Michigan Habilitation Supports Waiver (HSW)

Michigan Habilitation Supports Waiver (HSW)

If you or a family member has an intellectual or developmental disability (IDD) and lives in Michigan, the Habilitation Supports Waiver (HSW) is one of the most important programs available. It provides Medicaid-funded home and community-based services that help people with IDD live, work, and thrive in their communities rather than in institutions.

This guide covers who qualifies, what services are available, how the program works, and how to apply.

What Is the Michigan Habilitation Supports Waiver?

The Habilitation Supports Waiver (HSW) is a federally approved Section 1915(c) Medicaid Home and Community-Based Services (HCBS) waiver administered by the Michigan Department of Health and Human Services (MDHHS) (opens in new tab).

Its core purpose is to provide community-based supports to people with intellectual and developmental disabilities who would otherwise require the level of care provided in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). The HSW enables individuals with IDD to receive the supports they need while remaining at home and fully participating in their communities.

The HSW is administered locally by Michigan's 10 Prepaid Inpatient Health Plans (PIHPs) in collaboration with county Community Mental Health Services Programs (CMHSPs) (opens in new tab). It operates concurrently with Michigan's Section 1915(b) Managed Specialty Supports and Services Program. The program was most recently renewed effective October 1, 2024, with federal CMS approval.

Who Is Eligible for the HSW?

The HSW has no age restriction and is available to individuals of any age. To qualify, an applicant must meet all of the following:

  • Have an intellectual disability (ID) or developmental disability (DD) as defined by Michigan law
  • Be enrolled in Michigan Medicaid
  • Would require ICF/IID level of care if not for the availability of HSW supports
  • Reside in a community-based setting, not in a hospital, ICF/IID, nursing facility, correctional facility, or child-caring institution
  • Choose to participate in the HSW in lieu of ICF/IID services

Financial Eligibility (2026)

The following limits apply as of 2026, per Michigan Medicaid eligibility guidelines (opens in new tab):

What Services Does the HSW Cover?

The HSW provides a broad range of services designed to support community living, skill development, employment, and health. A complete service list is available on the CMS Michigan waiver factsheet (opens in new tab). Services are determined based on individual assessed needs through a person-centered planning process.

Community Living and Daily Support

  • Community Living Supports (CLS): assistance with daily living activities, personal care, community participation, and skill development
  • Overnight Health and Safety Support: supervision and monitoring during overnight hours
  • Personal Emergency Response System (PERS): devices that allow participants to call for help in emergencies

Employment and Habilitation

  • Supported Employment (Individual and Small Group): job coaching and assistance finding and maintaining competitive integrated employment
  • Out-of-Home Non-Vocational Habilitation: structured day activities focused on skill development and community inclusion
  • Prevocational Services: preparation and training for future employment

Family and Caregiver Supports

  • Respite Care: temporary relief for primary caregivers
  • Family Training: guidance for family members on supporting their loved one
  • Non-Family Training: training for non-family caregivers and support workers

Health and Medical Supports

  • Private Duty Nursing (PDN): available for qualified adults age 21 and older
  • Enhanced Medical Equipment and Supplies: specialized equipment beyond the standard Medicaid State Plan
  • Enhanced Pharmacy: medications and pharmacy services beyond standard Medicaid coverage

Home and Environment

  • Environmental Modifications: physical modifications to the home for safety and accessibility
  • Vehicle Modification: adaptive vehicle modifications to support transportation
  • Assistive Technology

Navigation and Financial

  • Supports Coordination: ongoing coordination of services, person-centered planning, and system navigation
  • Goods and Services: flexible funding for items that support community living goals
  • Financial Management Services (Fiscal Intermediary): support for self-directed participants managing their own budgets

Self-Determination: Directing Your Own Supports

Michigan's HSW offers a self-determination option that gives participants greater control over their services and budgets. Under this model, participants can choose their own support workers, hire and manage their own employees with the help of a Fiscal Intermediary, and design services that reflect their personal goals.

Note: Michigan does not allow payments to legal guardians or to relatives who are legally responsible for providing care. Subject to this, relatives who meet all provider qualifications may be paid as support workers.

How the HSW Is Administered

The HSW is a managed care program coordinated through Michigan's 10 regional Prepaid Inpatient Health Plans (PIHPs) (opens in new tab), which work with local Community Mental Health Services Programs (CMHSPs). Your local CMHSP serves as the entry point for HSW enrollment and ongoing service coordination. They conduct eligibility determinations, develop your person-centered plan, and connect you with approved providers.

Waiting List and Enrollment Priorities

Michigan manages HSW enrollment through a specific number of slots approved annually by CMS. Wait times can vary by region. When slots become available, Michigan prioritizes enrollment in the following order:

  • Children aging off the Children's Waiver Program (CWP)
  • Individuals determined to be at high risk of institutional placement
  • Adults age 21 and older who require private duty nursing and meet HSW eligibility criteria

Starting the application process early is strongly recommended.

How to Apply

To begin the HSW application process, contact your local Community Mental Health Services Program (CMHSP) (opens in new tab). Here are the steps:

  • Contact your local CMHSP and request an IDD eligibility determination and a level of care assessment
  • If eligible, your information will be submitted for HSW enrollment based on available slots
  • Once enrolled, work with your Supports Coordinator to develop your person-centered service plan

You can find your local CMHSP through the MDHHS website (opens in new tab) or by calling your county's Community Mental Health office. The process from application to enrollment can take several months, so it is important to start early.

How Family Love Care Can Help

At Family Love Care, we specialize in helping Michigan families navigate the Habilitation Supports Waiver process. From understanding whether your loved one qualifies, to connecting with the right Community Mental Health program and service providers, our team is here to provide guidance, advocacy, and compassionate support.

Reach out to us today to learn how Family Love Care can support your family every step of the way.