Utah New Choices Waiver Family Caregiver Pay: Who Can Be Paid
Utah's New Choices Waiver can pay a qualified adult child or other relative as a family caregiver for a parent who moves home from a nursing home or assisted living.
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Brevy Care Team
8 min read · Published October 16, 2026
Utah's New Choices Waiver can pay a qualified adult child or other relative as a family caregiver for a parent who moves home from a nursing home or assisted living.U.S. Government Publishing Office. (n.d.). 42 CFR §435.236 — Electronic Code of Federal Regulations (eCFR). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.236,Centers for Medicare & Medicaid Services. (n.d.). UT New Choices Waiver (0439.R04.00) - State Waivers List - Medicaid.gov (CMS). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83336 Bringing someone home is a heavy decision, and paid family care can make it workable. Call the New Choices Waiver Program at (800) 662-9651, option 6, while your relative still lives in the facility.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT
Yes, if not legally responsible for your relative and qualified to provide the service
Other relative
Yes, if not legally responsible for your relative and qualified to provide the service
Spouse
Only if approved as extraordinary care; up to 40 hours a week
Legal guardian
Not stated; ask the case manager
Relative who lives with your relative
Not stated; ask the case manager
These rules come from New Choices' 2021 amendment, Utah's July 1, 2025 Self-Administered Services guidance and Utah Administrative Code R414-523. Utah's current New Choices waiver took effect July 1, 2025; we couldn't check its text, and it may add requirements, so confirm current rules with the case manager.Centers for Medicare & Medicaid Services. (n.d.). UT New Choices Waiver (0439.R04.00) - State Waivers List - Medicaid.gov (CMS). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83336
Can a Spouse Be Paid Through New Choices?
As the spouse giving this care, you may wonder whether New Choices can pay you. Sometimes it can. New Choices' 2021 amendment added spouses as providers of Attendant Care, for extraordinary care, which R414-523 defines as care beyond what a spouse would ordinarily give someone the same age without a disability or chronic illness, needed to keep them healthy, safe and out of an institution. Under that amendment, a spouse may be eligible as the paid caregiver when:Centers for Medicare & Medicaid Services. (n.d.). UT New Choices Waiver (0439.R04.00) - State Waivers List - Medicaid.gov (CMS). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83336
your spouse chooses you, and the care team supports it;
you aren't also directing services on your spouse's behalf;
you provide no more than 40 hours a week of the service the agency approves; and
you have a unique ability to meet their needs, such as special skills or training like nursing licensure.Centers for Medicare & Medicaid Services. (n.d.). UT New Choices Waiver (0439.R04.00) - State Waivers List - Medicaid.gov (CMS). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83336
Under R414-523, you can meet the ability test without a license or special training if the state determines you able to meet your spouse's health and safety needs. This may not be the full current list, so confirm the spouse rules and hours with the case manager.Centers for Medicare & Medicaid Services. (n.d.). UT New Choices Waiver (0439.R04.00) - State Waivers List - Medicaid.gov (CMS). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83336
At each New Choices care planning meeting, the case manager or support coordinator asks whether paying you reflects your spouse's wishes, serves your spouse's and family's best interests, fits their assessed needs and increases their independence and community integration. If that review finds any of these isn't met, Utah denies the request, but your spouse can still appeal through a fair hearing. The amendment also asks for a backup-support plan, a service agreement you sign, and a review of whether the extra care could jeopardize your own well-being, a question worth answering honestly for yourself too.Centers for Medicare & Medicaid Services. (n.d.). UT New Choices Waiver (0439.R04.00) - State Waivers List - Medicaid.gov (CMS). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83336
How Does New Choices Pay a Family Caregiver?
