UT Community Supports Waiver for Individuals with Intellectual Disabilities and Other Related Conditions

The Community Supports Waiver for Individuals with Intellectual Disabilities and Other Related Conditions (CSW) is a Medicaid program that provides home and community-based services to eligible individuals in Utah. It is designed to help people with intellectual disabilities or related conditions live independently in their homes or other community settings. 

Overview

The CSW is an alternative to institutional care, such as intermediate care facilities for individuals with intellectual disabilities (ICF/ID).

The CSW serves individuals who have an intellectual disability or a related condition that results in functional impairment in three or more areas of significant life activity, such as self-care, learning, mobility, communication, self-direction, capacity for independent living, and economic self-sufficiency. The CSW also serves individuals who meet the financial and medical eligibility requirements for Medicaid and the level of care criteria for admission to an ICF/ID.

The CSW aims to provide individualized and person-centered services that support each participant's needs, preferences, and goals. The CSW also seeks to promote the health, safety, and well-being of participants and their families. 

Eligibility Requirements

To be eligible for the CSW, you must meet the following requirements:

• You must have an intellectual disability or a related condition that results in functional impairment in three or more areas of significant life activity, such as self-care, learning, mobility, communication, self-direction, capacity for independent living, and economic self-sufficiency.
• You must meet the financial and medical eligibility requirements for Medicaid and the level of care criteria for admission to an intermediate care facility for individuals with intellectual disabilities (ICF/ID).
• You must be a Utah resident, U.S. citizen, or qualified alien.
• You must be at least 18 years old or older.
• You must need ongoing support and supervision to live in the community.
• You must have a person-centered support plan that identifies your needs, preferences, and goals, and the services that will help you achieve them.
• You must agree to receive services from a qualified provider contracted with the Utah Department of Human Services, Division of Services for People with Disabilities (DSPD).

Services and Supports

The CSW offers a range of services and supports that can help you and your loved one with intellectual disabilities or related conditions to live more independently and comfortably in the community. Some of the services and supports available under the CSW include:

