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The Home and Community Based Alternatives program provides in-home services to eligible Utah residents with the objective of preventing the premature or unnecessary placement of individuals in nursing homes. This state-funded, assistance program prevents individuals from having to spend-down their resources and enroll in Medicaid. (The funding for this program is separate from the federal-state Medicaid budget.)
A broad range of services are available via this program, including personal care at home or in adult day care, assistance with chores and home maintenance, and minor home modifications to accommodate for aging-related impairments.
In some areas of the state, certain services are available to be 'consumer-directed.' Consumer direction—sometimes referred to as self-direction or cash and counseling—means the individual receiving care can select their caregiver rather than have program staff assign a care provider. Certain family members can be selected as care providers, meaning family members can become paid caregivers. Spouses are not eligible to be paid. However, adult children and siblings may be eligible, provided they obtain a Utah business license and provided the participant has attempted to receive care from a previously licensed provider and had an unsuccessful experience.
The Home and Community Based Alternatives Program is administered by Utah’s Department of Human Services’ Division of Aging and Adult Services and is funded by various sources, including federal, state, and local.
To be eligible for Utah's Alternatives Program, state residents must be at least 18 years of age and have a functional ability challenge, which puts them at risk for nursing home placement.
Financial requirements determine if care is provided free of charge or offered on a sliding scale. Final financial eligibility is determined by the local administering agency, so income limits may vary by location within the state. However, typically one's income must be just below 150% of the Federal Poverty Level (FPL) and applicants must have limited assets, excluding their home and vehicle. The approximate income and assets limits for 2018 are:
-Less than or equal to $1,508 / month or $18,096 / year in income
-A maximum of $6,000 in assets
-Less than or equal to $2,030 / month or $24,360 / year in income
-A maximum of $12,000 in assets
Medical expenses are considered when determining if one is income eligible for this program, and as a result, some deductions may be made for medical bills and health insurance premiums.
Readers should be aware that, if the financial eligibility requirements change, they do so prior to July 1 of each year, not on of January 1.
Under this program, there are a broad range of services and supports designed to allow the individual to remain living at home or in the community instead of in a nursing home. Some of these services are available for self-direction. The maximum allowable amount of monthly assistance cannot exceed $750 (in services), although not all individuals receive this amount in services. The following benefits and services may be available via this program:
The costs of services are based on a sliding scale, determined by a family's income, assets, and level of financial hardship. As of 2018, the maximum monthly fee a single individual can be charged for services is $39, and the maximum monthly fee a married couple can be charged is $53. Some participants don’t have to pay a fee at all. Local Area Agencies on Aging offices carry the responsibility of making final decisions on admissions and fee contributions.
Enrollment in the HCBA / Alternatives Program is managed by the state's network of Area Agencies on Aging. One can find their local Area Agency here. Very limited program information can be found here. At the time of this writing, a statewide waitlist for program services did exist.