Health and Human Services

Services for People with Disabilities

Rule 5: Self-Administered Services

Effective Date: 06/16/2026

Admin. Code Reference: R539-5

Rule Type: Current Rule

NOTICE OF SUBSTANTIVE CHANGE

TYPE OF FILING: Amendment

Rule or section number:

R539-5

Filing ID: 57819

Agency Information

1. Title catchline:

Health and Human Services, Services for People with Disabilities

Building:

Cannon Health Building

Street address:

288 N 1460 W

City, state:

Salt Lake City, UT

Mailing address:

PO Box 145145

City, state and zip:

Salt Lake City, UT 84114-5145

Contact persons:

Name:

Phone:

Email:

Bruce Quaglia

435-669-4855

bquaglia@utah.gov

Mariah Noble

385-214-1150

mariahnoble@utah.gov

Please address questions regarding information on this notice to the persons listed above.

General Information

2. Rule or section catchline:

R539-5. Self-Administered Services

4. Purpose of the new rule or reason for the change:

Upon internal review, the Division of Services for People with Disabilities (division) determined that it is necessary to update this rule to clarify that the review processes for receiving public funds through the self-administered services (SAS) model includes the possibility of an audit by the Department of Health and Human Services (department).

Additionally, the division determined it is appropriate to restrict SAS employees from using intrusive behavior intervention because SAS employees are not required to be trained on this type of intervention.

5. Summary of the new rule or change:

This filing adds Subsection R539-5(7) to restrict SAS employees from using intrusive behavior intervention.

This filing updates Subsection R539-5-7(2) to reformat the wording to be more consistent with other rules and comply with the Rulewriting Manual for Utah.

Finally, this filing adds language to Subsection R539-5-7(6) to specify that the department may audit any person who receives services through SAS.

Fiscal Information

6. Provide an estimate and written explanation of the aggregate anticipated cost or savings to:

A. State budget:

There is no anticipated fiscal impact to the state budget as a result of this filing because it is not the practice of SAS employees to use intrusive behavior intervention, so adding the restriction that SAS employees are not allowed to use this type of intervention does not alter existing practices.

Additionally, state employees already complete reviews of public funds disbursed through the SAS model, so adding clarifying language to this rule that an audit may occur does not change the current process.

Through the review process, individuals who fail to meet requirements may be required to pay back state funds, but that requirement is also already part of the process without this filing.

B. Local governments:

There is no anticipated fiscal impact to local governments because local governments do not interface with division programming.

C. Small businesses ("small business" means a business employing 1-49 persons):

There is no anticipated fiscal impact to small businesses because it is not the practice of SAS employees to use intrusive behavior intervention, so adding the restriction that SAS employees are not allowed to use this type of intervention does not alter existing practices.

Through the review process, individuals who fail to meet requirements may be required to pay back state funds, but that requirement is also already part of the process without this filing.

D. Non-small businesses ("non-small business" means a business employing 50 or more persons):

There is no anticipated fiscal impact to non-small businesses because a SAS agreement is only between an employer, who is the person in services, and the individuals they hire to train and provide services.

The division is unaware of any SAS services registered as non-small businesses.

As such, this rule does not apply to any non-small business.

E. Persons other than small businesses, non-small businesses, state, or local government entities ("person" means any individual, partnership, corporation, association, governmental entity, or public or private organization of any character other than an agency):

There is no anticipated fiscal impact to other persons because it is not the practice of SAS employees to use intrusive behavior intervention, so adding the restriction that SAS employees are not allowed to use this type of intervention does not alter existing practices.

Through the review process, individuals who fail to meet requirements may be required to pay back state funds, but that requirement is also already part of the process without this filing.

F. Compliance costs for affected persons:

There are no anticipated compliance costs for affected persons, as there were no identified costs for any party as a result of this filing.

It is not the practice of SAS employees to use intrusive behavior intervention, so adding the restriction that SAS employees are not allowed to use this type of intervention does not alter existing practices.

