RESPITE CARE SERVICES PROVIDER IN UTAH
OFFERING TEMPORARY RELIEF FOR PRIMARY CAREGIVERS WHILE ENSURING SAFE, SUPPORTIVE CARE FOR INDIVIDUALS WITH DISABILITIES

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Respite Care Services in Utah provide temporary, substitute care for individuals with intellectual or developmental disabilities (ID/DD), physical disabilities, or medically complex conditions. These services give family caregivers a needed break while ensuring that the individual receives safe, person-centered support. Respite services are offered through several 1915(c) Home and Community-Based Services (HCBS) Waivers administered by the Utah Department of Health and Human Services (DHHS) via the Division of Services for People with Disabilities (DSPD).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Authorizes Respite Services through HCBS waivers and ensures compliance with provider standards and Medicaid billing practices.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Oversees federal regulations and waiver program guidelines for respite and other HCBS.

2. RESPITE CARE SERVICES OVERVIEW

Respite Care temporarily relieves the primary caregiver from their caregiving responsibilities. Services are based on the individual’s Individual Support Plan (ISP) and are designed to ensure that care recipients remain safe, healthy, and engaged.

Service settings and formats include:

In-home respite (in the individual’s home)

Out-of-home respite (in a certified facility or provider's residence)

Overnight or weekend respite care

Emergency or planned respite

Activities covered under respite:

Supervision and companionship

Assistance with activities of daily living (ADLs)

Community outings (if part of the approved plan)

Health-related tasks (as allowed and delegated under Utah rules)

Note: Respite is distinct from personal care in that its primary purpose is to provide caregiver relief, not ongoing daily support.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with Utah Division of Corporations

Obtain EIN and Type 2 NPI

Enroll as a Utah Medicaid provider and complete DSPD contracting

Ensure respite staff are qualified and trained per DSPD standards

Maintain general liability and workers’ compensation insurance

Create a Respite Care Services Policy & Procedure Manual

Facility-based or out-of-home respite may require site certification through DSPD.

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register your business, EIN, and NPI
Step 2: Enroll with Utah Medicaid as a waiver service provider
Step 3: Apply to DSPD for respite service approval and contracting
Step 4: Complete MySupport provider orientation and submit staff credentials
Step 5: Obtain DSPD approval and begin providing authorized respite services

5. REQUIRED DOCUMENTATION

EIN, NPI, Articles of Incorporation

Medicaid and DSPD provider agreements

Staff qualifications and training records

Respite Services Policy Manual including:

Participant intake and care plan alignment

Staff supervision and scheduling logs

Emergency procedures and incident reporting

Participant rights and confidentiality policies

Infection control and health monitoring protocols

Daily shift documentation and Medicaid billing forms

6. STAFFING REQUIREMENTS

Role: Respite Care Worker
Requirements: Age 18+, background check, CPR/First Aid, experience or training in caring for individuals with disabilities

Role: Clinical Supervisor (if delegated healthcare tasks are performed)
Requirements: Licensed RN or healthcare professional, if applicable

All staff must complete:

HIPAA and client confidentiality training

Abuse, Neglect, and Exploitation Prevention (ANEP)

Basic ADL support training and emergency preparedness

ISP implementation and safety support training

DSPD MySupport modules

7. MEDICAID WAIVER PROGRAMS

Respite services are reimbursable under the following Utah waivers:

Community Supports Waiver (CSW) – for individuals with ID/DD

Acquired Brain Injury (ABI) Waiver

Physical Disabilities Waiver (PDW)

Medically Complex Children’s Waiver (MCCW) – for high-need children with 24/7 care needs

8. TIMELINE TO LAUNCH

Phase: Business Formation & Manual Preparation
Timeline: 1–2 months

Phase: Utah Medicaid & DSPD Contracting
Timeline: 2–3 months

Phase: Staff Training & Safety Readiness
Timeline: 30–45 days

Phase: Begin Service Delivery
Timeline: Upon participant approval and service plan inclusion

9. CONTACT INFORMATION

Utah Department of Health and Human Services (DHHS) – DSPD
Website: https://dspd.utah.gov

Utah Medicaid Provider Enrollment
Website: https://medicaid.utah.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH RESPITE CARE PROVIDER

WCG helps agencies and independent providers set up high-quality, waiver-compliant respite care programs for individuals and families across Utah.

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Scope of Work:

Medicaid and DSPD enrollment guidance

Respite Services Policy & Procedure Manual

Participant shift logs and documentation templates

Staff training packets and onboarding tools

Emergency protocol and caregiver substitution forms

Billing, audit, and readiness review support

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RESIDENTIAL HABILITATION SERVICES PROVIDER IN UTAH
DELIVERING ROUND-THE-CLOCK, PERSON-CENTERED SUPPORT TO HELP INDIVIDUALS WITH DISABILITIES LIVE SAFELY AND INDEPENDENTLY IN THEIR COMMUNITIES

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Residential Habilitation Services in Utah offer 24-hour or extended-period care and skill development for individuals with intellectual and developmental disabilities (ID/DD) who require structured support in a residential setting. These services are authorized under the Community Supports Waiver and other HCBS waiver programs managed by the Utah Department of Health and Human Services (DHHS) through the Division of Services for People with Disabilities (DSPD).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Regulates Residential Habilitation programs through provider enrollment, ISP oversight, quality reviews, and Medicaid billing.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Sets federal HCBS waiver requirements and monitors Utah’s waiver compliance.

2. RESIDENTIAL HABILITATION SERVICES OVERVIEW

Residential Habilitation provides assistance, supervision, and skill-building to individuals living in group homes, supervised apartments, or host homes. The goal is to help residents gain independence, develop life skills, and fully participate in community life.

Core services include:

Personal care assistance (e.g., bathing, grooming, toileting)

Life skills training (e.g., cooking, budgeting, self-advocacy)

Medication administration (under delegation by RN)

Behavioral supports (when authorized in the ISP)

Transportation and community integration activities

Overnight supervision and crisis support

Meal preparation, laundry, and light housekeeping

Socialization and daily structure

Settings may include:

Staffed Group Homes (multiple residents, 24-hour staffing)

Supervised Living Settings (individual apartments or shared homes)

Host Homes (licensed families or individuals supporting 1–2 clients)

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Utah Division of Corporations

Obtain EIN and NPI (Type 2)

Enroll with Utah Medicaid and contract with DSPD

If operating a group or host home: obtain Residential Support license through the Office of Licensing (OL)

Complete site inspections and fire safety checks

Maintain general liability and professional insurance

Develop a Residential Habilitation Services Policy & Procedure Manual

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register business entity, EIN, and NPI
Step 2: Apply with DHHS/DSPD as a Residential Habilitation provider
Step 3: Secure OL licensure for any physical residential settings
Step 4: Submit required documentation (policies, staffing plans, floor plans, etc.)
Step 5: Complete MySupport training modules
Step 6: Receive contract approval and begin accepting client referrals

5. REQUIRED DOCUMENTATION

Articles of incorporation, EIN, NPI

Medicaid enrollment and DSPD provider contract

Office of Licensing (OL) Residential Facility License (if applicable)

Proof of insurance and staff background checks

Residential Habilitation Policy Manual covering:

Intake procedures and ISP alignment

Medication delegation and administration

Staff scheduling and supervision

Emergency response and evacuation protocols

Rights, dignity, and client choice protections

Daily progress notes and data collection forms

Staff training logs and incident reporting procedures

Community activity and goal-tracking logs

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)
Requirements: Age 18+, background check, CPR/First Aid, completion of ANEP and ISP training

Role: Residential Manager / Program Supervisor
Requirements: Oversight of service delivery, staff training, ISP implementation

Role: Registered Nurse (as needed for med delegation)
Requirements: Utah RN license; supports health oversight and med delegation

All staff must complete:

HIPAA and confidentiality training

Abuse, Neglect, and Exploitation Prevention (ANEP)

Fire safety and emergency protocols

ISP-specific training and goal tracking

Behavior support and crisis de-escalation (as applicable)

7. MEDICAID WAIVER PROGRAMS

Residential Habilitation is covered under:

Community Supports Waiver (CSW) – for adults with ID/DD

Acquired Brain Injury Waiver (ABI) – in specific residential support settings

Physical Disabilities Waiver (PDW) – with service justification and authorization

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Development
Timeline: 1–2 months

Phase: Licensing (OL) & Medicaid Enrollment
Timeline: 2–4 months (includes facility inspections)

Phase: Staff Hiring & Training
Timeline: 45–60 days

Phase: Start of Service Delivery
Timeline: Once residential site is approved and participant ISPs are authorized

9. CONTACT INFORMATION

Utah Department of Health and Human Services (DHHS) – DSPD
Website: https://dspd.utah.gov

Utah Medicaid Provider Enrollment
Website: https://medicaid.utah.gov

Utah Office of Licensing (OL)
Website: https://hslic.utah.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH RESIDENTIAL HABILITATION PROVIDER

WCG helps residential providers develop licensed, person-centered habilitation programs that meet Utah DSPD and federal standards.

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Scope of Work:

Business registration and Medicaid/DSPD enrollment

Residential Support License application (OL)

Residential Habilitation Policy & Procedure Manual

Staff training packages and scheduling templates

Daily logs, ISP tracking tools, and med delegation forms

Quality assurance and audit readiness support

SUPPORTED EMPLOYMENT SERVICES PROVIDER IN UTAH
EMPOWERING INDIVIDUALS WITH DISABILITIES TO ACHIEVE COMPETITIVE, INTEGRATED EMPLOYMENT THROUGH PERSON-CENTERED SUPPORTS

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Supported Employment Services in Utah are designed to help individuals with intellectual, developmental, or physical disabilities find and maintain meaningful work in the community. These services promote independence, community inclusion, and economic self-sufficiency by providing tailored job development, coaching, and retention supports.

