I/DD Waivers in Utah

All states: Medicaid disability services map

Utah I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in Utah?

The Division of Services for People with Disabilities (DSPD), part of the Utah Department of Health and Human Services (DHHS), runs Utah's I/DD waivers day to day. It works under the DHHS Division of Integrated Healthcare, which is the state Medicaid agency. DSPD handles intake, eligibility, the waiting list and provider contracts, and most case management is done by private agencies under contract with DSPD.

• DSPD: operates the Community Supports, Community Transitions and Limited Supports waivers for people with intellectual disabilities or related conditions. It also operates the Acquired Brain Injury and Physical Disabilities waivers, which are not I/DD waivers.
• Division of Integrated Healthcare: the Medicaid agency. It approves DSPD's rates and pays provider claims through PRISM, Utah's Medicaid payment system.
• Front door: people apply to DSPD online through mySTEPS, by phone at 1-844-275-3773 (choose Apply for Services), or by mailing or emailing a paper intake packet, according to DSPD's intake page.
• Case management: called support coordination. Most of it is provided by privately owned agencies under contract with DSPD, and the person or family chooses the agency, according to DSPD's support coordination page. Support coordinators must be Qualified Intellectual Disabilities Professionals (QIDP) and certified in the UCANS assessment. DSPD staff provide case management in limited cases, including the Limited Supports Waiver.

What Medicaid waivers and programs serve people with I/DD in Utah?

Utah has three 1915(c) waivers for people with intellectual disabilities or related conditions. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. The Community Supports Waiver is by far the largest. We did not find any other federal authority, such as a 1915(i) or 1115 program, used for I/DD services in Utah; the federal waiver list shows only 1915(c) waivers for the state's home and community services.

• Community Supports Waiver for Individuals with Intellectual Disabilities and Other Related Conditions (CSW), control number 0158.R08.00: serves people of any age with an intellectual disability (starting before age 18) or a related condition (starting before age 22), with major limits in 3 or more areas of daily life, who meet the level of care for an intermediate care facility and Medicaid financial rules. Utah Medicaid's CSW page lists 24 services, including residential habilitation, supported living, day supports, center-based prevocational services, supported employment, personal assistance, companion, homemaker, respite, behavior consultation and support coordination. It served 6,168 people in fiscal year 2024. CMS approved its renewal on July 2, 2026, effective July 1, 2025 through June 30, 2030.
• Community Transitions Waiver (CTW), control number 1666.R01.00: serves people with an intellectual disability or related condition who live in an intermediate care facility and are moving to the community. It was created under the Christensen v. Miner settlement (2019), which drives moves from these facilities to community settings. Up to 25 people a year may move from the CSW to the CTW if they meet nursing service criteria. Services include residential habilitation, supported living, day supports, supported employment, nursing, medication monitoring and respite. It served 486 people in fiscal year 2024. Its renewal was approved on the same dates as the CSW.
• Limited Supports Waiver (LSW), control number 1886.R01.00: serves people on the DSPD waiting list who have lower support needs. It also serves some people with an acquired brain injury. Services are capped at $21,250 a year and include attendant care, respite, behavior services, integrated community learning, individual supported employment, remote supports and peer support. Services can be agency-based, self-administered, or a mix. It served 124 people in fiscal year 2024. CMS approved its renewal on June 4, 2026, effective July 1, 2026 through June 30, 2031.

DSPD also runs the Acquired Brain Injury Waiver (for adults 18 and older with a brain injury who need nursing facility care) and the Physical Disabilities Waiver. These use many of the same providers but are not counted here as I/DD waivers. Utah also has Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), including the state-run Utah State Developmental Center and private facilities, as the institutional option.

Does Utah pay for I/DD services through managed care?

No. Utah pays for DSPD waiver services fee-for-service. DSPD sets the rates, the Medicaid agency approves them and loads them into PRISM, and providers are paid claim by claim. A January 2025 brief written for DHHS says the department primarily funds home and community services through fee-for-service.

• Who pays claims: Utah Medicaid, through PRISM, at DSPD rates.
• Who coordinates services: private support coordination agencies under DSPD contract, chosen by the family, or DSPD staff in limited cases.
• Health plans: Utah's accountable care organizations cover physical health only, not DSPD waiver services.

