Get Paid as a Family Caregiver in Vermont

The Short Answer: Yes, Vermont Pays Family Caregivers

Vermont is one of the more flexible states when it comes to compensating family members for caregiving. Through several Medicaid-funded programs, an adult child, spouse, or other relative can be hired as a paid caregiver — but each program has its own eligibility requirements, pay structure, and supervision rules.

The common thread: your parent must qualify for Choices for Care, Vermont's Medicaid long-term care waiver, or another state-funded care program. Private-pay families set their own arrangements, but Medicaid-funded compensation only flows through these structured pathways.

Attendant Services Through Choices for Care

If your parent qualifies for the Choices for Care Highest or High Needs Group — meaning they meet the Nursing Facility Level of Care clinical threshold — they can receive home-based services through the waiver. Under this arrangement, your parent (or you as their authorized representative) can direct who provides their care, including hiring a family member.

The attendant services model works like this: the state authorizes a specific number of weekly care hours based on your parent's clinical assessment. A fiscal intermediary agency handles payroll, tax withholding, and workers' compensation. You're employed as a personal care attendant, paid hourly, with the rate set by the state's Medicaid reimbursement schedule.

The advantage is that you're functioning within a legitimate employment relationship — you receive W-2 income, accumulate Social Security credits, and may have access to employer-funded benefits depending on the fiscal agent. The limitation is that hours are capped by the clinical assessment, and the hourly rate reflects Medicaid reimbursement rather than market wages.

Adult Family Care (Shared Living)

Vermont's Adult Family Care program — sometimes called the shared living model — offers a different structure. Under this program, your parent receives room, board, and personal care in a private, unlicensed home-provider setting rather than a facility.

The authorized agency is paid a daily tiered rate, and the home provider receives a tax-free stipend rather than hourly wages. This is different from the attendant-services employment arrangement.

To participate, the home provider works through a designated Adult Family Care agency, which handles the program's approval and ongoing clinical oversight, training, and respite coordination.

This model works when a parent needs a 24-hour shared-living arrangement in a private home-provider setting. It provides a funded, supervised care plan in a home setting.

The Moderate Needs Pathway

If your parent doesn't meet the full nursing facility level of care but needs help with at least one daily activity at least three times per week, they may qualify for the Choices for Care Moderate Needs Group. This tier provides limited services such as homemaker assistance, adult day care, case management, and flexible-fund support; it is not the same as the self-directed attendant-care pathway above.

The service hours and scope are more restricted than the Highest or High Needs tiers, and the Moderate Needs Group is subject to waitlists when state funding is capped. But it provides a structured entry point for families where the parent's needs are real but don't yet rise to the level that would qualify for full waiver services.

What Disqualifies You

A few things can prevent a family caregiver from receiving compensation. Spouses face restrictions in some programs — Vermont's Choices for Care allows spouse caregivers in certain circumstances, but the rules are more complex than for adult children. Legal guardians who are also seeking caregiver compensation face additional oversight requirements, since they're effectively hiring themselves.

Background checks are required for compensated caregivers, including family members. A finding that is disqualifying under the program's provider rules can prevent participation.

Getting Started

The entry point is your parent's clinical and financial eligibility determination. Contact the Area Agency on Aging HelpLine at 1-800-642-5119 to request an options counseling session, which will assess your parent's care needs and map them to available programs.

The Vermont care decision guide walks through the Choices for Care application process and includes a Medicaid pre-screen worksheet that helps you determine financial eligibility before you invest time in the formal application — which involves compiling 60 months of financial records.

See more Vermont guides →