Medicaid - Part 5

Physical Disabilities Waiver (PWD) (Cont)

The services received are dependent on an individual?s needs and assigned budget. No service may duplicate a similar service offered through the Medicaid State Plan. A service is made available through the waiver only if there is no other means of obtaining it. However, once someone is brought into this waiver, he or she is eligible for all services that are necessary for his or her health and safety. A person may qualify to receive services through DSPD, however, he or she is not made eligible to receive services through the Physical Disabilities Waiver until funding is available. Only a very limited number of people can receive services through this waiver. DSPD maintains a waiting list of individuals who qualify for services and who are waiting to receive services through this waiver. Individuals are brought into services from the waiting list based on available funding and on their Minimum Data Set-Home and Community (MDS-HC) and Personal Assistance Critical Needs assessment score. Utah State law requires DSPD to serve the most critical first. This often means that a person can be on the waiting list for many years before being brought into services.

How do I apply for services?

  • To apply for the Physical Disabilities Waiver, call the DSPD State Office at (801) 538-4200 in Salt Lake County or (800) 837-6811 statewide to obtain a Physical Disabilities Application form.
  • You and your physician will need to complete the Physical Disabilities Application form. The nurse coordinator will review the form.
  • The nurse coordinator will use the MDS-HC and Personal Assistance Critical Needs assessment tools to evaluate your need for services.
  • You will be given a needs assessment score for placement on the wait list or into services.
  • Every 6 months you will receive a survey that you must complete to update your need for services. To learn more about the services offered through DSPD click on http://www.dspd.utah.gov/

 

Individuals Aged 65 and Older (Aging) Waiver

This Utah Medicaid Home and Community Based Waiver program serves people age 65 and older. The services provided through this waive allow the individual to remain in his or her own home or other community living arrangement instead of a Nursing Facility. The Department of Human Services, Division of Aging and Adult Services (DAAS), operates this waiver.
To be eligible for this waiver the individual must:

  • Be age 65 or older
  • Meet the admissions criteria for a Nursing Facility
  • Qualify for Medicaid based on his/her own income and resources at or below 100 % of the Federal Poverty Level after allowable deductions (spenddown is an option). What services are available through this waiver? In addition to the medical services available through regular Medicaid, this waiver provides the following special services:
  • Adult day care
  • Assistance with caregiver training
  • Case management
  • Chore services
  • Companion services
  • Home delivered meals
  • Homemaking services
  • Home modifications for physical accessibility
  • In-home caregiver respite
  • Non-medical transportation
  • Nursing home overnight caregiver respite
  • Personal care services (Home Health Aid or Personal Care Attendant)
  • Personal Emergency Response Systems
  • Specialized medical equipment, supplies, and assistive technology

A limited number of individuals can be served through this waiver. Services provided are dependent on an individuals needs and assigned budget. No service may duplicate a similar service available through the Medicaid State Plan. People are brought into waivered services based on their needs and available funding.

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