• Behavioral Consultation: This service provides assessment, intervention, and training to address behavioral issues that interfere with the participant's functioning and well-being. A qualified behavioral consultant works with the participant, the caregiver, and other service providers to develop and implement a behavior support plan consistent with the participant's needs and preferences.
• Chore Services: This service assists with household tasks that the participant or the caregiver cannot perform due to age, disability, or illness. These tasks may include cleaning, laundry, yard work, minor home repairs, and other essential activities for maintaining a safe and sanitary living environment.
• Companion Services: This service provides non-medical care, supervision, and socialization to the participant. A companion may assist the participant with activities of daily living, such as eating, dressing, grooming, and toileting, as well as recreational and leisure activities, such as reading, playing games, or going out for walks. A companion may also provide transportation to access community resources and services.
• Day Supports: This service provides opportunities for the participant to engage in meaningful and productive activities in a group setting outside of their home. These activities may include skill development, vocational training, employment support, socialization, recreation, and community integration. Day supports are provided by qualified staff in a licensed or certified facility or program.
• Emergency Response Systems: This service provides an electronic device that enables the participant to summon help in an emergency. The device may be worn as a pendant, bracelet, or belt clip or installed as a wall unit. The device is connected to a 24-hour response center that can dispatch emergency personnel or contact a designated caregiver or service provider.
• Environmental Adaptations: This service provides physical modifications to the participant's home or vehicle that are necessary to ensure their health, safety, and accessibility. These modifications may include ramps, grab bars, widened doorways, lowered countertops, vehicle lifts, and other adaptations the DSPD approves.
• Extended Living Supports: This service provides 24-hour residential care and supervision to the participant in a licensed or certified group home or host home. The service provider is responsible for meeting the participant's needs for personal care, health care, medication administration, nutrition, transportation, recreation, and community integration. The service provider also works with the participant to develop and implement a person-centered support plan that reflects their goals and preferences.
• Family/Ind. Training and Preparation: This service provides education and training to the participant and their family members or caregivers on their disability, needs, rights, and responsibilities. The topics may include self-advocacy, self-determination, informed choice, transition planning, guardianship options, financial planning, and other relevant issues. The service is delivered by a qualified trainer in a group or individual setting.
• Financial Management Services: This service assists with managing the participant's funds and paying for their waiver services. The service provider acts as the participant's representative payee or fiscal agent and ensures that their income and expenses are accounted for and reported according to Medicaid rules and regulations. The service provider also helps the participant access other financial benefits and resources they may be eligible for.
• Homemaker Services: This service assists with routine household tasks related to the participant's care. These tasks may include meal preparation, grocery shopping, dishwashing, bed making, and other activities necessary to maintain a healthy and comfortable living environment. The service provider may also assist the participant with personal care tasks.
• Living Start-up Costs: This service provides financial assistance for purchasing essential items needed for setting up a new living arrangement for the participant. These items may include furniture, appliances, bedding, dishes, and other household goods that the DSPD approves.
• Massage Therapy: This service provides therapeutic massage to the participant by a licensed massage therapist. Massage therapy can help to relieve pain, stress, muscle tension, and improve blood circulation, lymphatic drainage, and immune system function.
• Medication Monitoring: This service assists with managing the participant's medications by a qualified nurse or pharmacist. The service provider reviews the participant's medication regimen, educates them on proper medication usage, storage, and disposal, and monitors them for adverse effects or interactions. The service provider also coordinates with the participant's physician, pharmacy, and other healthcare providers to ensure that their medications are appropriate, effective, and safe.
• Non-medical Transportation: This service allows participants to access waiver services, community resources, and activities not covered by Medicaid state plan transportation. The transportation may be provided by a public transit system, a taxi company, a volunteer driver program, or a service provider contracted with the DSPD. Transportation must be the least costly and most appropriate mode available for the participant.
• Personal Assistance: This service assists with activities of daily living and instrumental activities of daily living by a qualified personal assistant. Activities of daily living include eating, bathing, dressing, grooming, toileting, transferring, and mobility. Instrumental activities of daily living include housekeeping, laundry, shopping, meal preparation, medication management, and money management. The personal assistant may also provide companionship, supervision, and transportation to the participant as needed.
• Personal Budget Assistance: This service assists with developing and managing a personal budget for the participant by a qualified financial counselor. The financial counselor helps the participant identify their income and expenses, set financial goals and priorities, create a spending plan, track their spending habits, and adjust as needed. The financial counselor also educates the participant on financial literacy topics such as banking, credit, debt, savings, investments, and taxes.
• Residential Habilitation: This service provides training and support to the participant to acquire, maintain, or improve skills related to living in the community. The skills may include self-care, communication, socialization, self-direction, problem-solving, decision-making, and community integration. The service is delivered by qualified staff in the participant's home or other community setting.
• Respite Care: This service temporarily relieves the participant's primary caregiver by providing care and supervision to the participant in their absence. Respite care can be provided in the participant's home or other community setting by a qualified respite provider. Respite care can help to reduce caregiver stress, prevent burnout, and enhance family well-being.
• Service Animal: This service provides a specially trained animal that performs tasks for the participant's benefit, like guiding, alerting, retrieving, pulling, or providing emotional support. The service animal must be certified by a recognized organization and comply with all applicable laws and regulations. The service covers the cost of acquiring, training, maintaining, and replacing the service animal as needed.
• Specialized Medical Equipment: This service provides equipment or supplies that are medically necessary for the participant's health, safety, or functioning. The equipment or supplies must be prescribed by a physician and approved by the DSPD. The equipment or supplies may include wheelchairs, walkers, lifts, beds, mattresses, cushions, commodes, shower chairs, oxygen tanks, nebulizers, catheters, ostomy supplies, and other items not covered by Medicaid state plan durable medical equipment.
• Supported Employment: This service assists with finding and maintaining paid employment in an integrated community setting for the participant. The service includes assessment, job, coaching, and retention, and follow-along support. The service provider works with the participant and the employer to ensure the employment is suitable, satisfying, and sustainable for both parties.
• Supported Living: This service provides ongoing support and supervision to the participant who lives in their own home or apartment in the community. The service provider helps the participant access and coordinate other waiver services and community resources necessary for their health, safety, and well-being. The service provider also assists the participant with activities of daily living, instrumental activities of daily living, personal care, medication management, transportation, recreation, and community integration as needed.
• Waiver Support Coordination: This service provides case management to the participant by a qualified waiver support coordinator. The waiver support coordinator helps the participant access and coordinate waiver services and other community resources appropriate for their needs and preferences. The waiver support coordinator also develops and monitors the participant's person-centered support plan that identifies their goals and outcomes and the services that will help them achieve them.

Compensation for Family Caregivers

One of the benefits of the CSW is that it allows unpaid family caregivers to receive compensation for providing care and support to their loved ones with intellectual disabilities or related conditions. Caregiver compensation is a temporary service option introduced in response to the COVID-19 pandemic.

Caregiver compensation is available for parents, spouses, and guardians of individuals enrolled in the CSW or the Acquired Brain Injury Waiver (ABIW). Caregivers can provide self-administered supported living services, including assistance with daily living activities, personal care, medication management, transportation, recreation, and community integration.

Caregivers can receive compensation for up to 40 hours per week based on the individual's documented and assessed needs. The DSPD determines the compensation rate and is subject to change. Caregivers must meet the same qualifications and requirements as any other self-administered service employee, such as completing the necessary paperwork, training, and documentation.

Caregiver compensation is a self-directed option under the CSW, which means that individuals and their families have more choice and control over who provides their services and how they are delivered. Self-directed services are managed through a fiscal agent, a company contracted with the DSPD to handle employee payroll and taxes. 

Caregiver compensation is a valuable service that can help individuals and their families to cope with the challenges and opportunities of living in the community during the COVID-19 emergency. It can also reduce caregiver stress, prevent burnout, and enhance family well-being. If you want to apply for caregiver compensation, don't hesitate to contact your support coordinator or visit the DSPD website for more information.

A note from Givers

If you are a family caregiver for someone with intellectual disabilities or related conditions, you may be eligible for compensation under the Community Supports Waiver. To find out if you qualify, please fill out this form.