New Choices Waiver

The New Choices Waiver Program is designed to serve individuals who are residing long term in a nursing facility, licensed assisted living facility, licensed small health care (Type N) facility or another type of Utah licensed medical institution (except institutions for mental disease). All participants must meet nursing facility level of care at the time of application and throughout their entire participation in New Choices Waiver. The Program offers an option for these individuals to move into integrated community-based settings if they wish to do so and if their needs can be safely met in the setting that they have chosen. When an individual is enrolled in the New Choices Waiver Program, they may receive an expanded package of supportive services through Medicaid which are intended to help with community-based living and are based on the assessed need of the individual. A description of the available services can be found below.

PLEASE NOTE: Individuals who are not currently living in one of the types of facilities listed above are not eligible to apply to the New Choices Waiver Program. There is a minimum length of stay requirement in each type of setting. For more information, please contact the New Choices Waiver Program at (800)662-9651, option 6 or [email protected].

Apply for New Choices Waiver Here opens in a new tab

For fastest processing, submit an online application for the New Choices Wavier Program. (First -time applicants will be required to create a UtahID account.) 

Paper applications will experience a delay and may be requested via our contact information below.

Please refer to the New Choices Waiver Fact Sheet opens in a new tab for more information.

Contact Information

From the Salt Lake City area: 801-538-6155, option 6
Outside the Salt Lake city area: 800-662-9651, option 6
(Phones are staffed 9:00am-12:00pm Monday, Wednesday, Thursday, and Friday. After these hours, there is the option to leave a voicemail which will be returned within a few business days)

Email: [email protected]
Fax: 801-323-1586

Mailing:
DHHS Office of Long Term Services & Supports
P.O. Box 143112
288 N 1460 W
SLC, UT 84114-3112

Services

New Choices Waiver offers an expanded package of supportive services that are intended to facilitate a participant's ability to reside in a home or community-based setting.  Services are available based on the assessed need of the participant and include those listed below.  The New Choices Waiver Description of Services opens in a new tab  provides a brief description of each service.

Policy

1. New Choices Waiver State Implementation Plan Effective 07.01.2025 opens in a new tab
2. Utah Medicaid Information Bulletin and Provider Manuals
3. Choking and Swallowing Advisory opens in a new tab

Forms

This is not an all-inclusive list of required forms for the New Choices Waiver. If a provider needs to obtain forms that do not appear in this list, please contact the New Choices Waiver Program.

• NCW Release of Information (ROI)
• Case Management Forms
  1. Notice of Decision opens in a new tab
  2. Cover Sheet opens in a new tab
  3. MDS-HC opens in a new tab
  4. Medication Management Review Form PDF opens in a new tab |  Word
  5. Memory Care Checklist PDF | Word
  6. Incident Reporting opens in a new tab
  7. 114AR DWS Release Form opens in a new tab

Case Management Services are services that assist participants to gain access to needed waiver services and other Medicaid State Plan services, as well as needed medical, social, educational, and other services, regardless of the funding source. For more information on the Case Management agencies that work with New Choices Waiver, please see the Case Management Agencies section.

Participants have the right to change case management agencies at any time; to facilitate a change the participant or their representative should contact the New Choices Waiver Program.

Helpful Links

Contact Information Utah Medicaid and Department of Workforce Services (DWS)

Concerns, Complaints, and Grievances

Participants of New Choices Waiver have the right to file a grievance by contacting the New Choices Waiver Program Office at 800-662-9651, option #6 (phones are staffed 9am-12pm on Monday, Wednesday, Thursday, and Friday), or by emailing [email protected].

The ability to file a grievance is accessible to all individuals, this includes individuals with disabilities and individuals with limited English proficiency, in accordance with §435.905. The following services are available:

• Medicaid Interpreter Services (embed link:https://medicaid.utah.gov/interpreter-services/)

• Utah Relay Services: 1-800-346-4128

• Interpreter Services: 1-866-608-9422

• Difficulty speaking, please  call: 1-888-346-5822

Individuals may also elect to contact Medicaid Constituent Services by calling 1-877-291-5583 or emailing:[email protected]. Please visit https://medicaid.utah.gov/concern-or-complaint/ for more information.

