Updated September 4, 2026. Quick answer: yes, through Self-Administered Services (SAS) model and Employment-related Personal Assistant Services (EPAS). Most adult family members can be hired and paid to provide the care. A spouse cannot be the paid caregiver; the federal rule against paying a “legally responsible relative” still applies here.
How Utah pays a family caregiver
| Program | Self-Administered Services (SAS) model and Employment-related Personal Assistant Services (EPAS) |
|---|---|
| Can a family member be paid? | Yes. “Examples of people who can be Personal Assistants include: Parents (If the EPAS participant is at least 18 years of age), Family, Friends, Neighbors, Co-workers, Individual hired through an ad” |
| Can a spouse be paid? | No. “A Personal Assistant: May NOT be a legal guardian (i.e. Parent to a minor child or Spouse)” |
Why the spouse question is different
Federal Medicaid rule treats a spouse (and a parent paying for a minor child) as a “legally responsible relative”, someone already assumed to owe the care for free, so paying them is barred by default. A state has to build an explicit exception into its waiver or state-plan option to pay a spouse at all; the rule for any other relative (an adult child, a sibling, a grandchild) is looser and usually allowed. That is why the two rows above can carry different answers on the same page.
The going rate
Not published by the state in the materials reviewed this session.
How it works
A waiver participant who chooses the Self-Administered Services model, or a working individual enrolled in EPAS, becomes the direct employer of their own personal assistant. A financial management/fiscal agent processes payroll, employer payroll taxes, and workers’ compensation on top of the negotiated hourly wage, while the participant recruits and directs the assistant, who can be a parent, sibling, adult child, friend, or other non-guardian relative, but not the participant’s own spouse or legal guardian.
What this doesn’t answer
Utah’s Aging Waiver provider manual describes the Self-Administered Services model and gives a payroll-tax example using a hypothetical wage, but that is only an illustration, not a published rate, and the manual does not separately restate a spousal exclusion the way the EPAS program page does. A 2015 New Choices Waiver amendment document also referenced removing legally responsible person as an allowed provider for Homemaker and Respite services, consistent with a general spousal restriction, but the full current policy language could not be located in the excerpts read this session, so the spouse answer here relies on the EPAS page rather than a waiver-specific statement.
Sources
- Utah Medicaid: Employment-related Personal Assistant Services (EPAS)
- Utah Medicaid Provider Manual: Home and Community-Based Waiver Services for Individuals Aged 65 and Over (Aging Waiver), updated April 2022
Read September 4, 2026.
Same question, other states: Vermont · Virginia.
Related: the private-pay caregiver-agreement rule · the household-employee tax rules once you’re being paid · what family caregiving actually costs unpaid.
General information drawn from each state’s own Medicaid agency and public program materials, not legal, tax or financial advice. Medicaid self-direction programs are administered state by state and change by budget cycle and waiver renewal; this page cannot see your own state’s current program status or your family’s eligibility. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.