Paid Family Caregiver Programs in Vermont

Last updated: 31 March 2026

Emergency help now

1. If the senior is unsafe, alone, or cannot get basic care today, call 911 or ask the hospital, primary care office, or rehab discharge planner for same-day social work or discharge help.
2. Call Vermont’s Senior Helpline at 1-800-642-5119 and ask for urgent caregiver, respite, and long-term care guidance.
3. Call the Choices for Care application contacts listed by the state: Benefits Service Center 1-800-479-6151 or Medicaid Call Center 1-855-899-9600, and say, “I need Long-Term Care Medicaid and Choices for Care.”

What this help actually looks like in Vermont

In Vermont, the main paid-family-caregiver path for seniors is usually Choices for Care. That program pays for long-term services and supports for adults age 18 and older who need nursing-home-level care and who meet Vermont’s long-term care Medicaid rules. The state’s Choices for Care options sheet shows that services can happen at home, in a family member’s home, in Adult Family Care, in Enhanced Residential Care, or in a nursing facility.

If the senior wants a relative paid at home, the key question is usually not “Does Vermont pay family caregivers?” It is: “Can this senior qualify for Choices for Care, and can the care be arranged through a consumer-directed, surrogate-directed, or Flexible Choices setup?”

There is also a separate Attendant Services Program for adults with a severe and permanent physical disability who can self-direct. That is real, but it is not the usual frailty-based program most older Vermonters use.

One important Vermont-specific change: Vermont’s HCBS case-management update says that, starting in mid-2025, Area Agencies on Aging became the home-and-community case managers for Choices for Care participants, including Flexible Choices. That means some older brochures are still useful for core program rules, but families should expect the Area Agencies on Aging to be the main home-based case-management contact now.

Quick facts

• Vermont does not list a simple, universal state program that pays any family caregiver of a senior just for helping at home.
• The main route is Choices for Care, which usually requires Long-Term Care Medicaid.
• Self-direction in Choices for Care can let a senior or surrogate hire a family member in some situations.
• Spouses can sometimes be paid under Choices for Care, but not for every task or service type.
• Legal guardians cannot be paid for Choices for Care personal care, and a surrogate employer cannot also be the paid worker for that same participant.
• ARIS Solutions and EVV rules matter in Vermont. Even after approval, timesheets and payroll setup are ongoing work.

Can a family member get paid in Vermont?

Vermont option	Medicaid required?	Can an adult child usually be paid?	Can a spouse be paid?	Best fit
Choices for Care home-based self-direction	Yes	Often yes, if approved and not in a barred role	Sometimes, but with strict limits	Seniors who need nursing-home-level care but want to stay home
Flexible Choices	Yes	Often yes	Sometimes, but same CFC spouse limits still matter	Families who want more control over budget and scheduling
Adult Family Care	Yes	Possibly, if the adult child is not the legal guardian or representative payee and the home is approved	No	Shared living in another person’s home
Attendant Services Program	Yes	Often possible	Rules differ and must be confirmed with DAIL	Adults with a severe and permanent physical disability who can self-direct
Choices for Care Moderate Needs / AAA caregiver support	No for Moderate Needs; No for AAA support	Sometimes through approved flexible funds, but not a guaranteed pay path	Usually not a wage program	People who need help but do not yet qualify for nursing-home-level care

Important: adult-child answers above are based on Vermont’s listed worker exclusions and service rules. Final approval still depends on age, background checks, the care plan, payroll setup, and whether the relative is also serving in a barred role such as legal guardian or surrogate employer.

Who qualifies

For the main senior path, the older adult usually needs to qualify for Choices for Care High or Highest Needs services. Vermont’s current Medicaid rules and the Choices for Care operations manual say this is for adults age 18 and older who need nursing-home-level care and meet financial rules for Long-Term Care Medicaid.

In plain English, that usually means the senior needs a lot of daily help with major activities such as toileting, eating, transfers, bed mobility, or has serious cognitive or medical needs that make nursing-home-level care the right standard. Vermont’s official Choices for Care rule also allows Highest Needs enrollment when special circumstances create immediate safety risk, such as loss of a primary caregiver or loss of housing.

Clinical eligibility is handled by the state through DAIL. Financial eligibility is handled by the state benefits system. Vermont Legal Aid’s Choices for Care application guide explains that DAIL decides the clinical side and the Economic Services side decides the financial side.