As you consider which case management agency you’d like to choose, keep in mind that all New Choices Waiver case management agencies are required to perform certain preset activities for each New Choices Waiver participant. Those include things like assessment of client’s needs, working with clients to develop person centered care plans to meet their assessed needs and to help achieve personal goals, performing at least once monthly monitoring, coordinating services, advocating for their clients and keeping accurate records.  However, case management agencies are private contracted organizations that are able to establish their own business hours, establish their own approach to how they will respond to urgent client situations, decide whether they will offer other programs or resources within their organization and determine which areas within the community-based system of care that they will choose to specialize in. For this reason it’s important to do a little research to know which agency is right for your own needs and preferences.

To receive a county specific Freedom of Choice Form contact the New Choices Waiver Program at (800) 662-9651, option 6 or [email protected]. Then begin reviewing agencies in your county by referring to their contact information below.

Case Management Agency Contacts

Abundant Solutions, LLC
991 Shepard Ln, Ste 210
Farmington, Utah 84025
(385) 393-6893
Email: [email protected]
Fax: (385) 316-8840

Adult Case Management
(385) 273-1456
Incident Report/Fax: (385) 273-1457
Email: [email protected]
https://adultcasemanagement.com/ opens in a new tab

Advocates for Independence
323 N Main Street, Suite 404
Tooele UT 84074
(801) 679-6461
Incident Report Fax: (801) 948-8001
http://www.advocatesforindependence.com opens in a new tab
Advocates for Independence Brochure opens in a new tab

Beehive Community Case Management
(801) 316-0046 or (385) 484-8464
Incident Report Fax: 1-385-474-8241
Beehive Community Case Management Brochure

Care Advocates
451 Bishop Federal Lane, Suite #150
SLC Utah 84115
(801) 722-4229
Incident Report Fax: (801) 702-8002
Care Advocates Brochure opens in a new tab

Davis County Health Department – Senior Services
22 South State
Clearfield, UT 84015
(801) 525-5050
Incident Report Fax: (801) 525-5071
http://www.daviscountyutah.gov/health/senior-services opens in a new tab
Davis County Health Department – Senior Services Brochure opens in a new tab

De Novo Case Management Services
(801) 960-3989
Incident ReportFax: (801) 991-2903
Incident Report Email: [email protected]
De Novo Services Case Management Brochure opens in a new tab

EnVision Quality Supports
6364 S. Highland Drive #201
Salt Lake City, UT 84121
(801) 209-1357
Incident Report Fax: (801) 874-1753
Incident Report Email: [email protected]
http://www.envisionquality.com opens in a new tab
EnVision Quality Supports Brochure opens in a new tab

Generations Case Management
(801) 979-2436
Incident Report Fax: (385) 389-3632
Email: [email protected]
https://generationscasemanagement.godaddysites.com/

MACS Plan
205 26th Street, Suite 12
Ogden, UT 84401
(801) 625-3786
Incident Report Fax: (801) 778-6818
Incident Report Email: [email protected]
MACS Plan Brochure opens in a new tab

Roads To Independence
3355 Washington Blvd.
Ogden, UT 84401
(801) 612-3215
(866) 734-5678 Toll Free
Incident Report Fax: (801) 612-3732
Incident Report Email: [email protected]
http://www.RoadsToIndependence.org opens in a new tab
Roads To Independence Brochure opens in a new tab

Salt Lake County Aging and Adult Services
2001 S. State Street #S1-600
Salt Lake City, UT 84114
(385) 468-3270
Incident Report Fax: (801) 487-6353
Incident Report Email: [email protected]
http://slco.org/aging-adult-services/ opens in a new tab
Salt Lake County Aging and Adult Services Brochure opens in a new tab

