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Getting paid to care for a family member in Utah

Yes. In Utah, a family member can be paid to give care through Personal Attendant Services. Whether a spouse can be paid depends on conditions set out below with their sources.

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Medicaid waiver

Aging Waiver

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Who qualifies

People age 65 or older who need a nursing facility level of care and meet Medicaid financial eligibility. The waiver provides services, such as help with household tasks, that help older adults stay in their homes or other community settings.

Source: Services (Utah Division of Aging and Adult Services)Checked

Medicaid self-directed care

Personal Attendant Services

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Who qualifies

Aging Waiver enrollees who are assessed to need personal attendant services. You, or a person appointed to decide for you, choose and keep the attendant, supervise the work and verify the attendant's time sheet. You can employ the attendant directly, using a Fiscal Management Agency for the employer paperwork, or use an agency-employed attendant.

Source: Waiver for Individuals Age 65 or Older (Aging Waiver), approved 1915(c) application UT.0247.R07.01, effective July 1, 2026 (CMS, medicaid.gov)Checked

Can a family member be paid

Yes. Yes for relatives other than a spouse or legal guardian. The approved waiver says relatives, other than legal guardians and spouses, may provide specified waiver services, and it lists relatives as allowed providers of Personal Attendant Services.

Medicaid does not pay for Personal Attendant Services performed for other members of the family.

Source: Waiver for Individuals Age 65 or Older (Aging Waiver), approved 1915(c) application UT.0247.R07.01, effective July 1, 2026 (CMS, medicaid.gov)Checked

Can a spouse be paid

Depends. Utah's approved waiver says both. Its section on legally responsible individuals (C-2-d, marked Yes) lets a spouse be paid for Personal Attendant Services as extraordinary care when the participant chooses the spouse and the team supports it, the spouse is not also directing services for the participant, the spouse has a unique ability to meet the participant's needs (for example, nursing licensure), and the spouse provides no more than 40 hours a week. But the same approved waiver's definition of Personal Attendant Services says payment will not be made for services furnished by the individual's spouse, and its section C-2-e says spouses are not permitted to provide waiver services under Administrative Rule R539-5-5.

Where a spouse is approved, the state reviews the whole support picture, including the risk to the spouse, and a third party verifies time sheets. A spouse who is considering this should confirm the current rule with the Area Agency on Aging case manager. The approved application is the ZIP file linked on the medicaid.gov page.

Source: Waiver for Individuals Age 65 or Older (Aging Waiver), approved 1915(c) application UT.0247.R07.01, effective July 1, 2026 (CMS, medicaid.gov)Checked

Can a legal guardian be paid

No. No. The approved waiver says legal guardians are not permitted to provide waiver services, and does not list legal guardians as providers of Personal Attendant Services.

Source: Waiver for Individuals Age 65 or Older (Aging Waiver), approved 1915(c) application UT.0247.R07.01, effective July 1, 2026 (CMS, medicaid.gov)Checked

Pay rate

When you employ the attendant directly, you negotiate the hourly wage with them. Employer payroll costs such as Social Security and Medicare taxes are paid on top of that wage.

Source: Utah Medicaid Provider Manual, HCBS Waiver for Individuals Age 65 or Older (Division of Integrated Healthcare, updated April 2022)Checked

Hours limit

Personal Attendant Services will not exceed five hours a day, unless an evaluation approves more for a limited time. A spouse providing the service through self-direction is limited to 25 hours a week, and routine respite is not provided while a spouse is the paid attendant.

Source: Waiver for Individuals Age 65 or Older (Aging Waiver), approved 1915(c) application UT.0247.R07.01, effective July 1, 2026 (CMS, medicaid.gov)Checked

How to apply

Aging Waiver

How to apply

Contact your local Area Agency on Aging (listed at daas.utah.gov/locations/) to learn more.

Source: Services (Utah Division of Aging and Adult Services)Checked

Personal Attendant Services

How to apply

Aging Waiver enrollees who need Personal Attendant Services are told about the option to direct the service themselves, including whether to employ the attendant directly or use an agency.

Source: Waiver for Individuals Age 65 or Older (Aging Waiver), approved 1915(c) application UT.0247.R07.01, effective July 1, 2026 (CMS, medicaid.gov)Checked

Sources

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