Supported Employment is an authorized service under Utah’s HCBS Medicaid Waivers and is coordinated by the Division of Services for People with Disabilities (DSPD). Providers play a vital role in helping individuals secure competitive, integrated employment based on their skills, preferences, and goals.

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Manages HCBS waiver programs, contracts with employment providers, and authorizes Supported Employment services as part of Individual Support Plans (ISPs).

Agency: Utah Division of Integrated Healthcare (DIH)
Role: Oversees Medicaid provider enrollment and reimbursement processes for waiver services.

Agency: Utah State Office of Rehabilitation (USOR)
Role: Collaborates with DSPD through joint planning and time-limited pre-employment supports via Vocational Rehabilitation (VR) programs.

2. SUPPORTED EMPLOYMENT SERVICES OVERVIEW

Supported Employment helps individuals with disabilities:

Identify employment goals through discovery and career profiling

Develop job readiness and pre-employment skills

Obtain competitive employment in integrated settings

Receive job coaching and on-the-job supports

Maintain employment with long-term support as needed

Key service types include:

Job Development & Placement – Identifying potential employers, preparing résumés, and setting up interviews

Job Coaching – One-on-one support during onboarding and skill acquisition

Employment Retention Supports – Long-term strategies for job sustainability

Self-Employment Assistance – Support with microenterprise development (case-by-case basis)

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business entity with Utah Division of Corporations

Obtain EIN and Type 2 NPI

Submit provider application through DSPD with relevant service codes

Maintain general liability insurance and background clearance protocols

Develop a comprehensive Supported Employment Services Policy & Procedure Manual

Enroll with Medicaid via the Utah Provider Enrollment Portal

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain EIN and Type 2 NPI
Step 2: Apply to become a DSPD provider for Supported Employment services
Step 3: Complete Medicaid enrollment via the DIH portal
Step 4: Complete staff credentialing and background checks
Step 5: Submit Policy & Procedure Manual for service approval
Step 6: Begin service delivery upon waiver authorization and ISP approval

5. REQUIRED DOCUMENTATION

Business registration, EIN, and NPI confirmation

DSPD provider agreement for employment services

Medicaid enrollment confirmation

Policy & Procedure Manual including:

Job development process and documentation standards

Job coaching protocols and staff supervision

Individualized service planning and goal tracking

Data collection, billing logs, and shift notes

Client rights, grievances, and confidentiality practices

Staff training plans for disability awareness and workplace integration

6. STAFFING REQUIREMENTS

Role: Employment Specialist / Job Coach
Requirements:

High school diploma or GED (some contracts may require a college degree)

Background check clearance

Training in Supported Employment best practices (e.g., ACRE or APSE preferred)

CPR/First Aid training

Ongoing DSPD training and competency verification

Optional Role: Program Coordinator / Supervisor
Responsibilities: Oversight of service quality, staff support, and compliance

All staff must complete:

Annual refresher trainings

Client-centered planning and ISP participation

Workplace safety and emergency preparedness

HIPAA and confidentiality training

7. MEDICAID WAIVER PROGRAMS

Supported Employment is an allowable service under:

Community Supports Waiver (CSW): Primary waiver for adults with ID/DD

Acquired Brain Injury (ABI) Waiver

Physical Disabilities Waiver (PDW) – On a limited basis

New Choices Waiver (NCW): For transitions from institutional care (when applicable)

All services must be included in the Individual Support Plan (ISP) and coordinated through a case manager.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Creation
Timeline: 2–3 weeks

Phase: DSPD and Medicaid Enrollment
Timeline: 1–3 months

Phase: Staff Training & Credentialing
Timeline: 2–4 weeks

Phase: Service Launch
Timeline: Begins upon DSPD approval and ISP authorization

9. CONTACT INFORMATION

Utah Division of Services for People with Disabilities (DSPD)
Website: https://dspd.utah.gov

Utah Division of Integrated Healthcare (DIH)
Website: https://medicaid.utah.gov

Utah Provider Enrollment Portal
Website: https://medicaid.utah.gov/become-a-medicaid-provider

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH SUPPORTED EMPLOYMENT PROVIDER
WCG equips agencies with the tools to launch effective Supported Employment programs that are waiver-compliant, person-centered, and workforce-ready

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Scope of Work:

DSPD and Medicaid provider enrollment support

Supported Employment P&P Manual development

ISP goal documentation templates

Job coaching and service note forms

Incident tracking and client rights documentation

Training plans for Employment Specialists and program staff

CHORES SERVICES PROVIDER IN UTAH
ENSURING A CLEAN, SAFE, AND SANITARY LIVING ENVIRONMENT FOR INDIVIDUALS WITH DISABILITIES THROUGH INTERMITTENT HOUSEHOLD ASSISTANCE

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Chores Services in Utah support individuals with disabilities who are unable to perform heavy or infrequent household tasks that are essential for health and safety. These services are offered under select 1915(c) Home and Community-Based Services (HCBS) Waivers administered by the Utah Department of Health and Human Services (DHHS), through the Division of Services for People with Disabilities (DSPD).

These services are intended to supplement, not replace, ongoing supports like personal care or homemaker services and are only approved when necessary due to functional limitations.

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Authorizes and monitors Chores Services through Utah’s HCBS waiver programs; provides oversight on reimbursement and service quality.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures that Utah’s Medicaid waiver programs meet federal HCBS guidelines, including coverage of intermittent non-medical services.

2. CHORES SERVICES OVERVIEW

Chores Services cover non-routine, heavy-duty household tasks that are critical to the individual’s health or safety and that no one else in the household can reasonably perform.

Examples of covered tasks:

Deep cleaning of unsanitary or hazardous living areas

Heavy lifting or trash removal (non-hazardous)

Cleaning after pest infestations (non-licensed support)

Organizing and decluttering to reduce fall or fire hazards

Cleaning following illness, hospitalization, or infection

Moving furniture to allow for accessibility or mobility devices

Limited yard work to ensure safe access to the home (e.g., clearing pathways)

Note: These are one-time or infrequent tasks and are not intended to be ongoing housekeeping services.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Utah Division of Corporations

Obtain EIN from the IRS and a Type 2 National Provider Identifier (NPI)

Enroll with Utah Medicaid and apply for DSPD provider status

Maintain general liability and worker’s compensation insurance

Create a Chores Services Policy & Procedure Manual that reflects DSPD’s standards

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register your legal entity and obtain your EIN and NPI
Step 2: Enroll as a Medicaid provider with Utah Medicaid
Step 3: Apply to become an approved DSPD provider of Chores Services
Step 4: Submit all required documentation, including service plans and safety procedures
Step 5: Complete DSPD training and MySupport onboarding
Step 6: Begin accepting referrals and providing chore-related services upon ISP authorization

5. REQUIRED DOCUMENTATION

Articles of incorporation, EIN, NPI

Utah Medicaid provider agreement and DSPD contract

Proof of business liability and auto insurance (if transporting supplies)

Chores Services Policy Manual including:

Intake and task approval process

Chore request forms and safety assessments

Documentation logs for tasks completed and time spent

Client safety and fall prevention protocols

Participant rights and consent procedures

Incident reporting and emergency procedures

HIPAA and data protection policies

6. STAFFING REQUIREMENTS

Role: Chores Services Worker
Requirements: Age 18+, background check, physical ability to perform tasks safely; no licensure required

Role: Program Supervisor (optional)
Requirements: Oversight experience with in-home support services

All staff must complete:

HIPAA and confidentiality training

Abuse, Neglect, and Exploitation Prevention training (ANEP)

Safety protocols for lifting, deep cleaning, and trash removal

Emergency preparedness and basic infection control

7. MEDICAID WAIVER PROGRAMS

Chores Services are authorized under the following waivers in Utah:

Community Supports Waiver (CSW) – for adults with ID/DD

Acquired Brain Injury (ABI) Waiver – for individuals with injury-related limitations

Physical Disabilities Waiver (PDW) – where functionally justified

Medically Complex Children’s Waiver (MCCW) – limited use when approved by care team

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Preparation
Timeline: 1–2 months

Phase: Medicaid Enrollment & DSPD Provider Application
Timeline: 2–3 months

Phase: Staff Training & Documentation Setup
Timeline: 30–45 days

Phase: Service Activation
Timeline: Upon approval and participant service plan authorization

9. CONTACT INFORMATION

Utah Department of Health and Human Services (DHHS) – DSPD
Website: https://dspd.utah.gov

Utah Medicaid Provider Enrollment
Website: https://medicaid.utah.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH CHORES SERVICES PROVIDER

WCG equips in-home service providers and support agencies with the tools to deliver chore-related Medicaid waiver services across Utah.

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Scope of Work:

Utah Medicaid and DSPD enrollment support

Chores Services Policy & Procedure Manual

Task request, documentation, and follow-up templates

Staff onboarding and training resources

Quality assurance tools and risk assessment forms

Billing and audit preparation guides

ADAPTIVE EQUIPMENT PROVIDER IN UTAH
ENHANCING INDEPENDENCE THROUGH SPECIALIZED EQUIPMENT DESIGNED TO SUPPORT DAILY LIVING, COMMUNICATION, AND MOBILITY

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Adaptive Equipment Services in Utah help individuals with disabilities or chronic conditions gain greater independence at home and in the community. These services include the evaluation, procurement, customization, and maintenance of specialized devices that improve function, communication, mobility, and safety.

