The Assistive Community Care Services (ACCS) program is an option for Vermont residents who are currently enrolled in a Community Medicaid program and are residing in or are moving into a Level III assisted living facility or residential care home. 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 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 at least 18 years old and 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 2023, the allowable Protected Income Level (PIL) for a single individual living inside Chittenden County is $1,358 per month. For those living outside of Chittenden County, the PIL is slightly lower at $1,258 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 an applicant’s countable assets, given the program participant has “intent” to return to the home or has a spouse or dependent who remains living in the home. However, should the program participant not have a spouse or dependent who lives in the home, the Medicaid applicant’s equity interest in the home must be less than $688,000. Other exempt assets include personal effects, such as clothing and a wedding ring, and pre-paid funeral / burial plans.
For those who exceed the asset limit, giving away assets or selling them under fair market value is not a viable solution to reach Medicaid’s asset limit. Doing so may violate Medicaid’s Look-Back Period (a 5-year stretch of time) and may result in a period of Medicaid ineligibility. For those with greater assets than Medicaid allows, consulting a Medicaid Planning Professional is highly advised, as they can help reallocate assets in order to help one become eligible without violating regulations.
It’s important to note that those who have a monthly income in excess of the PIL yet still cannot afford their 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 toward meeting the spend-down.
The following benefits are available through the ACCS program:
It’s important to note that ACCS does not cover the cost of room and board. However, individuals are entitled to a monthly personal needs allowance, also referred to as a minimum personal spending amount. 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 PDF.
Individuals not currently on Medicaid need to first apply for Medicaid. One’s local Area Agency on Aging office can assist one in applying for Medicaid. Those not eligible for Medicaid should 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.