New Choices Waiver Utah: Get Paid To Care For A Family Member

In some cases, yes. This is one of the biggest differences between Utah programs. The separate Employment-related Personal Assistant Services (EPAS) program explicitly states a personal assistant may not be a legal guardian, which it defines to include a spouse. The New Choices Waiver Self-Administered Services rules do not publish that same blanket exclusion, and several Medicaid guides note that under the New Choices Waiver even spouses can sometimes be hired to provide personal care. Because eligibility can turn on the specific situation and on who serves as the participant's designee, a spouse should not assume approval. Confirm directly with your case manager and Financial Management Services agency before counting on spousal pay. If the spouse is not eligible, adult children and most other relatives usually can be paid.

Utah does not set one fixed statewide hourly rate for self-administered attendants. Under Self-Administered Services, the participant is the employer and sets the wage, which must be at least the applicable minimum wage. In practice most family attendants earn roughly $13 to $17 per hour in 2026. Total pay is capped by the number of service units the case manager authorizes from the InterRAI MDS-HC assessment, and many family caregivers bring home up to about $2,570 per month depending on their approved hours. Attendants are paid as employees through a Financial Management Services agency, so federal, state, and local employment taxes are withheld from each paycheck. Hours worked over 40 in a single week are paid at an overtime rate, so families often schedule more than one attendant.

Plan for up to about three months from start to finish. Federal rules give Medicaid 45 days to process a standard application and up to 90 days when a disability determination is needed, and Utah advises that applications can take up to three months in practice. Two steps drive the timeline: the financial eligibility determination and the nursing facility level-of-care assessment (the InterRAI MDS-HC), which a registered nurse must schedule and complete. The New Choices Waiver also has limited enrollment slots, so if slots are full you may spend time on a waiting list before a slot opens. You can speed things up by gathering identification, proof of Utah residency, Social Security information, and proof of income and assets in advance, and by starting the referral early by calling 1-800-662-9651, option 6.

No professional license or certification is required to be a paid attendant under Self-Administered Services. You do not need to be a Certified Nursing Assistant, Home Health Aide, or nurse. Because the participant is the employer, the participant (or their designee) trains the attendant on the specific tasks they need help with. There are onboarding requirements handled through the Financial Management Services agency: a criminal background check, an employment agreement, an employee code of conduct, and a wage worksheet, plus Electronic Visit Verification for logging visits where required. Work cannot begin until the FMS agency confirms an official start date, and back pay for work done before that date is not allowed. This makes the New Choices Waiver welcoming to family members who have been caregiving informally and want to be paid for it.

With a traditional agency, the agency hires the aide, sets the schedule, supervises the work, and assigns whoever is available. Under Self-Administered Services (SAS) on the New Choices Waiver, the Medicaid participant is the employer. The participant recruits and hires the attendant (often a family member or friend they already trust), sets the wage, schedules the shifts, supervises the care, and can dismiss the employee if things are not working. A Financial Management Services agency acts as the common-law employer behind the scenes to run payroll, withhold taxes, verify qualifications, and process background checks, but it does not choose or supervise the attendant. Both models deliver the same attendant care and homemaker services; SAS simply gives the participant control over who provides them. Families who want continuity and trust generally prefer SAS.

Yes, in most cases. Utah guidance is clear that as long as an adult child does not serve as their parent's legal guardian, they can be hired to provide both personal (attendant) care and homemaker services under the New Choices Waiver. The adult child must be at least 18, pass the required criminal background check, and complete the employer and employee paperwork through the Financial Management Services agency. One important limit: the same person cannot be both the participant's designee (the person who helps run the employer responsibilities) and the paid employee. If an adult child wants to be the paid attendant, another person should serve as the designee, or the participant can self-direct. Many Utah families use this exact arrangement to turn years of unpaid caregiving into a paid role.

There is no flat number of hours. A case manager assesses the participant's functional needs using the InterRAI MDS-HC and translates those needs into authorized service units for attendant care and homemaker services. Someone who needs help a few times a day will be authorized fewer hours than someone who needs extensive daily support. The participant can split the authorized hours across more than one attendant, which is common when two family members share the caregiving. Keep in mind that hours over 40 per week for a single employee are paid at overtime, which uses up the authorized budget faster, so many families deliberately schedule a second attendant. Hours are reviewed and reauthorized over time, and can be adjusted if the participant's needs change.

Employment-related Personal Assistant Services (EPAS) is a separate Utah Medicaid self-directed program for working adults with disabilities who need personal assistance specifically to keep a job. To qualify for EPAS, a person must have a disability determination, be on Utah Medicaid, and work at least 40 hours a month in an integrated setting earning at least minimum wage. EPAS is not a waiver and has stricter rules on who can be the paid assistant: it explicitly bars a legal guardian, which it defines to include a spouse or the parent of a minor. You also cannot receive EPAS at the same time personal care is covered by a waiver like the New Choices Waiver. If your goal is to get paid to care for an aging or disabled family member at home, the New Choices Waiver Self-Administered Services option is usually the right path, not EPAS.