Adaptive Equipment is a covered service under several HCBS Medicaid Waivers in Utah when deemed medically necessary and included in an Individual Support Plan (ISP). Services must align with person-centered goals and are coordinated through the Division of Services for People with Disabilities (DSPD).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Approves and oversees waiver providers of adaptive equipment, authorizes funding, and ensures ISP alignment.

Agency: Utah Division of Integrated Healthcare (DIH)
Role: Manages Medicaid provider enrollment and reimbursement processes.

Agency: Utah Department of Commerce – Division of Occupational and Professional Licensing (DOPL)
Role: May regulate providers involved in clinical assessments or equipment requiring licensure (e.g., occupational therapists).

2. ADAPTIVE EQUIPMENT SERVICES OVERVIEW

Adaptive Equipment includes devices and modifications that support a person’s ability to perform daily activities, enhance communication, and increase participation in the community. These may be commercially produced or custom fabricated.

Examples of covered equipment:

Wheelchair ramps and lifts

Shower chairs, grab bars, and bed rails

Specialized eating utensils and reachers

Communication devices (e.g., speech-generating tablets)

Environmental controls (e.g., switch-activated lights)

Vehicle modifications and transfer aids

Mounting systems for mobility or communication tools

All items must be supported by an assessment and justification based on functional need and person-centered goals.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Utah Division of Corporations

Obtain EIN and Type 2 NPI

Apply through DSPD as an approved Adaptive Equipment provider

Enroll with Utah Medicaid via the DIH portal

Maintain liability insurance and equipment delivery/maintenance standards

Develop a Policy & Procedure Manual detailing service processes

For clinical assessments, ensure qualified staff hold valid state licensure

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register your business, obtain EIN and NPI
Step 2: Submit provider application to DSPD for Adaptive Equipment service code
Step 3: Complete Medicaid enrollment with DIH
Step 4: Submit Policy & Procedure Manual for approval
Step 5: Ensure staff credentials (if conducting evaluations)
Step 6: Begin service delivery upon ISP authorization

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI documentation

DSPD provider agreement and Medicaid enrollment confirmation

Policy & Procedure Manual including:

Equipment ordering, delivery, and setup process

Maintenance, repairs, and replacement protocols

Justification documentation and clinical evaluation tracking

Safety checks and installation procedures

HIPAA and privacy compliance

Staff training and licensure documentation (as applicable)

Client rights and grievance procedures

6. STAFFING REQUIREMENTS

Role: Adaptive Equipment Specialist / Technician
Requirements:

Trained in installation, setup, and maintenance of adaptive devices

May require manufacturer training for specific equipment

Must follow DSPD and safety standards

Optional Role: Occupational/Physical/Speech Therapist
Requirements (if conducting assessments):

Utah state licensure

Experience with assistive technology or environmental modifications

Participation in ISP meetings and service justification

All staff must complete:

HIPAA and client safety training

Adaptive equipment orientation and vendor-specific training

Documentation and billing compliance training

7. MEDICAID WAIVER PROGRAMS

Adaptive Equipment may be authorized under the following Utah waivers:

Community Supports Waiver (CSW): Primary waiver for individuals with ID/DD

Acquired Brain Injury (ABI) Waiver

Physical Disabilities Waiver (PDW)

Medically Complex Children’s Waiver (MCCW)

New Choices Waiver (NCW): Based on individualized needs and ISP planning

Services must be listed in the ISP, and equipment must be functionally necessary and cost-effective.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Manual Development
Timeline: 2–4 weeks

Phase: DSPD & Medicaid Enrollment
Timeline: 1–3 months

Phase: Staff Training & Vendor Coordination
Timeline: 2–4 weeks

Phase: Begin Service Delivery
Timeline: Upon DSPD approval and service authorization in ISP

9. CONTACT INFORMATION

Utah Division of Services for People with Disabilities (DSPD)
Website: https://dspd.utah.gov

Utah Division of Integrated Healthcare (DIH)
Website: https://medicaid.utah.gov

Utah Provider Enrollment Portal
Website: https://medicaid.utah.gov/become-a-medicaid-provider

Utah Division of Occupational and Professional Licensing (DOPL)
Website: https://dopl.utah.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH ADAPTIVE EQUIPMENT PROVIDER
WCG supports new providers in delivering customized, safe, and Medicaid-compliant adaptive equipment services that meet the evolving needs of Utah’s waiver participants.

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Scope of Work:

DSPD and Medicaid enrollment support

Adaptive Equipment Policy & Procedure Manual development

Equipment order forms and delivery logs

Evaluation documentation templates and justification tools

Safety inspection checklists and installation logs

HIPAA compliance and client rights documentation

Vendor sourcing and procurement assistance

HOME HEALTH CARE SERVICES PROVIDER IN UTAH
DELIVERING SKILLED NURSING AND THERAPEUTIC CARE IN THE COMFORT OF HOME TO SUPPORT HEALTH, HEALING, AND INDEPENDENCE

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Home Health Care Services in Utah deliver intermittent skilled nursing, rehabilitative therapy, and medical support to individuals recovering from illness, injury, or living with chronic conditions. These services enable individuals to avoid institutionalization, recover faster at home, and remain independent while meeting their healthcare needs.

Home Health is covered under Utah Medicaid’s State Plan benefits and may be authorized through HCBS Waivers for individuals who require skilled support as part of their Individual Support Plan (ISP). Oversight is managed by the Utah Department of Health and Human Services (DHHS) through the Division of Integrated Healthcare (DIH) and the Office of Licensing (OL).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Integrated Healthcare (DIH)
Role: Administers Medicaid benefits, including home health coverage, and oversees claims and provider enrollment.

Agency: Utah Office of Licensing (OL)**
Role: Issues Home Health Agency (HHA) licenses for agencies providing skilled services.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures compliance with federal Medicare/Medicaid home health conditions of participation.

2. HOME HEALTH CARE SERVICES OVERVIEW

Home Health services are delivered by licensed healthcare professionals and must be medically necessary and prescribed by a physician.

Covered services may include:

Skilled Nursing Care: Wound care, IV administration, chronic disease management

Home Health Aide Services: Personal care under RN supervision

Physical Therapy (PT)

Occupational Therapy (OT)

Speech-Language Pathology (SLP)

Medical Social Work and Counseling

Medication Management and Injections

Patient & Family Health Education

Coordination of Care with Primary Physicians

Home Health services must follow a physician-ordered Plan of Care and be documented per CMS standards.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Utah Division of Corporations

Obtain EIN and Type 2 NPI

Obtain Home Health Agency license through Utah’s Office of Licensing (OL)

Complete Medicare/Medicaid certification (if dual reimbursement is sought)

Enroll as a Medicaid Home Health provider via the Utah Medicaid Portal

Maintain clinical liability, malpractice, and workers’ comp insurance

Create a Home Health Services Policy & Procedure Manual per CMS guidelines

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register entity, obtain EIN and NPI
Step 2: Apply for Home Health Agency license via OL
Step 3: Submit Medicaid enrollment as Home Health provider
Step 4: Pass site inspections and ensure clinical compliance
Step 5: Complete credentialing for nursing and therapy staff
Step 6: Begin accepting referrals upon service authorization and plan of care approval

5. REQUIRED DOCUMENTATION

EIN, NPI, and Articles of Incorporation

OL HHA license and inspection certificates

Medicaid approval and provider contract

Home Health Services Policy & Procedure Manual including:

Skilled nursing scope of services

Therapy and aide protocols

Physician order and Plan of Care tracking

Medication administration and chronic care procedures

Infection control, wound care, and universal precautions

Staff credentialing and continuing education tracking

Patient rights, grievances, and HIPAA compliance

Charting, billing, and shift documentation templates

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)
Requirements: Utah licensure, CPR-certified, responsible for patient assessments, care plans, and supervision

Role: Licensed Practical Nurse (LPN)
Requirements: Works under RN direction; may provide hands-on skilled care

Role: Certified Home Health Aide (CHHA)
Requirements: Ongoing supervision by RN, trained in ADLs and safety

Role: Therapists – PT, OT, SLP
Requirements: Utah licensure; service authorization required

Role: Medical Social Worker (MSW)** (optional)
Requirements: Licensed for social services and patient counseling

All staff must complete:

HIPAA and documentation training

Universal precautions and infection control

Emergency response and reporting training

Annual skills validation and competency evaluations

7. MEDICAID WAIVER PROGRAMS

In addition to State Plan Medicaid, Home Health may be included in:

Community Supports Waiver (CSW) – for individuals with ID/DD needing skilled support

New Choices Waiver (NCW) – individuals transitioning from institutional care

Acquired Brain Injury (ABI) Waiver

Physical Disabilities Waiver (PDW) – case-by-case basis

Medically Complex Children’s Waiver (MCCW)

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Development
Timeline: 1–2 months

Phase: OL Licensing & Medicaid Enrollment
Timeline: 2–4 months

Phase: Staff Credentialing & Readiness Inspections
Timeline: 30–60 days

Phase: Launch of Services
Timeline: Begins upon physician order and plan of care authorization

9. CONTACT INFORMATION

Utah Office of Licensing (OL)
Website: https://hslic.utah.gov

Utah Division of Integrated Healthcare (DIH)
Website: https://medicaid.utah.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

​

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH HOME HEALTH CARE PROVIDER

WCG assists new and expanding agencies in launching Medicare/Medicaid-compliant home health programs with full documentation, clinical workflows, and licensing support.

