I/DD Waivers in Michigan

All states: Medicaid disability services map

Michigan I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in Michigan?

The Michigan Department of Health and Human Services (MDHHS) runs I/DD services through its Bureau of Specialty Behavioral Health Services. Michigan does not have a separate developmental disabilities agency. I/DD services are part of the public specialty behavioral health system, which also serves people with mental illness, serious emotional disturbance and substance use disorders.

• MDHHS: the state Medicaid agency. It oversees the Medicaid waivers for behavioral health and developmental disability and pays the regional health plans.
• Prepaid Inpatient Health Plans (PIHPs): 10 regional organizations that receive Medicaid funding for specialty behavioral health services, including I/DD services. MDHHS has posted signed fiscal year 2027 contracts with all 10.
• Community Mental Health Services Programs (CMHSPs): 46 county-based public agencies that deliver services directly or through contracted provider agencies. Their Access Centers are the front door for services.
• Case management: supports coordination and case management are provided by the CMHSPs and their contracted providers in each PIHP region. Since October 1, 2025, case managers must complete training on the federal home and community-based services (HCBS) settings rule at hire and every year.

What Medicaid waivers and programs serve people with I/DD in Michigan?

Michigan has two 1915(c) waivers for people with I/DD: the Habilitation Supports Waiver (HSW) and the Children's Waiver Program (CWP). A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. Both waivers run alongside two other federal authorities: an 1115 Behavioral Health Demonstration and a 1915(i) state plan benefit.

• Habilitation Supports Waiver (1915(c), control number MI.0167.R07.00): serves people of any age with intellectual or developmental disabilities who have Medicaid and meet the level of care for an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). Services include community living supports, out-of-home non-vocational habilitation, individual and small group supported employment, respite, overnight health and safety support, family and non-family training, environmental and vehicle modifications, enhanced medical equipment and pharmacy, personal emergency response systems, private duty nursing, and financial management services and goods and services for people who self-direct. Enrollment is capped. When CMS approved the prior renewal in 2019, it estimated 8,268 participants a year. We did not find the current limit.
• Children's Waiver Program (1915(c), control number MI.4119.R07.00): serves children under 18 with a developmental disability who meet ICF/IID level of care, need consistent in-home supports and live with a birth or adoptive parent or a relative who is their legal guardian. Parent income is not counted. Services include community living supports, respite, overnight health and safety support, family and non-family home care training, financial management services, environmental adaptations, specialized medical equipment, vehicle modifications and therapeutic activities. MDHHS says the program serves 669 children a year.
• 1915(i) state plan benefit: a Medicaid option for home and community services without a waiver slot. In Michigan it serves people with I/DD, serious mental illness or serious emotional disturbance who meet its needs criteria. It covers community living supports, skill building assistance, supported employment and respite, and since an amendment approved October 15, 2026, overnight health and safety supports.
• 1115 Behavioral Health Demonstration: the federal approval that lets Michigan deliver specialty services, including supports coordination and case management, through the PIHPs as managed care.

The Waiver for Children with Serious Emotional Disturbances (SEDW) also runs through the PIHPs, but it is not an I/DD waiver. ICF/IID care is the institutional option that the HSW and CWP are an alternative to.

Does Michigan pay for I/DD services through managed care?

Yes. MDHHS pays the 10 PIHPs ahead of time for each region's Medicaid specialty services, and the PIHPs share the financial risk, under federal managed care rules (42 CFR Part 438). The PIHPs pass funding to the county CMHSPs, which deliver services or contract with provider agencies. Provider agencies are paid by the PIHP or CMHSP network they contract with, not by a statewide fee schedule.

• The 10 PIHP regions: NorthCare Network, Northern Michigan Regional Entity (NMRE), Lakeshore Regional Entity, Southwest Michigan Behavioral Health, Mid-State Health Network, CMH Partnership of Southeast Michigan, Detroit Wayne Integrated Health Network, Oakland Community Health Network, Macomb County CMH and Region 10.
• Contract basis: the PIHP contract describes the program as prepaid and shared risk.
• Who coordinates services: the CMHSPs and their contracted providers provide supports coordination and case management within each region.

