Utah State Plan Medicaid Personal Care Services: In Home Care for the Elderly or Disabled

 

Program Description

The Utah State Plan Medicaid Personal Care Services provides in-home care to low income seniors so that they can continue living independently in the community. Assistance with everyday activities, like eating, dressing, grooming, mobility, and meal preparation, help to prevent unnecessary nursing home placements, as well as delay the need for placement.

Under this program, participants have the option of retaining an agency to provide personal care or using the Self-Administered Services (SAS) delivery model. Many readers may know this model by other names such as Consumer Directed Care, Self-Direction or Cash and Counseling. Self-Administered Services allow the participant to choose from whom they receive care services as opposed to the state choosing an agency on the beneficiary’s behalf. Using Self-Administered Services allows the participant to hire family members or friends to provide care (if they are not legally responsible for the program participant meaning spouses, parents and legal guardians cannot be compensated).

Personal Care Services is part of the Utah State Medicaid plan. There are no waiting lists for the services. 

 

Eligibility Guidelines

There is no specific age requirement in order to qualify for personal care services. However, one must be a resident of Utah and must be on Medicaid or be eligible for Medicaid. Applicants’ assistance needs cannot be so severe where they are limited to their bed. An assessment is performed by a licensed registered nurse in order to determine level of functioning. The individual must demonstrate an inability to perform at least two of the following activities:

  • Administer own medicine due to lack of memory
  • Toiletry - urinal, toilet, bedpan
  • Bathe or shower
  • Skin care
  • Move from location to location - includes using assistive devices, such as walkers and wheelchairs
  • Grooming 
  • Preparation of meals – includes planning and cleanup

If an individual is not currently on Medicaid, he or she must apply. For those 65 years of age or older, the income and asset eligibility requirements are as follows. As of 2017, an individual cannot have an income that exceeds $12,060 / year, or in other words, more than $1005 per month. The asset limit is $2,000, but certain items, such as a primary home, is considered exempt, given the individual lives in it and it is valued under $560,000.

Some individuals who are over these financial limits may be able to become eligible for the services available through Utah Medicaid through working with a planner who specializes in helping to access one’s benefits. If you know someone who is unable to afford their care, then you should read more about Medicaid planning services for them.

 An individual who is enrolled in the Home and Community Based Services Waiver or New Choices Waiver, and receives personal care services under these waivers, would not be eligible to receive personal care services under Utah’s State Medicaid program. 

 

Benefits and Services

Based on a care plan, which is prescribed by a doctor, several personal care services may be available up to 60 hours each month. Services can be provided by a state-approved home care agency or by an individual of the program participant’s choosing.

  • Medication Management
  • Grooming assistance – bathing, skin, nail, and oral care, shaving
  • Meal Preparation and tasks associated with it
  • Mobility – assistance with walking and use of assistive devices
  • Shopping for essential goods
  • Medical transportation
  • Household tasks for health/safety purposes, such as moving home furniture to allow an individual to more easily move about the home

 

How to Apply / Learn More

If an individual is currently enrolled in Medicaid in Utah, they should contact their local Department of Human Services office to learn more about personal care services or to apply for this option.

If an individual is not currently on Medicaid, one must apply for Medicaid. This can be done here or by going to your local Department of Human Services office. Click here to find the office located closest to you. For more information, call 866-435-7414.