the Agency's scheduling, billing and EVV systems and on phones, tablets and laptops: an assigned security official, a written risk analysis and risk management plan, workforce access controls and unique logins, security awareness training, incident response, backup and contingency plans, business associate agreements, physical and technical safeguards, and the rules every worker follows when using a personal or Agency phone for the EVV mobile application. 45 CFR §164.308 MI-HC-PRV-03 Breach Notification Sets how the Agency finds, assesses and reports a breach of clients' unsecured protected health information under the HIPAA Breach Notification Rule (the four-factor risk assessment, notice to each affected person without unreasonable delay and no later than 60 calendar days after discovery, media notice for more than 500 residents of a state, and notice to HHS), how it handles a breach of employees' or clients' Social Security, driver's license or financial account numbers under Michigan's Identity Theft Protection Act, and how every incident is logged. 45 CFR §164.404

Human resources9

MI-HC-CMP-01 Task Training and Competency of Direct Care Workers Requires every direct care worker to show competence in each task before performing it for any client: core skills checked at hire, client-specific training before the first visit with each client, registered nurse training and competency checks for asterisked and higher-level community living supports tasks, and re-checks at least once a year and whenever a concern arises. States that no Michigan rule sets training hours for non-medical home care workers and records competence on Form MI-HC-CMP-01-A. MPM MI Choice Waiver §4.1.D MI-HC-HR-01 Recruitment, Hiring, and Caregiver Qualifications Sets the minimum qualifications for every direct care worker (age, ability, health, dependability, communication and willingness to train), the people who may never be placed as caregivers, how the Agency recruits without breaking Home Help marketing limits, the direct-employment and no-non-compete rules for Home Help agency providers, how family members may work as caregivers, and the hiring steps that must be finished before a new worker is scheduled. MPM Home Help §8.2 MI-HC-HR-02 Criminal History Checks, Reference Checks, and CHAMPS Caregiver Enrollment Requires a statewide Michigan State Police criminal history review and reference checks for every employee and volunteer before they enter any client's home, Home Help CHAMPS enrollment with its criminal history screening before any Home Help service, and exclusion screening, and sets out how the Agency decides on a finding, how employees must report later arrests and convictions, and how background information is kept confidential. MPM MI Choice Waiver §9.4 MI-HC-HR-03 Personnel Records Lists what each personnel file must contain, keeps medical, background and immigration records separate and confidential, sets how long personnel, training, medical and earned sick time records are kept, and explains an employee's right under Michigan's Bullard-Plawecki Employee Right to Know Act to review, copy and respond to their personnel record. MCL 423.501 et seq. MI-HC-HR-04 Health and Fitness for Duty Requires every direct care worker to be in adequate health to do the work safely, sets the Agency's own health screening at hire (a health and fitness statement after a conditional offer and tuberculosis screening following CDC guidance for health care personnel), and covers working while ill, infectious illness, return to work, reasonable accommodation, drugs and alcohol, and confidentiality of health information. MPM Home Help §8.2 MI-HC-HR-05 Orientation and In-Service Training Requires every new staff member to complete orientation before working with any client, covering at least the MI Choice orientation topics, the Home Help program rules, abuse reporting, privacy, bloodborne pathogens, EVV, emergencies and conduct; requires in-service training for every direct care worker at least twice each fiscal year; and sets how training is planned, logged and checked. MPM MI Choice Waiver §9.17 MI-HC-HR-06 Job Descriptions, Staff Identification, and Performance Evaluation Requires a written job description for every position, a picture identification badge that every worker and volunteer shows on every visit, a performance evaluation at the end of the introductory period and each year with an individual in-service training plan when needed, and a fair, documented approach to discipline, including immediate discharge for threatening or coercing a client. MPM MI Choice Waiver §9.16 MI-HC-HR-07 Volunteers Sets out what volunteers may and may not do for the Agency, how they are recruited, checked, oriented, trained, supervised and evaluated, and the rules they follow on identification, confidentiality, solicitation and conduct. Volunteers never replace paid staff in delivering authorized Medicaid services. MPM MI Choice Waiver §9.14 MI-HC-HR-08 Wages, Hours, Earned Sick Time, and Workers' Compensation Covers the pay and leave rules every caregiver is owed: Michigan minimum wage, federal overtime (third-party home care employers cannot use the companionship or live-in exemptions), paid travel time between clients, earned sick time under the Earned Sick Time Act with the required written notice and poster, workers' compensation and unemployment insurance, payroll records that support Medicaid audits, and required workplace postings. MCL 408.961 et seq.

