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Home Care Children’s (HCC) / TEFRA Program

Home Care Children’s (HCC) Overview

TEFRA (Tax Equity and Fiscal Responsibility Act of 1982) also known as Home Care Children’s in Michigan, is a “Pathway to Medicaid” for children with disabilities. It gives States the option to make Medicaid benefits available to children with certain physical or mental disabilities who would not ordinarily be eligible for Supplemental Security Income (SSI) benefits because of their parent or guardian's income or resources.

Contact Information

Val Newton, BSN, RN phone: (517) 335-8992 email:

Caitlin Conroy, MSN, PNP-AC phone: (517) 335-4210 Email:

Eligibility Requirements

To be eligible, a child must meet the following requirements:

  • Be 18 years old or younger
  • Resident of the State of Michigan
  • Meet the Social Security definition of disability
  • Have qualifying income and resources
  • Meet one of the three following level of care qualifications; intermediate care for individuals with intellectual disabilities, skilled nursing facility, or hospital
  • It must be appropriate to care for the child at home
  • The estimated cost of caring for the child at home cannot exceed the estimated cost of caring for the child in the determined level of care

What to Submit:

All forms must be completed in full and submitted together at one time. Submitting partially completed forms, or forms separately WILL DELAY the process for determining eligibility for HCC.

  • Demographic form
  • DHHS-49 form
    • Must be completed by a pediatric provider
  • Current medical reports from specialty providers
  • Current IEP/IFSP (if applicable)
  • Community Mental Health Individual Plan of Service
  • 24-hr plan of care
    • Completed by parent/guardian
    • List services / supplies / supports child is trying to obtain and can not
    • Optional template here

How to Apply

Call your local health department or one of the above contacts to have a packet of forms and information sent to you.

Packet of completed forms and documents can be submitted to your local health department, emailed to or, faxed to MDHHS CSHCS  RE: HCC/TEFRA at 517-335-9491 or can be mailed to:

Capital Commons
400 South Pine Street
Lansing, MI 48933

Submitting packets without all required forms completely filled out will delay processing for program eligibility.

If medically approved, a Medicaid application will be mailed to family. This should be completed as instructed and returned to the Special Processing Office. Filling out any other Medicaid application or returning the mailed application to the local MDHHS office will delay processing.

Additional information:

For families

For Local Health Departments, please see SharePoint