Self-Direction and FMS in Utah

All states: self-direction map

Utah self-direction at a glance

Last verified against state sources: 2026-10-13.

Which Medicaid programs in Utah offer self-direction?

Utah offers self-direction in waivers run by the Division of Services for People with Disabilities (DSPD), in several waivers run by other parts of the Utah Department of Health and Human Services (DHHS), and in a work-related program called EPAS. The state's term for self-direction is Self-Administered Services (SAS). Utah has no single statewide self-direction page, so the rules sit in a different place for each program. The fullest description is DSPD's Self-Administered Services page.

• DSPD Self-Administered Services (SAS): available under the Community Supports, Community Transitions, Acquired Brain Injury and Limited Supports waivers (1915(c) waivers). It serves people with intellectual or developmental disabilities or related conditions, and adults with acquired brain injury. DSPD runs it. The family has employer authority: DSPD says families hire, train and supervise their own staff.
• Physical Disabilities Waiver: a 1915(c) waiver for adults 18 or older with a physical disability (functional loss of two or more limbs) who need a nursing facility level of care. DSPD runs it. The participant has employer authority. The state page requires that the participant be able to select, supervise and train their own attendant. Its only services are Financial Management Services, Personal Assistance, Personal Emergency Response and Specialized Medical Equipment.
• New Choices Waiver (Self-Administered Services option): a 1915(c) waiver run by the DHHS Office of Long Term Services and Supports. The participant acts as employer and works with a fiscal agent. We did not find a readable state list of which New Choices services can be self-administered.
• Aging Waiver (Waiver for Individuals Age 65 or Older): a 1915(c) waiver for adults 65 or older, run by the Division of Aging and Adult Services through local Area Agencies on Aging. Fiscal Management Services and Personal Budget Assistance are listed services, and fiscal agents publish worker packets for it. The state page does not describe the self-directed option in its own words.
• Employment-related Personal Assistant Services (EPAS): a Medicaid service for working people with physical, mental, cognitive or developmental disabilities who need personal assistance to keep a job (at least 40 hours of work a month, or self-employment). The DHHS Division of Integrated Healthcare runs it. The participant has employer authority: the participant selects and hires personal assistants. People on a 1915(c) waiver that covers personal care cannot also get EPAS.
• Technology Dependent Waiver: a 1915(c) waiver run by the Office of Long Term Services and Supports. Its services include Financial Management Services, Personal Attendant Services and Family Support Services. The participant or a representative is the employer, hires the caregiver, sets pay within program guidelines, and schedules and supervises the work.
• Medically Complex Children's Waiver: a 1915(c) waiver for children with medically complex conditions, run by the Office of Long Term Services and Supports. Its services include Financial Management Services, Routine Respite Care and Personal Attendant Services. We did not find a readable state source on how self-direction works in this waiver.

Employer authority means the person or family recruits, hires, schedules and supervises the workers. Budget authority means the person also manages a set amount of money for services. We did not find a state statement on whether any Utah program gives budget authority. In DSPD services the division sets a person-centered budget, and under rule R539-5-6 that limit cannot be exceeded unless the DSPD director approves a revised limit.

Who handles financial management services (FMS) in Utah?

Contracted fiscal agents handle financial management services in Utah. The three confirmed today are Acumen Fiscal Agent, Morning Sun Financial Services and WasatchSD (formerly PremierFMS-Utah). Utah uses a fiscal/employer agent model, which means the fiscal agent runs payroll and taxes while the person or a designated family member stays the legal employer. Because more than one fiscal agent serves most programs, families pick one.

A fiscal agent is the organization that handles the paperwork side of being an employer. DSPD says every SAS family must hire one, and that the fiscal agent handles payroll, processes and monitors employee background checks and helps manage the service budget. The family hires, trains and supervises the employees.

• Legal employer: in DSPD services the person or guardian names an SAS employer. Rule R539-5-4 says the SAS employer must use a fiscal agent contracted with the division and cannot also be the SAS employee. Morning Sun describes itself as the Fiscal Employer Agent and says it is not the employer.
• DSPD Self-Administered Services: Acumen Fiscal Agent, Morning Sun Financial Services and WasatchSD.
• Physical Disabilities Waiver: Acumen and Morning Sun.
• New Choices Waiver: Acumen and Morning Sun.
• Aging Waiver: Morning Sun and WasatchSD. Acumen lists aging programs by Area Agency on Aging on its Utah page but does not say whether each one is the Medicaid Aging Waiver.
• EPAS: the state's EPAS page names three financial management agencies: Acumen, WasatchSD and Morning Sun.
• Technology Dependent and Medically Complex Children's waivers: Morning Sun and WasatchSD.

The employer has duties of its own under rule R539-5-4. The SAS employer sends a written monthly summary to the support coordinator by the 15th of the following month. The employer also may not approve billing for an employee who works more than 40 hours a week unless an overtime form (2-9OT) has been submitted and approved through the request for services process.

The vendor list differs a little from one state source to another. For the current list of fiscal agents contracted for a given program, ask DSPD at 1-844-275-3773 or the program's own office.

Who can be a paid caregiver under self-direction in Utah?

Family members, friends and neighbors can be hired in Utah, but the limits depend on the program. In EPAS the personal assistant cannot be the participant's legal guardian, and the state gives a spouse and the parent of a minor child as examples. In DSPD services, parents, step-parents, legal guardians and spouses can be paid through a separate service called Caregiver Compensation when the person qualifies.

