1. Program Definition and Services

Companion Care Services in Utah provide non-medical supervision, socialization, and general safety monitoring for individuals with intellectual disabilities, developmental disabilities (ID/DD), or physical limitations. Operating under 1915(c) HCBS waivers via the Division of Services for People with Disabilities (DSPD), this service counteracts residential isolation and prompts community inclusion. Services include:

• Social Engagement & Activity Facilitation: Accompanying participants on neighborhood outings, walks, civic events, and recreational activities, as well as engaging in conversation and cognitive exercises
• Basic Out-of-Home Support: Assisting with non-medical routines, including incidental meal preparation, grocery shopping, laundry, and community resource navigation

2. Regulations

Operating requires compliance with Utah's established healthcare, administrative, and federal integration rules:

• Utah Administrative Code, Rule R539-2 (DSPD Service Provision Standards)
• Utah Administrative Code, Rule R539-3 (Rights and Protections for Persons with Disabilities)
• Utah Administrative Code, Rule R156-31b (Nurse Practice Act Rules regarding boundaries of care)
• Federal HCBS Final Settings Rule (42 CFR 441.301)

3. Licensing or Certification

Providers do not require an institutional health facility license to provide community-based companion care. Instead, agencies must satisfy administrative and quality reviews to be admitted into the DSPD Approved Vendor List (AVL). All field staff must clear formal criminal background checks before providing direct care.

4. Responsible State Agency

Two distinct divisions within the state health department coordinate programmatic oversight: The Utah Department of Health and Human Services (DHHS), via the Division of Services for People with Disabilities (DSPD), establishes service specifications, tracks compliance, and monitors vendor quality. The Division of Integrated Healthcare (DIH) holds authority over underlying Medicaid credentialing, electronic claims verification, and PRISM configurations.

5. Application Process

Launching your agency involves a sequential process connecting your corporate structure to state networks:

• Register your business legal entity with the Utah Division of Corporations
• Form an official state user profile through the secure online Utah ID gateway
• Complete fingerprint-based background check clearances for all staff via the state portal
• Log into the Medicaid PRISM portal to complete electronic healthcare provider onboarding
• Apply directly through the DSPD electronic procurement system to execute a formal waiver contract

6. Required Documentation

To complete enrollment, you must compile and submit a folder of corporate credentials and operational guidelines:

• Corporate formation records, active Federal EIN, and Type 2 NPI documentation
• Confirmed PRISM Medicaid approval files and signed DSPD vendor agreements
• Companion Care Services Policy & Procedure Manual (covering participant intake protocols, non-medical service boundary enforcement, community inclusion tracking, emergency response steps, and client grievance tracks)
• Verified background registry clearances for all employed companions
• Certificates of commercial general liability insurance and state-compliant workers' compensation insurance

7. Timeline for Approval

The end-to-end processing track spanning background screening clearances, electronic PRISM validation, and final DSPD waiver contract assignment typically takes 2 to 4 months.

8. Pre-Application Process

Form an LLC or Corporation with the Utah Division of Corporations, secure an EIN from the IRS, and obtain a corporate Type 2 National Provider Identifier (NPI) configured under specialized companion, personal support, or developmental disabilities service taxonomy pathways.

9. Pre-Application Training

Before receiving participant assignments or billing, the agency's primary management team must complete the online DSPD MySupport Provider Orientation training sequences and pass the required PRISM electronic billing modules.

10. Additional Notes

• Companion care is restricted and cannot be billed concurrently with any other intensive daytime waiver code (such as supported employment, day treatment, or residential support) during the same shift
• Staffing models require personnel to be at least 18 years of age and to complete mandatory Abuse, Neglect, and Exploitation Prevention (ANEP) training modules before working independently with participants
• If a companion provides transportation during an outing, the agency must maintain active tracking logs confirming valid driver's licenses, up-to-date local vehicle registrations, and commercial auto liability insurance for all company or employee vehicles used
• Providers must track services in strict quarter-hour units linked explicitly to the social or community engagement milestones outlined inside the individual's Person-Centered Support Plan (PCSP)

Why Choose Waiver Consulting Group?

Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.

With proven expertise, a structured process, and ongoing support, we take the guesswork out of launching your healthcare business. Whether you're a first-time entrepreneur or an established provider looking to expand, our team ensures you stay compliant, competitive, and fully operational.

To get started, click the link to request portal access