Financial rules are not simple. Vermont uses deductions, maintenance allowances, and patient-share rules, so there is not one easy monthly income number for every household. For the clearest current public summary, see Vermont Legal Aid’s updated 2026 pages on Choices for Care income limits and Choices for Care resource limits. That 2026 resource page lists countable resource limits of $2,000 for one person in long-term care, $3,000 for two people, and $5,000 if you own and still live in your home, with larger protections for a spouse.

If the senior does not meet nursing-home-level care, Vermont may still have a smaller option through Choices for Care Moderate Needs or the Area Agencies on Aging family caregiver supports. But those are not the same as guaranteed paid family caregiving.

Best programs, protections, portals, or options in Vermont

Choices for Care home-based consumer- or surrogate-directed personal care

What it is: Vermont’s official Choices for Care options sheet says eligible people can receive services at home and, if eligible, can hire their own caregivers through consumer- or surrogate-directed services.

Who can get it or use it: Adults age 18 and older who are clinically eligible for nursing-home-level care and financially eligible for Long-Term Care Medicaid under Choices for Care.

How it helps: This is the clearest Vermont path for paying an adult child, sibling, other relative, or trusted non-relative to provide home care. Under the CFC manual, a spouse or civil union partner can sometimes be paid for personal care, but the manual bars spouse payment for IADL help under personal care, and bars spouse payment for companion and respite services. The same manual says a legal guardian cannot be paid for CFC personal care, and a surrogate employer cannot also be the paid personal-care worker for that participant.

How to apply or use it: Start with the state’s Choices for Care contact sheet. Call the Benefits Service Center or Medicaid Call Center for the financial side, and ask for the regional Long-Term Care Clinical Coordinator contact for the clinical side.

What to gather or know first: Say early that you want consumer-directed or surrogate-directed services and that a relative may be the worker. Workers must usually be 18 or older and pass background checks under the CFC manual. Also know that home-based CFC services do not cover 24 hours a day, so most families still provide some unpaid care.

Flexible Choices for self-directed budgets

What it is: The federal Global Commitment demonstration materials describe Flexible Choices as a participant- or surrogate-directed option that converts a home-based service plan into a cash-style allowance. A Transition II consultant helps build the budget.

Who can get it or use it: People already eligible for home-based Choices for Care who want more control over workers, schedules, and some purchases.

How it helps: Flexible Choices is often the best Vermont option for families who want to hire and manage a relative directly. It can cover self-hired attendants and some goods or services that support staying home, as described in the state’s federal waiver materials.

How to apply or use it: Ask your CFC case manager or Area Agency on Aging for Flexible Choices. For budgeting support, contact Transition II. For payroll, direct deposit, and timesheets, you will usually work through ARIS Solutions.

What to gather or know first: The latest public Choices for Care wage memo we verified says that beginning July 6, 2025 the minimum wage is $15.49 an hour, the minimum total hourly rate to budget is $17.31, personal-care budgets are calculated with a base rate of $18.08, and companionship/respite budgets are calculated with a base rate of $17.70. Actual pay can still vary by service type, taxes, and the approved budget.

Adult Family Care under Choices for Care

What it is: The state options sheet and CFC manual describe Adult Family Care as a shared-living option where the participant lives in another person’s family home and receives 24-hour support there.

Who can get it or use it: People who qualify for Choices for Care and want a family-home setting instead of staying alone at home or moving to a nursing facility.

How it helps: This can work well when a senior cannot safely live alone, but does not want a nursing home. The home provider is paid through a daily tiered payment. The manual describes this as a “Difficulty of Care” payment, which can have different tax treatment than hourly wages.

How to apply or use it: Ask the CFC case manager or Area Agency on Aging to discuss Adult Family Care and the authorized agencies that arrange it.

What to gather or know first: This is not just hourly help in the senior’s current home. The CFC manual says the home provider cannot be the participant’s parent, stepparent, adoptive parent, domestic partner, spouse, legal guardian, or representative payee. Because adult children are not on that exclusion list, an adult child may sometimes qualify as the home provider if the agency approves the home and the child is not in a barred role. CFC also does not pay room and board in Adult Family Care.

Attendant Services Program (ASP / PDAC)

What it is: Vermont’s official disability and aging supports page says the Attendant Services Program supports personal care for adults with a severe and permanent disability who need physical help with daily activities to remain at home.

Who can get it or use it: Adults who are financially eligible for Medicaid, have a severe and permanent physical disability, and can direct their own care. This is usually not the right program for a senior whose main issue is age-related frailty and dementia without the program’s disability profile.