​

Scope of Work:

OL and Medicaid provider enrollment support

Home Health P&P Manual compliant with CMS

Plan of Care templates and medication logs

Staff credentialing packets and supervision logs

Infection control, safety, and incident response systems

Charting tools, shift notes, and billing documentation

HABILITATION SERVICES PROVIDER IN UTAH
EMPOWERING INDIVIDUALS WITH DISABILITIES THROUGH SKILL-BUILDING, ROUTINE SUPPORT, AND COMMUNITY PARTICIPATION

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Habilitation Services in Utah are designed to help individuals with intellectual or developmental disabilities (ID/DD) acquire, maintain, and improve skills necessary for independent living, community inclusion, and personal well-being. These services are authorized under Utah’s Home and Community-Based Services (HCBS) Waivers, primarily through the Community Supports Waiver (CSW) administered by the Division of Services for People with Disabilities (DSPD) under the Utah Department of Health and Human Services (DHHS).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Oversees waiver-based habilitation services, provider enrollment, service authorization, and quality compliance.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures federal Medicaid HCBS standards are met, including person-centered planning and habilitation outcome tracking.

2. HABILITATION SERVICES OVERVIEW

Habilitation Services help individuals develop the skills needed for daily living, self-care, employment readiness, and social inclusion. These services are person-centered, goal-oriented, and tailored to the individual’s Individual Support Plan (ISP).

Service types include:

Daily Living Skills Training: Cooking, hygiene, dressing, budgeting

Behavioral Skill Development: Emotional regulation, communication

Community Integration: Social outings, using public transportation

Safety Awareness & Self-Advocacy: Emergency response, boundaries

Household Management: Cleaning, laundry, meal preparation

Health & Wellness: Nutrition, medication reminders, appointments

Supported Decision-Making: Practicing choices and independence

Habilitation may be delivered in-home, in community settings, or in small group settings depending on the individual's needs and service model selected.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Utah Division of Corporations

Obtain EIN and Type 2 NPI

Enroll as a Medicaid provider in Utah

Apply to DSPD for habilitation provider approval

Maintain appropriate general liability and workers’ compensation insurance

Develop a Habilitation Services Policy & Procedure Manual

Note: Some group-based habilitation settings may require Office of Licensing (OL) certification depending on the model used.

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register business entity and obtain EIN and NPI
Step 2: Enroll in Utah Medicaid as a waiver provider
Step 3: Submit application and supporting documents to DSPD
Step 4: Complete MySupport training modules and quality requirements
Step 5: Receive DSPD approval and begin accepting participant referrals

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI

Medicaid and DSPD enrollment confirmation

Habilitation Policy & Procedure Manual including:

Individualized goal development and ISP implementation

Daily data collection and skill tracking forms

Staff training records and supervision structure

Safety plans, emergency response, and incident reporting

Participant rights and person-centered planning protocols

Monthly summary and billing documentation templates

6. STAFFING REQUIREMENTS

Role: Habilitation Specialist / Direct Support Professional (DSP)
Requirements: Age 18+, background check, CPR/First Aid, DSPD MySupport training

Role: Program Supervisor / Coordinator
Requirements: Oversight experience in HCBS or ID/DD services, ensures ISP alignment

All staff must complete:

HIPAA and confidentiality training

Abuse, Neglect, and Exploitation Prevention (ANEP)

Person-centered planning training

Daily documentation and outcome tracking training

Behavior support (if applicable) and emergency procedures

7. MEDICAID WAIVER PROGRAMS

Habilitation Services are reimbursable under:

Community Supports Waiver (CSW) – adults with ID/DD

Acquired Brain Injury Waiver (ABI) – when habilitation is justified

Physical Disabilities Waiver (PDW) – for skill-building and community re-entry

Medically Complex Children’s Waiver (MCCW) – on a case-by-case basis

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Development
Timeline: 1–2 months

Phase: Medicaid & DSPD Enrollment
Timeline: 2–3 months

Phase: Staff Hiring & MySupport Training
Timeline: 30–60 days

Phase: ISP Implementation & Service Launch
Timeline: Once authorizations are received

9. CONTACT INFORMATION

Utah Department of Health and Human Services (DHHS) – DSPD
Website: https://dspd.utah.gov

Utah Medicaid Provider Portal
Website: https://medicaid.utah.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

​

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH HABILITATION PROVIDER

WCG supports new providers in launching habilitation programs that focus on empowerment, life skills, and measurable participant progress.

​

Scope of Work:

Medicaid and DSPD enrollment support

Habilitation Services Policy Manual and ISP tools

Daily skills tracking forms and outcome measurement templates

Staff training packets and documentation systems

Participant rights policies and incident response tools

Community activity and independence-building frameworks

HOST HOME SERVICES PROVIDER IN UTAH
CREATING SAFE, FAMILY-LIKE ENVIRONMENTS WHERE INDIVIDUALS WITH DISABILITIES CAN THRIVE WITH PERSONALIZED, 24-HOUR SUPPORT

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Host Home Services in Utah offer a community-based residential alternative for individuals with intellectual or developmental disabilities (ID/DD) who require full-time support in a family-like setting. A Host Home Provider (also called a Professional Parent) opens their home to one or two participants and delivers personal care, supervision, habilitation, and community integration services under the Community Supports Waiver (CSW) administered by the Division of Services for People with Disabilities (DSPD).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Authorizes Host Home placements, oversees service planning, and ensures provider compliance with Medicaid HCBS waiver rules.

Agency: Office of Licensing (OL) – Utah DHHS
Role: Licenses Host Homes as certified residential settings (1–2 individuals max).

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Ensures HCBS settings meet federal waiver standards for person-centered, community-integrated residential care.

2. HOST HOME SERVICES OVERVIEW

Host Homes offer 24-hour, integrated residential care in the private home of a certified provider who supports the participant in all aspects of daily life. Services must be individualized and align with the participant’s Individual Support Plan (ISP).

Host Home services include:

Room and board in a safe, stable household

Personal care (e.g., bathing, hygiene, meals, toileting)

Life skills training and habilitation support

Transportation to appointments and activities

Behavioral support and medication assistance (if authorized)

Inclusion in family routines and community engagement

Overnight supervision and emergency response readiness

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your agency with the Utah Division of Corporations (if operating as a provider agency)

Obtain EIN and Type 2 NPI

Enroll as a Medicaid waiver provider through Utah Medicaid

Apply for Host Home certification via DSPD and the Office of Licensing (OL)

Complete background checks and fingerprinting for all household members over age 18

Obtain fire inspection, home safety inspection, and readiness documentation

Create a Host Home Services Policy & Procedure Manual

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register business entity (if applicable), obtain EIN and NPI
Step 2: Enroll with Utah Medicaid and submit DSPD waiver provider application
Step 3: Complete OL residential home certification process
Step 4: Submit required documents: home inspection reports, care plan protocols, staff qualifications, and policies
Step 5: Complete DSPD MySupport orientation and home visit
Step 6: Begin accepting participant placements upon certification and ISP approval

5. REQUIRED DOCUMENTATION

EIN, NPI, Articles of Incorporation (for agencies)

Medicaid and DSPD provider contracts

Host Home certification and OL license

Fire safety inspection and emergency evacuation plan

Host Home Services Policy Manual including:

Participant intake and matching protocols

Medication handling and health tracking procedures

Staff/household background check and training documentation

Daily schedule, personal goal tracking, and activity logs

Participant rights and dignity policies

Incident reporting and abuse prevention policies

Emergency response and on-call procedures

ISP implementation and outcome measurement tools

6. STAFFING REQUIREMENTS

Role: Host Home Provider / Professional Parent
Requirements: Age 21+, background check, CPR/First Aid certified, willingness to provide 24/7 care in their home

Role: Agency Case Manager (if applicable)
Requirements: Degree in a human services field, DSPD case coordination training

Role: Residential Supervisor / Nurse (optional for oversight)
Requirements: Depending on medical or behavioral complexity of clients

All involved personnel must complete:

HIPAA and confidentiality training

Abuse, Neglect, and Exploitation Prevention (ANEP)

Medication assistance and health documentation training

ISP implementation and goal tracking

Emergency response and behavioral support (if required)

7. MEDICAID WAIVER PROGRAMS

Host Home Services are offered under:

Community Supports Waiver (CSW) – for adults with ID/DD

Acquired Brain Injury Waiver (ABI) – select placements with justification

New Choices Waiver (NCW) – only for individuals transitioning out of institutional care (case-by-case)

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Manual Preparation
Timeline: 1–2 months

Phase: Medicaid and DSPD Enrollment
Timeline: 2–3 months

Phase: Home Certification, Inspections & Safety Readiness
Timeline: 30–60 days

Phase: Participant Matching & Service Start
Timeline: Begins once Host Home is certified and referrals accepted

9. CONTACT INFORMATION

Utah Division of Services for People with Disabilities (DSPD)
Website: https://dspd.utah.gov

Utah Office of Licensing (OL)
Website: https://hslic.utah.gov

Utah Medicaid Enrollment Portal
Website: https://medicaid.utah.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

​

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH HOST HOME PROVIDER

WCG supports agencies and individuals in launching and certifying high-quality Host Homes in line with DSPD and CMS expectations.

​

Scope of Work:

Host Home Certification and OL licensing guidance

Policy Manual development for Host Home operations

Intake, matching, and ISP implementation tools

Home safety checklist and evacuation plan templates

Medication logs, incident reports, and goal trackers

Staff/household training packets and compliance documents

ASSISTIVE TECHNOLOGY SERVICES PROVIDER IN UTAH
ENABLING GREATER INDEPENDENCE THROUGH PERSONALIZED EQUIPMENT, DEVICES, AND SUPPORT SERVICES

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Assistive Technology (AT) Services in Utah provide individuals with disabilities access to equipment and supports that enhance communication, mobility, learning, and independence. These services are covered under several 1915(c) Medicaid Home and Community-Based Services (HCBS) Waivers, administered by the Utah Department of Health and Human Services (DHHS) through the Division of Services for People with Disabilities (DSPD).

