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Assistive Community Care Services (ACCS) program is an option for Vermont residents who are currently enrolled in the community Medicaid program and are residing in or are moving into Level III, assisted living facilities and residential care homes. Functionally, these individuals cannot reside independently in their homes, but they do not require the level of care typically provided in nursing homes. By helping participants remain in assisted living, the state can avoid more expensive nursing home care. Through the ACCS program, eligible applicants are provided personal care service, routine nursing services, medication monitoring, and other benefits in Medicaid-approved, residential care homes and assisted living homes.
The services available through the ACCS program can be accessed via Community Medicaid and is an entitlement if an individual is enrolled in Medicaid. (In Vermont, the Medicaid program is also referred to as Green Mountain Care). ACCS services are also available via Long Term Care Medicaid such as Choices for Care (CFC), which as of January 31, 2015, consolidated with the Vermont Global Commitment to Health Waiver.
The ACCS program is administered by the Vermont Department of Disabilities, Aging and Independent Living.
To be eligible for the ACCS program, applicants must be Vermont residents who are 65 years of age or older, or over the age of 18 and be disabled. They must require the services provided by this program and reside in a Level III, assisted living facility or residential care home that is an approved Medicaid provider for this program.
There are also income and asset requirements, which are the same as for the Community Medicaid program. As of 2017, the allowable Protected Income Level (PIL) for a single individual living inside Chittenden County is $1,083 per month. For those living outside of Chittenden County the PIL is slightly lower at $1,008 per month. The asset limit, which refers to liquid assets, such as bank accounts, stocks, and bonds, is $2,000 for a single applicant.
The value of one’s home is not included in their countable assets, if the owner resides in the home. Since this program is for persons in assisted living, they cannot also reside in their home and therefore their home would be counted towards the asset limit. However, should the program participant have a spouse who remains living in the home, then the home would be exempt and not counted towards the asset limit should the value of the home’s equity not be greater than $560,000.
It’s important to note that those who have a monthly income in excess of the PIL, yet still cannot afford the full cost of care, may still be eligible for Medicaid and ACCS by utilizing what is called an income spend-down. Medical bills and other care expenses can go towards meeting the spend-down. For example, let’s take an individual who lives in Chittenden County, resides in an approved Medicaid provider home, and has a monthly income of $1,200. Since the PIL inside of Chittenden County is $1,083, the individual has a monthly income that is $117 in excess of the PIL. In this case, once the individual pays $117 towards medical costs and ACCS services, Medicaid will kick in the remainder.
The above information is current for 2017 as of January. A cost of living increase is expected in April or May of 2017 which may impact these numbers by 1%-2%.
It’s important to note, ACCS does not cover the cost of room and board. However, individuals are entitled to a monthly personal needs allowance of $65. With ACCS, consumer direction of services is not available.
For additional information on the ACCS program, download the Vermont Department of Disabilities, Aging and Independent Living brochure.
If an individual is not currently on Medicaid, they first need to apply for Medicaid. One’s local Area Agency on Aging office can assist in applying for Medicaid. If you are not eligible for Medicaid, one might consider working with a Medicaid planner to gain eligibility.
Those persons already on Medicaid should contact their local Agency of Human Services office to apply for this program.
To see which Level III assisted living / residential homes are in your area, click here.