Is there a waiting list for I/DD services in Michigan?

Both I/DD waivers have limited slots, and MDHHS does not publish a count of people waiting. People who have Medicaid are not placed on waiting lists for specialty behavioral health services, which include I/DD services.

• Children's Waiver Program: serves 669 children a year. MDHHS fills openings monthly and sends an invitation to apply when an opening occurs. Applicants are ranked using MichiCANS priority ratings, according to MDHHS letter L 26-02 (February 3, 2026).
• Habilitation Supports Waiver: MDHHS allocates slots to the PIHPs, and a PIHP asks MDHHS for a new slot when a person needs one. We did not find a statewide or regional count of people waiting for an HSW slot.
• People without Medicaid: CMHSPs keep waiting lists for people who meet criteria for specialty services but do not have Medicaid or MIChild and for whom funding is not available. Macomb County CMH's wait list procedure (March 2026) ranks that list by severity and urgency of need.

For a person's status, families can ask their county CMHSP Access Center. For Children's Waiver questions, MDHHS lists the mailbox MDHHS-BCCHPS-Waivers@michigan.gov.

How do people apply for I/DD services in Michigan, and how are budgets set?

People apply by calling or visiting the Access Center of the CMHSP in the county where they live. The PIHP or its designee screens the person and the CMHSP assesses need. Adults are assessed with the Supports Intensity Scale (SIS), and children applying for the Children's Waiver are assessed with MichiCANS. We did not find a published statewide method for turning assessment results into individual budgets.

• Eligibility: Michigan law defines a developmental disability by substantial limits in daily functioning, not by diagnosis. The HSW requires Medicaid eligibility and ICF/IID level of care. The CWP requires age under 18, ICF/IID level of care, need for in-home supports and living with a parent or relative guardian.
• Children's Waiver application: the PIHP enters a MichiCANS assessment and an Attestation Form into the state's Waiver Support Application. CMS approved an amendment allowing MichiCANS to be used for eligibility, and MDHHS uses it to set priority.
• Supports Intensity Scale: under the PIHP contract, each Medicaid-eligible adult 18 or older with I/DD who receives case management, supports coordination or respite is assessed with the SIS at least every 3 years by an independent assessor.
• Self-direction: both waivers include financial management services, so people can direct their own services and hire their own workers.

What day and residential services can I/DD providers offer in Michigan?

Providers can offer out-of-home non-vocational habilitation, skill building assistance, supported employment and community living supports, all contracted through the PIHP or CMHSP network. Group homes for adults with developmental disabilities are adult foster care homes licensed by the Department of Licensing and Regulatory Affairs (LARA). The research did not find a state license, staff ratio or billing unit for day services, other than the community living supports codes below.

Day and community services

• Out-of-home non-vocational habilitation (HSW): habilitation outside the home to build or keep skills. We did not find a published license requirement, staff ratio or billing unit.
• Skill building assistance (1915(i)): day and community skill building for people with I/DD or mental illness. We did not find a published license requirement, staff ratio or billing unit.
• Supported employment (HSW and 1915(i)): individual and small group. We did not find a published staff ratio or billing unit.
• Community living supports (HSW, CWP and 1915(i)): staff support for daily living and community participation. From November 1, 2026, HSW and 1915(i) providers bill code H2015 in 15-minute units when fewer than 10 hours a day are authorized, per diem code H0043 for 10 to 15 hours, and per diem code H0043-TJ for 16 or more hours.

Direct support professionals who provide community living supports, skill building, out-of-home non-vocational habilitation, supported employment or respite must complete HCBS settings and rights training at hire and every year.

Residential services

• Specialized residential homes: adult foster care homes licensed by LARA under Public Act 218 of 1979 and certified for a specialized program for people with developmental disabilities or mental illness. The license application states a minimum direct care staff ratio for each shift, staff must complete specialized training, and the program gets an on-site review once the home reaches half of its capacity, according to LARA's guide.
• Supported living in a person's own home: community living supports in the person's own or an unlicensed home, plus overnight health and safety supports (an awake staff person during sleep hours). From November 1, 2026, overnight supports use per diem code T2026 for 6 to 12 authorized hours a day and 15-minute code T2027 for under 6 hours.
• ICF/IID: the institutional option. We did not research facility counts.

