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Choices For Care (1115 Long-Term Care Medicaid Waiver)

  • Choices for Care is a Medicaid-funded, long-term care program to pay for care and support for older Vermonters and people with physical disabilities. The program assists people with everyday activities at home, in an enhanced residential care setting, or in a nursing facility.

Support includes hands-on assistance with eating, bathing, toilet use, dressing, and transferring from bed to chair; assistance with tasks such as meal preparation, household chores, and medication management and increasing or maintaining independence.

A second program is for Moderate Needs individuals who need minimal assistance to remain at home. This program offers limited case management, adult day services, and/or homemaker service.




Programs Include

The list below represents the Program options available under the Choices for Care (1115 Long-Term Care Medicaid Waiver). To find out more information on each program and how you can receive needed services click on the Program title.

  • Adult Family Care
    Adult Family Care is a new Home and Community Based Service option for Vermont’s Long-Term Care Medicaid Choices for Care (CFC) Program.
  • Attendant Services Program 
  • The Attendant Services Program supports independent living for adults with disabilities who need physical assistance with daily activities. This is a "Consumer Directed Personal Care" Program. Program participants hire, train, supervise, and schedule their personal care attendant(s). The program participant is the employer, and the attendant's hourly wage is funded by the program.
  • Flexible Choices
    Flexible Choices allows people to convert their plans of care for home-based services into a dollar-equivalent allowance.
  • Enhanced Residential Care (ERC)
    Services are provided in authorized licensed Level III Residential Care Facilities and Assisted Living Residences to people whose needs are greater than what is regularly available in these homes.


Information on Related Programs


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Services Include

Choices for Care offers the following services:

  • Case Management
  • Personal Care
  • Respite
  • Companion
  • Adult Day
  • Assistive Device
  • Home Modifications
  • Personal Emergency Response System


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To be eligible for Choices for Care the person must:

  • Be a Vermont resident.
  • Be 65 years of age or older or 18 years of age with a physical disability.
  • Meet specific clinical criteria.
  • Meet financial criteria for Vermont Long-Term Care Medicaid.

Moderate Need Individuals:

A separate eligibility criteria exists for Moderate Needs individuals. Information regarding program eligibility and service availability can be obtained directly from the Adult Day Centers, or Home Maker Agency (Home Health Agency) in your area.


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Applying for Services

  • Hospitals and Nursing Facilities have information packets at time of admission or discharge.


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Providers of Services

The list below indicates the available Choices for Care Service Providers. There are multiple service providers for each county and you can select a provider based on your needs. Click on the Service Provider listed to obtain contact information for a provider in your area.

  • Adult Day Centers
    Adult Day Centers provide an array of services to help older adults and adults with disabilities to remain as independent as possible in their own homes. Adult day services provide programs during the daytime. Programs include activities, social interaction, nutritious meals, health screening and monitoring, personal care, and transportation. Respite for family caregivers is also available.
  • Area Agencies on Aging
    Area Agencies on Aging provide support to people 60 and older in their efforts to remain active, healthy, financially secure, and in control of their own lives.
  • Assisted Living Facilities
    Assisted Living Facilities are state licensed residences that combine housing, health and supportive services to support resident independence and aging in place.
  • Home Health Agencies
    Health Agencies provide health services in the home. Services include: nursing; personal care; physical therapy; homemaker services; hospice care, and social work services.
  • Nursing Facilities
    Nursing homes provide nursing care and related services for people who need nursing, medical, rehabilitation, or other special services. They are licensed by the state and may be certified to participate in the Medicaid and/or Medicare programs. Certain nursing homes may also meet specific standards for subacute care or dementia care.
  • Residential Care Homes - Level III
    Residential care homes are state licensed group living arrangements designed to meet the needs of people who can not live independently and usually do not require the type of care provided in a nursing home. When needed, help is provided with daily activities such as eating, walking, toileting, bathing, and dressing. Residential care homes may provide nursing home level of care to residents under certain conditions. Level III homes provide nursing overview, but not full-time nursing care.
  • Personal Emergency Response Organizations
    Personal Emergency Response Organizations provide an array of services to help older adults and adults with disabilities to remain as independent as possible in their own homes.