Governance4

MI-HC-GOV-01 Legal Status, Program Participation, and Governing Body States the Agency's legal standing (Michigan does not license non-medical home care, so the Agency operates as a registered business and a Medicaid provider), the programs it may take part in and the standards each one imposes, and the duties of the governing body: adopting and reviewing policies, keeping the insurance the MI Choice Waiver requires, and managing a change of ownership, withdrawal from a program or closure without leaving clients or records unprotected. MCL 400.111b MI-HC-GOV-02 Administrator, Managing Employees, and Organizational Structure Sets out who runs the Agency day to day: the Administrator and the Alternate Administrator, the managing employees MDHHS treats as disclosed individuals, the organizational structure and lines of authority the MI Choice Waiver requires, the named contact person for each waiver agency, and how authority is delegated and recorded so that a supervisor is always available to direct care workers. MPM MI Choice Waiver §9.15 MI-HC-GOV-03 Medicaid Enrollment in CHAMPS, Ownership Disclosures, and Reporting Changes Explains how the Agency keeps its Michigan Medicaid enrollment in CHAMPS accurate: who must be enrolled or disclosed (the Agency, its owners, managing employees, agency caregivers and agency employees), what changes must be reported and by when (10 calendar days for Home Help enrollment changes, 10 business days for changes affecting Home Help payment authorization, 35 days for other enrollment changes), how revalidation is tracked, and who does each step. MPM Home Help §8.6.E MI-HC-GOV-04 Audits, Monitoring Reviews, Access to Records, and Provider Appeals Explains how the Agency prepares for and responds to the reviews that take the place of state licensing inspections for a Michigan home care provider: the MDHHS Home Help new agency compliance review and annual desk audits, MI Choice waiver agency monitoring reviews and home visits, unannounced MDHHS site inspections and record requests, how corrective action is carried out, and how the Agency appeals a negative action. MPM Home Help §8.10

Quality2

MI-HC-INC-01 Incidents and MI Choice Critical Incident Reporting Requires staff to report every incident involving a client to the office before the end of the shift on Form MI-HC-INC-01-A, and sets how the Agency reviews, investigates, corrects and learns from incidents. For MI Choice participants, it applies the waiver's critical incident list and reporting rules: unexpected deaths reported to the waiver agency within two business days, all other critical incidents within 30 calendar days (the Agency reports them by the next business day as its own standard), and abuse, neglect and exploitation also to Adult Protective Services. It also covers the Home Help report of changes affecting payment and notice to private-pay clients' representatives. MPM MI Choice Waiver §10.4 MI-HC-QM-01 Quality Management Program Sets up the Agency's quality management program: the measures it tracks (EVV visits without manual edits against the State's 85 percent quarterly threshold, worker service records for every billed visit, supervisory visits and in-service training at least twice each fiscal year, background checks, missed visits, incidents and critical incidents, abuse reports, complaints, record audits and client satisfaction), the quarterly quality review, improvement projects, how the Agency prepares for and responds to MI Choice monitoring reviews and Home Help desk audits, and the annual quality report to the governing body. MPM MI Choice Waiver §9.21

