<section number="26B-3-222"><effdate>5/6/2026</effdate><histories><history>Amended by Chapter <modchap sess="2026GS">155</modchap>, 2026 General Session</history><modyear>2026</modyear></histories><catchline>Medicaid waiver expansion for extraordinary care reimbursement.</catchline><subsection number="26B-3-222(1)">As used in this section:<subsection number="26B-3-222(1)(a)">"Existing home and community-based services waiver" means an existing home and community-based services waiver in the state that serves an individual:<subsection number="26B-3-222(1)(a)(i)">with an acquired brain injury;</subsection><subsection number="26B-3-222(1)(a)(ii)">with an intellectual or physical disability; or</subsection><subsection number="26B-3-222(1)(a)(iii)">who is 65 years old or older.</subsection></subsection><subsection number="26B-3-222(1)(b)">"Guardian" means a person appointed by a court to manage the affairs of a living individual.</subsection><subsection number="26B-3-222(1)(c)">"Parent" means:<subsection number="26B-3-222(1)(c)(i)">an individual who has a parent-child relationship, as defined in Section <xref depth="3" refnumber="81-5-102">81-5-102</xref>, with the other individual; or</subsection><subsection number="26B-3-222(1)(c)(ii)">a step-parent of the individual.</subsection></subsection><subsection number="26B-3-222(1)(d)">"Personal care services" means a service that:<subsection number="26B-3-222(1)(d)(i)">is furnished to an individual who is not an inpatient nor a resident of a hospital, nursing facility, intermediate care facility, or institution for mental diseases;</subsection><subsection number="26B-3-222(1)(d)(ii)">is authorized for an individual described in Subsection <xref depth="4" refnumber="26B-3-222(1)(d)(i)">(1)(d)(i)</xref> in accordance with a plan of treatment;</subsection><subsection number="26B-3-222(1)(d)(iii)">is provided by an individual who is qualified to provide the services; and</subsection><subsection number="26B-3-222(1)(d)(iv)">is furnished in a home or another community-based setting.</subsection></subsection><subsection number="26B-3-222(1)(e)">"Waiver enrollee" means an individual who is enrolled in an existing home and community-based services waiver.</subsection></subsection><subsection number="26B-3-222(2)">Before July 1, 2021, the department shall apply with CMS for an amendment to an existing home and community-based services waiver to implement a program to offer reimbursement to an individual who provides personal care services that constitute extraordinary care to a waiver enrollee who is the individual's spouse.</subsection><subsection number="26B-3-222(3)">If CMS approves the amendment described in Subsection <xref depth="4" refnumber="26B-3-222(2)">(2)</xref>, the department shall implement the program described in Subsection <xref depth="4" refnumber="26B-3-222(2)">(2)</xref>.</subsection><subsection number="26B-3-222(4)">The department shall by rule, made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, define "extraordinary care" for purposes of Subsection <xref depth="4" refnumber="26B-3-222(2)">(2)</xref>.</subsection><subsection number="26B-3-222(5)">Before July 1, 2023, the department shall apply with CMS for an amendment to an existing home and community-based services waiver to implement a program to offer reimbursement to an individual who provides personal care services that constitute extraordinary care to a waiver enrollee to whom the individual is a parent or guardian.</subsection><subsection number="26B-3-222(6)">If CMS approves the amendment described in Subsection <xref depth="4" refnumber="26B-3-222(5)">(5)</xref>, the department shall implement the program described in Subsection <xref depth="4" refnumber="26B-3-222(5)">(5)</xref>.</subsection><subsection number="26B-3-222(7)">The department shall by rule, made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, define "extraordinary care" for purposes of Subsection <xref depth="4" refnumber="26B-3-222(5)">(5)</xref>.</subsection></section>