How it helps: ASP is a self-directed option. It can allow relatives and other attendants to be hired. But spouse rules are not identical to Choices for Care, so families should never assume the same answer transfers from one program to the other.

How to apply or use it: Start through the state’s ASP information page and DAIL contacts. If you are already in self-direction, payroll typically runs through ARIS Solutions.

What to gather or know first: The latest public ASP Medicaid PDAC wage memo we verified says that beginning July 6, 2025 the minimum wage is $15.49 an hour and the minimum total hourly budget rate is $17.44. If a spouse might be the worker, ask DAIL for the rule before you switch programs or count on payment.

Choices for Care Moderate Needs and Area Agency on Aging caregiver support

What it is: Vermont’s official aging and disability page says Moderate Needs offers limited homemaker, adult day, case management, and flexible funds to help prevent or delay higher-cost long-term care. The same official page also lists Area Agency on Aging family caregiver support and respite.

Who can get it or use it: Moderate Needs is for people who do not yet meet nursing-home-level care and do not necessarily need Medicaid. AAA caregiver support is for older Vermonters and their caregivers, usually age 60 and older.

How it helps: Moderate Needs can sometimes support a self-hired attendant through flexible funds, as described in the state’s federal waiver materials. But it is limited funding and not an entitlement. AAA services can provide respite, counseling, information, referrals, and caregiver support, but they usually do not operate like a wage program for a family member.

How to apply or use it: Start with the Senior Helpline at 1-800-642-5119. Ask both about Moderate Needs and about local caregiver support, respite, adult day, meals, and benefits screening.

What to gather or know first: Moderate Needs can be a helpful bridge, but it is not the simple paid-family-caregiver path many people hope for. If the senior now needs a lot of hands-on ADL help, ask at the same time whether a full Choices for Care assessment is more appropriate.

Money Follows the Person if the senior is already in a nursing facility

What it is: Vermont’s official aging and disability page says Money Follows the Person works with Choices for Care to help people leave nursing facilities and return to community settings.

Who can get it or use it: Nursing-facility residents who want to return home or to another community-based setting.

How it helps: This is not direct caregiver pay by itself. But it can remove barriers that make home care possible, such as transition planning, home changes, and connection to the right community long-term care services.

How to apply or use it: Ask the nursing facility social worker, CFC case manager, or Area Agency on Aging whether a Money Follows the Person referral makes sense.

What to gather or know first: If the family’s real goal is “bring mom home and let my son or daughter help,” this program can matter a lot, even though it is not the wage source.

How much family caregivers get paid in Vermont

Latest public rate notices we verified

Program	Latest public wage or payment notice we verified	Why the actual pay can vary
Choices for Care self-direction	Effective 07/06/2025: minimum wage $15.49/hour; minimum total hourly budget $17.31; personal care base rate $18.08; companion/respite base rate $17.70	Employer taxes, service type, approved hours, and whether the budget can support a higher wage
Attendant Services Program PDAC	Effective 07/06/2025: minimum wage $15.49/hour; minimum total hourly budget $17.44	Employer taxes and the authorized budget
Adult Family Care	Not a simple hourly wage. Paid through a daily tiered home-provider arrangement	Tier level, agency contract, and the shared-living structure
Moderate Needs / AAA support	No single statewide posted hourly wage for a family caregiver in this guide	Funding is limited, budget-based, and often not set up as a family wage program

So, there is no one Vermont answer like “family caregivers get paid $X an hour.” The program, task, taxes, budget, and relationship all matter.

How to apply or use it without wasting time

1. Start with the right words. Say: “I want to apply for Long-Term Care Medicaid and Choices for Care, and I want to know if consumer-directed, surrogate-directed, or Flexible Choices care could let a family member be paid.”
2. Open both tracks. Vermont splits the process between clinical and financial eligibility. The Vermont Legal Aid guide explains this clearly.
3. Do not wait for an interview that may never be required. Vermont’s 2025 HBEE update repealed the interview requirement for long-term care Medicaid eligibility.
4. Tell them who the family worker might be. If you hope an adult child, spouse, or other relative will be paid, say that early. Relationship rules affect what option fits best.
5. Expect the Area Agency on Aging to matter. Under the HCBS case-management changes, AAAs are the key home-based case-management contact for CFC participants.
6. Use ARIS only after eligibility or when your case manager tells you to. ARIS Solutions handles payroll and timesheets. It does not approve Medicaid.
7. Learn the EVV rule before the first shift. Vermont’s ARIS EVV page says EVV is required for many home-based services when the worker does not live with the person receiving care and the service is provided in that person’s home.