Business4

MI-HC-BUS-01 Home Help Agency Provider Standards Sets out how the Agency works as an MDHHS-approved Home Help agency provider: keeping approved status, signing one Home Help Services Agreement (MSA-4676) per client, providing only the tasks and time on the provider Time and Task, meeting the adult services worker at the required interviews, submitting an accurate MSA-1904 invoice for each client each month, accepting the authorized payment as payment in full, reporting changes on time, and keeping records for seven years. MPM Home Help §8.6 MI-HC-BUS-02 MI Choice Waiver Contracts, Work Orders, and Billing Sets out how the Agency works as a contracted MI Choice direct service provider: holding a written contract with each waiver agency, accepting referrals and work orders, starting services only from the waiver agency's assessment and authorization, delivering only what the person-centered service plan authorizes, billing the waiver agency accurately, accepting MI Choice payment as payment in full, and meeting the home and community-based settings rule. MPM MI Choice Waiver §9.1 MI-HC-BUS-03 Electronic Visit Verification Requires every Medicaid personal care visit (Home Help and MI Choice) that starts or ends in the client's home to be recorded in HHAeXchange or an approved alternative EVV system that captures the six federal data elements, explains how workers clock in and out, how the live-in caregiver exemption works, how missed or wrong entries are corrected, and how the Agency keeps manual edits low enough to meet the 85 percent quarterly compliance threshold MDHHS enforces. 42 U.S.C. §1396b(l) MI-HC-BUS-04 Private Pay Services: Charges, Billing, and Cancellation Sets the Agency's own rules for private-pay services (a written schedule of charges before services start, billing, deposits, rate changes with notice, cancellation and refunds) and the firm limits that apply to Medicaid clients: authorized Home Help and MI Choice services are paid in full by the program, and a Medicaid client may be charged only for services the program does not cover, after being told in writing before the service. MCL 400.111b(14)

Ethics3

MI-HC-ETH-01 Code of Conduct, Professional Boundaries, and Marketing Sets the standards of conduct every employee and volunteer follows in clients' homes and in the community (dignity and respect, no smoking, no personal cell phone use, no threats or coercion, no solicitation or selling), the limits of the professional relationship (gifts, money, relationships, social media), and the rules for honest marketing that respect Home Help recruitment limits and federal rules on inducements and kickbacks. MPM MI Choice Waiver §9.12.E MI-HC-ETH-02 Client Money, Property, and Prevention of Theft Protects clients' money and belongings: workers never take, borrow or control a client's money, cards or property; shopping and errands follow a receipt-and-change procedure recorded on a form the client signs; money management under community living supports means helping the client manage, never managing for them; and suspected theft or exploitation is reported at once, investigated, and handled as a critical incident and an adult protective services report where it applies. MCL 400.11 MI-HC-ETH-03 Compliance Program, Fraud Prevention, and Exclusion Screening Sets up the Agency's compliance program: a compliance lead, written standards, training, an open reporting line with protection from retaliation, exclusion and sanction screening before hire and every month, accurate billing and documentation, prompt return of overpayments, and cooperation with the MDHHS Office of Inspector General and the Attorney General's Health Care Fraud Division. MCL 400.601 et seq.
Questions

Questions about this manual

Is this the right manual for my agency?

It is for Michigan agencies that give non-medical care: Home Help agency providers, MI Choice Waiver providers and private-pay agencies. Medicare-certified home health agencies need the Michigan home health manual, and licensed hospices need the Michigan hospice manual.

Michigan has no home care license. Which rules does the manual follow?

LARA licenses no home care agency category, so an agency's duties come from the programs it takes part in: the Home Help, MI Choice Waiver and electronic visit verification chapters of the Michigan Medicaid Provider Manual. Michigan laws apply too, such as adult abuse reporting (MCL 400.11a) and MIOSHA Part 554 on bloodborne pathogens. Each policy says which program a duty comes from.

What about our MI Choice waiver agency contract?

A waiver agency contract can set shorter time frames than the Medicaid Provider Manual. The policies tell staff to follow the contract and do not state numbers from it.

What do the 50 policies cover?

Client rights (4), service delivery (12), clinical tasks (2), safeguarding (2), infection control (2), emergency preparedness (1), records (2), privacy (3), human resources (9), governance (4), quality (2), business (4) and ethics (3).

Related

Guides, more Michigan manuals and home care in other states

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