How are I/DD provider rates set and how do agencies enroll in Michigan?

There is no statewide I/DD fee schedule that we found. MDHHS pays the PIHPs, and each PIHP and CMHSP sets the rates in its own provider contracts. The latest statewide rate change is an HSW amendment approved July 1, 2026 that added per diem rates for community living supports, with new codes starting November 1, 2026. Agencies must enroll in Michigan Medicaid through CHAMPS and then contract with the PIHP or CMHSP in their region.

• Direct care worker wage: MDHHS funds a direct care worker wage increase that PIHPs pass to providers. Providers that receive it must pay direct care workers at least the required wage, according to Region 10 PIHP policy. We did not confirm the current required wage amount. Ask your PIHP.
• Enrollment: all providers serving Michigan Medicaid beneficiaries must be screened and enrolled in CHAMPS, the state's Medicaid provider system. See MDHHS's provider enrollment page or call 1-800-292-2550, option 4. Agencies that bill services requiring EVV also need a National Provider Identifier (NPI).
• Network contracts: to serve HSW, CWP or 1915(i) participants, agencies contract with the PIHP or CMHSP network in their region.
• EVV: electronic visit verification (EVV) is required for community living supports (H2015) and respite (T1005) that start or stop in the home. Agencies can use the free state HHAeXchange system or an integrated third-party system. Community living supports delivered entirely in the community do not require EVV, according to MDHHS's behavioral health EVV page.
• EVV and payment: MDHHS says payment is not tied to EVV until further notice. Since April 1, 2026, PIHPs monitor an 85 percent threshold for visits verified without manual edits. We did not find whether the new per diem codes (H0043, H0043-TJ and T2026) require EVV.

What is changing next for I/DD services in Michigan?

From November 1, 2026, providers report new per diem codes for community living supports and overnight health and safety supports for HSW and 1915(i) participants. Direct support staff must also finish HCBS settings and rights training by March 30, 2027. Both changes are set out in MDHHS letter L 26-55 (October 16, 2026).

• Community living supports codes: H2015 in 15-minute units for under 10 authorized hours a day, H0043 per diem for 10 to 15 hours, and H0043-TJ per diem for 16 or more hours. This follows an HSW amendment approved July 1, 2026.
• Overnight health and safety supports codes: T2026 per diem for 6 to 12 hours a day and T2027 in 15-minute units for under 6 hours. This follows a 1915(i) amendment approved October 15, 2026 that added the service to the 1915(i).
• Children's Waiver: children on the CWP who meet the 1915(i) criteria can also enroll in the 1915(i) to use the new per diem codes.
• Staff training: direct support professionals providing community living supports, skill building assistance, out-of-home non-vocational habilitation, supported employment or respite must complete the training at hire and every year. MDHHS says provider training began in September 2026.

For other changes, such as waiver renewals or changes to the PIHP regions, check MDHHS's 2026 provider letters or ask your PIHP.

Michigan I/DD sources

• MDHHS: Behavioral health and developmental disability services
• MDHHS: Medicaid waivers (behavioral health and developmental disability)
• MDHHS: Habilitation Supports Waiver
• MDHHS: Children's Waiver Program
• CMS: Michigan waiver descriptions fact sheet
• MDHHS: FY2027 PIHP executed contracts
• MDHHS letter L 26-55: Community Living Supports and Overnight Health and Safety Supports (October 16, 2026)
• MDHHS letter L 26-02: Children's Waiver Program (February 3, 2026)
• MDHHS: Behavioral health EVV requirements
• MDHHS: Medicaid provider enrollment

Related reading

• Disability Services and Independent Living Guide
• Developmental Disabilities vs. Mental Health: Key Differences
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Outcome Measures in Disability Services: Measuring what matters
• I/DD services in every state (map)
• Michigan EVV requirements

Other states that use managed care for I/DD services

Arizona, Arkansas, Iowa, Kansas, North Carolina, Tennessee. See every state on the I/DD services map.

Page history

• October 23, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.