UT Physical Disabilities Waiver

The Physical Disabilities Waiver is a Medicaid program that provides home and community-based services to individuals with physical disabilities in Utah. This program helps people with physical disabilities live as independently as possible in their homes or other settings rather than in nursing facilities or other institutions. 

Overview of the Physical Disabilities Waiver

The Physical Disabilities Waiver is one of Utah's several Medicaid waivers to provide long-term care services to eligible individuals in the community. Medicaid waivers allow states to waive specific federal rules and regulations to offer more flexible and customized services to specific populations. The Physical Disabilities Waiver was established in 1998 and is administered by the Utah Department of Health.

The purpose of the Physical Disabilities Waiver is to provide services that help people with physical disabilities remain in their homes or other community-based settings, such as assisted living facilities or adult foster care homes. The waiver also aims to promote and support participant self-determination, meaning that individuals can make choices about their own lives and services. The waiver serves adults aged 18 and older with a physical impairment resulting in the functional loss of two or more limbs and who require at least 14 hours per week of personal assistance.

The Physical Disabilities Waiver offers services designed to meet each participant's needs and preferences. Some services include financial management, personal assistance, emergency response systems, and specialized medical equipment and supplies. These services are provided by qualified providers contracted by the state or hired by the participant. Participants can choose their providers, including family members, friends, or neighbors, and train and supervise them as they wish.

The Physical Disabilities Waiver can benefit participants and caregivers by providing support, resources, and options to enhance their quality of life and well-being. The waiver can help participants maintain their independence, dignity, and autonomy in their homes or communities. For caregivers, especially family members who provide unpaid care to their loved ones with physical disabilities, the waiver can help them get paid for their caregiving work and access other services that can reduce their stress and burden. 

According to a report by AARP, about 336,000 family caregivers in Utah provide an estimated 290 million hours of care each year, valued at $4.2 billion. However, many of these caregivers face financial hardships, health problems, and emotional challenges due to inadequate support and recognition for their work. The Physical Disabilities Waiver can help address some of these issues by providing caregivers with compensation, training, respite, and other assistance to improve their situation.

Eligibility Requirements

To qualify for the Physical Disabilities Waiver, you must meet the following eligibility requirements:

• You must be 18 years of age or older.
• You must have a physician certify the physical disability of the individual.
• You must have a physical impairment resulting in the functional loss of two or more limbs. You must also require at least 14 hours per week of personal assistance.
• You must be capable of selecting, supervising, and training your attendant.
• You must be capable of managing your own financial and legal matters.
• You must require a nursing facility level of care.
• You must meet the financial eligibility requirements for Medicaid. The income limit for Medicaid long-term care services is $2,430 per month for an individual and $4,860 for a couple in 2023. The asset limit is $2,000 for an individual and $3,000 for a couple in 2023. However, some assets are excluded from this calculation, such as your home, car, personal belongings, and burial funds.
• You must have at least one personal attendant trained and available to provide authorized services in a safe and adequately equipped residence for the care of the individual.

Services and Supports

The Physical Disabilities Waiver offers various services and supports designed to meet each participant's needs and preferences. These services and supports are intended to help people with physical disabilities live as independently as possible in their homes or other community-based settings, such as assisted living facilities or adult foster care homes. Some of the services and supports available under the waiver are:

• Financial Management Services: This service helps participants manage their waiver funds and pay their providers. It includes payroll, tax withholding, reporting, and other administrative tasks. Participants can choose between two types of financial management services: agency with choice or fiscal employer agent.
• Personal Assistance Services: This service assists with activities of daily living like bathing, dressing, eating, mobility, medication management, housekeeping, laundry, shopping, and transportation. Participants can choose their providers, including family members, friends, or neighbors, and train and supervise them.
• Personal Emergency Response System: This service provides an electronic device that allows participants to summon help in an emergency. The device is connected to a 24-hour response center that can contact the participant's designated emergency contacts or emergency services.
• Specialized Medical Equipment and Supplies: This provides medically necessary equipment and supplies not covered by Medicaid or other sources. Examples of specialized medical equipment and supplies include wheelchairs, walkers, lifts, ramps, beds, mattresses, cushions, catheters, ostomy supplies, and wound care supplies.

Compensation for Caregivers

The Physical Disabilities Waiver offers a self-directed option, allowing participants to choose their providers, including family members, friends, or neighbors, and train and supervise them as they wish. This option gives participants more control and flexibility over their services and supports and more opportunities to hire people they trust and are comfortable with. The self-directed option is administered by a fiscal agent, who handles the providers' payroll, tax withholding, reporting, and other administrative tasks.

A note from Givers

If you are interested in finding out if you are eligible for compensation as a family caregiver under the Physical Disabilities Waiver, please fill out this form, and we will get back to you as soon as possible.