MDHHS
Michigan Department of Health and Human Services
- Sets the program rules
- Scores the prescreen and runs the statewide waitlist
- Makes the final eligibility decision
A family's guide
The Children's Waiver, step by step
Even after years in this program, I still get confused about who does what. So I mapped it out the way it works for our family in Oakland County, Michigan. Other counties follow the same state rules but use different local agencies.
How it flows
Blue steps happen locally. The gold step is the statewide waitlist, which is why starting early matters so much.
- 1Your familyCounty
Call your county's community mental health "front door"
In Oakland County that's Oakland Community Health Network (OCHN) Access at (248) 464-6363. They screen your child and connect you with developmental disability services.
Ask them directly about the Children's Waiver Program and the prescreen.
- 2CountyState
Complete the Children's Waiver prescreen
The county helps you fill out the prescreen and sends it to the Michigan Department of Health and Human Services (MDHHS), which gives your child a priority score.
- 3State
Wait for a spot to open
MDHHS keeps a statewide waiting list ordered by priority. We waited almost two years. Get on the list as early as you can, even if you're not sure you'll need it yet.
- 4CountyState
Assessment and approval
When a spot opens, the county assesses your child and sends a certification to MDHHS, which makes the final eligibility decision and Medicaid enrollment follows.
- 5Supports coordinationYour family
Meet your supports coordinator and build the plan
A supports coordinator (our caseworker is with Easterseals MORC) becomes your main contact. Together you write a person-centered plan that sets which services and how many hours your child gets, then follows up on authorizations.
- 6Your familyFiscal intermediary
Choose self-determination and hire your own staff
With self-determination, you recruit and hire your own caregivers. A fiscal intermediary handles the payroll side. Ours is The Arc of Oakland County, which processes new-hire paperwork and timesheets. For us, it took almost a year after approval before our caregivers started working, so start asking around for people while you wait.
- 7Your family
Services begin
Your caregivers provide community living supports and respite: help getting to appointments, building life skills, and time for parents to rest and care for the rest of the family.
Who does what
OCHN
Oakland Community Health Network, the county's community mental health program
- Front door for services (Access line)
- Helps with the prescreen and assessment
- Funds and oversees local services
Easterseals MORC
Our supports coordination agency
- Assigns your caseworker
- Writes the person-centered plan with you
- Follows up on authorizations and therapy referrals
The Arc of Oakland County
Handles the money side of self-determination
- New-hire paperwork for your staff
- Timesheets and payroll
- Tracks hours used against your budget
You
The employer and the expert on your child
- Recruit, hire and schedule caregivers
- Approve timesheets
- Speak up in planning meetings
Caregivers
The people who make daily life possible
- Community living supports
- Respite for parents
- Rides to appointments and outings
Who qualifies
The basics under state policy
- Under age 18 and unmarried
- Has a developmental disability and needs the level of care usually given in an intermediate care facility, but can be cared for safely at home
- Lives at home with parents or a legal guardian
- Parents' income and assets don't count. Only the child's own income and assets are considered.
What I wish I had known
- Get on the waitlist early. The wait can take years.
- Keep copies of every evaluation, IEP and diagnosis letter. You'll be asked for them more than once.
- Ask about the Family Support Subsidy, a separate monthly payment for some families of children with severe developmental disabilities.
- Ask how many hours you're authorized for, and check your usage regularly.
Not in Oakland County?
Every county in Michigan has a community mental health services program that acts as the front door. Find yours on the MDHHS website, then ask about the Children's Waiver prescreen.
Official links
Children's Waiver Program
MDHHS program page
Eligibility policy (BEM 171)
MDHHS manual, PDF
OCHN developmental disability services
Oakland County, includes a Children's Waiver navigation guide
Self-determination guideline
MDHHS, PDF
The Arc of Oakland County
Fiscal intermediary information
Find your county's CMH
MDHHS directory