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Getting paid to care for a parent in Vermont

Updated 2026-08-10 · Every figure below is dated and sourced · Rules change — confirm with the agency
The short answer: Vermont's door is Choices for Care (CFC) — Consumer/Surrogate-Directed option and Flexible Choices (part of Vermont Long-Term Care Medicaid under the Global Commitment to Health 1115 waiver), run by Vermont Department of Disabilities, Aging and Independent Living (DAIL), Adult Services Division; financial eligibility through the Department of Vermont Health Access (DVHA); payroll through ARIS Solutions (fiscal agent). Pay: Statewide union floor: a directly hired caregiver must be paid at least $16.11/hr, effective 7/5/2026, set by the AFSCME Local 4802 (Vermont Homecare United) collective bargaining agreement. Be careful with the other numbers you will see. DAIL builds consumer/surrogate-directed budgets at $18.28/hr for personal care and $18.04/hr for companion and respite, but those are budget rates that already include the 11.78% employer payroll tax, not wages. The tax comes out of that same budget, so the most a family employer can actually put in a caregiver's pocket from the personal care rate is about $16.35/hr ($18.28 divided by 1.1178), and $18.04 is simply $16.11 plus tax. Realistic take-home wage is about $16.11 to $16.35/hr as of July 2026, not $18. Separately, if you see $51.91/hr on the DAIL SFY2027 rate sheet, that is the Medicaid BILLING rate a home health or home care agency charges ($12.98 per 15 minutes); a family caregiver never receives that. Adult Family Care live-in home providers are paid on a different system entirely: a daily tier rate from $101.26/day (Tier 1) to $205.18/day (Tier 10), SFY2027 rates on the DAIL rate sheet dated July 17, 2026, paid as a tax-free 'Difficulty of Care' stipend through an Authorized Agency.

Who can be the paid caregiver

Adult children, siblings, other relatives, and friends can be hired as the paid personal care attendant under the consumer- or surrogate-directed option. Attendants must be 18+ and pass DAIL background checks. Two traps that catch families: (1) If a surrogate has to manage the employment because your parent can't direct their own care, that surrogate CANNOT also be the paid caregiver. The CFC manual says a surrogate employer shall not be paid to provide personal care, respite, companion, or Flexible Choices services to the person they are a surrogate for. So one family member has to be the surrogate/employer and a different person has to be the one collecting the paycheck. Plan this before you apply. (2) If you are your parent's probate-appointed legal guardian, you cannot be paid for ANY Choices for Care service: not personal care, not respite, not companion care, not Flexible Choices, not Adult Family Care. Guardianship and getting paid are mutually exclusive here. For Adult Family Care (live-in daily-rate care), an adult child CAN be the paid home provider, but a spouse, parent, stepparent, adoptive parent, domestic partner, legal guardian, or representative payee cannot, and AFC home providers must be 21+.

The spouse question

Partially yes. Under CFC, a spouse or civil union partner CAN be paid for hands-on personal care (ADLs like bathing, dressing, transfers, plus meal prep and medication management) but CANNOT be paid for IADL-only help (housekeeping, shopping, transportation), respite care, or companion care, and cannot be the Adult Family Care home provider (CFC Program Operations Manual, High/Highest, rev. July 2020, confirmed Aug 2026). For an adult child caring for a parent this rarely matters, but it matters if your other parent expects pay too.

Waitlist reality

Highest Needs group: served without a waitlist once eligible (protected by program rules). High Needs group: new applicants CAN be waitlisted when state funds run short, ranked by a need score, with 60-day reviews. Moderate Needs group (light services, no full personal care) is capped by local funding. The separate Attendant Services Program's non-Medicaid General Fund track has been frozen to new entrants since July 2014. Medicaid financial approval itself commonly takes 1-3 months.

