RESPITE CARE SERVICES PROVIDER IN VERMONT
OFFERING RELIEF TO FAMILY CAREGIVERS WHILE ENSURING INDIVIDUALS WITH DISABILITIES RECEIVE SAFE, COMPASSIONATE, TEMPORARY CARE

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Respite Care Services in Vermont provide short-term relief to unpaid caregivers of individuals with developmental disabilities, physical impairments, or chronic medical needs. These services are essential in preventing caregiver burnout and ensuring continuity of care for individuals living at home or in community-based settings.

Respite is a covered service under several of Vermont’s Home and Community-Based Services (HCBS) Medicaid Waivers. Respite may be provided in the individual’s home, a provider’s residence, or a licensed community care setting and must align with the individual’s support plan.

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Administers Vermont’s HCBS Waiver programs and authorizes respite services through Designated Agencies (DAs) and Specialized Services Agencies (SSAs).

Agency: Department of Vermont Health Access (DVHA)
Role: Oversees Medicaid provider enrollment and billing compliance.

Agency: Designated Agency or Specialized Service Agency (DA/SSA)
Role: Coordinates service planning, ISP approval, and ongoing monitoring for individuals receiving respite care.

2. RESPITE CARE SERVICES OVERVIEW

Respite Care provides temporary, supportive supervision and assistance to individuals with disabilities, offering caregivers a break from their ongoing responsibilities. Services may be scheduled or provided on an emergency basis.

Types of respite:

In-home respite: Care provided in the individual’s residence

Out-of-home respite: Care provided in the provider’s certified home or respite setting

Planned or crisis respite: May be used for vacations, emergencies, or health-related caregiver absences

Core service elements include:

Supervision and companionship

Assistance with Activities of Daily Living (ADLs)

Behavior support (if trained and authorized)

Personal care and medication assistance (as per ISP)

All services must be consistent with the individual’s support plan and authorized through the local DA or SSA.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Become affiliated with a Designated or Specialized Service Agency

Complete DVHA provider enrollment (if billing Medicaid directly)

Pass required background checks and home inspections (for out-of-home settings)

Develop a Respite Care Policy & Procedure Manual per DAIL and Medicaid standards

Maintain liability insurance and follow HIPAA compliance protocols

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register legal entity and obtain EIN and NPI
Step 2: Contact local DA/SSA to become a contracted respite provider
Step 3: Submit application and policy manual to agency
Step 4: Complete all background checks and training requirements
Step 5: Set up recordkeeping and billing systems
Step 6: Begin providing respite services upon authorization in the Individual Support Plan (ISP)

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI confirmation

Agency affiliation letter or contract (DA/SSA)

Medicaid enrollment confirmation (if billing directly)

Policy & Procedure Manual including:

Intake and caregiver relief scheduling procedures

Client rights and safety protocols

Medication handling and personal care guidelines

Staff training requirements and emergency plans

Documentation templates for billing and service tracking

Incident reporting and grievance resolution procedures

HIPAA and confidentiality compliance policies

6. STAFFING REQUIREMENTS

Role: Respite Care Worker
Requirements:

High school diploma or GED (some DAs may require more)

Background check clearance

CPR/First Aid certification

Training in personal care, behavior management (if applicable), and ISP implementation

Optional Role: Respite Program Coordinator
Responsibilities: Scheduling, training oversight, and DA/SSA reporting

All staff must complete:

Mandatory orientation through DA/SSA

HIPAA and documentation training

Emergency response and incident reporting training

Annual skills review and competency checks

7. MEDICAID WAIVER PROGRAMS

Respite is a service component under the following Vermont HCBS Waivers:

Developmental Disabilities Home and Community-Based Services Waiver

Choices for Care (CFC) Waiver – For older adults and individuals with physical disabilities

Children’s Personal Care and High-Tech Programs – On a case-by-case basis

All respite services must be included in the ISP and authorized by the supporting agency.

8. TIMELINE TO LAUNCH

Phase: Business Setup & Agency Contact
Timeline: 2–3 weeks

Phase: Enrollment with DA/SSA and Medicaid
Timeline: 1–2 months

Phase: Staff Training & Home Inspection (if applicable)
Timeline: 2–4 weeks

Phase: Launch of Services
Timeline: Upon agency approval and ISP authorization

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

List of Designated Agencies
Website: https://mentalhealth.vermont.gov/services/designated-agencies

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT RESPITE CARE PROVIDER
WCG helps new and existing providers launch Medicaid-compliant respite care programs in partnership with Vermont’s local agencies.

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Scope of Work:

DA/SSA contracting and provider enrollment support

Respite Care Policy & Procedure Manual development

HIPAA, ADL, and medication support documentation

Training guides and caregiver orientation packets

Safety checklists and emergency response forms

Recordkeeping and time tracking templates for billing

RESIDENTIAL SUPPORT SERVICES PROVIDER IN VERMONT
DELIVERING SAFE, STABLE, AND SUPPORTIVE HOUSING ENVIRONMENTS FOR INDIVIDUALS WITH DISABILITIES WHO REQUIRE DAILY ASSISTANCE AND SUPERVISION

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Residential Support Services in Vermont provide 24-hour or scheduled assistance to individuals with intellectual or developmental disabilities, acquired brain injuries, or other qualifying conditions who cannot live independently. These services focus on skill-building, supervision, and creating a home-like environment that honors the individual’s preferences and promotes community integration.

Residential Supports are authorized through Vermont’s Medicaid Home and Community-Based Services (HCBS) Waivers and are overseen by the Department of Disabilities, Aging and Independent Living (DAIL) in coordination with Designated Agencies (DAs) or Specialized Service Agencies (SSAs).

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Regulates Residential Support Services under HCBS Waivers, monitors compliance, and ensures person-centered outcomes.

Agency: Department of Vermont Health Access (DVHA)
Role: Administers Medicaid enrollment and payment for authorized services.

Agency: Designated Agencies (DAs) / Specialized Services Agencies (SSAs)
Role: Coordinate Individual Support Plans (ISPs), authorize placement, and provide quality oversight.

2. RESIDENTIAL SUPPORT SERVICES OVERVIEW

Residential Support Services provide a structured living environment where participants receive individualized support based on their ISP. Services may occur in shared living homes, group homes, supervised apartments, or staffed residences.

Covered services may include:

24-hour supervision and direct care

Assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)

Medication administration and health monitoring

Support with meals, hygiene, and mobility

Behavioral support and crisis response

Transportation to community activities or day programs

Goal setting, skill development, and ISP progress tracking

Service delivery models are highly individualized and must support independence, dignity, and choice.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Contract with a DA or SSA to serve individuals in residential settings

Complete DVHA Medicaid enrollment (if billing directly)

Comply with all DAIL residential care regulations

Obtain necessary local zoning or fire safety approvals (depending on housing type)

Develop a Residential Support Services Policy & Procedure Manual

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register legal entity, obtain EIN and NPI
Step 2: Apply to contract with a Designated Agency or SSA
Step 3: Submit housing inspection reports (fire safety, egress, etc.)
Step 4: Enroll with DVHA for Medicaid billing (if not billing through DA/SSA)
Step 5: Train and credential direct support staff
Step 6: Launch services once placement is assigned and ISP is approved

5. REQUIRED DOCUMENTATION

EIN, NPI, and Articles of Incorporation

DA/SSA service contract or DAIL authorization

Medicaid provider enrollment (if applicable)

Residential Support Services Policy & Procedure Manual, including:

Supervision schedules and staff responsibilities

Medication administration and documentation procedures

Emergency preparedness and fire evacuation plans

Personal care and hygiene support guidelines

Behavioral response and de-escalation protocols

HIPAA, grievance, and client rights policies

ISP tracking tools and residential shift logs

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)
Requirements:

High school diploma or equivalent

Background check clearance

CPR/First Aid certification

Training in ADLs, safety, documentation, and person-centered care

Role: Residential Coordinator / Supervisor
Responsibilities:

Staff scheduling, ISP implementation, incident management, and communication with DA/SSA

Optional Role: Licensed Nurse or Behavioral Specialist
**Needed for participants requiring skilled health services or intensive behavioral supports

All staff must complete:

ISP-aligned training and goal implementation practices

HIPAA and confidentiality policies

Emergency response and fire safety drills

Documentation and incident reporting procedures

Annual performance evaluations and competency checks

7. MEDICAID WAIVER PROGRAMS

Residential Support Services are authorized under:

Developmental Disabilities Services Waiver (DDSW) – Core waiver for 24/7 residential support

Brain Injury Program – For individuals with ABI who require structured, supervised housing

Choices for Care (CFC) Waiver – May cover certain group residence options for older adults

High-Tech Pediatric and Transition Services – On a case-by-case basis for medically complex youth

All services must be tied to the participant’s ISP and align with Vermont’s HCBS residential setting requirements.

8. TIMELINE TO LAUNCH

Phase: Business Setup & Housing Readiness
Timeline: 3–4 weeks

Phase: DA/SSA Contracting & Medicaid Enrollment
Timeline: 1–2 months

Phase: Housing Inspections & Staff Hiring
Timeline: 4–6 weeks

Phase: Service Launch
Timeline: Begins upon ISP approval and resident placement

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Designated Agencies Directory
Website: https://mentalhealth.vermont.gov/services/designated-agencies

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT RESIDENTIAL SUPPORT PROVIDER
WCG helps agencies launch fully compliant, person-centered residential programs that meet Medicaid standards and promote long-term stability for participants with complex needs.

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Scope of Work:

DA/SSA contracting and DVHA enrollment assistance

Residential Policy & Procedure Manual development

Staff onboarding and training documents

Medication logs, shift reports, and ISP tracking templates

Fire safety and emergency preparedness plans

Behavior support documentation and incident reporting systems

SUPPORTED EMPLOYMENT SERVICES PROVIDER IN VERMONT
PROMOTING INCLUSION, INDEPENDENCE, AND ECONOMIC EMPOWERMENT THROUGH INDIVIDUALIZED JOB SUPPORTS

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Supported Employment Services in Vermont are designed to assist individuals with intellectual and developmental disabilities, acquired brain injuries, or physical impairments in obtaining and maintaining meaningful, competitive employment in their communities. Services are tailored to each individual’s strengths, preferences, and employment goals, as outlined in their Individual Support Plan (ISP).

