Every answer was written and checked ahead of time, with the official document next to it. Nothing is made up on the spot.
Do I need a license to run a non-medical home care agency in Vermont?
No separate license in the documents we hold, but Medicaid work needs DAIL certification.
Vermont's home health rules cover Medicare-certified agencies that give skilled care, and they say private duty services are not subject to designation. To provide home care services and bill Medicaid, an agency must be certified by DAIL as a Home Care Provider and enrolled in Vermont Medicaid. Covered services are personal care, respite and companion for Choices for Care participants.
Sources (3)
Written and checked September 23, 2026
How do I become a Choices for Care home care provider?
Apply to DAIL's Adult Services Division.
Send the Home Care Provider Application with 10 required policies, two letters of support, and a description of the unmet need and your staffing in each area you want to serve, to AHS.DAILASDProviderEnrollment@vermont.gov. DAIL reviews accepted applications within 10 business days. With conditional approval you can bill Medicaid from that date. DAIL does an initial certification review 30 to 90 days after you start services. You must also be enrolled as a Vermont Medicaid provider.
Sources (2)
Written and checked September 23, 2026
How long does home care provider certification last?
Up to three years.
Certification lasts no more than three years, subject to DAIL's approval. Send a renewal application at least 60 days before it expires. If you file late, DAIL may suspend or revoke your certification. DAIL may also do one announced review a year and unannounced reviews at any time.
Written and checked September 23, 2026
How do I open a home health agency in Vermont?
Certificate of Need, Medicare certification, then DAIL designation.
You must get a Certificate of Need from the Green Mountain Care Board and federal Medicare certification before you apply to DAIL for designation. You need approval before you start operating. Designation lasts four years; file for renewal at least 60 calendar days before it expires. DAIL can give a provisional designation for up to one year to an agency seeking its first Medicare certification.
Written and checked September 23, 2026
Do live-in caregivers have to use EVV in Vermont?
No.
EVV is not required when the care provider lives in the home with the care recipient, or when services are given entirely outside the home. It is required if care happens in the home but starts or ends in the community.
Sources (2)
Written and checked September 23, 2026
What EVV system does Vermont use?
Sandata, free from the state.
Agencies can sign up for the free Sandata system through Sandata Learn. Home health agencies that use another vendor's EVV system should check, ideally daily, that their visit data reaches the Vermont Aggregator. Medicaid denies personal care and home health claims that are within EVV's scope and have missing or non-compliant EVV data.
Sources (4)
Written and checked September 23, 2026
What background checks do home care workers need?
Registries, criminal record and exclusion lists.
Workers paid with DAIL-administered funds need child and adult abuse registry checks, a Vermont criminal record check (VCIC), and federal exclusion list checks, plus a driving record check if they drive clients. They cannot start until the checks are satisfactory, and Medicaid will not pay for services given before then. A worker with certain convictions can ask for a variance; the agency must decide within 15 business days.
Written and checked September 23, 2026
What training do aides need before they work for a home care provider?
Eight topics, plus a competency check.
Before giving services, all staff must be trained in cultural sensitivity, participant rights, mandatory reporting, person-centered thinking, crisis management, emergency preparedness, incident reporting, and universal precautions and infection control. Direct care workers also need training in each participant's specific needs. A supervisor must assess their competency before they start, and the agency must make in-person monitoring visits at least every 90 days.
Written and checked September 23, 2026
Are there Medicaid health plans in Vermont?
No.
The state's Global Commitment to Health waiver runs Medicaid through a 'managed care-like' model. DVHA is treated as a non-risk prepaid inpatient health plan under federal managed care rules. Providers enroll with, and bill, Vermont Medicaid through its fiscal agent, Gainwell Technologies.
Sources (2)
Written and checked September 23, 2026
How long do I have to file a Vermont Medicaid claim?
180 days from the date of service.
Medicaid primary claims must be received within 180 days from the first date of service. When another insurer (not Medicare) pays first, the limit is 365 days. Waiting for prior authorization is not an accepted reason for filing late.
Written and checked September 23, 2026