Caregiver Programs in Utah: Paid, Respite, Support (2026)

Utah caregiver programs can pay family members: EPAS lets a worker with a disability hire family as a personal assistant.1 Under the waiver text Utah posts, the Medicaid Aging Waiver can also pay an adult child or other relative as an attendant.2 For people 65 and older who need a nursing-facility level of care and meet Medicaid's financial rules, the Medicaid Aging Waiver can cover respite care, though it serves a limited number of people.3

If you are caring for an aging parent, a spouse, or an adult child with a disability, the hard part is rarely whether help exists. It is knowing what is there and where to start. This guide maps every major caregiver program in Utah for 2026, from EPAS self-direction and Medicaid HCBS waivers to NFCSP caregiver support and VA benefits.

You don't have to figure this out alone, and you don't have to fund all of it from your savings.

In This Guide

• Utah Caregiver Programs at a Glance
• Utah Programs That Pay Family Caregivers
• Respite Care Programs
• Where to Get Help in Utah
• VA Caregiver Benefits in Utah
• Taxes for Utah Caregivers
• Frequently Asked Questions
• Learn More

Utah Caregiver Programs at a Glance

Utah Programs That Pay Family Caregivers

Employment-related Personal Assistant Services (EPAS)

EPAS is a Utah Medicaid self-directed service for people with disabilities who are employed and need personal assistance to remain working. The participant selects and hires their own personal assistant, and assistants may only help with daily activities (ADLs and IADLs) in support of the participant keeping their job.1

The spouse rule: Utah's Medicaid State Plan does not cover these services when provided by a legally responsible family member or guardian, and Utah Medicaid's EPAS page says a personal assistant may not be a legal guardian, naming a parent to a minor child or a spouse. So Medicaid does not pay a spouse, or the parent of a minor participant, as an EPAS assistant. The page's examples of who can be a personal assistant are parents (if the participant is at least 18), family, friends, neighbors, co-workers, and someone hired through an ad. The assistant must be at least 16, have a valid driver's license, and have automobile liability insurance. Someone in a Utah 1915(c) HCBS waiver may not receive EPAS when personal care is provided as part of their covered waiver services.1

If you are a spouse hoping to be the paid caregiver, this is hard news. It is also a rule about EPAS, not about every Utah program: the Aging Waiver and the New Choices Waiver can pay a spouse, but only for care the state approves as extraordinary care and only if other conditions are met (see the waivers section below).2,4 For a veteran household there may be another route: a spouse can be the Primary Family Caregiver paid the VA's PCAFC stipend, if VA approves the joint application.6 See VA Caregiver Benefits in Utah below.

How to Start EPAS in Utah

HCBS Waivers (Aging, Physical Disabilities, New Choices)

For people who are not employed or need a broader package of services, Utah's Medicaid HCBS waivers fund in-home services for people who meet a nursing-facility level of care: the Aging Waiver (age 65+, with referrals starting at your Area Agency on Aging), the Physical Disabilities Waiver (ages 65+ or 18 to 64 with a physical disability; it may provide personal care assistance, and applications go through the Division of Services for People with Disabilities), and the New Choices Waiver (age 65+, or 18 to 64 and meeting SSA disability criteria, with the goal of moving people out of institutional care). Space is limited and may not be available in all areas.2

Who the Aging Waiver can pay. The paid service is Personal Attendant Services, which the participant can self-direct: the participant, or another duly appointed party, chooses and keeps the attendant, supervises the work and verifies the attendant's time sheet, and a participant who employs the attendant directly must use a Fiscal Management Agency. The waiver text Utah has posted says relatives other than legal guardians and spouses may provide specified waiver services, so an adult child can be the paid attendant. A spouse may be paid only for care the state approves as extraordinary care. The conditions that text and Utah's rule R414-523 list include that the spouse is the participant's choice and supported by the care team, isn't also directing services, can meet the participant's needs, and works no more than 40 hours a week of approved service. When the participant self-directs Personal Attendant Services and employs the spouse as the attendant, the limit is lower: 25 hours a week. Other attendants or an agency can cover any unmet need, and routine respite isn't provided while a spouse is the paid attendant. The same waiver text says a legal guardian may not provide waiver services. Personal Attendant Services are capped at 5 hours a day, though a time-limited authorization beyond that is possible after an evaluation. The waiver documents Utah posts aren't shown to be the current approved edition, which CMS lists as a newer one, so the current waiver may add requirements: confirm the rules for your relationship with your Area Agency on Aging case manager.2 Our guide to Utah Aging Waiver family caregiver pay walks through each relationship and how to start.

