Get Paid to Care for Your Elderly Parent in Vermont
Vermont's Choices for Care is Long-Term Care Medicaid; its Flexible Choices self-directed option gives a cash budget that a participant or a surrogate can use to hire and pay relatives, including an adult child, with payroll handled by ARIS Solutions. Notably, unlike most states, Vermont can allow a spouse to be paid in certain highest-needs cases.
This guide covers what Vermont family caregivers need to know: the program structure, pay rates, who can be paid, eligibility, how to apply, and other programs that may supplement your income.
Vermont pays family caregivers $14–$24 per hour through the Choices for Care – Flexible Choices option within the Choices for Care (Global Commitment to Health 1115 Long-Term Care Medicaid waiver). Your parent must meet a nursing-facility level of care but prefer to remain at home.
Vermont's Main Program: Choices for Care – Flexible Choices
Choices for Care – Flexible Choices is a self-directed option within Vermont's Choices for Care (Global Commitment to Health 1115 Long-Term Care Medicaid waiver), which provides home and community-based care for seniors and adults with disabilities who meet a nursing-facility level of need. Under self-direction, your parent (or you as their authorized representative) can hire, train, schedule, and supervise the personal-care attendant — and that attendant can be you, an adult child.
What the Program Pays For
Authorized self-directed services typically include:
- Personal care: bathing, grooming, dressing, oral hygiene
- Toileting assistance and incontinence care
- Mobility help: transferring, positioning, ambulation support
- Meal preparation and feeding assistance
- Light housekeeping directly related to health and safety
- Medication reminders (not administration, which requires a nurse)
- Supervision for individuals with cognitive impairment, including dementia
Pay Rates Across Vermont
| Region | Typical Hourly Rate | Notes |
|---|---|---|
| Statewide (Flexible Choices) | $14–$24/hr | Participant or a surrogate sets the wage from an approved cash budget paid through ARIS Solutions |
| Chittenden / Burlington area | $16–$24/hr | Higher metro wages; relatives such as an adult child may be hired |
| Rural Northeast Kingdom | $14–$20/hr | DAIL determines nursing-home level of care before enrollment |
Rates are set within the participant's approved plan-of-care budget and the state's limits; the figures above are typical ranges, not guarantees.
Who Can Be Paid
Adult children and other relatives can be hired and paid; spouses and civil union partners are generally excluded, though Vermont's Choices for Care does permit a spouse to be paid in some highest-needs situations. Always confirm the current rules with Department of Vermont Health Access (DVHA) / Department of Disabilities, Aging and Independent Living (DAIL) before you count on a specific arrangement.
Eligibility Requirements
Your Parent Must:
- Be enrolled in full Vermont Medicaid (not just a savings program)
- Meet the clinical criteria for a nursing-facility level of care
- Be enrolled in the Choices for Care (Global Commitment to Health 1115 Long-Term Care Medicaid waiver) (or its self-directed option)
- Live in Vermont in a community setting (not a nursing home)
- Be able to direct their own care, or have a legal/authorized representative who can
You (the Caregiver) Must:
- Be 18 years of age or older
- Meet the program's relationship rules (see above)
- Pass a criminal background check and registry search
- Complete any required caregiver orientation and training
- Be legally authorized to work in the United States
- Submit timesheets through ARIS Solutions
How to Apply: Step-by-Step
- Apply for Vermont Medicaid. Apply online at dvha.vermont.gov/members/long-term-care or call 1-802-476-0100. Your parent must meet income and asset limits.
- Request a long-term-services assessment. Contact your local Medicaid or aging office to request a comprehensive functional assessment that determines whether your parent qualifies for the Choices for Care (Global Commitment to Health 1115 Long-Term Care Medicaid waiver).
- Enroll in the waiver. Once deemed eligible, your parent is enrolled in the Choices for Care (Global Commitment to Health 1115 Long-Term Care Medicaid waiver) and assigned a case manager or care coordinator.
- Request the self-directed (CFC) option. During care planning, ask specifically for the consumer/self-directed service model and state that you, the adult child, want to be the hired caregiver.
- Enroll with ARIS Solutions. Complete enrollment paperwork — W-4, I-9, and background authorization — so payroll, tax withholding, and timesheets are handled for you.
- Complete orientation. Finish any state-required caregiver orientation covering personal-care techniques, emergency procedures, and reporting.
- Begin care and submit timesheets. Provide care per the authorized plan and submit electronic timesheets; payroll is processed on a regular cycle with taxes withheld.
Check Your Parent's Eligibility
Our free Benefits Checker helps identify whether your parent qualifies for Vermont's caregiver-pay programs and other benefits.