These services are covered under Vermont’s Home and Community-Based Services (HCBS) Medicaid Waivers and are administered through the Department of Disabilities, Aging and Independent Living (DAIL) in partnership with Designated Agencies (DAs) and Specialized Services Agencies (SSAs).

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Oversees waiver programs, approves provider qualifications, and ensures ISP alignment with employment outcomes.

Agency: Department of Vermont Health Access (DVHA)
Role: Manages Medicaid provider enrollment and reimbursement for Supported Employment services.

Agency: Designated Agencies (DAs) / Specialized Services Agencies (SSAs)
Role: Coordinate service planning, monitor employment progress, and authorize services through the ISP.

2. SUPPORTED EMPLOYMENT SERVICES OVERVIEW

Supported Employment includes services that help individuals prepare for, secure, and retain competitive employment in integrated work environments. The focus is on building long-term career success while honoring personal choice and autonomy.

Covered services include:

Job discovery and career profiling

Job development and employer outreach

On-the-job coaching and skill building

Transportation training or coordination (if job-related)

Workplace accommodations and task modification

Ongoing job retention and career advancement support

Self-employment exploration and assistance (if applicable)

Services must be person-centered, goal-directed, and delivered in accordance with the participant’s ISP and employment plan.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Establish a contract or partnership with a Designated Agency or SSA

Complete Medicaid enrollment through DVHA (if billing directly)

Carry liability insurance and develop staff training protocols

Create a Supported Employment Policy & Procedure Manual

Employ qualified staff with relevant experience and training in employment services

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register business, obtain EIN and NPI
Step 2: Apply to become an affiliated provider through a DA or SSA
Step 3: Submit Policy Manual, staff resumes, and insurance documents for review
Step 4: Enroll with DVHA (if billing Medicaid directly)
Step 5: Complete required staff training (person-centered planning, documentation, workplace safety)
Step 6: Begin service delivery following ISP employment goal authorization

5. REQUIRED DOCUMENTATION

EIN, NPI, Articles of Incorporation

DA/SSA contract or DAIL approval

Medicaid enrollment letter (if applicable)

Supported Employment Policy & Procedure Manual, including:

Job development and placement process

Staff roles, documentation, and supervision protocols

Client rights, HIPAA, and confidentiality policies

Risk management and safety procedures

Employer communication templates

Progress note, employment plan, and time tracking forms

Annual review and satisfaction survey process

6. STAFFING REQUIREMENTS

Role: Employment Specialist / Job Coach
Requirements:

High school diploma or equivalent (Bachelor’s preferred)

Experience in workforce development or disability services

Background check clearance

Training in person-centered planning and employment support practices (e.g., ACRE, APSE preferred)

Optional Role: Program Supervisor
Responsibilities: Staff support, QA monitoring, DA/SSA liaison

All staff must complete:

Orientation on employment-first principles

ISP-based documentation and time tracking training

Safety and emergency preparedness

HIPAA and grievance protocol training

Ongoing continuing education or credentialing (recommended annually)

7. MEDICAID WAIVER PROGRAMS

Supported Employment Services are covered under:

Developmental Disabilities Services Waiver (DDSW) – Core waiver for individuals with ID/DD

Brain Injury Program – Focus on re-entry and skill redevelopment

Choices for Care (CFC) – On a limited basis, often through specialized employment pilots or partnerships

Children’s Personal Care / Transition Programs – When coordinated as part of youth-to-adult planning

All services must be included in the ISP, reviewed regularly, and coordinated with Vocational Rehabilitation (VR) when applicable.

8. TIMELINE TO LAUNCH

Phase: Business Setup & Policy Manual Development
Timeline: 2–4 weeks

Phase: DA/SSA Enrollment & Medicaid Provider Registration
Timeline: 1–2 months

Phase: Staff Hiring, Training & Credentialing
Timeline: 2–3 weeks

Phase: Begin Service Delivery
Timeline: Upon approval and employment-related ISP goal authorization

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Vocational Rehabilitation – Vermont Division
Website: https://vocrehab.vermont.gov

Designated Agencies Directory
Website: https://mentalhealth.vermont.gov/services/designated-agencies

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT SUPPORTED EMPLOYMENT PROVIDER
WCG helps providers launch employment-first services that meet Medicaid, waiver, and local agency expectations while promoting career empowerment for individuals with disabilities.

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Scope of Work:

DA/SSA and DVHA enrollment support

Supported Employment Policy & Procedure Manual development

Job coaching documentation and employer communication tools

Progress tracking forms and billing logs

Training plans for Employment Specialists

Risk mitigation, HIPAA, and grievance policies

ADAPTIVE EQUIPMENT SERVICES PROVIDER IN VERMONT
SUPPORTING INDEPENDENT LIVING THROUGH CUSTOMIZED DEVICES THAT ENHANCE MOBILITY, COMMUNICATION, AND DAILY FUNCTIONING

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Adaptive Equipment Services in Vermont provide individuals with disabilities access to devices and supports that promote safety, independence, and participation in daily activities. These services include evaluation, acquisition, customization, and maintenance of mobility aids, communication devices, and functional tools that meet disability-related needs.

Adaptive Equipment is covered under several of Vermont’s Medicaid Home and Community-Based Services (HCBS) Waivers when the need is outlined in the participant’s Individual Support Plan (ISP). Oversight is provided by the Department of Disabilities, Aging and Independent Living (DAIL) in collaboration with Designated Agencies (DAs) and Specialized Services Agencies (SSAs).

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Authorizes adaptive equipment services through HCBS Waivers, ensures medical necessity and ISP alignment.

Agency: Department of Vermont Health Access (DVHA)
Role: Processes Medicaid enrollment and reimbursement for equipment and services.

Agency: Designated Agencies (DAs) / Specialized Services Agencies (SSAs)
Role: Coordinate ISP development and authorize equipment needs based on functional assessments.

2. ADAPTIVE EQUIPMENT SERVICES OVERVIEW

Adaptive Equipment Services involve the provision and support of specialized devices used to assist individuals in their daily lives. These may be off-the-shelf or custom-built to meet specific needs.

Examples of covered equipment:

Wheelchairs and seating systems

Grab bars, reachers, and adaptive eating utensils

Communication devices (e.g., AAC systems)

Transfer aids and lift systems

Adaptive switches and controls for home electronics

Sensory equipment for behavioral support

Custom orthotics or prosthetics (when not covered by other benefits)

All equipment must be justified based on a clinical evaluation and be included in the ISP. Duplicative or recreational items are not reimbursable.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Contract with a Designated Agency or apply through DAIL as an Adaptive Equipment provider

Enroll with DVHA for Medicaid reimbursement (if billing directly)

Maintain general liability insurance and device warranties

Develop a Policy & Procedure Manual for Adaptive Equipment services

For evaluative services, collaborate with licensed clinicians (OT, PT, SLP)

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain EIN and NPI
Step 2: Apply to DAIL or contract with a Designated Agency
Step 3: Enroll with DVHA as a Medicaid equipment services provider
Step 4: Submit staff credentials, vendor partnerships, and Policy Manual for review
Step 5: Set up procurement, delivery, and maintenance tracking systems
Step 6: Begin service delivery upon ISP authorization and order approval

5. REQUIRED DOCUMENTATION

EIN, NPI, and Articles of Incorporation

DA/SSA service contract or DAIL provider approval

Medicaid enrollment confirmation (if applicable)

Policy & Procedure Manual including:

Equipment procurement, delivery, and installation workflows

Maintenance and repair schedules

Safety and troubleshooting guidelines

Documentation of medical necessity and functional assessments

Client rights and consent procedures

HIPAA compliance and data security protocols

Coordination protocols with therapists and support coordinators

Tracking forms for equipment delivery and satisfaction surveys

6. STAFFING REQUIREMENTS

Role: Adaptive Equipment Specialist / Technician
Requirements:

Experience with assistive technology or rehabilitation equipment

Manufacturer certifications for installation (as needed)

HIPAA and safety training

Background check clearance

Optional Role: Licensed Therapist (OT, PT, SLP)
Responsibilities: Provide clinical justification, assessments, and recommendations for device selection

All staff must complete:

Device handling and safety training

Documentation and ISP integration training

HIPAA, emergency response, and incident reporting procedures

7. MEDICAID WAIVER PROGRAMS

Adaptive Equipment may be covered under:

Developmental Disabilities Services Waiver (DDSW)

Choices for Care (CFC) Waiver

Brain Injury Program

Children’s Personal Care and High-Tech Waivers

Attendant Services Program (ASP) – On a limited basis with demonstrated functional need

All requests must be documented in the ISP, accompanied by a justification of medical necessity, and pre-approved by DAIL or the supervising DA/SSA.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Vendor Setup
Timeline: 2–3 weeks

Phase: DA/SSA Contracting or DAIL Enrollment
Timeline: 1–2 months

Phase: Medicaid Enrollment (if applicable)
Timeline: 4–6 weeks

Phase: Documentation, Staff Training & Service Launch
Timeline: Begins upon ISP approval and equipment authorization

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Vermont Assistive Technology Program (VATP)
Website: https://atp.vermont.gov

Designated Agencies Directory
Website: https://mentalhealth.vermont.gov/services/designated-agencies

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT ADAPTIVE EQUIPMENT PROVIDER
WCG supports new and expanding providers in launching Medicaid-compliant Adaptive Equipment services that meet functional needs, regulatory standards, and ISP goals.