Is there a waiting list for I/DD services in Utah?

Yes. DSPD's fiscal year 2025 annual report counts 5,950 people waiting in 2025, up from 5,345 in 2024, while 7,472 people were in services. People who are found eligible are ranked on the list until funding opens. Rank is not first come, first served, so a person's place can change as others join.

• How rank is set: DSPD scores each person with the Needs Assessment Questionnaire (NAQ, also called the Critical Needs Assessment). The score weighs severity of need (50 percent), caregiver support (30 percent) and time waiting (20 percent), according to DSPD's waiting list page.
• Who is selected: for the Community Supports Waiver, people are chosen by NAQ score and time waiting. For the Limited Supports Waiver, people are chosen for lower service needs and time waiting. Most people on the Limited Supports Waiver stay on the waiting list for fuller services.
• Another count: a December 2025 Utah Legislature policy brief says 6,006 people were waiting as of July 2025, with an average wait of 5.4 years.
• Funding: the Legislature has added ongoing waiting list funding every year since 2022, including $6.0 million in the 2025 General Session. In fiscal year 2025, 281 people entered services through waiting list funding.

DSPD's waiting list page links to a dashboard that may show a newer count. Families can ask DSPD at 1-844-275-3773 about a person's place on the list.

How do people apply for I/DD services in Utah, and how are budgets set?

People apply to DSPD online through mySTEPS, by phone or with a paper intake packet, and have 90 days to finish intake. DSPD decides whether the person qualifies and mails a Notice of Agency Action with the decision. Eligible people are scored with the NAQ and placed on the waiting list. Once in services, the person's support plan is built around the UCANS assessment.

• Eligibility: a qualifying diagnosis (intellectual disability starting before 18, or a related condition starting before 22) with major limits in 3 or more areas of daily life, the level of care for an intermediate care facility under rule R414-502-8, and Medicaid financial eligibility.
• Assessment: the Utah Comprehensive Assessment of Needs and Strengths (UCANS) is the main tool for the person-centered support plan and risk assessment in the Community Supports Waiver.
• Budgets and limits: residential habilitation is paid at an individualized daily rate based on assessed need. The Limited Supports Waiver caps services at $21,250 a year. We did not find a published method for how DSPD sets other individual budgets. Ask the person's support coordinator or DSPD.
• Self-direction: under Self-Administered Services (SAS), a family member acts as the employer and must use a DSPD-contracted fiscal agent for payroll. DSPD's Caregiver Compensation service also lets parents, step-parents, guardians and spouses be paid for supported living.

What day and residential services can I/DD providers offer in Utah?

Day and employment providers in Utah offer day supports, supported employment and center-based prevocational services. Residential providers offer residential habilitation in group homes and supervised private homes, host homes, professional parent homes and supported living. All of these providers must be certified by DSPD, under DSPD contract and enrolled in Medicaid, and DSPD checks their qualifications every year.

Day and employment services

• Day Supports (group, individual and partial day): help with community life and with building or keeping self-help, social and daily living skills, mostly in community settings. Models include non-site-based supports, a mixed site and community hub, and senior supports. It is not job training. Billed in 15-minute units and daily, and transport may be billed separately. A site-based hub serving 4 or more people must be licensed. The research did not find a published staff ratio. 4,375 people used day programs in fiscal year 2025.
• Supported Employment (individual, co-worker, work groups and self-employment): help to get, keep or grow a job in the community paying at least minimum wage. Work groups are two to eight people. Billed in 15-minute units, with a daily rate equal to four units, according to DSPD's service code manual. 895 people used supported employment in fiscal year 2025.
• Center-Based Prevocational Services (CSW and CTW): work skill building in a center setting. We did not find a published license type, ratio or billing unit for this service.