Check Eligibility NowOther Programs That May Pay Vermont Family Caregivers
VA Veteran-Directed Care & PCAFC
If your parent is a veteran enrolled in VA healthcare, the Veteran-Directed Care program provides a monthly budget that can pay family caregivers, and the Program of Comprehensive Assistance for Family Caregivers (PCAFC) offers a monthly stipend for eligible primary caregivers. Contact the caregiver support coordinator at your parent's VA medical center or call 1-855-260-3274.
Personal Care Agreement (Private Pay)
If your parent does not qualify for Medicaid, a formal written Personal Care Agreement lets them pay you from their own funds at fair-market rates. Drafted with an elder-law attorney, it must be prospective and reasonable — and it keeps payments from being treated as "gifts" during the Medicaid 5-year look-back.
State Respite & Caregiver Support
Through the National Family Caregiver Support Program, Vermont's Area Agencies on Aging fund respite, training, and counseling. These rarely pay ongoing wages but reduce your out-of-pocket costs. Find your local agency through the Eldercare Locator (1-800-677-1116) or 1-833-840-0061.
Tax Implications for Family Caregivers
- W-2 wages: The financial management agency issues you a W-2; federal income tax, Social Security, and Medicare are withheld.
- IRS Notice 2014-7: If you live in the same home as your parent (the Medicaid waiver participant), your self-directed wages may be excludable from federal gross income. Consult a CPA before filing — see IRS guidance on Medicaid waiver payments.
- Earned Income Tax Credit: These wages count as earned income and may qualify you for the EITC.
Maintain daily logs of services provided — date, time in, time out, and a brief description. Medicaid audits self-directed arrangements, and accurate records protect both you and your parent.
What Vermont Caregivers Are Actually Earning
At 30 hours per week and about $19 per hour, you would earn roughly $2,470 per month. At 40 hours per week and $24 per hour, earnings reach about $4,160 per month — around $49,920 per year before taxes.
For comparison, a nursing home costs far more per year, and agency home care runs roughly $30–$40 per hour. A self-directed arrangement lets your parent receive care from someone they trust, while you earn income that partially replaces what you may have given up to provide care.
Contact Information
- Department of Vermont Health Access (DVHA) / Department of Disabilities, Aging and Independent Living (DAIL): asd.vermont.gov/services/choices-for-care-program | 1-802-476-0100
- Apply for Medicaid: dvha.vermont.gov/members/long-term-care
- State aging services: asd.vermont.gov | 1-833-840-0061
- Eldercare Locator (find local help): eldercare.acl.gov | 1-800-677-1116
- Medicaid (federal): medicaid.gov
Frequently Asked Questions
Through Choices for Care Flexible Choices, family caregivers are typically paid roughly $14–$24 per hour, with the exact wage set by the participant or surrogate from an approved Medicaid cash budget. Pay is processed by the fiscal agent ARIS Solutions.
Choices for Care (CFC) is Vermont's Long-Term Care Medicaid program for people who need a nursing-home level of care but want to stay at home or in the community. Its Flexible Choices option lets participants self-direct a cash budget to hire their own caregivers.
Generally spouses and civil union partners are excluded under Flexible Choices, but Vermont's Choices for Care is unusual in that it can permit a spouse to be paid in certain highest-needs situations. Adult children and other relatives are routinely allowed.
The Choices for Care program, operated under Vermont's Global Commitment to Health 1115 Long-Term Care Medicaid waiver, lets family caregivers be paid through its Flexible Choices self-directed option.
Call DAIL/DVHA at 1-802-476-0100 or toll-free 1-833-840-0061 to request a Long-Term Care Medicaid application, or apply online at dvha.vermont.gov/members. DAIL determines clinical eligibility and DVHA confirms financial eligibility.
Yes. If your parent qualifies for Choices for Care at a nursing-home level of care, an adult child can be hired and paid to provide care, including for dementia, through the Flexible Choices self-directed option.
Related Guides
- How to Get Paid to Care for Your Parent (National Overview)
- How to Apply for Medicaid for an Elderly Parent
- Caregiver Tax Deductions 2026
- VA Benefits for Elderly Parents
- Power of Attorney for an Elderly Parent
- Medicaid Spend-Down Rules
This guide is general information, not legal or financial advice. Program names, pay rates, and eligibility rules change and vary by county — confirm details with Department of Vermont Health Access (DVHA) / Department of Disabilities, Aging and Independent Living (DAIL). Sources: asd.vermont.gov · dvha.vermont.gov.