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Scope of Work:

Medicaid and DA/SSA enrollment support

Adaptive Equipment Policy & Procedure Manual development

Procurement and installation documentation templates

HIPAA, device safety, and client consent forms

Coordination workflows for therapists and case managers

Maintenance logs and delivery tracking sheets

SKILLED NURSING SERVICES PROVIDER IN VERMONT
DELIVERING MEDICALLY NECESSARY NURSING CARE IN THE HOME AND COMMUNITY TO SUPPORT COMPLEX HEALTH NEEDS AND PROMOTE INDEPENDENCE

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Skilled Nursing Services in Vermont offer professional, clinical support to individuals with chronic conditions, disabilities, or post-acute needs. These services are delivered by licensed nurses and are essential for individuals requiring ongoing medical oversight outside of institutional settings.

Skilled Nursing is covered under Vermont Medicaid’s State Plan and Home and Community-Based Services (HCBS) Waivers. Services must be authorized through an Individual Support Plan (ISP) or physician-ordered Plan of Care and are overseen by the Department of Vermont Health Access (DVHA) and the Department of Disabilities, Aging and Independent Living (DAIL).

1. GOVERNING AGENCIES

Agency: Department of Vermont Health Access (DVHA)
Role: Administers Medicaid billing, prior authorizations, and reimbursement for skilled nursing services.

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Authorizes waiver-based nursing services, ensures compliance with HCBS ISP goals.

Agency: Vermont Secretary of State – Office of Professional Regulation (OPR)
Role: Licenses Registered Nurses (RNs) and Licensed Practical Nurses (LPNs).

Agency: Designated Agencies (DAs) / Specialized Services Agencies (SSAs)
Role: Coordinate waiver service delivery and provide authorization for ISP-based nursing supports.

2. SKILLED NURSING SERVICES OVERVIEW

Skilled Nursing Services involve medical care delivered by an RN or LPN to address complex health needs, prevent complications, and support safe living in the home or community.

Covered services may include:

Medication administration and injections

Wound care and dressing changes

Ventilator or tracheostomy care

Catheter and ostomy care

Chronic condition monitoring (e.g., diabetes, epilepsy, seizures)

Pain and symptom management

Teaching and training caregivers or family members

Emergency response readiness (for high-risk cases)

Services must be deemed medically necessary, follow a physician’s order, and be documented per Medicaid standards.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Secure professional licenses for all nursing staff (RN, LPN)

Contract with a Designated Agency or apply for independent approval through DVHA

Develop a Skilled Nursing Policy & Procedure Manual

Obtain liability and malpractice insurance

Complete Medicaid enrollment through DVHA (if billing directly)

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register business, obtain EIN and NPI
Step 2: Apply for provider affiliation through a Designated Agency or DAIL
Step 3: Submit licensure and credentials of nursing staff
Step 4: Complete Medicaid provider enrollment with DVHA
Step 5: Submit Policy & Procedure Manual for review
Step 6: Begin service delivery upon Plan of Care or ISP authorization

5. REQUIRED DOCUMENTATION

EIN, NPI, and Articles of Incorporation

Professional licensure verification for RNs and LPNs

Medicaid enrollment confirmation (if applicable)

DA/SSA affiliation (if applicable)

Skilled Nursing Policy & Procedure Manual including:

Clinical care protocols and standing orders

Medication administration and documentation standards

Infection control, wound care, and universal precautions

Shift note templates and nursing assessments

Emergency procedures and on-call availability plans

HIPAA, patient rights, and grievance policies

Staff supervision, CEU tracking, and competency review

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)
Requirements:

Vermont license from OPR

CPR certification

Skilled in assessments, care planning, and documentation

Responsible for training LPNs and aides

Role: Licensed Practical Nurse (LPN)
Requirements:

Vermont license

Provides hands-on skilled nursing care under RN direction

Must document per Plan of Care and ISP guidelines

Optional Role: Clinical Supervisor / Nurse Administrator
Responsibilities: Oversees program quality, ensures compliance, supervises clinical staff

All staff must complete:

HIPAA and emergency response training

Infection control and documentation protocols

Annual skills check and clinical competency review

Ongoing CEUs and license renewals

7. MEDICAID WAIVER PROGRAMS

Skilled Nursing is an authorized service under:

Choices for Care (CFC) Waiver – Adults with physical disabilities or age-related needs

Developmental Disabilities Services Waiver (DDSW) – Individuals with ID/DD and medical needs

Brain Injury Program – High-needs cases requiring specialized care

Children with High-Tech Needs – Pediatric participants needing tracheostomy or vent care

Children’s Personal Care Services (CPCS) – For children requiring skilled intervention in the home

All services must be linked to the Individual Support Plan (ISP) or physician Plan of Care and reviewed regularly.

8. TIMELINE TO LAUNCH

Phase: Entity Formation & Licensing Verification
Timeline: 2–3 weeks

Phase: Policy Manual & DA/SSA Contracting
Timeline: 2–4 weeks

Phase: Medicaid Enrollment with DVHA
Timeline: 1–2 months

Phase: Staff Training & Compliance Review
Timeline: 2–3 weeks

Phase: Service Launch
Timeline: Upon authorization and physician order approval

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Vermont Secretary of State – Office of Professional Regulation (OPR)
Website: https://sos.vermont.gov/opr

Designated Agencies Directory
Website: https://mentalhealth.vermont.gov/services/designated-agencies

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT SKILLED NURSING PROVIDER
WCG helps licensed professionals and clinical teams build Medicaid-compliant Skilled Nursing Services programs that align with state regulations and meet the needs of medically complex individuals across Vermont.

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Scope of Work:

DVHA enrollment and provider credentialing support

Skilled Nursing Policy & Procedure Manual development

Shift note, medication log, and Plan of Care templates

Staff onboarding, supervision, and CEU tracking tools

Infection control, HIPAA, and grievance policies

DA/SSA collaboration and ISP alignment protocols

HABILITATION SERVICES PROVIDER IN VERMONT
BUILDING DAILY LIVING SKILLS AND COMMUNITY PARTICIPATION FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES THROUGH PERSONALIZED SUPPORTS

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Habilitation Services in Vermont are designed to help individuals with intellectual or developmental disabilities acquire, maintain, and improve skills necessary for everyday living. These supports promote independence, inclusion, and person-centered growth by focusing on functional abilities rather than medical care.

Habilitation is a core service under Vermont’s Medicaid Home and Community-Based Services (HCBS) Waivers and is authorized through an Individual Support Plan (ISP). Oversight is provided by the Department of Disabilities, Aging and Independent Living (DAIL), in collaboration with Designated Agencies (DAs) and Specialized Service Agencies (SSAs).

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Oversees habilitation services under HCBS Waivers, ensures alignment with person-centered ISP goals and Medicaid standards.

Agency: Department of Vermont Health Access (DVHA)
Role: Manages Medicaid provider enrollment and reimbursement for habilitation services.

Agency: Designated Agencies (DAs) / Specialized Services Agencies (SSAs)
Role: Coordinate ISP development, service delivery, provider contracting, and performance monitoring.

2. HABILITATION SERVICES OVERVIEW

Habilitation Services are non-medical supports that assist individuals in learning or enhancing skills related to personal care, community integration, and independent living. Services must be tailored to the individual’s unique goals and functional needs.

Covered habilitation services include:

Daily living skills training (e.g., cooking, hygiene, money management)

Social and communication skill-building

Transportation training and travel safety

Self-advocacy, decision-making, and self-direction supports

Community access and participation (e.g., volunteering, classes)

Support with health-related routines and safety awareness

Functional mobility or adaptive skill practice (non-therapeutic)

Services must be documented in the ISP, with specific outcomes and progress measured regularly.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Contract with a Designated Agency or SSA to provide habilitation supports

Complete Medicaid enrollment with DVHA (if billing directly)

Develop a Habilitation Services Policy & Procedure Manual

Maintain liability insurance and comply with background screening requirements

Train staff in HCBS, ISP documentation, and person-centered approaches

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register business, obtain EIN and NPI
Step 2: Apply to contract with a DA/SSA for habilitation service delivery
Step 3: Submit Policy Manual, staff credentials, and insurance documentation
Step 4: Enroll with DVHA for Medicaid billing (if authorized)
Step 5: Complete required staff training and documentation onboarding
Step 6: Begin service delivery upon ISP authorization and staff-client matching

5. REQUIRED DOCUMENTATION

EIN, NPI, Articles of Incorporation

DA/SSA service agreement or DAIL approval

Medicaid provider enrollment confirmation (if applicable)

Habilitation Policy & Procedure Manual, including:

Staff training and supervision plans

Risk management and emergency response protocols

ISP-aligned goal tracking and service note templates

Community access and transportation safety guidelines

HIPAA compliance and client confidentiality policies

Client rights, grievance, and incident reporting forms

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP) / Habilitation Support Worker
Requirements:

High school diploma or equivalent

Background check clearance

CPR/First Aid certification (recommended)

Training in person-centered planning and disability awareness

Experience supporting individuals with I/DD preferred

Optional Role: Program Supervisor
Responsibilities: Staff oversight, ISP coordination, and QA documentation

All staff must complete:

DAIL- or DA-approved habilitation training

HIPAA and rights training

ISP documentation and progress reporting procedures

Emergency preparedness and safety drills

Annual competency and incident response refresher training

7. MEDICAID WAIVER PROGRAMS

Habilitation Services are authorized under:

Developmental Disabilities Services Waiver (DDSW) – Core service for individuals with I/DD

Brain Injury Program – Skill reinforcement after functional loss

Choices for Care (CFC) – Community participation habilitation (case-specific)

Transition-Aged Youth Programs – Often embedded into school-to-community services

All services must align with the ISP and demonstrate measurable progress toward increased independence or community engagement.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Development
Timeline: 2–3 weeks

Phase: DA/SSA Contracting & Medicaid Enrollment
Timeline: 1–2 months

Phase: Staff Hiring, Background Checks & Training
Timeline: 2–4 weeks

Phase: Service Launch
Timeline: Upon DA/SSA approval and ISP assignment

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Designated Agencies Directory
Website: https://mentalhealth.vermont.gov/services/designated-agencies

​

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT HABILITATION SERVICES PROVIDER
WCG guides providers in launching person-centered Habilitation Services with a strong focus on skill-building, community engagement, and regulatory compliance.

