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Home care programs · Vermont

Vermont home care programs

Vermont pays for care at home through 7 programs. Consumer-directed care is available through Attendant Services Program (ASP), Children's Personal Care Services (CPCS), and Choices for Care Self-Directed Services (Consumer-Directed, Surrogate-Directed, Flexible Choices). Family members can be paid caregivers in 3 of them.

Verified Oct 9, 2026Sources: official state and federal agencies

Every state
Programs
7
Consumer-directed
Yes
Family can be paid
Yes
Structured family caregiving
No
On this page
Programs

Every way Vermont pays for care at home

Vermont pays for care at home through 7 programs. Consumer-directed care is available through Attendant Services Program (ASP), Children's Personal Care Services (CPCS), and Choices for Care Self-Directed Services (Consumer-Directed, Surrogate-Directed, Flexible Choices). Family members can be paid caregivers in 3 of them.

ProgramTypeCan family be paidHow it differs
Home Health Services (Vermont Medicaid)State Plan home health (42 CFR 440.70); Global Commitment to Health 1115Home healthNoSkilled home health: nursing, therapy and aide visits under a plan of care from a licensed home health agency; run as an 1115 demonstration, paid fee-for-service.
Choices for Care Home-Based Services (agency directed) (CFC)1115 Global Commitment to Health (Choices for Care); Health Care Administrative Rule 7.102Agency personal careNot statedAgency personal care: non-medical daily help from aides a licensed agency employs; run as an 1115 demonstration, paid fee-for-service.
Attendant Services Program (ASP)Vermont Medicaid (Global Commitment) with a frozen General Fund componentConsumer-directedNot statedConsumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as state funds outside Medicaid, paid fee-for-service.
Children's Personal Care Services (CPCS)State Plan personal care with 1115 Global Commitment authority for legally responsible adult payments; Health Care Administrative Rule 4.233Consumer-directedYesConsumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as an 1115 demonstration, paid fee-for-service.
Choices for Care Self-Directed Services (Consumer-Directed, Surrogate-Directed, Flexible Choices)1115 Global Commitment to Health (Choices for Care); Rule 7.102Consumer-directedYesConsumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as an 1115 demonstration, paid fee-for-service.
Choices for Care Moderate Needs1115 Global Commitment to Health (Choices for Care); Rule 7.102Waiver in-homeNot statedWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as an 1115 demonstration, paid fee-for-service.
Adult Family Care (AFC)1115 Global Commitment to Health (Choices for Care); Rule 7.102Adult family careYesAdult family care: care in a family or foster home that is paid to house and help the person; run as an 1115 demonstration, paid fee-for-service.
Guide

Home health vs home care vs consumer-directed care in Vermont

What each kind of program is, who employs the caregiver and when a family member can be paid.

Home health: the medical benefit

In Vermont, skilled home health is Home Health Services (Vermont Medicaid). It is a medical benefit: a doctor or other practitioner orders nursing, therapy or home health aide visits under a written plan of care, and the visits stop when the skilled need ends.

Only a licensed home health agency enrolled with Vermont Medicaid can bill it, and the agency's own nurses, therapists and aides make the visits. Family members are not paid under this benefit.

Home care: non-medical personal care through an agency

Help with bathing, dressing, eating, toileting and household tasks is "home care" or personal care. In Vermont the agency route is Choices for Care Home-Based Services (agency directed) (CFC). No skilled need is required; the person qualifies on functional need, usually measured by an assessment of daily activities.

The agency recruits, trains, schedules and pays the aides, and it is the employer. The aide is agency staff rather than a relative.

Consumer-directed care: the person hires their own aide

Vermont's consumer-directed option is Attendant Services Program (ASP), Children's Personal Care Services (CPCS), and Choices for Care Self-Directed Services (Consumer-Directed, Surrogate-Directed, Flexible Choices). The person receiving care, or a representative, recruits, hires, trains, schedules and supervises the aide, and can let go of one. A fiscal intermediary runs payroll, taxes and background checks, so the person never handles wages directly.

This is the route most families use to be paid: Children's Personal Care Services (CPCS) and Choices for Care Self-Directed Services (Consumer-Directed, Surrogate-Directed, Flexible Choices) allow a relative to be hired as the paid aide. Which relatives qualify (adult children, parents of adults, spouses, legal guardians) and how a live-in caregiver is treated are set program by program.

Structured family caregiving: a paid live-in family caregiver

Vermont has no structured family caregiving program. A family caregiver is paid instead through consumer-directed care (Children's Personal Care Services (CPCS) and Choices for Care Self-Directed Services (Consumer-Directed, Surrogate-Directed, Flexible Choices)), by the hour, as the participant's chosen aide.

Other ways Vermont pays for care at home

Waiver in-home services: Choices for Care Moderate Needs. These pay for in-home supports for people who meet a nursing-home or similar level of care, often with more services than state plan personal care and, in some programs, a waiting list or enrollment cap.

Adult family care: Adult Family Care (AFC). The person lives in a family or foster home that is paid to provide housing and daily care.

Which one fits

  • Needs nursing, wound care, injections or therapy at home: home health (Home Health Services (Vermont Medicaid)).
  • Needs daily help and wants an agency to supply and manage the aide: Choices for Care Home-Based Services (agency directed) (CFC).
  • Wants to choose the aide, including a relative where allowed: Attendant Services Program (ASP), Children's Personal Care Services (CPCS), and Choices for Care Self-Directed Services (Consumer-Directed, Surrogate-Directed, Flexible Choices).
  • Meets nursing-home level of care and needs more than personal care: Choices for Care Moderate Needs.
In the workspace

Vermont program rules, side by side

Eligibility, the family caregiver rules (spouses, parents, live-in caregivers), employer of record, fiscal intermediary, caregiver training, provider requirements, how to enroll, published pay, EVV and waiting lists: 81 details across 7 programs.

