Utah’s New Choices Waiver (NCW) is a Medicaid program intended to help elderly and disabled individuals who currently reside in a Medicaid-funded nursing home, assisted living community, or small health care facility. This program provides a variety of care services and supports to enable persons to move from their current community back into their homes or into the homes of family members and caregivers. New Choices pays for supports, such as chore services, home access modifications, home delivered meals, non-medical transportation, and care services, like adult day care and attendant care.
The New Choices Waiver is only for persons who are living in one of the settings mentioned above. 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 more liberal income requirements than does the Aging Waiver.
The New Choices Waiver allows for participant direction, often referred to as consumer direction or self-direction, of certain care services. For instance, friends and relatives can be hired to provide homemaker and attendant care services. However, spouses and legal guardians cannot be paid to provide care.
To receive assistance under New Choices, individuals must be Utah residents who require a nursing home level of care, and eligible and receiving care services from Medicaid. As mentioned previously, applicants must be residing in Medicaid-funded nursing homes, assisted living facilities, or small health care facilities. In addition, persons must reside in those locations for a minimum period of time. For nursing home residents, they must live there for at least 90 days prior to their application for this waiver. For assisted living facilities and small health care facilities, applicants must have resided there for a minimum of one year.
In addition, applicants must be at least 18 years of age and not be suffering from a mental illness (for which there are other forms of assistance). Those between the ages of 18 and 64 must be disabled.
Utah Medicaid sets financial requirements for this waiver that differ from regular Medicaid admissions in the state. Individual participants are limited to no more than $2,000 in savings or other liquid assets and must have gross monthly income below $2,349. The asset and income limits are effective for 2020. This income limit is equivalent to three times the current Federal Benefit Rate (FBR).
For applicants who are married and their spouses are not also applying for Medicaid, income in their names can be transferred to their non-applicant spouses. This is called a monthly maintenance needs allowance, and as of 2020, allows as much as $3,216 / month to be transferred. This spousal allowance ensures non-applicant spouses have enough income to support themselves, while also lowering applicants’ countable income for eligibility purposes. In addition, there is a community spouse resource allowance that allows non-applicant spouses to keep as much as $128,640 (in 2020) of the couples joint assets. This is in addition to the $2,000 in resources the applicant spouses are able to keep.
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 individuals directly and to help family members care for them.
State social workers prioritize individuals who currently 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 March 1, July 1, and November 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.
The New Choices Medicaid Waiver is operated by the Utah Division of Medicaid and Health Financing. For additional information about this program, click here.