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Scope of Work:

DA/SSA and Medicaid enrollment support

Habilitation Policy & Procedure Manual development

ISP goal documentation and progress tracking forms

DSP onboarding and training templates

Risk management, HIPAA, and grievance forms

Community integration planning and transportation protocols

ADULT HEALTH SERVICES PROVIDER IN VERMONT
DELIVERING DAYTIME MEDICAL MONITORING, THERAPEUTIC SUPPORT, AND SOCIAL ENGAGEMENT FOR ADULTS WITH CHRONIC CONDITIONS OR DISABILITIES

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Adult Health Services in Vermont provide structured, medically supervised day services for adults who require ongoing health-related support and social engagement. These services are designed to promote wellness, delay institutional care, and offer respite to family caregivers.

Covered under Vermont’s Medicaid Home and Community-Based Services (HCBS) Waivers, Adult Health Services are typically provided in a licensed adult day health center and coordinated through the Department of Disabilities, Aging and Independent Living (DAIL) and the Department of Vermont Health Access (DVHA).

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Oversees Adult Day and Adult Health Services under HCBS Waivers, including licensing, service standards, and compliance.

Agency: Department of Vermont Health Access (DVHA)
Role: Handles Medicaid enrollment, claims, and reimbursement for authorized services.

Agency: Vermont Division of Licensing and Protection (DLP)
Role: Inspects and licenses adult day health centers providing skilled services.

2. ADULT HEALTH SERVICES OVERVIEW

Adult Health Services offer daytime support to individuals who are medically frail or have disabilities that impact daily functioning. Services focus on physical and mental health, socialization, and caregiver relief.

Core service components include:

Nursing assessments and health monitoring

Medication administration and chronic condition support

Physical, occupational, or speech therapy (if authorized)

Therapeutic activities and exercise programs

Personal care (e.g., bathing, toileting, grooming)

Nutritional meals and dietary oversight

Behavioral supports and social work services

Transportation to and from the day center (if included in the ISP)

Services must be provided in a licensed setting and tailored to the individual’s care plan or ISP.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Apply for Adult Day Health Services license via DLP (if providing skilled services)

Enroll with DVHA as a Medicaid provider

Maintain liability insurance and emergency response protocols

Develop a comprehensive Adult Health Services Policy & Procedure Manual

Employ licensed clinical and support staff based on care needs

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register legal entity and obtain EIN and NPI
Step 2: Apply for Adult Day Health Services license through the Division of Licensing and Protection
Step 3: Enroll with DVHA for Medicaid billing
Step 4: Develop staffing plan and complete background checks
Step 5: Submit Policy & Procedure Manual for approval
Step 6: Begin accepting participants once licensed and ISP authorizations are in place

5. REQUIRED DOCUMENTATION

EIN, NPI, and Articles of Incorporation

Adult Day Health Center license

Medicaid provider enrollment confirmation

Adult Health Services Policy & Procedure Manual, including:

Clinical monitoring and documentation protocols

Medication handling and personal care procedures

Emergency preparedness and infection control

Staff roles, training plans, and credentialing

Participant rights, grievances, and HIPAA compliance

Activity schedules and progress tracking forms

Transportation coordination policies (if applicable)

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)
Requirements: Vermont licensure, responsible for health assessments, medication administration, and supervision

Role: Licensed Practical Nurse (LPN)
Requirements: Provides hands-on nursing care under RN supervision

Role: Program Aides / Personal Care Attendants
Requirements: Trained in ADLs, safety, and infection control; background checks required

Role: Activity Coordinator
Requirements: Designs therapeutic and recreational activities

Optional Roles: Social Worker, PT/OT/SLP, Dietitian (based on participant needs)

All staff must complete:

HIPAA and client rights training

CPR/First Aid certification

Infection control and emergency response drills

Annual competency reviews and continuing education

7. MEDICAID WAIVER PROGRAMS

Adult Health Services may be authorized under:

Choices for Care (CFC) Waiver – Primary waiver for older adults and individuals with physical disabilities

Brain Injury Program – For structured daytime supports and therapy reinforcement

Developmental Disabilities Services Waiver (DDSW) – On a case-by-case basis if clinically indicated

All services must be documented in the Individual Support Plan (ISP) and reviewed routinely.

8. TIMELINE TO LAUNCH

Phase: Business Setup & Facility Preparation
Timeline: 1–2 months

Phase: Licensing & Medicaid Enrollment
Timeline: 2–4 months

Phase: Staffing & Policy Manual Finalization
Timeline: 4–6 weeks

Phase: Service Launch
Timeline: Upon licensure, Medicaid enrollment, and ISP authorization

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Vermont Division of Licensing and Protection (DLP)
Website: https://dlp.vermont.gov

​

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT ADULT HEALTH SERVICES PROVIDER
WCG helps providers design and launch comprehensive, Medicaid-compliant Adult Health Services that deliver both medical monitoring and meaningful engagement in community-based settings.

​

Scope of Work:

DLP licensing and Medicaid enrollment guidance

Adult Health Services Policy & Procedure Manual development

Staffing plan, credentialing logs, and supervision tools

Activity schedules, care logs, and medication tracking forms

Infection control and emergency response documentation

Client rights and HIPAA compliance materials

ASSISTIVE TECHNOLOGY PROVIDER IN VERMONT
ENABLING GREATER INDEPENDENCE THROUGH SPECIALIZED DEVICES THAT SUPPORT MOBILITY, COMMUNICATION, AND DAILY FUNCTIONING

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Assistive Technology (AT) Services in Vermont help individuals with disabilities access and use specialized equipment that enhances their independence, safety, and participation in daily life. These services may include evaluation, acquisition, customization, training, and maintenance of both high- and low-tech devices.

AT is a covered service under several of Vermont’s Medicaid Home and Community-Based Services (HCBS) Waivers and must be outlined in the participant’s Individual Support Plan (ISP). These services are coordinated through the Department of Disabilities, Aging and Independent Living (DAIL) and its network of Designated and Specialized Service Agencies (DAs/SSAs).

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Approves AT services through waiver programs and oversees provider qualifications and documentation.

Agency: Department of Vermont Health Access (DVHA)
Role: Administers Medicaid funding and billing systems for authorized AT services.

Agency: Designated Agencies (DAs) / Specialized Services Agencies (SSAs)
Role: Coordinate AT assessments and include AT services in Individual Support Plans (ISPs).

2. ASSISTIVE TECHNOLOGY SERVICES OVERVIEW

Assistive Technology services support individuals in acquiring and using devices that increase functional capabilities. Devices can be commercial off-the-shelf or custom designed to meet specific needs.

Examples of covered AT devices:

Communication aids (e.g., speech-generating devices)

Environmental control units (e.g., remote-operated lights or doors)

Adaptive computer software or hardware

Mobility supports (e.g., adapted walkers, powered chairs)

Sensory equipment (e.g., visual timers, calming devices)

Adaptive switches and mounts

Modified utensils, grooming tools, and writing aids

AT services can also include professional evaluation, training, fitting, and routine maintenance.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Apply through a Designated or Specialized Service Agency for AT provider status

Complete Medicaid enrollment (if billing DVHA directly)

Maintain liability insurance and follow device safety standards

Develop a Policy & Procedure Manual for Assistive Technology services

Secure manufacturer certifications for staff (as applicable for device support)

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain EIN and NPI
Step 2: Contact local DA/SSA to contract as an AT provider
Step 3: Submit Policy Manual and staff qualifications to agency
Step 4: Enroll with DVHA (if required for billing reimbursement)
Step 5: Coordinate with AT professionals (e.g., OT/PT/Speech) for device justification
Step 6: Begin delivering services upon ISP authorization

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI

DA/SSA agreement or contract

Medicaid enrollment confirmation (if billing DVHA directly)

Assistive Technology Policy & Procedure Manual, including:

Device evaluation and selection process

Equipment ordering, tracking, and delivery protocols

Installation and training guidelines

Maintenance and repair logs

Staff training documentation and certifications

Participant consent and HIPAA compliance policies

AT justification reports and service documentation forms

6. STAFFING REQUIREMENTS

Role: Assistive Technology Specialist / Technician
Requirements:

Background in rehabilitation, technology, or disability services

Manufacturer/device-specific certifications (recommended)

Experience in client training and equipment setup

HIPAA and confidentiality training

Optional Role: Licensed Therapist (OT, PT, SLP)
Requirements:

Vermont licensure

Provides clinical evaluation and justification for AT use

All staff must complete:

Client safety and dignity training

ISP and Medicaid documentation training

Emergency procedures and device safety protocols

Annual skills assessments (recommended)

7. MEDICAID WAIVER PROGRAMS

Assistive Technology is covered under the following Vermont HCBS Waivers:

Developmental Disabilities Services Waiver

Choices for Care (CFC) Waiver – For older adults and physically disabled individuals

Children’s Personal Care and High-Tech Services Waiver – On a case-by-case basis

Brain Injury Program – As part of individualized support plans

AT must be functionally necessary, not duplicative of other services, and included in the ISP with supporting documentation.

8. TIMELINE TO LAUNCH

Phase: Business Setup & Documentation Prep
Timeline: 2–4 weeks

Phase: DA/SSA Enrollment & Policy Manual Approval
Timeline: 1–2 months

Phase: Staff Training & Equipment Vendor Setup
Timeline: 2–3 weeks

Phase: Begin Service Delivery
Timeline: Upon authorization in ISP and agency agreement

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Vermont Assistive Technology Program (VATP)
Website: https://atp.vermont.gov

​

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT ASSISTIVE TECHNOLOGY PROVIDER
WCG helps new and existing providers implement Medicaid-compliant Assistive Technology services by guiding them through policy creation, agency alignment, and device documentation.