Assistive Technology can include both devices and related services, such as customization, training, and repairs, to ensure individuals can successfully use the equipment as part of their Individual Support Plan (ISP).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Reviews requests for assistive technology, authorizes services in ISP, and oversees provider enrollment and compliance.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight of HCBS waiver implementation and standards for assistive technology funding and usage.

2. ASSISTIVE TECHNOLOGY SERVICES OVERVIEW

Assistive Technology services include the assessment, acquisition, customization, maintenance, and training of equipment that promotes an individual’s functioning, communication, learning, or safety.

Covered items and supports may include:

Communication devices (e.g., speech-generating devices)

Electronic organizers or smart tech for memory/cognitive support

Adaptive keyboards, switches, and computer access tools

Specialized hearing, vision, or mobility equipment

Remote monitoring systems and safety alerts

Home automation supports (e.g., voice-controlled lights, smart locks)

Setup and user training by qualified AT specialists

Repair, replacement, or reprogramming of existing AT devices

Note: All AT items must be medically necessary, approved in the ISP, and aimed at increasing functional independence or reducing the need for human assistance.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Utah Division of Corporations

Obtain EIN and Type 2 NPI

Enroll as a Medicaid provider with Utah Medicaid

Apply to DSPD for Assistive Technology provider certification

Ensure AT devices and services meet Medicaid durability and function standards

Maintain insurance for liability, equipment handling, and technical services

Develop an Assistive Technology Services Policy & Procedure Manual

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain EIN and NPI
Step 2: Submit Medicaid provider application
Step 3: Apply for DSPD approval as an AT provider
Step 4: Submit service descriptions, device categories, and technician credentials
Step 5: Complete DSPD orientation and readiness verification
Step 6: Begin receiving referrals and providing AT consultations or devices per ISP

5. REQUIRED DOCUMENTATION

Business registration, EIN, and NPI

Medicaid and DSPD provider approval

AT Policy & Procedure Manual including:

Device evaluation and recommendation process

Participant needs and ISP alignment

Equipment acquisition, customization, and delivery protocols

Staff credentials and device handling procedures

Safety standards and infection control (as applicable)

Training and usage support logs

Warranty, repairs, and return documentation

Billing and documentation forms (invoicing, delivery receipt, AT use verification)

6. STAFFING REQUIREMENTS

Role: Assistive Technology Specialist / Consultant
Requirements: Experience with AT devices; preferred certifications include RESNA ATP (Assistive Technology Professional), OT/PT with AT training, or relevant tech background

Role: Technician / Equipment Support Staff
Requirements: Knowledge of setup, maintenance, and configuration of AT devices

All staff must complete:

HIPAA and client confidentiality training

Abuse, Neglect, and Exploitation Prevention (ANEP)

DSPD ISP alignment and documentation practices

Manufacturer-specific device setup training

Participant-centered equipment education techniques

7. MEDICAID WAIVER PROGRAMS

Assistive Technology is covered under:

Community Supports Waiver (CSW)

Acquired Brain Injury (ABI) Waiver

Physical Disabilities Waiver (PDW)

Medically Complex Children’s Waiver (MCCW)

New Choices Waiver (NCW) – For individuals transitioning from nursing facilities

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Development
Timeline: 1–2 months

Phase: Utah Medicaid & DSPD Enrollment
Timeline: 2–3 months

Phase: Staff Setup, Training, & Equipment Readiness
Timeline: 30–60 days

Phase: Begin Service Delivery
Timeline: Begins upon ISP authorizations and referral acceptance

9. CONTACT INFORMATION

Utah Division of Services for People with Disabilities (DSPD)
Website: https://dspd.utah.gov

Utah Medicaid Provider Enrollment Portal
Website: https://medicaid.utah.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

​

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH ASSISTIVE TECHNOLOGY PROVIDER

WCG helps new agencies or specialists launch Medicaid-approved assistive technology services tailored to individuals’ home and community needs.

​

Scope of Work:

AT Medicaid and DSPD enrollment guidance

Assistive Technology Services Policy Manual development

AT referral, documentation, and delivery templates

Equipment inventory, repair, and tracking logs

Staff onboarding materials for AT specialists and technicians

Compliance, billing, and audit readiness support

BEHAVIORAL SUPPORT SERVICES PROVIDER IN UTAH
ENHANCING BEHAVIORAL STABILITY AND QUALITY OF LIFE FOR INDIVIDUALS WITH DISABILITIES THROUGH POSITIVE INTERVENTION AND CARE PLANNING

​

Behavioral Support Services in Utah assist individuals with intellectual disabilities, developmental disabilities (ID/DD), autism spectrum disorder (ASD), or co-occurring mental health conditions to reduce challenging behaviors and develop functional alternatives. These services are part of the Home and Community-Based Services (HCBS) system and are authorized under Medicaid waiver programs administered by the Utah Department of Health and Human Services (DHHS), formerly the Department of Human Services (DHS), through the Division of Services for People with Disabilities (DSPD).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Administers and authorizes Behavioral Supports through HCBS waivers; oversees service delivery standards and reimbursement.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Approves Utah’s waiver programs and ensures they comply with federal HCBS regulations.

2. BEHAVIORAL SUPPORT SERVICES OVERVIEW

Behavioral Support Services help individuals address maladaptive behaviors and replace them with safer, socially appropriate alternatives. Services must be person-centered and based on a Functional Behavior Assessment (FBA).

Common components include:

Conducting FBAs to identify causes of behavior

Developing and implementing Positive Behavior Support Plans (PBSPs)

Training families, caregivers, and direct support staff on behavior strategies

Monitoring behavior data and revising PBSPs as needed

Providing direct behavior consultation or intervention

Ensuring safety and dignity in all interventions

All supports must align with goals outlined in the Person-Centered Support Plan (PCSP) and Individual Support Plan (ISP).

​

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business entity with the Utah Division of Corporations

Obtain Employer Identification Number (EIN) and National Provider Identifier (NPI, Type 2)

Enroll with Utah Medicaid and become a contracted DSPD provider

Employ or contract with a licensed behaviorist (e.g., BCBA, LBA, LCSW, LMFT, psychologist)

Obtain Division of Professional Licensing (DOPL) clearance if applicable

Develop a Behavioral Support Services Policy & Procedure Manual

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain NPI and EIN
Step 2: Complete Utah Medicaid provider enrollment
Step 3: Apply with DSPD to become a behavioral support service provider
Step 4: Submit staff credentials and policy documentation
Step 5: Complete provider training through MySupport (state learning platform)
Step 6: Receive DSPD contract approval and begin providing authorized services

5. REQUIRED DOCUMENTATION

EIN, NPI, Utah business registration

Medicaid and DSPD provider agreements

Staff licenses or board certification (BCBA, psychologist, etc.)

Behavioral Support Services Policy Manual including:

FBA and PBSP procedures

Documentation templates (progress notes, data sheets)

Training logs for family and DSPs

Emergency interventions and safety protocols

HIPAA and participant rights protection

Behavior incident reports and trend tracking

Quality assurance and billing documentation

6. STAFFING REQUIREMENTS

Role: Licensed Behavior Specialist / Consultant
Requirements: Licensed BCBA, psychologist, LCSW, LMFT, or equivalent; background check and Medicaid credentialing

Role: Behavior Support Technician (optional)
Requirements: Trained in plan implementation and data collection

All staff must complete:

Abuse, neglect, and exploitation prevention (ANEP) training

HIPAA, documentation, and client rights training

MySupport system onboarding (DSPD eLearning)

Positive behavior supports and trauma-informed care training

7. MEDICAID WAIVER PROGRAMS

Behavioral Support Services are available under the following Utah waivers:

Community Supports Waiver – For individuals with ID/DD living in home or community settings

Acquired Brain Injury (ABI) Waiver – For individuals with brain injuries and behavioral needs

Physical Disabilities Waiver – If behavioral needs are significant and authorized

Medically Complex Children’s Waiver (MCCW) – For children with both medical and behavioral needs (case-by-case)

Autism Waiver – For young children diagnosed with ASD receiving ABA-based interventions

8. TIMELINE TO LAUNCH

Phase: Business Formation & Credentialing
Timeline: 1–2 months

Phase: Utah Medicaid and DSPD Contracting
Timeline: 2–4 months

Phase: Staff Hiring & Training
Timeline: 30–60 days

Phase: Begin Service Delivery
Timeline: Once ISP authorizations and behavioral support goals are approved

9. CONTACT INFORMATION

Utah Department of Health and Human Services (DHHS) – DSPD
Website: https://dspd.utah.gov

Utah Medicaid Provider Enrollment
Website: https://medicaid.utah.gov

Division of Professional Licensing (DOPL)
Website: https://dopl.utah.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

​

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH BEHAVIORAL SUPPORT PROVIDER

WCG partners with clinicians, ABA providers, and IDD specialists to help launch and scale compliant behavioral support services in Utah.

​

Scope of Work:

Medicaid and DSPD provider enrollment

Behavioral Support Policy & Procedure Manual

FBA, PBSP, and progress note templates

HIPAA and documentation training guides

Staff credentialing and tracking tools

Quality assurance and incident response templates

HOME MODIFICATION PROVIDER IN UTAH
CREATING SAFER, MORE ACCESSIBLE HOMES FOR INDIVIDUALS WITH DISABILITIES TO LIVE WITH DIGNITY AND INDEPENDENCE

​

Home Modification Services in Utah help individuals with disabilities or chronic conditions remain in their homes safely by making structural changes that enhance mobility, accessibility, and self-sufficiency. These modifications are designed to reduce the risk of institutionalization, prevent injuries, and support participation in daily routines.

