Vermont Medicaid’s Attendant Services Program

Program Description

This program is designed for disabled, Vermont residents that require assistance to manage their activities of daily living.  Policymakers designed it to help persons remain living in their homes and avoid institutional (nursing home) placement.  The participant is responsible for hiring, training and managing their own care providers and receives financial assistance to pay for that care.  This type of program is also referred to as consumer-direction or Cash and Counseling

As mentioned, the program is intended to help participants avoid nursing home placements. However, this does not mean the participants must living at home.  The programs regulations allow for participants to reside in group living environment such as adult foster care homes and certain licensed assisted living residences. 

Under Vermont's Attendant Services, participants can hire and compensate certain family members as caregivers. 

Friends, neighbors and family members can be hired to provide attendant care services. This means the adult children of aging parents that require assistance can be paid to be caregivers. However, spouses and civil union partners are excluded for being paid in this program. Caregivers are paid a Medicaid-approved hourly rate which is estimated at somewhere between $14 - $18.

To help avoid confusion, it is worth noting that there are the three possible funding sources for the Attendant Services Program and the name of the program changes slightly depending on the source. One might find the program referred to as General Fund Participant Directed Attendant Care (PDAC), Medicaid PDAC or General Fund Personal Services.


Eligibility Guidelines

The eligibility requirements for this program vary slightly depending on which source of funding is used. Regardless of funding source, program participants must meet functional and financial requirements. Functionally, persons must have a disability and require assistance managing at least two of their activities of daily living.

Financially, persons must be eligible for Vermont Medicaid (Green Mountain Care) or nearly eligible. Both income and assets are considered. As of early 2017, single applicants must have less than the allowed Protected Income Level (PIL) of $1008 per month (or $1083 in Chittenden county). They are permitted up to $2,000 in countable resources. Worth noting is that one's home and vehicle can be excluded from the countable resource calculation.

Married couples with a single Medicaid applicant are subject to different rules. The non-applicant spouse is allowed to retain up to $120,900 in countable assets. This is referred to as the Community Spouse Resource Allowance or CSRA. Jointly held assets can be claimed by the non-applicant spouse thereby reducing the applicant's countable resources.

There are many exceptions to the income and asset limits. Working with a professional Medicaid Planner can help individuals structure their income and assets using trusts to ensure their eligibility for the Attendant Services Program.   More information.


Benefits and Services

This program provides self-directed, personal assistance with the activities and instrumental activities of daily living.  All of the following activities are possible though not everyone will be approved to receive assistance with each of them.  

  • Bathing
  • Dressing
  • Grooming
  • Eating
  • Mobility Assistance
  • Meal Preparation
  • Meal Planning
  • Medication Administration
  • Housekeeping
  • Laundry
  • Shopping for Groceries and Essentials


How to Apply / Learn More

One can learn more about the program and download an application from the Vermont Department of Disabilities, Aging & Independent Living webpage. Alternatively, an Attendant Services Program representative can be reached at the following number: (802) 871-3043.  The program's regulations are available here, but be forewarned these are not written for a consumer audience.  One can also download an application.

 Did You Know? Vermont ranks second in the nation as the healthiest state for aging.   A survey considered 35 different criteria and only Minnesota came out above the Green Mountain State.