Medically Complex Children’s Waiver

Purpose

(The Medically Complex Children’s Waiver (MCCW) is designed to offer supportive services to the parents and caregivers of medically complex children who meet the waiver eligibility criteria. MCCW allows program participants to access Medicaid services, assisting them to live as independently and productively as possible within their communities.

The Utah Department of Health and Human Services (DHHS) is accepting applications on an on-going basis for the MCCW. MCCW is funded to provide services to approximately 900 children. All applications received, that meet MCCW criteria, will be placed on a waitlist. As spots become available, applicants will be enrolled based on highest confirmed acuity score.

Applications can be submitted online, by fax or by mail. Please note, when submitting an online application, please allow enough time to complete it once it has been started.

Eligibility Requirements

In order to qualify a child must meet ALL the following criteria:

  • Be 18 years old or younger
  • Have 3 or more separate specialty physicians (MD or DO) in addition to their primary care provider; seen within the last 24 months. Example: Neurologist, Cardiologist, Pulmonologist, etc. *Multiple providers within the same specialty will count as one specialty
  • Have medical complexity that involves 3 or more organ systems
  • Children who are not meeting age-appropriate milestones for their activities of daily living; this includes eating, toileting, dressing, bathing and mobility
  • Meet minimum medical score by demonstrating a level of medical complexity based on a combination of need for device-based supports, high utilization of medical therapies, and treatments and frequent need for medical intervention
  • Children who have an SSI Disability Designation through the SSA or a disability determination by the State Medical Review Board, this will be coordinated as part of the MCCW application process

Services

  • Traditional Medicaid State plan benefits
  • RN Case Management
  • Skilled Nursing Respite Care
  • Routine Respite Care
  • Personal Attendant Services
  • Financial Management Services

MCCW program participants receive 13 hours a month in respite care services.

To apply for MCCW, please click HERE.

Answers to frequently asked questions about the application process and other program details are available at: FAQ Sheet (Español) | FAQ Sheet (English)