Division of Child and Family Services. This service is not for ongoing daycare nor is this service intended to supplant resources otherwise available for child-care. Respite care may not be offered at the same time as the person is receiving any other service, either contained within this Home and Community-Based Services waiver or from other sources including the Medicaid State Plan that will afford the person with care and supervision. Respite care may not be offered for relief or substitution of staff paid to provide care and supervision to persons as part of the residential or day habilitation services they receive in this Home and Community-Based Services waiver. X Participant-directed as specified in Appendix E X Provider Service Delivery Method managed (check each that applies): Specify whether the service may Legally X Relative Legal Guardian be provided by Responsible (check each that Person applies): Provider Specifications Provider X Individual. List types: X Agency. List the types of agencies: Category(s) Self-directed Respite Agency based--Respite (check one or both): Provider Qualifications Provider Type: License Certificate Other Standard (specify) (specify) (specify) Agency Licensed by the Certified by DSPD as Under state contract with DSPD as an State of Utah as a an authorized provider authorized provider of services and specific category of of services and supports to people with disabilities in facility/agency as supports to people accordance with 62A-5-103, UCA. follows: with disabilities in accordance with Enrolled as a Medicaid provider UCA. Licensed Residential Treatment Programs R501-19, UAC Licensed Residential Support Programs R501-22, UAC Nursing Facility: R432-150, UAC Assisted Living Facility: R432-270, UAC Self-directed Certified by DSPD as Under state contract with DSPD as an Respite an authorized provider authorized provider of services and of services and supports to people with disabilities in
Division of Child and Family Services. This service is not for ongoing daycare nor is this service intended to supplant resources otherwise available for child-care. Respite care may not be offered at the same time as the person is receiving any other service, either contained within this Home and Community-Based Services waiver or from other sources including the Medicaid State Plan that will afford the person with care and supervision. Respite care may not be offered for relief or substitution of staff paid to provide care and supervision to persons as part of the residential or day habilitation services they receive in this Home and Community-Based Services waiver. Service Delivery Method (check each that applies): X Participant-directed as specified in Appendix E X Provider managed Specify whether the service may be provided by (check each that applies): Legally Responsible Person X Relative Legal Guardian Provider Specifications Provider Category(s) (check one or both): X Individual. List types: X Agency. List the types of agencies: Self-directed Respite Agency based--Respite Provider Qualifications Provider Type: License (specify) Certificate (specify) Other Standard (specify) Agency Licensed by the State of Utah as a specific category of facility/agency as follows: Licensed Residential Treatment Programs R501-19, UAC Licensed Residential Support Programs R501-22, UAC Nursing Facility: R432-150, UAC Assisted Living Facility: R432-270, UAC Certified by DSPD as an authorized provider of services and supports to people with disabilities in accordance with UCA. Under state contract with DSPD as an authorized provider of services and supports to people with disabilities in accordance with 62A-5-103, UCA. Enrolled as a Medicaid provider Self-directed Respite Certified by DSPD as an authorized provider of services and Under state contract with DSPD as an authorized provider of services and supports to people with disabilities in
ABI%20Waiver%20Amendment%20-%20Final%20Draft%20for%20Public%20Comment.docx