Vermont Attendant Services Program: Vermont 2026 Guide
Vermont’s Attendant Services Program (ASP) helps adults with disabilities who need help with daily activities hire, train and supervise their own attendants. It is run by DAIL and includes Participant-Directed Attendant Care (PDAC), funded with state money and Medicaid.
This page explains who can use the Attendant Services Program in 2026, how family members can be paid, what the program covers, how to apply, and how it fits with nursing home Medicaid. For the full statewide rules on income, assets, spouses and the look-back, see our Vermont Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
What the Attendant Services Program is
ASP is consumer-directed: the participant (or, in limited cases, a representative) is the employer, chooses the attendant, and sets the schedule within approved hours. A fiscal agent handles payroll. ASP is for people with permanent disabilities who can direct their own care and who are not already receiving the same services through Choices for Care.
Family caregiver and self-directed programs let a Medicaid member, or a representative, choose who provides care and, in many cases, pay a relative or friend. A fiscal agent or provider agency usually handles payroll, taxes and background checks. Who can be paid varies: adult children usually can, spouses often cannot.
Who qualifies in 2026
Vermont looks at both how much help a person needs and what they own and earn. In general, to qualify for the Attendant Services Program an applicant must:
- be 18 or older with a permanent disability;
- need help with at least two activities of daily living;
- be able to direct their own care;
- live in Vermont; and
- meet the program’s financial rules, which differ for Medicaid and state-funded slots.
Financial rules. For the Attendant Services Program, the Vermont Department of Disabilities, Aging and Independent Living applies the long-term care Medicaid rules for income and assets, generally the same ones used for nursing home care. Bank and investment accounts count toward the limit, but a home, one vehicle, household goods and limited burial funds generally do not. The five-year look-back on gifts and below-value transfers applies here too, so large gifts in the past five years can delay services.
The main Vermont long-term care figures for 2026, taken from our state guide, are below.
| Item | 2026 figure |
|---|---|
| Income limit (applicant) | $2,982 a month (institutional income standard) |
| Asset limit (single applicant) | $2,000 |
| Asset limit (couple, both applying) | $3,000 |
| Home equity limit | $752,000 |
| Spouse at home: resource allowance (CSRA) | Up to $162,660 |
| Spouse at home: monthly income allowance | $2,707 (standard) / maximum $4,066.50 |
| Personal needs allowance (nursing home) | $79.93 a month |
| Look-back period | 60 months (5 years) |
Couples. Spousal impoverishment rules generally apply to waiver applicants in Vermont, protecting a share of assets and income for the spouse at home. The spousal allowance pages explain how these amounts are figured.
Services the Attendant Services Program can cover
Depending on assessed need, the Attendant Services Program can include:
- wages for attendants chosen by the participant
- help with activities of daily living
- help with related household tasks
- fiscal agent payroll services
What is usually not covered. Payment is for care tasks in the plan, not for rent, food or household bills. Caregiver pay is generally taxable, with special treatment for some live-in arrangements.
How to apply for the Attendant Services Program
The usual sequence for the Attendant Services Program is below. Running the financial application and the care assessment in parallel can shorten the wait.
- Contact DAIL to ask about the Attendant Services Program.
- Complete an assessment.
- Hire an attendant and complete employer paperwork with the fiscal agent.
- Hours are authorized.
- Services start.
Practical tips. Keep copies of everything you send and note the name of each person you speak with. Assessors only see one visit, so describe what a difficult day looks like and have a regular helper in the room. Memory problems, falls and the need for supervision all count, even when the person can still do some tasks alone. If the answer is no, the written notice explains how to request a fair hearing and the deadline.
Waiting lists and timing
State-funded slots are limited, and there can be a waiting list.
Getting on a list early, before a crisis, is usually wise. Stopgaps can include state plan home care, adult day centers, PACE where it operates and local aging services. The waiver waiting lists page explains common rules.
How it relates to nursing home Medicaid
the Attendant Services Program and nursing home Medicaid serve the same group of people; the difference is where care is given. One practical difference: nursing home Medicaid has no enrollment cap in Vermont, while a waiver can. A participant who later needs a nursing home keeps Medicaid, though more of their income then goes toward care. People leaving a nursing home often get priority for waiver openings, with help from Money Follows the Person.
Planning ahead for the Attendant Services Program
The need for the Attendant Services Program often arrives suddenly, after a hospital stay or a fall. Some preparation goes a long way. Begin with a list of daily tasks, the people who handle them, and the gaps that appear when a caregiver is away. That list supports the assessment and shows where paid help would make the biggest difference.
For the Medicaid application, collect bank statements, income notices, insurance cards, and proof of identity and Vermont residence. Keep older statements too: if a waiver or nursing home becomes necessary, the five-year look-back applies. Without a durable power of attorney, a family member may need a court order to manage finances, so signing one early is wise.
Finally, review the plan every few months. Needs change, and Vermont’s programs are designed to change with them through reassessments. A running log of health changes helps with every later review.
Tips for families
Discuss the arrangement openly with siblings, and plan for the caregiver’s own job, health and time off. A daily log of care is useful for everyone. Without a written caregiver agreement, earlier payments to relatives can be treated as gifts in the look-back. Line up backup help in advance.
Many families find it worthwhile to talk with a Certified Medicaid Planner before applying for the Attendant Services Program. A planner who knows Vermont’s rules can review income and assets, explain which program fits, map the timing against any waiting list, and help with the paperwork. Fees vary: roughly $500 to $6,000 for application help, $2,500 to $15,000 or more for full planning, and $150 to $600 an hour for advice.
Related pages
- Vermont Medicaid guide
- Vermont Choices for Care: High and Highest Needs
- Paid family caregivers
- Consumer-directed care
- Caregiver agreements
- HCBS waivers explained
- In-home care and Medicaid
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.