Checklist of documents or proof

• Photo ID and Social Security number for the senior
• Medicare card, Medicaid card if any, and other insurance information
• Proof of Vermont address
• Social Security award letter, pension statements, wage stubs, and other income proof
• Bank statements, investment statements, burial plans, life insurance cash-value details, and property records
• Power of attorney, guardianship, representative-payee, or advance-directive papers if someone helps manage decisions
• Recent hospital, rehab, or doctor records showing why daily help is needed
• A short list of what help the senior needs with bathing, dressing, toileting, eating, walking, transfers, memory, and medication
• If self-direction is likely, the possible caregiver’s legal name, contact info, and direct-deposit details for later payroll setup through ARIS

Reality checks

• Most Vermont seniors who get a family member paid do it through Medicaid long-term care, not through a simple aging grant.
• Approval does not mean every unpaid hour the family already gives will become paid time.
• Choices for Care home-based services are not 24-hour-a-day coverage.
• Adult children are usually easier to fit into Vermont’s self-direction rules than spouses.
• Adult Family Care is a shared-living model, not regular hourly home care.
• Moderate Needs is useful, but it is limited funding and not an entitlement.

Common mistakes to avoid

• Calling only ARIS first. ARIS is payroll, not eligibility.
• Using old handouts and missing the 2025 case-management change to AAAs.
• Assuming a spouse can be paid for everything. In CFC, spouse limits are real.
• Not mentioning up front that the likely caregiver is also the legal guardian, representative payee, or possible surrogate employer.
• Thinking Adult Family Care will cover room and board. It does not.
• Ignoring EVV, timesheets, or payroll paperwork and then being surprised by delayed pay.
• Letting appeal deadlines pass because the denial letter was confusing.

Best options by need

• The senior needs heavy daily help and an adult child wants to be paid: ask first about Choices for Care home-based self-direction.
• The family wants the most control over wages and scheduling: ask about Flexible Choices.
• The senior cannot safely live alone and could move into a relative’s home: discuss Adult Family Care.
• The senior has a severe permanent physical disability and can direct care personally: look at the Attendant Services Program.
• The senior is not yet nursing-home-level but the caregiver needs support now: ask about Moderate Needs and Area Agency on Aging caregiver services.
• The senior is stuck in a nursing facility and wants to come home: ask about Money Follows the Person plus CFC.

What to do if denied, delayed, blocked, or waitlisted

First, ask for the denial or reduction in writing. Vermont’s notices should tell you why the decision was made and how to challenge it. If the problem is clinical eligibility for Choices for Care, the Vermont Legal Aid denial guide says you can request a DAIL Commissioner’s Review within 30 days of the decision, and you can also appeal to the Human Services Board within 90 days.

If the problem is financial eligibility, missing proof, or confusing state notices, call the Office of the Health Care Advocate at 1-800-917-7787. If the problem involves poor treatment, long-term care services, or a Choices for Care complaint, contact the Vermont Long-Term Care Ombudsman Project at 1-800-889-2047.

If the family is told Moderate Needs funding is limited or unavailable, do not stop there. Ask the Senior Helpline about respite, adult day, meals, transportation, and whether the senior’s needs now justify a full Choices for Care High/Highest assessment.

Plan B / backup options

• Area Agency on Aging caregiver support for respite, counseling, and local resources
• Private-pay care with a written caregiver agreement if the family is paying a relative directly
• Adult day services, which Vermont lists among available aging and long-term supports on its official aging supports page
• Personal emergency response systems and home modifications that may be available within Choices for Care home-based services
• Long-term care insurance, if the policy allows payment to an informal or family caregiver
• Veteran-related home-care options if the older adult receives VA services; ask the VA social worker what is actually available in the senior’s area before counting on it

Local resources if verified and useful

• Age Well
• Central Vermont Council on Aging
• Northeast Kingdom Council on Aging
• Southwestern Vermont Council on Aging
• Senior Solutions
• Senior Helpline statewide: 1-800-642-5119
• Choices for Care brochure with regional clinical coordinator numbers
• ARIS Solutions Vermont AHS programs: 1-800-798-1658
• Transition II: 866-572-7127
• Office of the Health Care Advocate: 1-800-917-7787
• Vermont Long-Term Care Ombudsman Project: 1-800-889-2047

Diverse communities in Vermont

Language help matters. Vermont’s public Medicaid materials and notices include language-assistance information, and the state’s Medicaid line at 1-855-899-9600 is the right place to ask for help in another language. Family structure matters too. Vermont rules sometimes say “spouse,” sometimes “civil union partner,” and in Adult Family Care they also mention “domestic partner,” so ask your case manager to apply the rule that fits your household, not a generic internet answer.