​

Scope of Work:

DA/SSA and Medicaid enrollment support

AT Policy & Procedure Manual development

Vendor and equipment sourcing strategies

Staff onboarding checklists and training plans

Service logs, device justification forms, and HIPAA templates

Coordination tools for therapist collaboration and ISP alignment

BEHAVIORAL HEALTH SERVICES PROVIDER IN VERMONT
SUPPORTING EMOTIONAL WELL-BEING AND FUNCTIONAL SKILL DEVELOPMENT THROUGH INDIVIDUALIZED MENTAL HEALTH AND BEHAVIORAL SUPPORTS

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Behavioral Health Services in Vermont provide therapeutic, rehabilitative, and support interventions for individuals living with mental illness, emotional disturbance, or behavioral challenges. These services promote wellness, safety, and stability in the home, school, or community settings.

Behavioral Health Services are reimbursable through Vermont Medicaid and integrated into Home and Community-Based Services (HCBS) Waivers when aligned with an Individual Support Plan (ISP) or treatment plan. Oversight is provided by the Department of Mental Health (DMH), the Department of Vermont Health Access (DVHA), and the Department of Disabilities, Aging and Independent Living (DAIL) in collaboration with Designated Agencies (DAs) and Specialized Service Agencies (SSAs).

1. GOVERNING AGENCIES

Agency: Vermont Department of Mental Health (DMH)
Role: Regulates community mental health and clinical behavioral supports statewide.

Agency: Department of Vermont Health Access (DVHA)
Role: Manages Medicaid reimbursement, provider enrollment, and billing for behavioral health services.

Agency: Department of Disabilities, Aging and Independent Living (DAIL)
Role: Authorizes behavioral supports under HCBS Waivers for individuals with developmental disabilities or acquired brain injuries.

Agency: Designated Agencies (DAs) / Specialized Services Agencies (SSAs)
Role: Coordinate ISP development, manage referrals, authorize waiver-based behavioral interventions, and monitor outcomes.

2. BEHAVIORAL HEALTH SERVICES OVERVIEW

Behavioral Health Services address psychiatric, emotional, and behavioral needs through structured, therapeutic interventions delivered by licensed or credentialed professionals.

Core services may include:

Clinical assessments and diagnostic evaluations

Individual, group, and family therapy (in person or via telehealth)

Behavioral support planning and implementation

Crisis stabilization and de-escalation support

Skill-building in self-regulation and social interaction

Care coordination and wraparound supports

Psychiatric consultation and medication management (via MD/NP)

Functional Behavior Assessments (FBAs) and Behavior Support Plans (BSPs)

Services must be goal-driven, time-limited, and tied to measurable outcomes in a person-centered treatment plan or ISP.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register entity with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Employ or subcontract with licensed mental health professionals

Contract with a Designated Agency (DA) or SSA, or apply for direct approval through DMH

Enroll with DVHA for Medicaid reimbursement

Maintain liability and malpractice insurance

Develop a Behavioral Health Services Policy & Procedure Manual

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and secure EIN and NPI
Step 2: Submit application to DMH or contract with DA/SSA for behavioral health services
Step 3: Enroll as a Medicaid provider through DVHA
Step 4: Submit clinical licensure documentation and staff rosters
Step 5: Submit Behavioral Health Policy Manual for review
Step 6: Begin delivering services upon treatment plan or ISP authorization

5. REQUIRED DOCUMENTATION

EIN, NPI, and Articles of Incorporation

Medicaid enrollment confirmation

Staff credentials and state licensure (e.g., LCMHC, LICSW, BCBA, psychologist)

Behavioral Health Services Policy & Procedure Manual, including:

Intake and consent protocols

Clinical assessment and treatment planning templates

Incident response and de-escalation procedures

Billing and encounter documentation logs

Client rights, HIPAA, and grievance procedures

Staff training plans and clinical supervision structure

Emergency management and safety protocols

6. STAFFING REQUIREMENTS

Role: Licensed Clinical Mental Health Counselor (LCMHC)
Requirements: Vermont licensure, experience with behavioral and mental health diagnostics

Role: Licensed Independent Clinical Social Worker (LICSW)
Requirements: Vermont license, provides therapy and care coordination

Role: Board-Certified Behavior Analyst (BCBA)
Requirements: Certification and licensure; develops and monitors behavioral plans

Role: Behavioral Interventionist / Technician
Requirements: High school diploma or higher, trained and supervised by BCBA or clinician

Optional Roles: Psychiatric Nurse Practitioner (NP), Clinical Psychologist, Peer Support Specialists

All staff must complete:

HIPAA, confidentiality, and rights training

Mandated reporter and crisis response protocols

Clinical documentation and ISP alignment training

Annual CEUs and competency evaluations

7. MEDICAID WAIVER PROGRAMS

Behavioral Health Services are authorized under:

Developmental Disabilities Services Waiver (DDSW) – Behavior support and therapeutic interventions for individuals with ID/DD

Brain Injury Program – Behavior management for re-acclimation and safety

Choices for Care (CFC) Waiver – Limited, behavior-focused supports for adults with physical disabilities

Children with Emotional Disturbance Waivers / High-Tech Services – Pediatric services coordinated with schools or home health

All services must be aligned with the ISP, include measurable goals, and be authorized by the interdisciplinary team.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Licensing Verification
Timeline: 2–3 weeks

Phase: Medicaid Enrollment & DA/DMH Approval
Timeline: 1–2 months

Phase: Staff Hiring & Credentialing
Timeline: 2–4 weeks

Phase: Documentation & Policy Manual Submission
Timeline: 2–3 weeks

Phase: Begin Service Delivery
Timeline: Upon referral and treatment/ISP authorization

9. CONTACT INFORMATION

Vermont Department of Mental Health (DMH)
Website: https://mentalhealth.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Vermont Secretary of State – Office of Professional Regulation (OPR)
Website: https://sos.vermont.gov/opr

Designated Agencies Directory
Website: https://mentalhealth.vermont.gov/services/designated-agencies

​

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT BEHAVIORAL HEALTH PROVIDER
WCG supports clinicians, agencies, and behavioral consultants in launching comprehensive, Medicaid-compliant Behavioral Health Services that improve outcomes and ensure regulatory alignment.

​

Scope of Work:

DMH and DVHA enrollment guidance

Behavioral Health Policy & Procedure Manual development

Clinical documentation and ISP/treatment plan templates

Staff credentialing and training tracking tools

HIPAA, safety, and incident reporting materials

Behavior support plan templates and FBA toolkits

HOME MODIFICATION SERVICES PROVIDER IN VERMONT
ENHANCING ACCESSIBILITY, SAFETY, AND INDEPENDENCE FOR INDIVIDUALS WITH DISABILITIES THROUGH STRUCTURAL ADAPTATIONS TO THEIR HOMES

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Home Modification Services in Vermont enable individuals with disabilities or chronic health conditions to remain safely in their homes by adapting the physical environment to meet their functional needs. These services help prevent institutionalization, reduce injury risks, and improve quality of life through customized, disability-specific modifications.

Home modifications are covered under Vermont Medicaid’s HCBS Waivers when included in an approved Individual Support Plan (ISP). Oversight is provided by the Department of Disabilities, Aging and Independent Living (DAIL), in collaboration with Designated Agencies (DAs) or Specialized Service Agencies (SSAs).

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Authorizes funding for home modifications under HCBS Waivers and ensures alignment with participants’ ISPs.

Agency: Department of Vermont Health Access (DVHA)
Role: Manages Medicaid enrollment and payment for approved modification services.

Agency: Vermont Division of Fire Safety & Department of Public Safety
Role: Ensures that contractors comply with local building codes and safety regulations.

Agency: Designated Agencies (DAs)/Specialized Services Agencies (SSAs)
Role: Coordinate ISP planning, service authorization, and post-modification inspection or review.

2. HOME MODIFICATION SERVICES OVERVIEW

Home Modification Services include physical changes to a residence that enable greater independence, mobility, and access for individuals with functional limitations. Modifications must be necessary, cost-effective, and directly related to the individual’s disability.

Examples of allowable modifications:

Wheelchair ramps and widened doorways

Grab bars, roll-in showers, and accessible toilets

Stair lifts, ceiling lifts, and handrails

Non-slip flooring and lighting enhancements

Lowered countertops and kitchen access adaptations

Reinforced walls for equipment mounting

Smart home features that support accessibility (case-by-case)

Modifications must not be for general home improvement or aesthetic upgrades.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Obtain a Vermont contractor license (if performing structural modifications)

Maintain liability and workers’ comp insurance

Apply to provide services through a Designated Agency (DA) or directly under DAIL

Develop a Home Modification Policy & Procedure Manual

Ensure subcontractors meet all state construction and safety standards

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register legal entity, obtain EIN and NPI
Step 2: Secure contractor license from the Vermont Office of Professional Regulation (as required)
Step 3: Apply for DA/SSA partnership or submit application to DAIL
Step 4: Complete Medicaid enrollment via DVHA (if billing directly)
Step 5: Submit Policy Manual and staff credentials for approval
Step 6: Begin service delivery following ISP authorization and environmental assessment

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI

Valid contractor’s license (if applicable)

Medicaid provider enrollment (if billing DVHA)

DA/SSA contract or DAIL approval

Policy & Procedure Manual including:

Scope of work and cost estimation procedures

Pre- and post-modification documentation and approvals

Staff and subcontractor qualifications and training

Safety, inspection, and incident reporting procedures

Client consent and grievance forms

Billing, recordkeeping, and HIPAA compliance policies

6. STAFFING REQUIREMENTS

Role: Licensed Contractor / Construction Specialist
Requirements:

Valid Vermont contractor’s license

Familiarity with ADA standards and DAIL home modification criteria

Background check clearance

Workers’ compensation and general liability insurance

Optional Role: Accessibility Specialist / Project Coordinator
Responsibilities:

Coordinates project timelines, communicates with case managers, and ensures compliance

All staff must complete:

Client rights and HIPAA training

Safety and incident response training

Environmental assessment documentation (in collaboration with care teams)

7. MEDICAID WAIVER PROGRAMS

Home Modifications are authorized under the following Vermont Medicaid HCBS Waivers:

Developmental Disabilities Services Waiver (DDSW)

Choices for Care (CFC) Waiver

Brain Injury Program

Children’s Personal Care/High-Tech Waivers – When modifications are functionally necessary

Attendant Services Program (ASP) – In limited cases

All modifications must be included in the Individual Support Plan (ISP), justified through an environmental assessment, and pre-approved by DAIL or the supporting agency.