Southeastern Utah Association of Local Governments
375 S. Carbon Avenue
Price, UT 84501
(435) 613-0036
Incident Report Fax: (435) 637-5448
Southeastern Utah Association of Local Governments Brochure opens in a new tab

Utah Case Management
12760 S Park Avenue #520
Riverton UT 84065
(801) 407-0047
Incident Report Fax: (888) 400-9232
Incident Report Email: [email protected]
http://utahcasemanagement.com/ opens in a new tab
Utah Case Management Brochure opens in a new tab

Young at Heart Case Management 
P.O. Box 53
Hooper, UT 84315
(801) 358-6713 or (385) 580-8765
Incident Report Fax: (385) 390-0671
Young at Heart Case Management Brochure

All negative events experienced by NCW participants must be reported by NCW service providers to the participant’s case management agency within 24 hours of discovery. The list below includes examples of negative events that should be reported; this list is not all-inclusive.

Per the NCW Service Implementation Plan, the case management agency must notify the NCW Program Office of any negative events/incidents experienced by participants within 24 hours or on the first business day after the incident.

• Death, regardless of the circumstances
• Changes in medical or functional status
• Falls with or without injury
• ER treatment for any reason
• Hospital admission for any reason
• Mental health decline
• Start or stop of hospice or home health services
• A move to a skilled nursing facility
• Any negative event that occurs at the client’s place of residence or that occur while the client is in the community
• Events that rise to a comparable level as those described in the Incident Reporting Protocol brochure

Case management agencies must review all negative events experienced by NCW participants and report any possible critical incidents to the NCW Program within 24 hours of receiving notification.

The New Choices Waiver Program strongly encourages providers to contact the Program prior to submitting or validating PRISM records to verify all of the items needed. The Program can be reached at (801)538-6497 or email [email protected].

Enrollment

All New Choices Waiver providers must complete an Attachment B that corresponds to the New Choices Waiver service(s) that the provider is qualified to provide and intends to offer. If the provider plans to offer more than one New Choices Waiver service, the provider must complete a separate Attachment B for each of the distinct services. The final (signature) page of each Attachment B must be uploaded to PRISM.

For Adult Residential Services providers including assisted living facilities, independent living facilities, community residential treatment facilities and small health care (Type N) facilities, if your facility offers more than one level of care it is important to complete a separate Attachment B for each/all of the residential levels of care that you are licensed or certified to provide. (For example, a licensed ALF with a secure memory care unit should complete an Attachment B for ALF Type 1 & 2 and a separate Attachment B for ALF secure memory care. Another example, a licensed ALF (non-memory care) that has a certified independent living wing should complete an Attachment B for ALF Type 1 & 2 and a separate Attachment B for certified independent living.)

All Home and Community-Based Services (HCBS) Medicaid waiver providers must be compliant with the Settings Rule by March 2022.  As part of submitting an application providers are required to complete a Settings Rule self- attestation (based on setting); quiz and survey.  Please visit HCBS Settings Rule Transition Planning for more information.

Validation

For existing providers going through the validation process, it is very important that your PRISM provider profile matches existing New Choices Waiver provider enrollment records. Services that you have previously been approved for should be added under the “specialties'' section in PRISM if they are not already listed. Please verify that the counties of service selected are reflective of your current business operations. If your PRISM file does not align with previously approved services, or your agency is desiring to add additional services, your application may be returned for edit to ensure congruence in the records. If you need to verify which service(s) your agency has signed up to offer through New Choices Waiver, please return to your provider profile within the PRISM Portal and review this information in the section labeled “HCBS Waiver and EPAS.” An Attachment B must be submitted for each of the approved NCW services.

Contact Information

Email: [email protected]
From the Salt Lake City area: 801-538-6155, option 6
Outside the Salt Lake City area: 800-662-9651, option 6
(Phones are staffed 9:00am-12:00pm Monday, Wednesday, Thursday, and Friday. After these hours, there is the option to leave a voicemail which will be returned within a few business days)