Home Modifications are covered under several Utah Medicaid HCBS Waivers and must be included in the Individual Support Plan (ISP). Modifications must be medically necessary, cost-effective, and tied to the person’s disability-related needs. Approval and oversight are coordinated through the Division of Services for People with Disabilities (DSPD).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Approves providers and authorizes funding for home modifications under HCBS Waivers.

Agency: Utah Division of Integrated Healthcare (DIH)
Role: Manages Medicaid enrollment, reimbursement processes, and regulatory compliance.

Agency: Utah Department of Commerce – Division of Occupational and Professional Licensing (DOPL)
Role: Oversees contractor licensing and building code compliance for modifications involving structural changes.

2. HOME MODIFICATION SERVICES OVERVIEW

Home Modification Services include physical adaptations to a person’s primary residence that are required to ensure health, safety, and accessibility. These services promote independent living and are guided by individualized needs outlined in the ISP.

Common approved modifications include:

Wheelchair ramps and widened doorways

Accessible bathrooms: roll-in showers, grab bars, raised toilets

Kitchen modifications: lowered counters, accessible cabinets

Ceiling lifts and stair glides

Handrails and non-slip flooring

Widened hallways or entryways

Environmental control units (when part of broader adaptation)

Note: Cosmetic or non-disability-related renovations are not covered. All work must comply with state building codes and DSPD standards.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Utah Division of Corporations

Obtain EIN and Type 2 NPI

Apply to become a DSPD-approved provider under Home Modifications

Obtain a Utah General Contractor License (B100 or R100) if performing structural work

Enroll with Utah Medicaid through the Provider Enrollment Portal

Carry general liability and workers’ compensation insurance

Develop a Home Modification Services Policy & Procedure Manual

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register business, obtain EIN and NPI
Step 2: Secure appropriate contractor license via DOPL (if applicable)
Step 3: Apply to DSPD as a Home Modification provider
Step 4: Complete Medicaid enrollment through DIH
Step 5: Submit Policy & Procedure Manual and service descriptions
Step 6: Begin work following service authorization and environmental assessment

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, NPI

Valid contractor license (if structural work is performed)

DSPD provider agreement and Medicaid enrollment letter

Policy & Procedure Manual including:

Modification request, assessment, and approval process

Scope-of-work templates and inspection checklists

Contractor safety, liability, and code compliance protocols

Documentation of cost estimates and receipts

Client consent, grievance, and HIPAA compliance

Recordkeeping for before-and-after photos and service logs

6. STAFFING REQUIREMENTS

Role: Licensed Contractor / Modification Technician
Requirements:

Valid Utah contractor license for structural modifications

Knowledge of ADA and DSPD accessibility standards

Background check clearance

Experience working with individuals with disabilities (preferred)

Role: Project Coordinator (optional for larger teams)
Responsibilities: Coordination with case managers, timelines, and compliance

All staff involved must complete:

Client rights, safety, and HIPAA training

DSPD service orientation

Ongoing documentation and billing protocol training

7. MEDICAID WAIVER PROGRAMS

Home Modification is a covered service under the following HCBS Waivers:

Community Supports Waiver (CSW) – Individuals with intellectual or developmental disabilities

Acquired Brain Injury (ABI) Waiver

Physical Disabilities Waiver (PDW)

Medically Complex Children’s Waiver (MCCW)

New Choices Waiver (NCW) – May include home modifications during transition to community living

Modifications must be cost-effective, linked to disability needs, and pre-approved in the ISP.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Licensing
Timeline: 2–4 weeks

Phase: DSPD and Medicaid Enrollment
Timeline: 1–3 months

Phase: Manual Development & Staff Readiness
Timeline: 2–4 weeks

Phase: Service Launch
Timeline: Begins after environmental assessment and service authorization

9. CONTACT INFORMATION

Utah Division of Services for People with Disabilities (DSPD)
Website: https://dspd.utah.gov

Utah Division of Integrated Healthcare (DIH)
Website: https://medicaid.utah.gov

Utah Provider Enrollment Portal
Website: https://medicaid.utah.gov/become-a-medicaid-provider

Utah Division of Occupational and Professional Licensing (DOPL)
Website: https://dopl.utah.gov

​

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH HOME MODIFICATION PROVIDER
WCG supports contractors, builders, and accessibility experts in launching compliant home modification services tailored to Medicaid waiver populations across Utah

​

Scope of Work:

DSPD and Medicaid provider enrollment support

Policy & Procedure Manual tailored to home safety modifications

Scope-of-work and cost estimate templates

Documentation tools for before/after comparisons

Client rights, consents, and grievance forms

HIPAA compliance and job site safety procedures

COMPANION CARE SERVICES PROVIDER IN UTAH
OFFERING SOCIAL ENGAGEMENT AND BASIC NON-MEDICAL SUPPORT TO PROMOTE INDEPENDENCE AND WELL-BEING FOR INDIVIDUALS WITH DISABILITIES

​

Companion Care Services in Utah provide non-medical supervision and social support to individuals with intellectual and developmental disabilities (ID/DD) or physical limitations. These services promote independence, reduce isolation, and ensure individuals’ safety and emotional well-being in home or community-based settings. Companion services are covered under various 1915(c) Home and Community-Based Services (HCBS) Waivers, administered by the Utah Department of Health and Human Services (DHHS) through the Division of Services for People with Disabilities (DSPD).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Authorizes Companion Care through HCBS waivers, monitors service quality, and ensures compliance with Medicaid rules.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Oversees federal Medicaid regulations and ensures waiver programs comply with HCBS standards.

2. COMPANION CARE SERVICES OVERVIEW

Companion Care involves supervision, social interaction, and support with light daily activities that do not require hands-on personal care. The goal is to support individuals in achieving their person-centered outcomes and promoting social inclusion.

Core components include:

Providing company and supervision at home or during outings

Assisting with tasks such as reading, games, and conversation

Accompanying individuals on community activities, events, or walks

Monitoring safety and general well-being

Supporting the individual’s routine without delivering medical or hands-on care

Companion Care is distinct from Personal Care: it does not include bathing, toileting, or mobility assistance.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Utah Division of Corporations

Obtain EIN and Type 2 NPI

Enroll as a Utah Medicaid provider

Apply for DSPD waiver contracts as a Companion Care provider

Maintain liability and worker’s compensation insurance

Create a Companion Care Services Policy & Procedure Manual

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register business, obtain EIN and NPI
Step 2: Enroll with Utah Medicaid and complete MySupport training
Step 3: Apply to become an approved DSPD waiver provider
Step 4: Submit staffing plan, service outlines, and safety protocols
Step 5: Receive DSPD contract approval and begin offering authorized services

5. REQUIRED DOCUMENTATION

EIN, NPI, Articles of Incorporation

Medicaid and DSPD provider contracts

Liability insurance certificates

Companion Care Policy Manual including:

Participant intake and service plan alignment

Daily activity logs and shift notes

Emergency response and safety monitoring procedures

Confidentiality and rights protection policies

Abuse, neglect, and exploitation prevention policies

Staff training protocols and documentation tools

6. STAFFING REQUIREMENTS

Role: Companion Care Provider
Requirements: Age 18+, background check, ability to communicate effectively and support participants in a non-medical capacity

Role: Supervisor / Scheduler (recommended)
Requirements: Oversight experience with DSPD services or in-home support

All staff must complete:

HIPAA and confidentiality training

DSPD Abuse, Neglect, and Exploitation Prevention (ANEP)

Participant rights and dignity protection

DSPD MySupport provider orientation

Basic safety and emergency response training

7. MEDICAID WAIVER PROGRAMS

Companion Care Services are reimbursable through the following Utah waivers:

Community Supports Waiver (CSW) – for individuals with ID/DD

Acquired Brain Injury (ABI) Waiver – where social support is essential for stability

Physical Disabilities Waiver (PDW) – based on functional need

Medically Complex Children’s Waiver (MCCW) – on a case-by-case basis with medical team approval

8. TIMELINE TO LAUNCH

Phase: Business Formation & Manual Creation
Timeline: 1–2 months

Phase: Medicaid Enrollment & DSPD Contracting
Timeline: 2–3 months

Phase: Staff Hiring & Readiness Training
Timeline: 30–45 days

Phase: Service Delivery
Timeline: Begins after ISP and service authorizations are issued

9. CONTACT INFORMATION

Utah Department of Health and Human Services (DHHS) – DSPD
Website: https://dspd.utah.gov

Utah Medicaid Provider Enrollment
Website: https://medicaid.utah.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH COMPANION CARE PROVIDER

WCG assists new providers in launching high-quality, person-centered Companion Care services tailored to Utah’s DSPD requirements.

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Scope of Work:

Medicaid and DSPD enrollment and contracting

Companion Care Policy Manual development

Staff training guides and emergency plans

Participant activity logs and monitoring templates

Service documentation and shift reports

HIPAA, ANEP, and rights compliance templates

PERSONAL CARE SERVICES PROVIDER IN UTAH
DELIVERING ESSENTIAL HANDS-ON ASSISTANCE TO PROMOTE SAFETY, DIGNITY, AND INDEPENDENCE IN DAILY LIVING

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Personal Care Services (PCS) in Utah support individuals who require non-medical, hands-on assistance with daily living activities due to aging, disability, or chronic health conditions. These services are a key component of Utah’s Home and Community-Based Services (HCBS), enabling participants to remain safely in their homes and communities.