8. TIMELINE TO LAUNCH

Phase: Business Setup & Licensing
Timeline: 2–4 weeks

Phase: DA/SSA Partnership or DAIL Enrollment
Timeline: 1–2 months

Phase: Medicaid Enrollment (if applicable)
Timeline: 4–6 weeks

Phase: Service Launch
Timeline: Begins upon environmental assessment and ISP authorization

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Vermont Division of Fire Safety
Website: https://firesafety.vermont.gov

Office of Professional Regulation (OPR) – Contractors
Website: https://sos.vermont.gov/opr

​

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT HOME MODIFICATION PROVIDER
WCG guides contractors and accessibility specialists through the licensing, documentation, and service delivery process to successfully launch compliant Home Modification services in Vermont.

​

Scope of Work:

Contractor licensing and Medicaid provider enrollment support

Home Modification Policy & Procedure Manual development

Scope-of-work and environmental assessment templates

Documentation tools for before/after photos, approvals, and billing

Staff onboarding, background check, and compliance tracking

HIPAA, safety, and grievance response forms

THERAPY SERVICES PROVIDER IN VERMONT
DELIVERING REHABILITATIVE AND DEVELOPMENTAL THERAPIES TO HELP INDIVIDUALS ACHIEVE INDEPENDENCE, MOBILITY, AND COMMUNICATION GOALS

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Therapy Services in Vermont support individuals with disabilities, injuries, or developmental delays by providing skilled interventions that enhance mobility, functional abilities, speech, and daily living skills. These services are essential for both recovery and long-term skill development and may be provided in homes, community settings, or clinical environments.

Therapies are covered under Vermont Medicaid’s State Plan and several Home and Community-Based Services (HCBS) Waivers when outlined in the Individual Support Plan (ISP). Services must be prescribed by a licensed healthcare provider and delivered by licensed therapists or therapy assistants under supervision.

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Coordinates therapy services under HCBS waivers and monitors provider qualifications and ISP compliance.

Agency: Department of Vermont Health Access (DVHA)
Role: Oversees Medicaid provider enrollment and therapy service reimbursement.

Agency: Vermont Office of Professional Regulation (OPR)
Role: Licenses Physical Therapists, Occupational Therapists, and Speech-Language Pathologists.

Agency: Designated and Specialized Service Agencies (DAs/SSAs)
Role: May contract directly with therapy providers and authorize services through ISPs.

2. THERAPY SERVICES OVERVIEW

Therapy services help individuals build or restore functional skills, reduce barriers to independence, and improve quality of life through personalized intervention.

Covered therapies include:

Physical Therapy (PT): Gait training, muscle strengthening, mobility and pain management

Occupational Therapy (OT): Fine motor skills, sensory integration, adaptive equipment use

Speech-Language Pathology (SLP): Communication, language development, swallowing therapy

Augmentative & Alternative Communication (AAC) Support: Device evaluation and training

Feeding Therapy: If clinically indicated and approved

Therapies must be medically necessary, ordered by a licensed provider, and outlined in the individual’s ISP or treatment plan.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Employ or contract with licensed PT, OT, or SLP professionals

Apply to DVHA as a Medicaid-enrolled therapy provider

Affiliate with a Designated Agency (if serving HCBS waiver populations)

Carry professional liability insurance

Develop a Therapy Services Policy & Procedure Manual

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register entity and secure EIN and NPI
Step 2: Apply for DVHA Medicaid enrollment as a therapy provider
Step 3: Contract with Designated Agencies (if serving HCBS populations)
Step 4: Submit staff licenses, credentials, and Policy Manual for approval
Step 5: Complete staff onboarding and training
Step 6: Begin services upon referral, physician order, and ISP authorization

5. REQUIRED DOCUMENTATION

EIN, NPI, and Articles of Incorporation

DVHA enrollment confirmation

Staff licensure from the Vermont Office of Professional Regulation

Agency contracts (if applicable)

Therapy Services Policy & Procedure Manual including:

Intake and assessment procedures

Documentation standards and progress note templates

Coordination with ISPs and case managers

Emergency and infection control protocols

Billing and compliance workflows

HIPAA and patient confidentiality policies

Client rights and grievance procedures

Supervision protocols for therapy assistants

6. STAFFING REQUIREMENTS

Role: Licensed Physical Therapist (PT)
Requirements: Vermont licensure, background check, CPR certification

Role: Licensed Occupational Therapist (OT)
Requirements: Vermont licensure, experience with adaptive interventions

Role: Speech-Language Pathologist (SLP)
Requirements: ASHA certification, Vermont license, AAC knowledge preferred

Optional Role: Therapy Assistant (PTA, OTA, SLPA)
Requirements: Vermont certification; must work under licensed therapist supervision

All staff must complete:

HIPAA and ISP training

Medicaid billing and documentation training

Annual licensure renewal and CEUs

Emergency response and incident reporting training

7. MEDICAID WAIVER PROGRAMS

Therapy services may be authorized under:

Developmental Disabilities Services Waiver (DDSW) – Children and adults with ID/DD

Choices for Care (CFC) Waiver – Older adults and individuals with physical disabilities

Brain Injury Program – Cognitive and rehabilitative therapies

Children with High-Tech Needs or Medically Complex Conditions – Intensive therapy needs

School-based Medicaid Programs – For therapy services integrated into IEPs

All therapies must be supported by documentation, physician order, and ISP alignment.

8. TIMELINE TO LAUNCH

Phase: Entity Formation & Credentialing Setup
Timeline: 2–4 weeks

Phase: Medicaid Enrollment & Policy Manual Approval
Timeline: 1–2 months

Phase: Staff Training & DA Contracting (if applicable)
Timeline: 2–3 weeks

Phase: Service Launch
Timeline: Begins upon referral and service plan authorization

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Vermont Office of Professional Regulation (OPR)
Website: https://sos.vermont.gov/opr

Designated Agencies Directory
Website: https://mentalhealth.vermont.gov/services/designated-agencies

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT THERAPY SERVICES PROVIDER
WCG helps therapy professionals and organizations launch compliant, impactful rehabilitation services under Medicaid and HCBS Waivers across Vermont.

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Scope of Work:

DVHA provider enrollment support

Therapy Services Policy & Procedure Manual development

Supervision protocols and documentation templates

Therapist onboarding and credentialing tools

ISP integration and progress note frameworks

HIPAA and emergency policy templates

COMMUNITY INTEGRATION SERVICES PROVIDER IN VERMONT
FOSTERING INDEPENDENCE, INCLUSION, AND SOCIAL PARTICIPATION THROUGH ENGAGEMENT IN MEANINGFUL COMMUNITY EXPERIENCES

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Community Integration Services in Vermont support individuals with disabilities or acquired conditions in participating more fully in their communities. These services are designed to reduce isolation, build natural supports, and increase confidence by helping individuals explore and engage in community life based on their interests, goals, and abilities.

Community Integration is covered under Vermont’s Medicaid Home and Community-Based Services (HCBS) Waivers and is authorized through an Individual Support Plan (ISP). Oversight is provided by the Department of Disabilities, Aging and Independent Living (DAIL), in collaboration with Designated Agencies (DAs) and Specialized Services Agencies (SSAs).

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Authorizes and regulates community integration services under HCBS Waivers.

Agency: Department of Vermont Health Access (DVHA)
Role: Manages Medicaid provider enrollment and reimbursement.

Agency: Designated Agencies (DAs) / Specialized Services Agencies (SSAs)
Role: Coordinate ISP development, authorize service delivery, and oversee quality and compliance.

2. COMMUNITY INTEGRATION SERVICES OVERVIEW

Community Integration Services help individuals connect with their communities through structured, supported, and person-centered engagement. Activities are designed to support skill development, relationship building, and meaningful participation.

Examples of covered services:

Accompanied access to libraries, recreation centers, or volunteer sites

Support to attend community classes or interest groups

Peer-to-peer engagement and social skill development

Participation in clubs, civic groups, or faith-based communities

Travel training for public transportation

Support in pursuing hobbies, cultural events, or wellness activities

Building informal support networks (friends, neighbors, mentors)

Services must be aligned with the individual’s ISP goals and emphasize integration, not facility-based care or segregation.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Contract with a Designated Agency or SSA for waiver service delivery

Enroll with DVHA (if billing Medicaid directly)

Maintain general liability insurance and background screening protocols

Develop a Community Integration Services Policy & Procedure Manual

Hire and train staff in person-centered approaches and community safety

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register entity, obtain EIN and NPI
Step 2: Apply to serve as a contracted provider through a DA or SSA
Step 3: Complete DVHA Medicaid enrollment (if applicable)
Step 4: Submit staff credentials, training plans, and Policy Manual
Step 5: Pass background checks and orientation requirements
Step 6: Begin providing services upon ISP authorization

5. REQUIRED DOCUMENTATION

EIN, NPI, Articles of Incorporation

DA/SSA contract or DAIL approval

Medicaid enrollment confirmation (if billing directly)

Community Integration Services Policy & Procedure Manual, including:

Service planning and activity risk assessments

Staff-to-individual ratio and supervision guidelines

Documentation and billing protocols

Emergency preparedness and community incident response

HIPAA, client rights, and consent procedures

Cultural sensitivity and anti-isolation best practices

Transportation safety and public interaction guidelines

6. STAFFING REQUIREMENTS

Role: Community Support Worker / Integration Specialist
Requirements:

High school diploma or equivalent (college preferred)

Experience supporting individuals with disabilities

Background check clearance

CPR/First Aid certification (recommended)

Optional Role: Program Coordinator
Responsibilities: Oversee service planning, training, and quality monitoring

All staff must complete:

Orientation on person-centered thinking and ISP goals

HIPAA and client rights training

Transportation and community safety procedures

Incident reporting and emergency response training

Annual skills refreshers and supervision sessions

7. MEDICAID WAIVER PROGRAMS

Community Integration is a covered service under:

Developmental Disabilities Services Waiver (DDSW) – Core habilitative support for individuals with I/DD

Brain Injury Program – Rebuilding social and community skills post-injury

Choices for Care (CFC) Waiver – For older adults seeking engagement and wellness

Children’s High-Tech / Transition Programs – For building independence before adulthood

All services must be documented in the ISP, goal-oriented, and delivered in inclusive, non-segregated settings.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Creation
Timeline: 2–3 weeks

Phase: DA/SSA Contracting & Medicaid Enrollment
Timeline: 1–2 months

Phase: Staff Hiring & Training
Timeline: 2–4 weeks

Phase: Service Launch
Timeline: Upon participant referral and ISP authorization

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Designated Agencies Directory
Website: https://mentalhealth.vermont.gov/services/designated-agencies

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT COMMUNITY INTEGRATION PROVIDER
WCG supports providers in creating person-driven Community Integration Services that meet waiver standards and promote lasting connections between individuals and their communities.