Who the New Choices Waiver can pay. Relatives who aren't legally responsible for the participant can be hired as employees through Self-Administered Services, which cover attendant care, homemaker services and respite for a participant who lives in a private residence. A spouse may be paid only for approved extraordinary care, and no more than the hours the care plan approves. The spouse must be the participant's choice and supported by the care team, must not also be directing services, and must be able to meet the participant's needs, either through specialized training such as nursing licensure or because the Department determines the spouse able to meet the participant's health and safety needs. The 2021 version of the waiver capped a paid spouse at 40 hours a week. These conditions come from the 2021 waiver text and Utah's rule R414-523, and CMS lists a newer edition of the waiver that may add requirements, so confirm the rules with the New Choices Waiver case manager.4 See Utah New Choices Waiver family caregiver pay for the details.

DSPD caregiver compensation. For people who receive services from the Division of Services for People with Disabilities, caregiver compensation allows parents, step-parents, legal guardians and spouses to be paid caregivers for individuals who qualify for living support.9 The rules cited here do not say who the Physical Disabilities Waiver can pay, so ask DSPD about it by name.

To start the Aging Waiver, contact your Area Agency on Aging: an AAA case manager must evaluate whether the waiver is appropriate for the person, who must be medically appropriate for institutional care.2 Financially, Utah Medicaid's countable-asset limit for a single applicant is $2,000. For the New Choices Waiver, one eligibility group (the Special Income Group) allows income up to 300% of the federal Supplemental Security Income rate, $2,982 a month in 2026, and a Spenddown Waiver Group serves people who cannot qualify under any other group.10

For the full guide to paid pathways: How to Get Paid as a Family Caregiver in Utah.

Respite Care Programs

Medicaid Respite (HCBS Waivers)

Utah Medicaid's Aging Waiver lists respite care among its services (it may be provided in long-term-care settings), alongside adult day health, homemaker, personal attendant, and chore services. Access is not open-ended: the person must be 65 or older, require a nursing-facility level of care, and meet Medicaid's financial rules; the waiver serves a limited number of people; and a participant can use only the services they are assessed as needing.3 On the New Choices Waiver, respite care is one of the services covered through Self-Administered Services.4 If your family member is already on a waiver, ask the case manager whether respite fits their assessed needs.

NFCSP Support Through Utah's Area Agencies on Aging

The National Family Caregiver Support Program (NFCSP), authorized by Title III-E of the Older Americans Act, sends federal grants to the states, and services are provided by an Area Agency on Aging or an entity it contracts with. They cover information about available services, help getting access to them, individual counseling, support groups, caregiver training, respite care, and limited supplemental services.5

Eligible caregivers include adult family members or other informal caregivers of someone 60 or older, or of someone of any age with Alzheimer's disease or a related disorder. Respite and supplemental services carry an extra condition: the person you care for must be frail, meaning unable to perform at least two activities of daily living without substantial help, or, because of a cognitive or other mental impairment, needing substantial supervision because they behave in a way that poses a serious health or safety hazard to themselves or someone else. Ask your Area Agency on Aging what respite it can offer.5

For the full respite guide: Respite Care in Utah.