• EPAS: the assistant must be at least 16 and hold a driver's license and auto liability insurance. The assistant may not be the participant's legal guardian. Parents can be assistants only when the participant is 18 or older. Other family, friends and neighbors can be hired.
• DSPD Caregiver Compensation: DSPD's Caregiver Compensation page says parents, step-parents, legal guardians and spouses can be paid caregivers for people in DSPD services who qualify. It requires training, a clinician's medical and behavioral certification and a monthly summary. DSPD describes it as an ongoing service.
• DSPD SAS employees in general: under rule R539-5-5 an SAS employee must be at least 16. An employee under 18 needs a parent or guardian to co-sign the employee agreement and may not transport the person. The fiscal agent may not approve payment if the employee agreement is not signed and followed.
• Technology Dependent Waiver: Morning Sun's caregiver enrollment packet says the caregiver may be a family member, neighbor or friend who meets the same qualifications as any other employee, including a background screening and fingerprinting. We did not find a statement on whether the parent of a minor child can be the paid caregiver.
• New Choices, Aging, Physical Disabilities and Medically Complex Children's waivers: we did not find a readable state rule on which relatives can be paid. Ask the case manager or the program office.

On hours, the one confirmed rule is the DSPD rule above: more than 40 hours a week for an SAS employee needs an approved overtime form.

Does EVV apply to self-directed workers in Utah?

Yes. Electronic visit verification (EVV) applies to self-directed personal care in Utah, and workers record their shifts in the EVV tool their fiscal agent provides. The state does not run a single EVV system for self-directed workers. The state itself does not hold back a claim for missing EVV before payment. It reviews EVV records after payment, and a fiscal agent can set a stricter payroll rule of its own.

• Which services: the state EVV page lists DSPD Self-Administered Services codes as personal care that requires EVV, including the personal assistance codes used in the Physical Disabilities Waiver and the Caregiver Compensation codes.
• The state rule: rule R414-522 requires EVV records within three months of the claim. The state enforces it through an annual review after payment and can take money back.
• Acumen: Acumen's Utah page says entering time in its web portal does not satisfy EVV. Employees clock in and out in real time in the DCI mobile app, certain programs may use an approved landline, and DSPD employers can order an EVV fob. Acumen's DSPD enrollment packet has the employer acknowledge that employees will not be paid for shifts reported without the EVV step. That is Acumen's payroll rule, not a state claims rule.
• Morning Sun: as Fiscal Employer Agent, Morning Sun sets up employer, employee and participant records for EVV and helps manage EVV time entries. Its Technology Dependent Waiver packet has caregivers record each shift in an EVV app on a phone or tablet, and the employer approves the shifts.
• Live-in caregivers: the state EVV page carries federal guidance that a caregiver who lives with the person receiving services need not log an in-home visit. Acumen posts an EVV Live-In Caregiver Attestation form for DSPD employees.

Several points could not be confirmed. We did not find the EVV tool or pay rule used by WasatchSD, or whether Morning Sun declines to pay shifts that lack EVV. The state's EPAS page does not mention EVV, and we did not find a readable source on EVV for the Medically Complex Children's Waiver or a state description of the EVV tool for Aging Waiver self-direction. Ask the fiscal agent how shifts must be recorded before the first shift is worked.

What is changing next for self-direction in Utah?

We did not find an upcoming change to self-direction in Utah as of our last check on October 13, 2026. No fiscal agent procurement, vendor transition or new EVV date for self-directed workers appeared on the state pages we read. That is not proof that nothing is planned, so confirm with DSPD or the program office before you plan around it.

Several recent changes are already in effect and worth knowing:

• SAS service code descriptions: a new version of the DSPD SAS service code descriptions took effect on April 30, 2026. We could not read what changed.
• New SAS agreement forms: DSPD posted new SAS Employer and Employee Agreement forms in July 2026, so the agreements in current use are 2026 versions.
• Rule R539-5: the Self-Administered Services rule was amended by emergency rule effective December 18, 2024, and the current version was adopted effective March 3, 2025.
• New Choices Waiver renewal: the renewal is approved from July 1, 2025 through June 30, 2030.
• Fiscal agent name change: PremierFMS-Utah has rebranded to WasatchSD. The date of the rebrand is not published.

Utah self-direction sources

• Utah DSPD: Self-Administered Services (SAS)
• Utah DSPD: Caregiver Compensation
• Utah Medicaid: Employment-related Personal Assistant Services (EPAS)
• Utah Medicaid: Physical Disabilities Waiver
• Utah Medicaid: Electronic Visit Verification
• Utah Administrative Code R414-522 (Electronic Visit Verification)
• Utah Administrative Code R539-5-4 (SAS employer requirements)
• Utah Administrative Code R539-5-5 (SAS employee requirements)
• Acumen Fiscal Agent: Utah programs and EVV

Related reading

• Self-Directed Medicaid Home Care Services in 2026
• Understanding Self-Direction and FMS
• Why Do Self-Directed Participants Choose Your FMS as Their Fiscal Intermediary?
• Self-Direction Fiscal Intermediary: A Guide for Participant-Directed Care
• Self-direction in every state (map)
• Utah EVV requirements

Other states with a choice of FMS vendors

Alaska, Colorado, Georgia, Idaho, Kentucky, Louisiana, Maryland, Minnesota, North Carolina, Texas. See every state on the self-direction map.

Page history

• October 13, 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 FMS organizations and agencies that support self-direction. If you would like to talk through your program, contact Ankota or read more about Ankota's self-direction and FMS software.