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Program Contacts

For information about Choices for Care:

  • Adult Services Division  Choices For Care Program: (802) 241-0294
  • Choices for Care – Long-Term Care Clinical Coordinators (LTCCC)
Region Contact Person Contact Information
Barre David O'Vitt (802) 476-1646
Bennington Stephanie Clarke (802) 447-2850
George Jurasinski
(802) 251-2118
Burlington Brenda Smith
Jeanne Buley
(802) 871-3058
Hartford Chris Malone (802) 296-5592
Middlebury Mary Scarborough (802) 388-5730
Morrisville Maura Krueger (802) 888-0510
Newport Paulette Simard (802) 334-3910
Rutland Celine Aprilliano (802) 786-5971
Springfield Carol Wakeley
(802) 885-8875
St Albans Kate Dempsey (802) 524-7913
St Johnsbury Julie Bigelow (802) 748-8361


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Policies and Guidelines

Listing of Choices for Care Policies and Guidelines:

  • Choices for Care 1115 Highest & High Needs Manual
    The operational protocol manual describing the eligibility criteria, services and program procedures to assist individuals, case managers and service providers in planning and managing services for the highest and high needs individuals.
  • Choices for Care 1115-Moderate Needs Manual
    The operational protocol manual describing the eligibility criteria, services and program procedures to assist individuals, case managers and service providers in planning and managing services for moderate needs individuals.
  • Quality Management Plan (April 2007)
    The Quality Management Plan guides the activities of the Division of Disability and Aging Services Quality Management Unit staff and establishes the standards for assessing the quality of services throughout Vermont.
  • 1115 Long-Term Care Waiver Approval Letter (June 2005)
    Letter from the Centers for Medicare & Medicaid Services approving the State of Vermont's Long-Term Care Plan section 1115 demonstration for a 5 year period.


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Choices for Care Publications:

    Choices for Care Renewal Documentation

  • DAIL-DDSD/ASD Service Codes and Rates
    Service Codes and Rates for all DAIL-DDSD/ASD services, includes Choices for Care, Adult Day services, Traumatic Brain Injury and Developmental Disabilities Services, Children's Personal Care and High Technology Home Care, and services for Older Vermonters.

     This handbook explains the role and responsibility of being an employer for you personal care needs.

  • Choices for Care Reports to CMS
    Choices for Care reports that are submitted to CMS as mandated.
  • Choices for Care Data Reports
    These reports present data that documents the status and progress of Choices for Care. Taken together, this data is intended to provide useful insight into the enrollment and service trends within Choices for Care.
  • Choices for Care 1115 Demonstration Waiver Operational Protocol
    The State of Vermont in an effort to further improve its programs developed this demonstration initiative to provide greater choice and the highest quality services possible to recipients in need of long-term care. Through this demonstration the Vermont Agency of Human Services (AHS) will undertake broad based reform of the long-term care service system by offering a continuum of care that includes a series of options, including both home- and community-based alternatives and traditional nursing facility services. This publication will give a full description of the eligibility criteria and benefit package for each of the three clinical groups included in this Operational Protocol along with additional information.
  • VT Long-Term Care Plan - Budget Neutrality Projections (May 2004)
    Vermont 1115 Demonstration; The Vermont Long-Term Care Plan with revised budget neutrality tables to incorporate minor adjustments and to include all Medicaid costs for individuals receiving long-term care services.


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Manuals and Guides


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Choices for Care Form Categories

Flexible Choices Forms


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Attendant Services Program

Highest and High Needs Forms


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Moderate Needs Forms



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Legislation, Statutes and Regulations


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Training, Conferences and Events Calendar


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