ProgramFamily rulesEmployerEligibilityPay
See Vermont's program rules — start free

Who can be paid, who employs the caregiver, what each program requires of agencies and caregivers, how to become a provider and what it pays, for all 7 programs.

  • Family caregiver rules
  • Provider requirements
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Program by program

Vermont's programs

What each program is and how it differs from the others. Locked details open in the workspace.

Home Health Services (Vermont Medicaid)

Home health

State Plan home health (42 CFR 440.70); Global Commitment to Health 1115 · VT Department of Vermont Health Access (DVHA)

Skilled home health: nursing, therapy and aide visits under a plan of care from a licensed home health agency; run as an 1115 demonstration, paid fee-for-service.

Can family be paid?No
How to get set up
Provider track · 6 steps
  1. Get a Certificate of Need
  2. 5 more steps: forms, fees, timelines and links
Family / participant track · 3 steps
  1. Confirm Vermont Medicaid coverage
  2. 2 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredFamily caregiver rulesEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerEVVWaiting list or capManaged-care plansHow it differs, in detailSetup checklistUnlock the details →

Choices for Care Home-Based Services (agency directed) (CFC)

Agency personal care

1115 Global Commitment to Health (Choices for Care); Health Care Administrative Rule 7.102 · VT Department of Disabilities, Aging and Independent Living (DAIL)

Agency personal care: non-medical daily help from aides a licensed agency employs; run as an 1115 demonstration, paid fee-for-service.

Can family be paid?Not stated
How to get set up
Provider track · 8 steps
  1. Apply for DAIL home care approval
  2. 7 more steps: forms, fees, timelines and links
Family / participant track · 8 steps
  1. Apply for long-term care Medicaid
  2. 7 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerEVVWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

Attendant Services Program (ASP)

Consumer-directed

Vermont Medicaid (Global Commitment) with a frozen General Fund component · VT DAIL Adult Services Division

Consumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as state funds outside Medicaid, paid fee-for-service.

Can family be paid?Not stated
How to get set up
Provider track · 1 step
  1. Payroll runs through ARIS
Family / participant track · 4 steps
  1. Submit Attendant Services application
  2. 3 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredEmployer of recordFiscal intermediaryProvider requirementsHow to become a providerEVVWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

Children's Personal Care Services (CPCS)

Consumer-directed

State Plan personal care with 1115 Global Commitment authority for legally responsible adult payments; Health Care Administrative Rule 4.233 · VT Department of Health, Children with Special Health Needs

Consumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as an 1115 demonstration, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 2 steps
  1. Designated agencies provide trained assessors
  2. 1 more step: forms, fees, timelines and links
Family / participant track · 6 steps
  1. Confirm Medicaid and functional need
  2. 5 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsProvider requirementsHow to become a providerPay rateEVVWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

Choices for Care Self-Directed Services (Consumer-Directed, Surrogate-Directed, Flexible Choices)

Consumer-directed

1115 Global Commitment to Health (Choices for Care); Rule 7.102 · VT DAIL

Consumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as an 1115 demonstration, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 2 steps
  1. State uses single F/EA, ARIS
  2. 1 more step: forms, fees, timelines and links
Family / participant track · 11 steps
  1. Apply for long-term care Medicaid
  2. 10 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsProvider requirementsHow to become a providerPay rateEVVWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

Choices for Care Moderate Needs

Waiver in-home

1115 Global Commitment to Health (Choices for Care); Rule 7.102 · VT DAIL with local Moderate Needs providers

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as an 1115 demonstration, paid fee-for-service.

Can family be paid?Not stated
How to get set up
Provider track · 4 steps
  1. Get DAIL Choices for Care approval
  2. 3 more steps: forms, fees, timelines and links
Family / participant track · 4 steps
  1. Apply to local Moderate Needs provider
  2. 3 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredEmployer of recordProvider requirementsHow to become a providerWaiting list or capHow it differs, in detailSetup checklistUnlock the details →

Adult Family Care (AFC)

Adult family care

1115 Global Commitment to Health (Choices for Care); Rule 7.102 · VT DAIL

Adult family care: care in a family or foster home that is paid to house and help the person; run as an 1115 demonstration, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 6 steps
  1. Confirm eligible agency type
  2. 5 more steps: forms, fees, timelines and links
Family / participant track · 8 steps
  1. Apply for long-term care Medicaid
  2. 7 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerPay rateWaiting list or capHow it differs, in detailSetup checklistUnlock the details →
FAQ

Frequently asked questions

Can family members get paid to be caregivers in Vermont?

Yes. Children's Personal Care Services (CPCS), Choices for Care Self-Directed Services (Consumer-Directed, Surrogate-Directed, Flexible Choices), and Adult Family Care (AFC) let a family member be the paid caregiver. Which relatives qualify, including spouses and parents of minor children, is set program by program.

Does Vermont have consumer-directed care?

Yes: Attendant Services Program (ASP), Children's Personal Care Services (CPCS), and Choices for Care Self-Directed Services (Consumer-Directed, Surrogate-Directed, Flexible Choices). The person receiving care hires and directs their own aide, and a fiscal intermediary handles payroll.

Does Vermont have structured family caregiving?

No. Vermont does not run a structured family caregiving program. Family caregivers are paid through consumer-directed care instead.

What is the difference between home health and home care in Vermont?

Home health (Home Health Services (Vermont Medicaid)) is medical: nursing, therapy and aide visits ordered by a practitioner and delivered by a licensed home health agency. Home care (Choices for Care Home-Based Services (agency directed) (CFC)) is non-medical help with daily activities, based on functional need.

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