PCS is authorized under Utah Medicaid and several waiver programs administered by the Utah Department of Health and Human Services (DHHS) through the Division of Services for People with Disabilities (DSPD) and the Division of Integrated Healthcare (DIH).

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1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Integrated Healthcare (DIH) & DSPD
Role: Oversees Medicaid reimbursement, provider enrollment, and care plan authorization for Personal Care services.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Establishes HCBS standards and ensures personal care services meet person-centered, home-based delivery requirements.

2. PERSONAL CARE SERVICES OVERVIEW

Personal Care Services help individuals with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) that they cannot perform independently due to a physical or cognitive limitation.

Covered supports include:

Bathing, grooming, and hygiene

Dressing and undressing

Toileting and incontinence care

Mobility, transfers, and ambulation

Meal preparation and feeding assistance

Light housekeeping, laundry, and errands (IADLs)

Medication reminders (non-skilled support only)

Accompaniment to medical appointments and community activities

Services are authorized through an individualized Service Plan or ISP and delivered in the participant’s home or other community settings.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Utah Division of Corporations

Obtain EIN and Type 2 NPI

Enroll with Utah Medicaid as a Personal Care provider

Complete DSPD or DIH program enrollment as applicable

Maintain general liability, workers’ compensation, and auto insurance

Create a Personal Care Services Policy & Procedure Manual

Note: PCS agencies providing skilled services may also need a Home Health Agency license through the Utah Office of Licensing (OL).

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register business entity, obtain EIN and NPI
Step 2: Apply to Utah Medicaid via the Provider Enrollment Portal
Step 3: Submit DSPD or DIH program application for waiver service authorization
Step 4: Upload required documentation (staffing plan, P&P manual, supervision structure)
Step 5: Complete Medicaid and waiver-specific training
Step 6: Receive approvals and begin accepting participant referrals

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI confirmation

Medicaid and waiver program enrollment approval

Personal Care Services Policy Manual including:

ADL/IADL service delivery protocols

Participant rights and dignity policies

Daily task logs and timekeeping procedures

Emergency response and critical incident reporting

Infection control and safety measures

Supervision and quality assurance protocols

Service billing, documentation, and HIPAA compliance

6. STAFFING REQUIREMENTS

Role: Personal Care Aide (PCA) / Direct Support Professional (DSP)
Requirements: Age 18+, CPR/First Aid certified, background check, on-the-job training for ADLs/IADLs

Role: Supervisor / Program Coordinator
Requirements: Oversight of care delivery and adherence to Medicaid care plans

Optional: RN oversight (if combined with skilled services or medication management)

All staff must complete:

Abuse, Neglect, and Exploitation Prevention (ANEP)

HIPAA and confidentiality training

Basic infection control and emergency preparedness

Documentation and daily task tracking procedures

Person-centered care and safety training

7. MEDICAID WAIVER PROGRAMS

Personal Care Services are reimbursable under:

Community Supports Waiver (CSW)

Acquired Brain Injury (ABI) Waiver

Physical Disabilities Waiver (PDW)

Medically Complex Children’s Waiver (MCCW)

New Choices Waiver (NCW) – For individuals transitioning from institutional care

State Plan Medicaid Personal Care Program (outside of waiver, based on need)

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Manual Development
Timeline: 1–2 months

Phase: Medicaid & Waiver Enrollment
Timeline: 2–3 months

Phase: Staff Hiring & Documentation Setup
Timeline: 30–45 days

Phase: Begin Service Delivery
Timeline: Once authorized and referrals are received

9. CONTACT INFORMATION

Utah Division of Integrated Healthcare (DIH)
Website: https://medicaid.utah.gov

Utah Division of Services for People with Disabilities (DSPD)
Website: https://dspd.utah.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH PERSONAL CARE PROVIDER

WCG helps new agencies become fully compliant PCS providers by streamlining enrollment, training, and documentation tools.

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Scope of Work:

Medicaid and waiver enrollment application assistance

Personal Care Services Policy Manual and compliance checklists

Daily task logs, shift notes, and timekeeping templates

Staff onboarding packets and training outlines

Supervision protocols and quality assurance dashboards

Billing support and HIPAA-aligned documentation systems

NON-MEDICAL TRANSPORTATION SERVICES PROVIDER IN UTAH
SUPPORTING ACCESS TO ESSENTIAL SERVICES FOR INDIVIDUALS WITH DISABILITIES THROUGH RELIABLE COMMUNITY TRANSPORTATION

Non-Medical Transportation (NMT) Services in Utah are designed to help individuals with disabilities or long-term care needs travel to and from Medicaid-covered services, community activities, employment, and other essential appointments. These services promote independence, reduce institutionalization, and ensure community integration by removing transportation barriers.

NMT is an allowable service under Utah’s Medicaid State Plan and several HCBS Waivers for individuals who need help accessing day programs, employment supports, or routine medical care. Oversight is managed by the Utah Department of Health and Human Services (DHHS) through the Division of Services for People with Disabilities (DSPD) and the Division of Integrated Healthcare (DIH).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Approves providers, authorizes transportation under HCBS Waivers, and coordinates with case managers.

Agency: Utah Medicaid – Division of Integrated Healthcare (DIH)
Role: Administers Medicaid benefits and claims, including provider enrollment and reimbursement for transportation services.

Agency: Utah Department of Commerce – Division of Corporations
Role: Registers businesses operating in the state, including transportation providers.

2. NON-MEDICAL TRANSPORTATION SERVICES OVERVIEW

Non-Medical Transportation services assist eligible individuals in reaching:

Day programs or adult day health centers

Supported employment and job training sites

Medical or therapy appointments not requiring ambulance transport

Community integration or habilitation services

Grocery stores, banks, or similar essential errands as authorized

Transportation options include:

Door-to-door rides with trained drivers

Group transportation in wheelchair-accessible vans

Mileage reimbursement for family members or caregivers

Escort assistance when medically appropriate or required by ISP

Transportation must be pre-authorized in the Individual Support Plan (ISP) and tracked using logs for Medicaid billing compliance.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Utah Division of Corporations

Obtain EIN and Type 2 NPI

Apply for DSPD provider approval if billing through HCBS Waivers

Maintain vehicle registration, insurance, and driver background checks

Develop and submit a Non-Medical Transportation Services Policy & Procedure Manual

Complete Medicaid enrollment through the Utah Provider Enrollment Portal

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register company, obtain EIN and Type 2 NPI
Step 2: Submit DSPD application to become an HCBS Transportation provider
Step 3: Enroll with Medicaid via DIH portal
Step 4: Undergo background checks and driver clearance
Step 5: Conduct vehicle inspections and ensure ADA compliance
Step 6: Start providing services upon ISP authorization and transportation plan approval

5. REQUIRED DOCUMENTATION

EIN, NPI, and Articles of Incorporation

DSPD provider agreement and Medicaid enrollment confirmation

Policy & Procedure Manual including:

Vehicle maintenance and safety protocols

Incident and emergency procedures

Staff hiring and training documentation

Transportation logs and trip documentation

Service authorization tracking from case managers

HIPAA compliance and client confidentiality policies

ADA-accessible transport procedures

6. STAFFING REQUIREMENTS

Role: Driver/Transportation Aide
Requirements:

Valid Utah driver’s license

Clean driving record and background clearance

CPR/First Aid certification preferred

ADA training, including safe wheelchair handling

Annual vehicle safety and emergency response training

Role: Transportation Coordinator (optional for agencies with multiple vehicles)
Responsibilities: Route planning, schedule coordination, compliance audits

All staff must complete:

Client safety and rights training

HIPAA and documentation compliance

Annual driver recertification and road safety reviews

7. MEDICAID WAIVER PROGRAMS

NMT services may be covered under the following Utah HCBS Waivers:

Community Supports Waiver (CSW): ID/DD populations needing routine transportation

Acquired Brain Injury (ABI) Waiver

Physical Disabilities Waiver (PDW)

Medically Complex Children’s Waiver (MCCW)

New Choices Waiver (NCW): For those transitioning from institutions

Waiver eligibility and authorization must be outlined in the Individual Support Plan (ISP) and coordinated with case managers.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Creation
Timeline: 2–4 weeks

Phase: DSPD & Medicaid Enrollment
Timeline: 1–3 months

Phase: Driver Credentialing & Vehicle Readiness
Timeline: 2–4 weeks

Phase: Service Launch
Timeline: Upon waiver approval and ISP service authorization

9. CONTACT INFORMATION

Utah Division of Services for People with Disabilities (DSPD)
Website: https://dspd.utah.gov

Utah Division of Integrated Healthcare (DIH)
Website: https://medicaid.utah.gov

Utah Medicaid Provider Enrollment Portal
Website: https://medicaid.utah.gov/become-a-medicaid-provider

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH NON-MEDICAL TRANSPORTATION PROVIDER
WCG helps new agencies launch fully compliant Non-Medical Transportation services under Utah’s HCBS Waivers. From paperwork to policies, we’ve got you covered.

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Scope of Work:

DSPD and Medicaid provider enrollment guidance

NMT Policy & Procedure Manual development

Vehicle safety protocols and emergency response plans

Transportation logs, mileage sheets, and compliance templates

HIPAA and client rights forms

Staff background check and credentialing support

CASE MANAGEMENT SERVICES PROVIDER IN UTAH
COORDINATING INDIVIDUALIZED SUPPORTS TO HELP PARTICIPANTS ACCESS, NAVIGATE, AND MAXIMIZE MEDICAID WAIVER SERVICES

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Case Management Services in Utah ensure individuals receiving Home and Community-Based Services (HCBS) are supported with planning, coordination, advocacy, and oversight across all aspects of care. Case Managers serve as the central point of contact for individuals with disabilities and their families, helping to develop service plans, monitor outcomes, and connect participants to needed providers and community resources.