Before anyone cuts back at work, it helps to see exactly how the money moves. Under New Choices Self-Administered Services, your relative, their designee, or both hire individual employees, not an agency, to deliver attendant care, homemaker services or respite care.Centers for Medicare & Medicaid Services. (n.d.). UT New Choices Waiver (0439.R04.00) - State Waivers List - Medicaid.gov (CMS). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83336
Your relative is the employer, and your relative or the designee sets the wage and schedule. A New Choices Financial Management Services (FMS) agency collects time records, prepares payroll and handles employment taxes, so you aren't left to sort out tax withholding on your own.medicaid-documents.dhhs.utah.gov. (2025). New Choices Waiver Attachment C: Self-Administered Services (effective 07-01-2025) - Utah DHHS Medicaid (medicaid-documents.dhhs.utah.gov). Retrieved Oct 18, 2026, from https://medicaid-documents.dhhs.utah.gov/Documents/pdfs/ltc/nc/2025-07-01%20%20DHHS%20NCW%20Attachment%20C%20Self-Administered%20Services.pdf
The case manager decides which Self-Administered Services your relative qualifies for and, for attendant care, assesses how much help is needed. A New Choices employee can be authorized to work more than 40 hours a week if your relative doesn't want an additional caregiver, and hours over 40 are paid as overtime.Centers for Medicare & Medicaid Services. (n.d.). UT New Choices Waiver (0439.R04.00) - State Waivers List - Medicaid.gov (CMS). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83336,medicaid-documents.dhhs.utah.gov. (2025). New Choices Waiver Attachment C: Self-Administered Services (effective 07-01-2025) - Utah DHHS Medicaid (medicaid-documents.dhhs.utah.gov). Retrieved Oct 18, 2026, from https://medicaid-documents.dhhs.utah.gov/Documents/pdfs/ltc/nc/2025-07-01%20%20DHHS%20NCW%20Attachment%20C%20Self-Administered%20Services.pdf That assessment shapes how many paid hours you can count on, so be specific with the case manager about the help your relative needs each day. If your relative disagrees with an action Utah Medicaid takes, they can request a fair hearing.U.S. Government Publishing Office. (n.d.). 42 CFR 431.221 — Request for hearing (federal 90-day fair-hearing window). ecfr.gov. Retrieved Aug 2, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-431/subpart-E/subject-group-ECFR8f8db4b82dfda3f/section-431.221 The paperwork a hired relative completes is in the steps below.
Agencies offer the same services if your family prefers, though Utah's guidance doesn't say whether an agency can employ your relative. Someone receiving any type of Adult Residential Services can't use New Choices Self-Administered Services.Centers for Medicare & Medicaid Services. (n.d.). UT New Choices Waiver (0439.R04.00) - State Waivers List - Medicaid.gov (CMS). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83336
We found no published New Choices family caregiver pay rate, so ask the case manager how the wage is set before anyone cuts back a job.
Who Qualifies and How to Start in Utah
Moving a parent home is a big, sometimes scary step, so check these rules early. New Choices usually can't be started from home. To apply, your relative must:U.S. Government Publishing Office. (n.d.). 42 CFR §435.236 — Electronic Code of Federal Regulations (eCFR). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.236
live long term in a nursing facility, licensed assisted living, a licensed small health care (Type N) facility or another Utah licensed medical institution other than an institution for mental disease, and meet that setting's minimum stay, such as 90 days or more of Utah Medicaid-paid nursing facility care or 365 days or more at nursing facility level of care in licensed assisted living (all routes), or transfer from another Utah home and community-based services waiver with an immediate or impending need for nursing facility care;U.S. Government Publishing Office. (n.d.). 42 CFR §435.236 — Electronic Code of Federal Regulations (eCFR). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.236,U.S. Government Publishing Office. (2026). 42 CFR 441.310 - Limits on Federal financial participation (FFP) for home and community-based services (eCFR, title-42 issue date 2026-09-01). ecfr.gov. Retrieved Sep 6, 2026, from https://www.ecfr.gov/current/title-42/section-441.310
meet nursing facility level of care when applying and while enrolled; Utah's rule requires at least two of three factors: substantial hands-on help with daily activities because of diagnosed medical conditions, disorientation to person, place or time that the attending physician says requires nursing facility care, or care needs that can't be met safely in a less structured setting; andU.S. Government Publishing Office. (n.d.). 42 CFR §435.236 — Electronic Code of Federal Regulations (eCFR). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.236,Utah Office of Administrative Rules. (n.d.). Utah Administrative Code R414-502, Nursing Facility Levels of Care (Utah Office of Administrative Rules, current-rules RTF). rules.utah.gov. Retrieved Oct 4, 2026, from https://rules.utah.gov/publicat/code_rtf/r414-502.rtf
