Attendant Services Program Vermont: Medicaid Personal Care Without Nursing Home Level of Care

Most families assume Medicaid will only pay for a personal care aide if their parent qualifies for nursing home-level care. In Vermont, that's not true. The Attendant Services Program (ASP) covers personal care for people who need help with daily activities but don't meet the clinical threshold required by Choices for Care.

What ASP Covers

ASP is a consumer-directed State Plan program — not a waiver, which means it doesn't carry waitlists the way Choices for Care's High and Moderate Needs tiers do. The program pays for a personal care attendant to help with:

• Bathing, dressing, grooming, and personal hygiene
• Transfers (bed to wheelchair, in and out of the bath)
• Toileting assistance
• Mobility support within the home
• Meal preparation directly related to dietary needs

The key clinical threshold: your parent must need physical hands-on assistance with at least two activities of daily living (ADLs). This is a lower bar than Choices for Care's Highest Needs tier, which requires extensive or total assistance with specific late-loss ADLs.

Financial Eligibility (2026)

ASP uses standard Community Medicaid (MABD) income and asset limits — not the Choices for Care limits:

• Monthly income: $1,375 (outside Chittenden County) or $1,483 (Chittenden County)
• Countable assets: $2,000 for an individual
• 60-month lookback: Does not apply to ASP — this is a significant difference from Choices for Care's High/Highest Needs tiers, where the lookback period scrutinizes all asset transfers from the prior five years

If your parent's income exceeds the MABD limit, ask DVHA whether the medically needy pathway applies; standard Community Medicaid uses a six-month accounting period. Vermont's medically needy pathway does not require a Miller Trust.

Who You Can (and Can't) Hire

ASP is consumer-directed, which means your parent (or your family, acting as surrogate employers) hires, trains, schedules, and supervises the personal care attendant directly. The program allows hiring:

• Adult children
• Siblings
• Grandchildren
• Friends
• Neighbors
• Professional caregivers

However, ASP explicitly prohibits paying the following as personal care attendants:

• Spouses or civil union partners of the care recipient
• Court-appointed legal guardians

This is stricter than Choices for Care, which allows spousal hiring under narrow, clinically documented circumstances. Under ASP, the prohibition is absolute.

How Payroll Works Through ARIS Solutions

Although you manage the caregiver directly, you don't handle payroll yourself. ARIS Solutions serves as Vermont's contracted fiscal employer agent. Once enrolled, ARIS processes:

• Bi-weekly payroll from submitted timesheets
• Federal and state tax withholding
• W-2 issuance at year-end
• Workers' compensation insurance coverage

Your family completes the ARIS Employer Enrollment Packet to register as the employer of record, and each caregiver completes the Employee Hiring Packet (including Form I-9 verification and mandatory background checks).

ASP vs. Choices for Care: When Each Applies

For many families, ASP serves as a bridge — it gets paid personal care in place quickly while you work through the longer Choices for Care application process for the broader service package.

Our Vermont Home Care Navigator covers both pathways side by side, with step-by-step instructions for the ARIS enrollment process, background check procedures, and the financial calculations that determine which program your parent qualifies for.

See more Vermont guides →