These services are authorized under Utah’s 1915(c) HCBS waiver programs, administered by the Department of Health and Human Services (DHHS), primarily through the Division of Services for People with Disabilities (DSPD).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Oversees case management across HCBS waivers, including training, enrollment, monitoring, and quality assurance.

Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Sets federal HCBS waiver guidelines and mandates that case management services remain conflict-free and person-centered.

2. CASE MANAGEMENT SERVICES OVERVIEW

Case Managers support individuals in gaining access to HCBS, medical, behavioral, educational, and social services. They serve as liaisons between participants, providers, and the DSPD, ensuring services are delivered in accordance with each participant’s Individual Support Plan (ISP).

Key functions include:

Conducting needs assessments and service planning

Developing, monitoring, and revising ISPs

Facilitating participant choice and self-determination

Identifying and coordinating waiver and community resources

Monitoring service quality and ensuring health and safety

Addressing barriers to service access

Ensuring documentation, billing accuracy, and compliance with waiver guidelines

Note: Utah follows CMS guidelines requiring conflict-free case management — meaning agencies that provide direct services cannot also provide case management to the same individuals.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Utah Division of Corporations

Obtain EIN and Type 2 NPI

Enroll as a Utah Medicaid provider

Apply for DSPD Case Management Provider approval

Ensure compliance with Conflict-Free Case Management requirements

Maintain general liability and professional insurance

Develop a Case Management Services Policy & Procedure Manual

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register entity and acquire EIN and NPI
Step 2: Enroll with Utah Medicaid as a case management provider
Step 3: Apply for DSPD case management certification and meet training prerequisites
Step 4: Submit required policies, supervision plan, and sample service documentation
Step 5: Complete MySupport and DSPD orientation
Step 6: Begin receiving case assignments and initiate ISP development

5. REQUIRED DOCUMENTATION

EIN, NPI, Articles of Incorporation

Utah Medicaid and DSPD enrollment confirmation

Conflict-Free Assurance Attestation

Case Management Services Policy Manual including:

Participant rights and person-centered planning procedures

Needs assessment protocols

ISP development, review, and revision processes

Monthly monitoring and contact log requirements

Critical incident tracking and reporting

Transition/discharge protocols

Service documentation and billing forms

Staff training and supervision documentation

6. STAFFING REQUIREMENTS

Role: Case Manager
Requirements: Bachelor’s degree in social work, psychology, nursing, or a related field; relevant experience; background check

Role: Clinical Supervisor (recommended for oversight of complex cases)
Requirements: Master's degree or licensed professional in human services or healthcare

All staff must complete:

HIPAA and confidentiality training

Abuse, Neglect, and Exploitation Prevention (ANEP)

DSPD MySupport training modules

Person-Centered Planning (PCP) training

ISP documentation and monitoring procedures

Emergency preparedness and critical incident response

7. MEDICAID WAIVER PROGRAMS

Case Management is a required and reimbursable service under:

Community Supports Waiver (CSW)

Acquired Brain Injury (ABI) Waiver

Physical Disabilities Waiver (PDW)

Medically Complex Children’s Waiver (MCCW)

New Choices Waiver (NCW) – For individuals transitioning from institutional settings

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Development
Timeline: 1–2 months

Phase: Medicaid Enrollment & DSPD Certification
Timeline: 2–3 months

Phase: Staff Hiring & Required Training
Timeline: 30–45 days

Phase: Start of Service Delivery
Timeline: Begins upon assignment of participant cases

9. CONTACT INFORMATION

Utah Department of Health and Human Services (DHHS) – DSPD
Website: https://dspd.utah.gov

Utah Medicaid Provider Enrollment
Website: https://medicaid.utah.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH CASE MANAGEMENT PROVIDER

WCG equips new agencies with everything needed to offer high-quality, conflict-free case management services in compliance with Utah Medicaid and DSPD standards.

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Scope of Work:

Medicaid and DSPD enrollment support

Conflict-Free Case Management policy framework

Case Management Services Manual and ISP templates

Staff onboarding packets and monthly monitoring logs

Quality assurance tools and incident response forms

Billing, service documentation, and audit preparation

MEAL & NUTRITION SERVICES PROVIDER IN UTAH
PROMOTING HEALTH AND WELL-BEING THROUGH INDIVIDUALIZED MEAL SUPPORT FOR PEOPLE WITH DISABILITIES AND CHRONIC HEALTH NEEDS

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Meal & Nutrition Services in Utah are designed to ensure that individuals with disabilities or chronic medical conditions have access to nutritionally appropriate meals that meet their dietary, cultural, and functional needs. These services support independent living, reduce caregiver burden, and help prevent malnutrition, weight loss, or other health complications.

Meal & Nutrition Services are covered under several of Utah’s Home and Community-Based Services (HCBS) Waivers, especially for individuals with limited ability to prepare meals independently. These services must be tied to the participant’s Individual Support Plan (ISP) and are authorized by the Division of Services for People with Disabilities (DSPD).

1. GOVERNING AGENCIES

Agency: Utah Department of Health and Human Services (DHHS) – Division of Services for People with Disabilities (DSPD)
Role: Approves providers and authorizes Meal Services under Medicaid HCBS Waivers, ensuring alignment with ISP goals and dietary needs.

Agency: Utah Division of Integrated Healthcare (DIH)
Role: Handles Medicaid provider enrollment and processes claims for reimbursed meal services.

Agency: Utah Department of Agriculture and Food (UDAF)
Role: May regulate facilities involved in meal preparation, handling, or delivery for public consumption.

2. MEAL & NUTRITION SERVICES OVERVIEW

Meal & Nutrition Services include the planning, preparation, and delivery of meals that meet the dietary requirements of individuals with disabilities. This service may also include training or support to help individuals prepare simple meals themselves when possible.

Examples of approved services:

Delivery of prepared, nutritionally balanced meals

Medically tailored meals for diabetes, low sodium, or texture-modified diets

Grocery shopping assistance for prescribed foods

Meal preparation assistance in the home

Nutrition counseling (if provided by a licensed professional)

Staff training on participant dietary needs

All meals must support the participant’s ISP and may not duplicate services provided through other public programs (e.g., SNAP).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business entity with Utah Division of Corporations

Obtain EIN and Type 2 NPI

Apply through DSPD as a provider of Meal Preparation or Delivery services

Enroll with Utah Medicaid through the DIH Provider Portal

Maintain general liability and food handling insurance

Secure Food Handler permits and kitchen certifications (if preparing meals)

Develop a Meal & Nutrition Services Policy & Procedure Manual

4. UTAH PROVIDER ENROLLMENT PROCESS

Step 1: Register your business, obtain EIN and NPI
Step 2: Apply as a DSPD-approved provider for meal-related services
Step 3: Complete Medicaid enrollment through the DIH portal
Step 4: Pass any kitchen/food safety inspections (if applicable)
Step 5: Submit Policy & Procedure Manual for approval
Step 6: Begin service delivery upon DSPD authorization and ISP implementation

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI confirmation

DSPD approval letter and Medicaid enrollment

Food Handler permits and any kitchen certifications (if applicable)

Policy & Procedure Manual including:

Meal planning and special diet protocols

Food handling, preparation, and delivery safety

Recordkeeping and delivery logs

Grocery shopping procedures (if applicable)

Client rights, confidentiality, and grievance policies

Staff training on dietary restrictions, allergies, and ISP meal requirements

HIPAA compliance and food allergy documentation

6. STAFFING REQUIREMENTS

Role: Meal Prep or Delivery Staff
Requirements:

Food Handler Permit (required for anyone preparing meals)

CPR/First Aid recommended

Knowledge of food allergies, dietary needs, and portion control

Must pass background check and driver clearance (for delivery staff)

Optional Role: Registered Dietitian or Nutritionist
Requirements:

Utah licensure

Provides assessments and nutrition planning when included in ISP

All staff must complete:

HIPAA and client confidentiality training

Food safety and universal precautions

ISP-focused documentation and reporting training

7. MEDICAID WAIVER PROGRAMS

Meal & Nutrition Services may be available under:

Community Supports Waiver (CSW)

Acquired Brain Injury (ABI) Waiver

Physical Disabilities Waiver (PDW)

Medically Complex Children’s Waiver (MCCW)

New Choices Waiver (NCW) – On a case-by-case basis

All services must be included in the ISP and must address a functional or medical need related to nutrition and independent living.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Food Safety Setup
Timeline: 2–4 weeks

Phase: DSPD & Medicaid Enrollment
Timeline: 1–3 months

Phase: Staff Credentialing & Manual Approval
Timeline: 2–4 weeks

Phase: Service Launch
Timeline: Begins upon ISP authorization and participant assignment

9. CONTACT INFORMATION

Utah Division of Services for People with Disabilities (DSPD)
Website: https://dspd.utah.gov

Utah Division of Integrated Healthcare (DIH)
Website: https://medicaid.utah.gov

Utah Department of Agriculture and Food (UDAF)
Website: https://ag.utah.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — UTAH MEAL & NUTRITION SERVICES PROVIDER
WCG helps new and existing providers build safe, person-centered, and Medicaid-compliant nutrition support services across Utah’s HCBS Waivers.

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Scope of Work:

DSPD and Medicaid provider enrollment support

Food safety policy & procedure manual development

Sample menus and meal tracking forms

Grocery support and delivery documentation tools

Staff onboarding guides and Food Handler permit guidance

ISP-aligned meal plan templates and special diet logs