Worth knowing: Disqualifiers and fine print: the parent must need nursing-home level of care AND qualify financially for Long-Term Care Medicaid (income/asset limits, 5-year look-back). Caregivers with a substantiated abuse/neglect/exploitation record, an OIG Medicaid/Medicare exclusion, or certain criminal convictions cannot be paid; hired attendants must be 18+ (AFC home providers 21+). A probate-appointed legal guardian cannot be paid for ANY Choices for Care service - personal care, respite, companion care, Flexible Choices, or Adult Family Care - so taking guardianship of your parent will cost you the paycheck. A surrogate employer likewise cannot be paid for the services they direct, so the person signing as employer and the person being paid have to be two different people. Spouses are blocked from IADL-only work, respite, and companion pay, and from being AFC home providers. The wage floor rises most Julys under the AFSCME contract (about $15.49 in July 2025 to $16.11 in July 2026), so re-verify each July on the ARIS Solutions wage memos. Employers must budget an extra 11.78% for payroll taxes under Choices for Care (12.59% in the Attendant Services Program), and it comes out of the authorized budget rather than on top of it, which is what caps the wage you can actually pay. Flexible Choices gives a cash-style monthly budget, but the two official sources disagree on the amount: the ARIS memo dated 6/24/2026 says the base rate rises to $1,750.57/month on 7/5/2026, while DAIL's SFY2027 Medicaid rate sheet dated 7/17/2026 lists $1,752.37/month - ask your Flexible Choices consultant which figure your budget is built on. The real-time length of any High Needs waiting list is not published; Highest Needs cases are enrolled without waiting.

Other doors in Vermont

ProgramWhat to know
Adult Family Care (within Choices for Care)Vermont's structured-family-caregiving analog: the parent lives with (or moves in with) an approved home provider — an adult child qualifies, a spouse does not — who is paid a daily tier rate of $101.26-$205.18/day (SFY2027) through an Authorized Agency, plus paid respite days for the family.
Attendant Services Program (ASP/PDAC)Participant-directed attendant care for adults with severe permanent disabilities who can self-direct their care; Medicaid-funded track pays attendants at least $16.11/hr (eff. 7/5/2026) via ARIS; the non-Medicaid General Fund track has been frozen to new applicants since July 2014. Contact: Wanda Wright, DAIL, 802-595-4917.
CFC Moderate Needs GroupFor parents not yet at nursing-home level of care: limited homemaker/adult day/flexible funds (about $3,500/yr cap), with a self-hire minimum around $17.49/hr budgeted incl. taxes; funding is capped locally, so availability varies.
Veteran-Directed Care / VA caregiver programsIf the parent is a veteran: VA White River Junction health care runs caregiver support (va.gov/white-river-junction-health-care/health-services/caregiver-support/); ask about Veteran-Directed Care availability there — ARIS Solutions administers VDC budgets regionally — plus PCAFC and Aid & Attendance. VDC's current WRJ rollout status was not independently confirmed.
National Family Caregiver Support ProgramThrough the five Area Agencies on Aging (1-800-642-5119): respite grants and supports for unpaid family caregivers — help, but not a wage.

Wartime veteran or surviving spouse in the family? VA Aid & Attendance stacks on top of state programs — see the national guide.

How to apply — step by step

  1. 1. Call your local Area Agency on Aging Senior HelpLine at 1-800-642-5119 to get a case manager and options counseling, or call the DAIL Adult Services Division at 802-241-0294 to reach your Long-Term Care Clinical Coordinator nurse for the clinical (nursing-home level of care) assessment.
  2. 2. Apply for Long-Term Care Medicaid through DVHA: call 802-476-0100 (toll-free 1-833-840-0061) and say you need 'Long-Term Care Medicaid,' or apply online at dvha.vermont.gov/members. Expect the financial review to take up to 3 months.
  3. 3. Once clinically and financially approved, choose the Home-Based consumer/surrogate-directed option (or Flexible Choices) with your Area Agency on Aging case manager and build the service plan/budget that names your family member as the hired caregiver.
  4. 4. Enroll as an employer with ARIS Solutions, the state's fiscal agent (800-798-1658): employee hiring packet, background check, tax forms.
  5. 5. Caregiver starts logging hours on ARIS timesheets and is paid at least $16.11/hr (current CBA minimum) from the authorized budget.

Where to start: Area Agency on Aging Senior HelpLine: 1-800-642-5119 (statewide entry point); DAIL Adult Services Division / Long-Term Care Clinical Coordinator: 802-241-0294; Long-Term Care Medicaid application (DVHA): 1-833-840-0061 or dvha.vermont.gov/members

Do it yourself vs. get help

Free, accredited help first, always: your Area Agency on Aging (eldercare.acl.gov) walks families through these applications at no charge, and your county Veterans Service Officer files VA claims free. Where Resbit fits: if you're working a job and don't have hours for hold music, Resbit finds what your family qualifies for, fills out the paperwork down to the signature line, and does the chasing — flat $49/month, and the screener that starts it is free.

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Sources & dates checked: Program rules and payment rates change. Everything here is educational — real eligibility is decided by the agencies, based on your family's details.