Choices for Care Vermont: Get Paid To Care For A Family Member

It depends on which group you qualify for, and this is where Vermont is unusually generous. In the Highest Needs group, which covers people who meet a nursing-facility level of care, a legally married spouse can be hired and paid as your caregiver through the Flexible Choices self-directed option. Most states flatly forbid paying a spouse, so this is a real advantage of Vermont Choices for Care. However, in the Moderate Needs group, spouses are not allowed to be the paid caregiver, and a spouse also cannot be paid under Vermont's separate Attendant Services Program. Because the rule turns on your assessment result, it is worth confirming your specific situation with DAIL and your case manager before you count on paying a spouse. Call the Senior Helpline at 1-800-642-5119 to check.

In 2026, most self-directed Choices for Care caregivers in Vermont earn roughly $16 to $22 per hour. Vermont does not use one fixed statewide rate for self-direction. Instead, state policy sets a floor at no less than the current Medicaid rate on file and then allows a reasonably higher flexible wage, so families can offer enough to attract and keep a good caregiver within their approved budget. As a real-world reference, the average caregiver pay reported through ARIS Solutions, Vermont's fiscal employer agent, sits in the high-$16 to low-$18 range. Caregivers are paid as W-2 household employees, so federal and Vermont income taxes, Social Security, and Medicare are withheld from each check, and caregivers can accrue Vermont Earned Sick Leave. Your advisor or case manager helps set the exact wage as part of building your care budget.

Plan on roughly 45 to 120 days from your first call to your caregiver's first paycheck. The timeline has two moving parts that run in parallel. First, financial eligibility for long-term care Medicaid is verified by the Economic Services Division, which can take several weeks and longer if documents are missing. Second, a registered nurse must complete an in-person clinical assessment to determine whether you meet the Highest Needs or Moderate Needs criteria. Once both are approved, choosing a self-directed option and enrolling your caregiver with ARIS Solutions, including the background check and payroll setup, usually adds another two to four weeks. You can speed things up by gathering documents early: proof of Vermont residency, identification, Social Security numbers, and proof of income and assets. Calling the Senior Helpline at 1-800-642-5119 first helps you avoid delays.

One of the biggest advantages of self-directed Choices for Care is that no formal training, certification, or license is required. Your caregiver does not need to be a Certified Nursing Assistant, a Home Health Aide, or any other licensed professional. Because you, the participant, or your surrogate are the employer, you decide who is qualified and you train them on the specific tasks you need help with, such as bathing, dressing, meals, and getting around the house. There are still some basic onboarding steps handled through ARIS Solutions, the fiscal employer agent: a background check, federal employment paperwork (I-9 and W-4), direct deposit setup, and enrollment in Electronic Visit Verification for recording hours. The caregiver must be at least 18 years old. This light-touch approach is exactly why Choices for Care works so well for families who have already been providing informal care and simply want to be paid for it.

Both are self-directed paths within Choices for Care, and both let you hire the caregiver you trust, but they are structured a bit differently. Flexible Choices gives you a monthly cash allowance built with an advisor. You control that budget and use it to purchase care and certain goods and services, acting as the employer of your chosen caregiver. It offers the most flexibility, and in the Highest Needs group it is the option that can pay a spouse. The surrogate-directed path works with a case manager who writes a care plan and budget with you; a surrogate, often a relative or friend, can act as the employer on your behalf if you cannot manage the employer duties yourself. In both options, ARIS Solutions handles payroll, taxes, background checks, and Electronic Visit Verification. Your options counselor or case manager will help you pick the path that fits your needs and how much control you want.

Choices for Care is divided by level of need, and the group you land in changes both your benefits and your caregiver options. The Highest Needs group is for people who clearly meet a nursing-facility level of care, confirmed by a registered nurse assessment. It unlocks the fullest self-directed benefit, a larger care budget driven by your assessed needs, and it is the only group where you can pay a spouse. The Moderate Needs group is a smaller benefit for people who do not yet need nursing-facility care but are at risk of decline, for instance needing help several times a week or general supervision due to impaired judgment. Moderate Needs still lets you hire adult children, other relatives, and friends, but it does not allow a spouse to be your paid caregiver, and its monthly budget funds fewer hours. Your nurse assessment determines which group you qualify for.

Choices for Care is administered by Vermont's Department of Disabilities, Aging and Independent Living (DAIL) through its Adult Services Division, under the Agency of Human Services. Financial Medicaid eligibility is handled by the Economic Services Division, and your local Area Agency on Aging provides options counseling and, in many cases, case management. When it comes to paying your caregiver, Vermont uses a fiscal employer agent called ARIS Solutions. ARIS is the entity that processes payroll, withholds and files taxes, runs the caregiver's background check, manages timesheets and Electronic Visit Verification, and issues paychecks, usually by direct deposit. Importantly, ARIS does not choose your caregiver, set their schedule, or supervise care. Those decisions stay with you, the participant, or your surrogate. This division of labor is what lets families keep full control over who provides care while leaving the paperwork and payroll to professionals.

Yes. Adult children are among the most common paid caregivers in self-directed Choices for Care, and there is no rule against being paid to care for your own parent as long as they are the enrolled participant, you are at least 18, and you are not their legal guardian. You can also live in the same home as the person you care for. Being enrolled in Choices for Care does not reduce your parent's other Medicaid benefits. They keep their doctor visits, hospital coverage, prescription drugs, and durable medical equipment; Choices for Care simply adds the home and community based care package on top. If your parent is also on Medicare, Medicare continues to cover acute care while Vermont Medicaid covers the long-term personal care through Choices for Care. To get started, call the Vermont Senior Helpline at 1-800-642-5119 and ask about Choices for Care options counseling.