VT Choices for Care

Note: The Choices for Care waiver was incorporated into the Global Commitment to Health waiver in 2015. As a result, the services and criteria for eligibility that were offered by the Choices for Care waiver remain accessible through the Global Commitment to Health waiver.

Choices for Care (CFC) is a crucial Medicaid long-term care program in Vermont, designed to support older state residents who require moderate to high levels of care assistance. Its primary goal is to enable elderly individuals to continue living at home or in their communities, whether in assisted living residences, adult family care homes, or nursing home facilities. CFC takes a compassionate and understanding approach towards caregivers, recognizing them as an integral part of the healthcare system and aiming to provide valuable insights while advocating for their well-deserved compensation.

Overview of Choices for Care

Choices for Care (CFC) is a vital Medicaid long-term care program in Vermont dedicated to assisting and supporting older residents who require moderate to high levels of care assistance. The primary purpose of CFC is to enable elderly individuals to maintain their independence and dignity while receiving the care they need, all within their preferred living environment. Through CFC, participants can remain in their homes, reside in assisted living or adult family care homes, or opt for nursing home care if necessary.

The program caters to a diverse range of services, encompassing personal care and various forms of support to enhance independence and assist caregivers in providing the necessary assistance. This comprehensive approach includes coverage for home modifications, such as wheelchair ramps and walk-in tubs, to create a safe and accessible living space.

One of the standout features of CFC is its consumer-directed option, Flexible Choices, which offers participants cash benefits in place of traditional care services, allowing eligible individuals to have greater control over their care decisions and hire family members, excluding legal guardians and spouses, as their caregivers.

Choices for Care's specific goals and objectives are two-fold: to empower older state residents by providing them with choices and options for their Care, promoting a sense of autonomy and self-determination. Secondly, the program aims to alleviate the burden on caregivers, recognizing their invaluable role in the healthcare system, by offering various support services and caregiver payment options. Through these initiatives, CFC seeks to create a more compassionate and inclusive long-term care system that addresses the needs of both care recipients and caregivers.

Eligibility Requirements for Choices for Care

To qualify for Vermont's Choices for Care (CFC) Medicaid long-term care program, individuals must meet specific eligibility criteria encompassing general and financial requirements.

1. Age: Applicants must be at least 18 years old. However, individuals aged 65 and older may be subject to less stringent functional criteria.
2. Level of Need: Individuals between 18 and 64 must have a physical disability, while those aged 65 and older must require a nursing home level of Care. A disability is not mandatory for applicants aged 65 and above.
3. Income Limits: The applicant's income should be below 300% of the Federal Benefit Rate (FBR), which, in 2023, amounts to $2,742 per month. When only one spouse applies, the non-applicant spouse's income is not considered for couples. The applicant spouse may transfer part of their income to the non-applicant spouse as a spousal allowance to ensure sufficient support for the non-applicant spouse. The maximum spousal allowance in 2023 is $3,715.50 per month. (If both spouses in a couple are applying for the waiver, each spouse can have up to $2,742 in monthly income.)
4. Asset Limits: Single applicants are allowed up to $2,000 in countable assets in 2023, which increases to $5,000 if the applicant lives in their home. For couples applying together, the asset limit is $4,000. However, when only one spouse receives Medicaid, the non-applicant spouse can have up to $148,620 in assets.

Applicants who exceed these income and/or asset limits, or have concerns about their asset transfer history, are encouraged to seek advice from a Medicaid planner before applying. These financial and legal experts can guide strategies to qualify for Medicaid in Vermont while ensuring compliance with the program's requirements.

Services and supports

While the program does allow participants to choose nursing home care, its primary objective is to prevent institutionalization and promote community-based living. To achieve this, CFC provides carefully curated care and support services tailored to each individual's needs. These services include:

1. Adult Day Care: Structured programs and activities offered during the day, providing social interaction and supervision while family caregivers attend to other responsibilities.
2. Assisted Living / Enhanced Residential Care Services: Assisted living and certain residential care facilities are covered, offering necessary services and support to residents. However, room and board expenses are not covered.
3. Assistive Technology and Devices: Access to specialized equipment and devices to enhance the individual's ability to perform daily tasks and improve mobility.
4. Case Management: Dedicated case managers work closely with participants and their families to assess needs, develop care plans, and coordinate services effectively.
5. Companion Services: Companionship and assistance with non-medical tasks to combat loneliness and improve the overall well-being of the participant.
6. Home Modifications: Funding for home modifications such as wheelchair ramps, grab bars, and walk-in tubs to create a safe and accessible living environment.
7. Personal Care: Assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), including bathing, dressing, meal preparation, medication management, and more.
8. Personal Emergency Response Systems: Devices allowing individuals to call for help in emergencies or accidents, providing added security and peace of mind.
9. Respite Care: Temporary relief for family caregivers, allowing them to take breaks while ensuring their loved ones continue to receive Care and support.

Compensation for caregivers

Under the Vermont-designed Choices for Care (CFC) Medicaid long-term care program, a consumer-directed option called Flexible Choices allows participants residing in a home-based setting to receive compensation for caregiving services provided by family members. This compensation is provided as cash benefits, allowing eligible individuals to use the funds to pay for their care services. Family members, except legal guardians and spouses, can be hired as caregivers, recognizing their vital role in supporting their loved ones. By compensating unpaid family caregivers, CFC acknowledges their significant contributions to the care recipients' well-being while promoting a more inclusive and supportive long-term care system.

Learn more about Medicaid consumer-directed care >>

A note from Givers

Choices for Care (CFC) recognizes caregivers and offers compensation through the Flexible Choices option. If you are a family caregiver in Vermont, take a moment to fill out this form to determine if you are eligible for compensation. Your dedication deserves acknowledgment.