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Scope of Work:

DA/SSA and DVHA enrollment guidance

Community Integration Policy & Procedure Manual development

ISP-aligned goal tracking and progress documentation

Activity risk assessments and emergency response tools

HIPAA, incident reporting, and grievance compliance materials

Staff onboarding and person-centered training guides

HOMEMAKER SERVICES PROVIDER IN VERMONT
SUPPORTING INDEPENDENT LIVING BY ASSISTING INDIVIDUALS WITH NON-MEDICAL HOUSEHOLD TASKS AND DAILY ROUTINES IN THE COMFORT OF THEIR OWN HOMES

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Homemaker Services in Vermont provide essential non-medical support that helps individuals with disabilities, chronic conditions, or age-related needs maintain a clean, safe, and healthy living environment. These services are designed to delay or prevent institutional care and promote independence in the community.

Homemaker Services are covered under Vermont’s Medicaid Home and Community-Based Services (HCBS) Waivers when authorized in the participant’s Individual Support Plan (ISP). Oversight is provided by the Department of Disabilities, Aging and Independent Living (DAIL) and the Department of Vermont Health Access (DVHA), often in collaboration with Designated Agencies (DAs) or Specialized Service Agencies (SSAs).

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Authorizes homemaker services through HCBS Waivers and monitors provider compliance.

Agency: Department of Vermont Health Access (DVHA)
Role: Manages Medicaid enrollment and reimbursement for homemaker services.

Agency: Designated Agencies (DAs) / Specialized Services Agencies (SSAs)
Role: Coordinate ISP development, authorize homemaker tasks, and oversee service quality.

2. HOMEMAKER SERVICES OVERVIEW

Homemaker Services support individuals in completing non-medical household tasks they are unable to manage independently due to a physical, cognitive, or developmental condition.

Examples of covered tasks:

Light housekeeping (vacuuming, dusting, sweeping)

Laundry and linen changes

Meal planning and preparation

Grocery list development (shopping support may be allowed with approval)

Dishwashing and kitchen clean-up

Bed-making and organizing living spaces

Basic errands (as approved in ISP)

These services are goal-oriented and must directly relate to the participant’s functional needs as documented in the ISP.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Contract with a Designated Agency or SSA for waiver service delivery

Complete Medicaid enrollment with DVHA (if billing directly)

Maintain general liability and workers’ compensation insurance

Develop a Homemaker Services Policy & Procedure Manual

Train staff in privacy, safety, and ISP-based documentation

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and secure EIN and NPI
Step 2: Apply to contract with a DA/SSA or seek approval from DAIL
Step 3: Enroll with DVHA for Medicaid billing (if applicable)
Step 4: Submit Policy Manual and staff credentials
Step 5: Complete required staff training and background checks
Step 6: Begin providing services upon ISP authorization

5. REQUIRED DOCUMENTATION

EIN, NPI, Articles of Incorporation

Medicaid enrollment confirmation (if applicable)

DA/SSA service contract or DAIL approval

Homemaker Services Policy & Procedure Manual, including:

Task list and service scope definitions

Cleaning and safety protocols

Emergency procedures and incident reporting

Documentation and billing forms

HIPAA compliance and client confidentiality policies

Staff orientation and supervision guidelines

Client rights and grievance procedures

6. STAFFING REQUIREMENTS

Role: Homemaker / Home Support Worker
Requirements:

High school diploma or GED (recommended)

Background check clearance

CPR/First Aid training (preferred)

Knowledge of safe cleaning practices and respectful communication

Optional Role: Service Coordinator / Supervisor
Responsibilities: Staff scheduling, quality assurance, and DA/SSA communication

All staff must complete:

Training on client dignity and person-centered care

HIPAA and privacy best practices

Household safety and universal precautions

Documentation and time tracking procedures

7. MEDICAID WAIVER PROGRAMS

Homemaker Services may be covered under:

Choices for Care (CFC) Waiver – Primary waiver for older adults and adults with physical disabilities

Developmental Disabilities Services Waiver (DDSW) – In specific cases, based on functional needs

Brain Injury Program – May include homemaker supports to maintain community living

Attendant Services Program (ASP) – When homemaker tasks are part of an approved service plan

All services must be pre-approved in the ISP and support health, safety, and independent living goals.

8. TIMELINE TO LAUNCH

Phase: Business Setup & Policy Manual Development
Timeline: 2–3 weeks

Phase: DA/SSA Contracting & Medicaid Enrollment
Timeline: 1–2 months

Phase: Staff Hiring & Training
Timeline: 2–4 weeks

Phase: Service Launch
Timeline: Upon ISP authorization and participant assignment

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Designated Agencies Directory
Website: https://mentalhealth.vermont.gov/services/designated-agencies

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT HOMEMAKER SERVICES PROVIDER
WCG helps agencies and entrepreneurs build reliable, person-centered Homemaker Services programs that meet Medicaid standards and promote dignity and independence for Vermont’s waiver participants.

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Scope of Work:

DVHA and DA/SSA enrollment support

Homemaker Services Policy & Procedure Manual development

Task checklists, time logs, and shift notes

Staff training materials and onboarding forms

HIPAA and grievance policy templates

Documentation and compliance support tools

CASE MANAGEMENT SERVICES PROVIDER IN VERMONT
COORDINATING CARE, RESOURCES, AND GOALS TO HELP INDIVIDUALS WITH DISABILITIES THRIVE IN HOME AND COMMUNITY SETTINGS

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Case Management Services in Vermont help individuals with disabilities, complex health needs, or age-related challenges navigate services, secure supports, and remain safely in their preferred setting. Case Managers serve as the central point of coordination between individuals, families, service providers, and state programs.

Case Management is a required support under Vermont’s Home and Community-Based Services (HCBS) Waivers and is administered through the Department of Disabilities, Aging and Independent Living (DAIL) and Designated Agencies (DAs). Services must align with the individual’s person-centered support plan and focus on promoting choice, independence, and quality of life.

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Oversees HCBS Waivers and contracts with Designated Agencies to deliver case management services.

Agency: Department of Vermont Health Access (DVHA)
Role: Administers Medicaid funding and enrollment for case management services.

Agency: Designated Agencies (DAs)
Role: Coordinate ISP development, approve and monitor case managers, and ensure delivery of waiver-authorized services.

2. CASE MANAGEMENT SERVICES OVERVIEW

Case Management helps individuals access the services they need by developing and overseeing an Individual Support Plan (ISP). This service ensures that participants receive appropriate supports and are empowered to direct their own care when possible.

Key responsibilities include:

Conducting functional and needs-based assessments

Developing and updating ISPs with the participant and their support team

Coordinating services (e.g., personal care, respite, therapies, employment)

Monitoring service delivery and satisfaction

Making referrals and connecting families with resources

Facilitating transitions from schools, hospitals, or institutions

Advocating for the individual’s goals and rights

Case Management is not a direct service—it is administrative, relational, and coordination-focused.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Apply through a Designated Agency to become an affiliated Case Management provider

Complete Medicaid enrollment (if authorized to bill directly)

Maintain liability insurance and confidentiality protocols

Develop a Case Management Services Policy & Procedure Manual

Employ qualified Case Managers with education and experience in human services

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain EIN and NPI
Step 2: Establish affiliation with a local Designated Agency
Step 3: Submit staff qualifications and Policy Manual for approval
Step 4: Complete enrollment through DVHA if billing Medicaid
Step 5: Attend case management training required by DAIL or the DA
Step 6: Begin service delivery following ISP assignment and participant consent

5. REQUIRED DOCUMENTATION

EIN, NPI, and Articles of Incorporation

DA contract or DAIL approval (if independent agency)

DVHA enrollment documentation

Case Management Policy & Procedure Manual, including:

Intake and assessment procedures

ISP development, review, and revision timelines

Service coordination and referral processes

Recordkeeping and monitoring documentation

Participant rights, consent, and grievance handling

HIPAA compliance and confidentiality protocols

Staff supervision, continuing education, and evaluation tools

6. STAFFING REQUIREMENTS

Role: Case Manager / Service Coordinator
Requirements:

Bachelor's degree in human services, social work, psychology, or a related field

1–2 years of experience with disability services or community-based supports

Background check clearance

Strong documentation, communication, and advocacy skills

Role: Case Management Supervisor (recommended for agencies)
Requirements:

Supervisory experience and knowledge of HCBS standards

Responsible for quality assurance and staff support

All staff must complete:

DAIL- or DA-provided case management training

HIPAA and ISP documentation protocols

Client rights and incident response training

Ongoing professional development and annual reviews

7. MEDICAID WAIVER PROGRAMS

Case Management is a required service under:

Developmental Disabilities Services Waiver (DDSW)

Choices for Care (CFC) Waiver

Children’s Personal Care Services (CPCS)

Brain Injury Program

High-Tech and Medically Complex Children’s Programs

Each waiver outlines specific goals and outcomes that must be addressed in the participant’s ISP, monitored by the Case Manager.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Manual Development
Timeline: 2–3 weeks

Phase: DA Affiliation & Medicaid Enrollment
Timeline: 1–2 months

Phase: Staff Credentialing & Training
Timeline: 2–4 weeks

Phase: Begin Service Delivery
Timeline: Upon approval and ISP assignment from DA or DAIL

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Designated Agencies Directory
Website: https://mentalhealth.vermont.gov/services/designated-agencies

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT CASE MANAGEMENT PROVIDER
WCG assists new and expanding agencies with launching effective, compliant Case Management programs across Vermont’s Medicaid system.