Through the review process, individuals who fail to meet requirements may be required to pay back state funds, but that requirement is also already part of the process without this filing.

G. Regulatory Impact Summary Table (This table includes only fiscal impacts the agency was able to measure. If the agency could not estimate an impact, it is excluded from this table but described in boxes A through F.)

Regulatory Impact Summary Table

Fiscal Cost

FY2026

FY2027

FY2028

FY2029

FY2030

State Budget

Local Governments

Small Businesses

Non-Small Businesses

Other Persons

Total Fiscal Cost

Fiscal Benefits

FY2026

FY2027

FY2028

FY2029

FY2030

State Budget

Local Governments

Small Businesses

Non-Small Businesses

Other Persons

Total Fiscal Benefits

Net Fiscal Benefits

H. Department head comments on fiscal impact and approval of regulatory impact analysis:

The Executive Director of the Department of Health and Human Services, Tracy S. Gruber, has reviewed and approved this regulatory impact analysis.

Citation Information

7. Provide citations to the statutory authority for the rule. If there is also a federal requirement for the rule, provide a citation to that requirement:

Section 26B-6-403

Public Notice Information

9. The public may submit written or oral comments to the agency identified in box 1.

A. Comments will be accepted until:

04/14/2026

10. This rule change MAY become effective on:

04/21/2026

NOTE: The date above is the date the agency anticipates making the rule or its changes effective. It is NOT the effective date.

Agency Authorization Information

Agency head or

designee and title:

Tracy S. Gruber, Executive Director

Date:

02/25/2026

R539. Health and Human Services, Services for People with Disabilities.

R539-5. Self-Administered Services.

R539-5-1. Authority and Purpose.

(1) Section 26B-6-403 authorizes this rule.

(2) This rule establishes a procedure and a standard for a person participating in the self-administered services (SAS) delivery model.

R539-5-2. Definitions.

Terms used in this rule are the same as defined in Rule R539-13. Additionally:

(1) "Division of Archives and Records Service" means the state agency that preserves and manages Utah government records under the Department of Government Operations.

(2) "Monthly summary" means documentation submitted to the support coordinator by the SAS employer summarizing the services delivered to the person.

R539-5-3. Requirements for Participation in Self-Administered Services (SAS).

(1) A person shall obtain authorization from the division to participate in the SAS program.

(2) A support coordinator shall validate annually that the person satisfies each participation requirement to continue in the self-administered services program.

(3) After the division determines the amount of the person-centered budget through the RFS process, a[n] SAS employee may be hired by

the SAS employer to provide support services consistent with the authorized budget amount, frequency, and duration identified in the person's PCSP.

(4) The person or the person's guardian shall:

(a) designate an individual to act as the SAS employer;

(b) ensure that the SAS employer adheres to the terms of the SAS employer agreement; and

R539-5-4. SAS Employer Requirements.

(1) The SAS employer:

(a) may not simultaneously be the SAS employee;

(b) shall adhere to Rule R380-80;

(d) shall adhere to the terms of the person's PCSP;

(e) shall sign and adhere to the terms of the person's SAS employer agreement; and

(f) shall ensure that any services provided conform to current service code descriptions.

(i) The SAS service code descriptions are found on the division's website.

(ii) The division shall communicate SAS service code description changes to a fiscal agent before the implementation of the change.

(iii) A fiscal agent shall communicate SAS service code description changes to SAS employers and SAS employees before the implementation of the change.

(2) The SAS employer shall maintain each record about the SAS employee, SAS employer, and person in accordance with retention schedules established by the division and available through the Division of Archives and Records Service.

(3) The SAS employer shall ensure that division, department, and state or federal auditors have immediate access to any record about the SAS employee, SAS employer, and person, upon request.

(4) The SAS employer shall use a fiscal agent contracted with the division and shall provide the fiscal agent with any requested documentation for each SAS employee.