be 65 or older, or 18 through 64 and meet Social Security disability criteria.U.S. Government Publishing Office. (n.d.). 42 CFR §435.236 — Electronic Code of Federal Regulations (eCFR). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.236
In the Special Income Group, one of New Choices' six financial coverage groups, income can't exceed 300% of the Supplemental Security Income (SSI) rate, $2,982 a month in 2026, and a spouse's income isn't counted.U.S. Government Publishing Office. (n.d.). 42 CFR §435.236 — Electronic Code of Federal Regulations (eCFR). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.236 Being over that line isn't the end of the road: New Choices also has a Spenddown Waiver Group for people who can't qualify under any other group.U.S. Government Publishing Office. (n.d.). 42 CFR §435.236 — Electronic Code of Federal Regulations (eCFR). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.236 A single New Choices applicant can have up to $2,000 in countable assets; if your relative is married, the spouse at home may keep more under separate rules (Utah's income and asset limits).U.S. Government Publishing Office. (2024). 42 U.S.C. 1396r-5 (Social Security Act sec. 1924, spousal impoverishment), U.S. Code 2024 edition, govinfo.gov — the federal framework Utah's four-limb Community Spouse Asset Allowance mirrors; the dollar cap binds only clauses (i) and (ii)(II), and the (e)(2) fair-hearing and (f)(3) court-order routes carry no dollar amount. govinfo.gov. Retrieved Oct 13, 2026, from https://www.govinfo.gov/content/pkg/USCODE-2024-title42/html/USCODE-2024-title42-chap7-subchapXIX-sec1396r-5.htm
1
Step 1
Call the New Choices Waiver Program at (800) 662-9651, option 6,
and ask about openings. Space in Utah's waivers is limited and may not be available in all areas; Utah reserves most New Choices slots for people in nursing facilities, hospitals or other medical facilities, so ask about waits.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT,U.S. Government Publishing Office. (n.d.). 42 CFR §435.236 — Electronic Code of Federal Regulations (eCFR). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.236
2
Step 2
Apply for Medicaid if your relative isn't enrolled yet
Utah Department of Workforce Services (DWS) eligibility workers decide eligibility; apply through myCase online, by mail, by fax or at a DWS office (how to apply).U.S. Government Publishing Office. (2024). 42 U.S.C. 1396r-5 (Social Security Act sec. 1924, spousal impoverishment), U.S. Code 2024 edition, govinfo.gov — the federal framework Utah's four-limb Community Spouse Asset Allowance mirrors; the dollar cap binds only clauses (i) and (ii)(II), and the (e)(2) fair-hearing and (f)(3) court-order routes carry no dollar amount. govinfo.gov. Retrieved Oct 13, 2026, from https://www.govinfo.gov/content/pkg/USCODE-2024-title42/html/USCODE-2024-title42-chap7-subchapXIX-sec1396r-5.htm
3
Step 3
Ask the case manager for Self-Administered Services
My parent is already at home. Can we use New Choices?
Usually not, and that's hard news when you're already doing the care. Utah says people not living in a qualifying Utah facility can't apply, apart from a transfer route for someone on another Utah home and community-based services waiver with an immediate or impending need for nursing facility care.U.S. Government Publishing Office. (n.d.). 42 CFR §435.236 — Electronic Code of Federal Regulations (eCFR). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.236 For a parent 65 or older at home, Utah's Aging Waiver is the program to look at: it helps older adults stay home, and the Division of Aging and Adult Services takes questions at (801) 538-3910.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT
Can a family member be paid if my relative lives in assisted living on New Choices?
Possibly not. New Choices Self-Administered Services, through which your relative can hire family as individual employees, are limited to a participant in a private residence, so ask the case manager whether your relative's assisted living counts.Centers for Medicare & Medicaid Services. (n.d.). UT New Choices Waiver (0439.R04.00) - State Waivers List - Medicaid.gov (CMS). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83336 See how families in Utah pay for assisted living.
Find personalized help getting paid through Utah's New Choices Waiver at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.
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Brevy Care Team
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