The Vermont Adult Day Services program is for seniors over the age of 65, as well as for those 18 years of age and older with a cognitive or physical disability. Adult Day Services is often referred to as Adult Day Care or Adult Day Health, or in Medicaid-speak, Day Health Rehabilitation Services. This program is intended to help individuals continue to live in the community at large, rather than require institutionalization, such as nursing home care. This is achieved by providing daytime supervision and assistance with Activities of Daily Living (ADL), recreational and therapeutic activities, and meals in approved, nonresidential, adult day care centers. The Adult Day Services program also offers respite to relieve primary caregivers of their caregiving duties.
While the adult day care facilities are private entities, the Adult Services Division (ASD) of the Vermont Department of Disabilities, Aging & Independent Living, certifies them. ASD is under the Vermont Agency of Human Services (AHC).
To be eligible for the Vermont Adult Day Services program, individuals must be residents of Vermont who are at least 65 years old, or are a minimum of 18 years of age and disabled. Disabilities can include chronic conditions such as COPD, diabetes, Alzheimer’s and other dementias. Since all the Adult Day Service providers are private entities, each facility is responsible for establishing their own eligibility criteria. Therefore, further criteria may differ based on the provider, such as the amount of assistance an applicant requires.
To have Adult Day Services covered by Medicaid, also called Green Mountain Care in Vermont, one must be eligible for the Choices for Care or Community Medicaid. Community Medicaid requirements are largely financial in nature and vary depending on the applicant’s age and marital status. For individuals age 65 or older, a one-person or two-person household can have to $1,166 in monthly income. There is one exception, which is for those residing in Chittenden County. Here, a one-person or two-person household can have a higher monthly income limit of $1,266. (These are the current limits as of 2022).
A countable asset limit also exists for persons 65 and older. Single applicants are allowed combined assets valued at no greater than $2,000, while married applicants can have up to $3,000. However, many common assets are exempt from that figure, including one’s home (with an equity interest value up to $636,000 in 2022), a car, home furnishings, personal items, and burial plots or burial insurance. Past asset transfers are also considered to ensure an applicant has not given away assets for the sake of qualifying for Medicaid. This is called the Medicaid Look-Back Period, and if one is found to be in violation of this 5-year period, one may be ineligible for Medicaid for a given length of time.
Persons unsure of their eligibility status may find greater clarification here.
Persons over the financial eligibility limits above need not be discouraged. Professional Medicaid planners are skilled in restructuring finances to enable persons to financially qualify for Medicaid. Learn more here.
Adult Day Services offers a wide variety of services, which may vary by location. These include nursing services, such as checking vital signs, medication management, activities to improve physical and cognitive functioning, activities to foster socialization, assistance with personal care, such as grooming and toiletry, snacks and meals, health education, and respite care. Transportation to and from the adult day care center may also be provided.