(5) The SAS employer shall submit a written monthly summary to the support coordinator by the 15th day of the following month.

(6) The SAS employer may not approve billing for a[n] SAS employee providing more than 40 hours of services per week unless a form 2-

9OT has been submitted and approved through the RFS process.

(7) The SAS employer shall ensure that the person approves the hiring of any SAS employee.

R539-5-5. SAS Employee Requirements.

(1)(a) A[n] SAS employee shall be 16 years of age or older.

(b) A[n] SAS employee who is younger than 18 years of age:

(i) shall have the SAS employee agreement co-signed by the SAS employee's parent or guardian; and

(ii) may not transport the person.

(2) A[n] SAS employee:

(a) shall adhere to Rule R380-80;

(b) shall adhere to the DHHS Critical Incident Reporting Guide;

(d) shall ensure that any services provided conform to current service code descriptions; and

(e)(i) shall sign and adhere to the terms of the person's SAS employee agreement.

(ii) If the SAS employee fails to complete and sign the SAS employee agreement or adhere to the terms and requirements of the agreement, the fiscal agent may not approve payment to the SAS employee.

(3) A[n] SAS employee shall be capable of providing the services for which they have been hired.

(4) A[n] SAS employee may provide a personal care service as described in Section 26B-3-222.

(5) The SAS employee may not simultaneously be the SAS employer.

(6) Any service provided must be included in the PCSP.

(7) A SAS employee may not engage in intrusive behavior intervention, as described in Section R539-4-6.

R539-5-6. SAS Division Requirements and Limitations.

(1) A person may not exceed the budget limit in the person's person-centered budget.

(2)(a) The division director may authorize the revised budget limit if the director determines there is no other available delivery method that will appropriately meet the person's needs and circumstances.

(b) The review must include the following information provided by the support coordinator from the perspective of the person's person-centered planning team:

(i) a brief summary of the person's situation and the need for the high level of SAS;

(ii) demonstration of how changing from the SAS delivery model to the provider-based services delivery model would negatively impact the person mentally, emotionally, or physically, resulting in either regression or increased behaviors affecting the health and safety of the person and others;

(iii) demonstration of how this service would be a better fit to utilize SAS instead of out-of-home placement;

(iv) evidence that it is not possible to use a provider; and

(v) information that describes how this service would:

(A) improve the person's behaviors or progress;

(B) positively impact the person's ambition, independence, or socialization; or

R539-5-7. Review Process, Recovery of Funds, and Penalties.

(1)(a) Funds for self-administered services are public funds that are appropriated to, and approved by, the division.

(b) Funds are for the delivery of services for the person during the approved period and for the purposes stipulated in service code descriptions.

(c) Public funds are subject to applicable federal, state, and local laws and regulations pertaining to the use of public funds.

(2) The division may require the person to use a contracted provider if the SAS employer has violated any law, rule, or SAS employer or

employee agreement.[fails to meet a requirement in:

(a) federal or state law or rule;

(b) the SAS employee agreement; or

(3) The support coordinator shall review any billing quarterly to ensure that, for each service, no duplication of a service, fraud, or overlap of submitted timesheets has occurred for SAS and provider-based services.

(4) The misuse of any funds provided for a purpose other than those in the service description may subject the caregiver and contracted provider, if applicable, to administrative sanctions, criminal prosecution, or liability for repayment of the misused funds.

(5) For any findings of duplication of services, erroneous timesheet submissions, or exceeding the amount of service authorized in the person's person-centered budget, the department:

(a) shall recover any associated fund; and

(b) may make a referral to the Utah Office of Inspector General and the Medicaid Fraud Control Unit if waste, fraud, or abuse of funds is suspected.

(6) The department may audit any person who receives services through the SAS delivery model.

KEY: disabilities, self-administered services

Date of Last Change: [July 23, 2025]2026

Notice of Continuation: June 24, 2024

Authorizing, and Implemented or Interpreted Law: 26B-6-402; 26B-6-403

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