Obsolete 0715 - 380 Home and Community Based (HCB) Waiver Programs

Policy Effective October 1, 2012 - June 30, 2015

Contact DWS Program Specialist for Previous Policy

Utah has seven HCB waiver programs. They are:

Physical Disabilities Waiver (PDW)
Technology Dependent Waiver (TDW)
Utah Community Supports Waiver (UCSW)
Acquired Brain Injury Waiver (ABIW)
Aging Waiver (AW)
New Choices Waiver (NCW)
Medicaid Autism Waiver

The number of people who can be served on each waiver is limited.

HCB waivers allow Medicaid to cover extra services as an alternative to institutionalization. Without the waiver services the client would need the level of care provided in a nursing home. The NCW is designed specifically to allow people in institutions to leave the institution and be served in less restrictive community settings.

For a list of services each waiver provides read pamphlet PM 993.

Need for Level of Care

One of these agencies will determine the need for the level of care:

Division of Services for People with Disabilities (DSPD),
Division of Community and Family Health Services (DCFHS),
Area Agency on Aging (AAA).
Dept. of Health Bureau of Authorization and Community Based Services (BACBS)

The form 927 is proof the client needs the level of care provided in a nursing home and it sets the date when waiver services will begin. The 927 will be valid until the BACBS tells us the client no longer meets the criteria. Coordinate all case closures with the agency that approves waiver services.

Restriction of Medicaid due to Substantial Home Equity

An individual applying for home and community based services who has substantial home equity in his or her home is ineligible for Medicaid coverage for home and community based services. (See Table II for current home equity limit) This rule applies to all waiver applicants and recipients who apply for institutional or waiver services on or after January 1, 2006. (See sec. 371) Do not approve Waiver Medicaid for someone with substantial home equity. Determine eligibility for non-waiver Medicaid according to the rules in ABD policy, but do not allow the cost of waiver services as a medical expense deduction.