Where to Get Help in Utah

Utah's Area Agencies on Aging are the front door for most caregiver support that is not tied to a Medicaid waiver: they deliver NFCSP services, and the Aging Waiver referral also begins with them.5,2 If your loved one is already on the Aging or New Choices waiver, ask their case manager about changes to the service plan.2,4

VA Caregiver Benefits in Utah

VA runs its own caregiver and pension programs, separate from Medicaid. The PCAFC caregiver stipend, for one, requires the veteran to be enrolled in VA health care.6

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran. The stipend is calculated from the federal GS-4, Step 1 annual rate for the veteran's locality, divided by 12, then multiplied by a factor set in 38 CFR 71.40(c)(4)(i). A spouse can be the paid caregiver.6

VA's first screen has four parts, and all must be true: the veteran has a VA disability rating (individual or combined) of 70% or higher, was discharged or has a date of medical discharge, needs at least 6 months of continuous, in-person personal care services, and is enrolled in VA health care. A 70% rating alone is not enough: you and the veteran apply together, and VA decides eligibility through that application process. Those four are a first screen, not the whole test: the regulation adds conditions VA weighs in that review, including that the same personal care is not already regularly provided by another person or program. The caregiver must be at least 18 and either a family member (spouse, son, daughter, parent, stepfamily, or extended family) or someone who lives full time with the veteran, or is willing to. The stipend is paid only by direct deposit set up through the VA customer engagement portal.6

Which factor applies turns on how the household came into the program. Under the current program (the veteran meets 38 CFR 71.20(a)), the factor is 0.625, or 1.00 if the VA determines the veteran is "unable to self-sustain in the community." For a legacy participant or legacy applicant (38 CFR 71.20(b) or (c)), the factor comes instead from the sum of the veteran's 2019 clinical ratings, and no self-sustain determination is required: 1.00 for a sum of 21 or higher, 0.625 for 13 to 20, and 0.25 for 1 to 12.6 A veteran who meets both the current and the legacy criteria is paid whichever of the two amounts is higher, and a legacy participant's stipend cannot fall below what the caregiver was eligible to receive the day before October 1, 2020, so long as the veteran stays at the address on record. The legacy schedule lapses October 1, 2028. If your household was in the program before that 2020 date, ask which schedule you are being paid on, because the rating-sum route can reach the full 1.00 factor with no self-sustain finding at all.6

Because EPAS excludes spouses, the PCAFC stipend is one route through which a Utah spouse can be paid to provide care, if the veteran qualifies and VA approves the joint application.1,6

VA Aid and Attendance Pension

Veterans and surviving spouses who qualify for VA pension with Aid and Attendance must have a net worth (assets plus income for VA purposes) within the limit of $163,699 for December 1, 2025 to November 30, 2026. The VA publishes the maximums annually as a ceiling, not a flat award. VA pays the difference between the claimant's countable income and the maximum, so a veteran with no dependents and Aid and Attendance is capped at $29,093/year, and a veteran with one dependent at $34,488/year. VA computes the monthly payment by subtracting countable income from that annual maximum and dividing by 12. Unreimbursed medical expenses can reduce income for VA purposes, but only the amount above 5% of the maximum counts.12

The Utah Department of Veterans and Military Affairs has accredited Veteran Service Officers who help with VA claims, applications and appeals at no cost.11

Taxes for Utah Caregivers

IRS Notice 2014-7

Under IRS Notice 2014-7, qualified Medicaid Home and Community-Based Services (HCBS) waiver payments for personal care may be excluded from the care provider's federal gross income, but only for care in the provider's own home where the person cared for also lives under their plan of care. A provider who keeps a separate home may not exclude the payments, and the exclusion applies to federal gross income only.13 Talk to a tax preparer familiar with the rule before filing.

Utah State Income Tax

Utah has a single income tax rate for all income levels, so paid caregiving income is taxed at the same Utah rate as any other income.14 For 2026 that rate is a flat 4.45% under Utah Code 59-10-104. The Utah State Tax Commission's rate page still labels 4.5% as current, but that was the 2025 rate, so use the rate for the tax year you are filing.8

Learn More

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.