Residential services

• Residential Habilitation Supports: daily help with skills, daily living, personal care and oversight in group homes (4 or more residents, licensed by the DHHS Office of Licensing) or supervised private homes (3 or fewer). Paid at an individualized daily rate that does not include room and board. 2,785 people in fiscal year 2025.
• Host Home Support: residential habilitation in a family home for up to 3 adults 18 or older, in a DSPD-certified setting. 850 people in fiscal year 2025.
• Professional Parent Services: a family home for up to 3 people under 22. Providers are licensed child placing agencies. 111 people in fiscal year 2025.
• Supported Living: hourly support in the person's own home, family home or apartment, from an agency or through SAS. 3,165 people in fiscal year 2025, 1,643 of them through Caregiver Compensation. Supported living requires EVV.
• ICF/IID: the institutional option, including the Utah State Developmental Center and private facilities. 32 people moved from private facilities to home and community services in fiscal year 2025.

How are I/DD provider rates set and how do agencies enroll in Utah?

DSPD sets provider rates, and the Medicaid agency approves them before they are loaded into PRISM. Most rates are reviewed every 5 years, using provider cost surveys for some services and rates in nearby states for others. Agencies must enroll as Utah Medicaid providers and also be certified by and under contract with DSPD. We did not find a published DSPD rate table.

• Cost-based services: residential habilitation, host home and professional parent, day supports, center-based employment and daily transportation are reviewed every 5 years against cost survey data, with a target of 100 to 120 percent of allowable costs, according to the Community Supports Waiver plan.
• Hourly services: routine respite, supported employment, supported living and support coordination are compared every 5 years with rates in surrounding states. Other services are tied to Medicaid State Plan rates. The Legislature can also change rates.
• Latest rate changes: the Legislature funded a 19.5 percent home and community services provider rate increase in 2022, and kept the 5 percent direct-care increase from the federal American Rescue Plan Act (ARPA) after that funding ended.
• Enrollment: agencies enroll through Utah Medicaid's become a Medicaid provider page and the PRISM portal. DSPD contract solicitations are posted through DHHS Purchasing and the Utah Supplier Portal, as listed on DSPD's RFP page.
• EVV: in-home DSPD services, including personal assistance, companion, homemaker, respite, supported living and the SAS codes, need electronic visit verification (EVV). Utah lets agencies choose any compliant EVV vendor that sends data to the state's UEVV system, and checks compliance through post-payment audits, according to Utah Medicaid's EVV page. Residential and day habilitation codes are not on the EVV list.

What is changing next for I/DD services in Utah?

As of October 23, 2026, we did not find a confirmed change with a set effective date for Utah's I/DD waivers. Utah has proposed waiver amendments that would change supported employment and access for people leaving the State Developmental Center. These are proposals, not final decisions, and they still need CMS approval.

• October 2026 proposal: Utah's waiver amendment summary proposes letting families self-administer supported employment in the Community Supports, Community Transitions and Acquired Brain Injury waivers, and letting residents of the Utah State Developmental Center enter the Community Transitions Waiver. Public comments close November 26, 2026.
• May 2026 proposal: an earlier amendment, tied to ongoing work with the U.S. Department of Justice, proposed adding job discovery and milestone payments to supported employment in the same three waivers and clarifying admissions from the State Developmental Center. We did not find whether CMS approved it.
• Rate study: DSPD hired Health Management Associates for a rate study, and a March 2026 waiver update describes new rate models for supported job development, supported employment and massage therapy. We did not find whether these rates are approved or when they would start.

All three I/DD waivers were renewed by CMS in mid-2026. For news on amendments and rates, check DSPD's Medicaid waivers page or ask DSPD.

Utah I/DD sources

• Utah DSPD: Medicaid waivers
• Utah DSPD: Fiscal year 2025 annual report (December 2025)
• Utah Legislature: DSPD policy brief (December 2025)
• Utah DSPD: Waiting list
• Utah DSPD: Intake process
• Utah DSPD: Support coordination
• Utah Medicaid: Community Supports Waiver
• Utah Medicaid: HCBS waiver amendment executive summary (October 2026)
• Utah Medicaid: Electronic visit verification
• Utah Medicaid: Become a Medicaid provider

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• Goal Tracking and Strategy Management in Disability Services
• I/DD services in every state (map)
• Utah EVV requirements

Page history

• October 23, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.