FAQ

Can my daughter or son get paid to care for me at home in Vermont?

Often, yes. The most common route is Choices for Care with consumer-direction, surrogate-direction, or Flexible Choices. Vermont’s worker exclusion lists do not generally ban adult children as paid workers in home-based CFC, so adult children are often the most workable family relationship for paid care. But the senior still has to qualify, the care plan has to authorize the service, and the child cannot be serving in a barred role like legal guardian for the same paid service.

Can a spouse be paid in Vermont?

Sometimes. Vermont’s posted Choices for Care spouse-payment guidance allows spouse payment in some situations. But the current CFC manual bars spouse or civil-union-partner payment for IADL help under personal care and bars spouse payment for companion and respite services. So the honest Vermont answer is: yes, but only in a narrower way than many families expect.

Does the senior need Medicaid to get a family member paid?

Usually yes. For the main senior path in Vermont, paid family caregiving is tied to Choices for Care, which is Long-Term Care Medicaid. The main exception is Moderate Needs, which does not require full Medicaid, but that program has limited funding and is not a simple guaranteed family wage program.

What is the difference between regular home-based Choices for Care and Flexible Choices?

Regular home-based CFC can include agency-delivered services or some consumer/surrogate direction. Flexible Choices goes further by turning the service plan into a self-directed budget, with a Transition II consultant helping the participant or surrogate manage it. Families who want more control over hiring and scheduling often prefer Flexible Choices.

How much does Vermont pay a family caregiver?

There is no one statewide number for every family caregiver. The latest public Choices for Care wage memo we verified says the minimum wage effective July 6, 2025 is $15.49 an hour, but actual pay depends on taxes, service type, and the approved budget. Adult Family Care is not a simple hourly wage at all.

Who handles payroll and timesheets once a family member is approved?

In many Vermont self-directed setups, ARIS Solutions handles payroll, tax-related forms, direct deposit, timesheets, and EVV instructions. ARIS is important, but it is not the office that decides whether you qualify for Medicaid or Choices for Care.

What if Choices for Care says I do not meet nursing-home-level care?

Do not assume that is the end. The Vermont Legal Aid denial guide says you can ask for a DAIL Commissioner’s Review within 30 days, and you can also appeal to the Human Services Board within 90 days. You should also ask whether Moderate Needs, AAA respite, or a re-assessment makes sense.

Is Adult Family Care the same as hiring my niece or son by the hour?

No. Adult Family Care is a shared-living model in another person’s home. It is not the same as hourly personal care in the senior’s own house. The relationship rules are also different. For example, spouses cannot be Adult Family Care home providers.

Resumen en español

Vermont no tiene un programa simple que le mande un cheque a cualquier familiar que cuida a una persona mayor. Para la mayoría de los adultos mayores, la vía real es Choices for Care, el programa estatal de cuidado a largo plazo de Medicaid, especialmente cuando el cuidado se organiza con autodirección o con Flexible Choices.

Un hijo adulto muchas veces sí puede ser trabajador pagado si el adulto mayor califica y si el hijo no está en un rol prohibido, como tutor legal del mismo servicio. El cónyuge a veces puede recibir pago, pero las reglas son más estrictas. Para empezar, llame a la Senior Helpline al 1-800-642-5119 y también al Benefits Service Center o Medicaid Call Center para pedir Long-Term Care Medicaid y Choices for Care.

About This Guide

Editorial note: This guide was written for GrantsForSeniors.org to help Vermont seniors, caregivers, and adult children compare the real paid-family-caregiver options that exist in Vermont, not wishful or generic national advice.

Verification line: We checked Vermont state program materials, Vermont HCBS case-management updates, ARIS payroll notices, and Vermont Legal Aid guidance that was current through March 2026, including public rate notices effective July 6, 2025 and Vermont Legal Aid pages updated in January 2026.

Corrections line: If a Vermont agency updates a rule, pay floor, phone number, or portal, please notify GrantsForSeniors.org so this guide can be reviewed and corrected quickly.

Disclaimer: This article is general educational information, not legal, tax, or individualized benefits advice. Medicaid and caregiver-pay rules are fact-specific. When money, property, or guardianship is involved, get advice before acting.