New Choices Waiver: Home Care and Support from Utah Medicaid

What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through state-specific "Medicaid Waivers," which are also called Home and Community Based Services (HCBS) Waivers or Waiver Funded Services.

Waiver Description

Utah's New Choices Waiver is a Medicaid program intended to help individuals who currently reside in a Medicaid-funded, assisted living community or nursing home. The program provides a variety of care services and supports to enable them to move from their current community back into their homes or into the homes of family members and caregivers. The Waiver pays for supports, such as chore services, home access modifications, home delivered meals, transportation, care services like adult day care, and attendant care. 

The New Choices Waiver is only for persons who are already receiving assistance from Medicaid for nursing home care. Utah offers a similar Medicaid waiver for those who require nursing home level care but are not already receiving it and wish to remain living at home. This is called the "Elderly" or "Aging Waiver." The New Choices Waiver offers a more liberal income requirements than the Aging Waiver. 

 

Eligibility Guidelines

To receive assistance under New Choices, individuals must be Utah residents, eligible and receiving care services from Medicaid and reside in an assisted living or a Medicaid-funded nursing home for at least 1 year prior to their application for this waiver. In addition, they must be at least 18 years of age and not be suffering from a mental illness (for which there are other forms of assistance). 

Utah Medicaid sets financial requirements for this waiver that differ from regular Medicaid admissions in the state. Individual participants should be limited to not more than $2,000 savings or other liquid assets and have gross monthly income below $2,205, the income limit effective March 1, 2017.

 

Did You Know? The five cities in Utah with the highest percentage of residents 65 and older are Scofield, in Carbon County; Marysvale, in Piute County; Leeds, in Washington County; Antimony, in Garfield County; and Manila, in Duchesne County.

Benefits and Services

New Choices is intended to help persons who require nursing home level of care to return to their homes as such the following services and supports are available to help the individuals directly and to help families member care for them.  

  • Adult Day Care
  • Assistive Technology
  • Attendant Care
  • Caregiver Training
  • Chore Services
  • Durable and Home Medical Equipment
  • Environmental Accessibility Adaptations
  • Home Delivered Meals
  • Homemaker Services
  • Medication Assistance Services
  • Personal Emergency Response Systems (PERS)
  • Respite Care
  • Residential Care (Adult Foster Care)
  • Transition Services
  • Transportation

 

How to Apply / Learn More

State social workers prioritize individuals who current reside in a state licensed nursing home or medical facility. For those who are interested in this program and do not currently live in a skilled nursing center, they must apply during three, 2-week, open enrollment periods starting on July 1, September 1, and March 1. 

As this program is designed for persons already receiving Medicaid services and residing in nursing homes, interested parties should contact their nursing home or Medicaid administrators with questions regarding processes and availability. One can request application forms and instructions by dialing (800) 662-9651, and selecting number 6.