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Scope of Work:

DA affiliation and Medicaid enrollment support

Case Management Policy & Procedure Manual development

Intake, assessment, and ISP tracking templates

HIPAA, client rights, and consent forms

Training plans for new Case Managers

Quality assurance, documentation, and service logs

NON-MEDICAL TRANSPORTATION SERVICES PROVIDER IN VERMONT
ENSURING SAFE, RELIABLE ACCESS TO COMMUNITY SERVICES, WORK, AND DAILY LIFE FOR INDIVIDUALS WITH DISABILITIES

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Non-Medical Transportation (NMT) Services in Vermont provide essential access to community-based programs, employment, health-related appointments, and other critical services for individuals with disabilities or chronic conditions. These services promote independence, inclusion, and person-centered living.

NMT is covered under several of Vermont’s Medicaid Home and Community-Based Services (HCBS) Waivers when outlined in an Individual Support Plan (ISP). Oversight is provided by the Department of Disabilities, Aging and Independent Living (DAIL) in partnership with Designated Agencies (DAs), Specialized Services Agencies (SSAs), and the Department of Vermont Health Access (DVHA).

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Authorizes NMT under HCBS Waivers, ensures services align with ISP goals and transportation needs.

Agency: Department of Vermont Health Access (DVHA)
Role: Manages Medicaid enrollment, billing, and reimbursement.

Agency: Designated Agencies (DAs) / Specialized Services Agencies (SSAs)
Role: Coordinate ISPs, authorize transportation routes, and ensure provider compliance.

2. NON-MEDICAL TRANSPORTATION SERVICES OVERVIEW

NMT Services support individuals in accessing their communities when public or informal transportation options are unavailable or insufficient. Services must directly relate to the goals in the ISP and promote social, vocational, or personal independence.

Covered transportation purposes include:

Travel to employment, job training, or volunteer work

Attendance at adult day programs or community events

Access to waiver-authorized services (e.g., therapy, respite, habilitation)

Support for grocery shopping, errands, or banking (if approved in ISP)

Travel to social, civic, or recreational activities

Services may be provided via agency vehicles, taxis, public transit with training, or mileage reimbursement models.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Obtain commercial vehicle insurance and perform routine safety inspections

Apply to become an approved transportation provider via a DA, SSA, or DAIL

Complete Medicaid enrollment through DVHA (if billing directly)

Develop a Non-Medical Transportation Services Policy & Procedure Manual

Perform staff background checks and driver safety training

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register legal entity and obtain EIN and NPI
Step 2: Apply through a DA/SSA or DAIL to become a contracted provider
Step 3: Submit vehicle insurance, inspection records, and Policy Manual
Step 4: Enroll with DVHA as a Medicaid transportation provider (if billing directly)
Step 5: Complete staff credentialing, driver checks, and training
Step 6: Begin transportation services upon ISP authorization and route approval

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, NPI

Proof of commercial vehicle insurance and inspection compliance

Medicaid provider enrollment confirmation (if applicable)

DA/SSA contract or DAIL approval

Policy & Procedure Manual including:

Driver training and supervision protocols

Vehicle safety, maintenance, and sanitation procedures

Route planning, tracking, and mileage documentation

Emergency response and incident reporting procedures

Passenger assistance policies (e.g., wheelchair support, supervision)

HIPAA, confidentiality, and client rights documentation

Billing templates, time logs, and shift notes

6. STAFFING REQUIREMENTS

Role: Transportation Driver / Mobility Aide
Requirements:

Valid Vermont driver’s license and clean driving record

CPR/First Aid training (recommended)

Background check clearance

Training in disability awareness, passenger safety, and defensive driving

Optional Role: Transportation Coordinator
Responsibilities: Route scheduling, vehicle tracking, staff supervision, and compliance monitoring

All staff must complete:

HIPAA and client rights training

Emergency and vehicle safety procedures

Passenger assistance protocols

Annual driving record reviews and skills check

7. MEDICAID WAIVER PROGRAMS

NMT is authorized under:

Developmental Disabilities Services Waiver (DDSW) – For community access and employment-related travel

Brain Injury Program – For structured travel to therapy or integration programs

Choices for Care (CFC) Waiver – In limited cases for access to adult day health or medical-related services

Children’s High-Tech / Transition Services – Case-by-case, typically school-to-community travel

All transportation services must be functionally necessary, reflected in the ISP, and pre-approved by the case manager or service coordinator.

8. TIMELINE TO LAUNCH

Phase: Business Setup & Vehicle Preparation
Timeline: 2–3 weeks

Phase: DA/SSA Contracting or DAIL Approval
Timeline: 1–2 months

Phase: Medicaid Enrollment (if applicable)
Timeline: 4–6 weeks

Phase: Staff Hiring & Safety Training
Timeline: 2–3 weeks

Phase: Service Launch
Timeline: Begins upon ISP approval and participant assignment

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Vermont DMV – Commercial Vehicle Resources
Website: https://dmv.vermont.gov

Designated Agencies Directory
Website: https://mentalhealth.vermont.gov/services/designated-agencies

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT NON-MEDICAL TRANSPORTATION PROVIDER
WCG helps new and expanding providers build safe, reliable, and Medicaid-compliant transportation programs that promote access and community inclusion.

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Scope of Work:

DVHA and DA/SSA enrollment support

NMT Policy & Procedure Manual development

Vehicle maintenance logs and driver onboarding packets

Trip documentation templates and HIPAA forms

Incident reporting and emergency response plans

Route tracking, time logs, and mileage billing tools

HOME HEALTH CARE SERVICES PROVIDER IN VERMONT
DELIVERING SKILLED NURSING AND THERAPEUTIC CARE IN THE COMFORT OF HOME TO PROMOTE HEALING, SAFETY, AND INDEPENDENCE

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Home Health Care Services in Vermont provide medically necessary skilled care to individuals recovering from illness or injury, living with chronic conditions, or needing rehabilitation. Services are delivered in the individual’s home to help them remain independent, avoid institutionalization, and recover safely with professional support.

Home Health Care is covered under Vermont Medicaid’s State Plan and may be integrated into Home and Community-Based Services (HCBS) Waivers when aligned with the participant’s care plan. Oversight is provided by the Vermont Department of Disabilities, Aging and Independent Living (DAIL), the Department of Vermont Health Access (DVHA), and the Division of Licensing and Protection (DLP).

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Coordinates home- and community-based care programs and waiver integration.

Agency: Department of Vermont Health Access (DVHA)
Role: Administers Medicaid enrollment and reimbursement for Home Health services.

Agency: Division of Licensing and Protection (DLP)
Role: Licenses and certifies Home Health Agencies, conducts surveys, and enforces compliance with federal CMS conditions.

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Oversees federal Medicare/Medicaid certification for home health providers.

2. HOME HEALTH CARE SERVICES OVERVIEW

Home Health services are prescribed by a physician and delivered under a formal Plan of Care. Services are provided by licensed professionals and must be intermittent (not 24-hour care).

Covered services include:

Skilled nursing (e.g., wound care, IV therapy, medication injections)

Home health aide assistance with ADLs

Physical Therapy (PT)

Occupational Therapy (OT)

Speech-Language Pathology (SLP)

Medical social services and counseling

Chronic disease monitoring and health education

Care coordination and discharge planning

Services must meet medical necessity criteria and follow documentation and quality standards set by CMS and DLP.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with Vermont Secretary of State

Obtain EIN and Type 2 NPI

Apply for a Home Health Agency license through DLP

Complete Medicare/Medicaid certification survey process (CMS 855A)

Enroll with Vermont Medicaid via the DVHA provider portal

Maintain clinical liability and workers’ comp insurance

Develop a CMS-compliant Home Health Policy & Procedure Manual

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register business, obtain EIN and NPI
Step 2: Apply for Home Health license with the Division of Licensing and Protection
Step 3: Submit CMS 855A application for Medicare/Medicaid certification
Step 4: Complete initial survey and Life Safety Code inspection
Step 5: Enroll with DVHA for Medicaid reimbursement
Step 6: Credential staff and prepare for audit-readiness
Step 7: Launch services upon Plan of Care approval and referral

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI

DLP Home Health license and CMS survey report

Medicare/Medicaid certification letter

DVHA Medicaid enrollment documentation

Home Health Services Policy & Procedure Manual, including:

Nursing protocols and therapy service scopes

Physician order and Plan of Care tracking

Infection control and safety procedures

Medication administration and chronic care workflows

HIPAA and patient confidentiality standards

Emergency response and incident reporting procedures

Staff supervision, training, and credentialing logs

Shift notes, billing templates, and outcome tracking tools

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)
Requirements: Vermont licensure; responsible for patient assessments and care plans

Role: Licensed Practical Nurse (LPN)
Requirements: Works under RN supervision; provides direct skilled care

Role: Certified Home Health Aide (HHA)
Requirements: Supervised by RN; trained in ADLs and safety monitoring

Role: Physical, Occupational, and Speech Therapists (PT, OT, SLP)
Requirements: Vermont-licensed; services must be physician-ordered

Role: Medical Social Worker (optional)
Requirements: Vermont licensure; offers counseling and resource planning

All staff must complete:

HIPAA and CMS documentation training

Universal precautions and infection control

Annual skills validations and continuing education

CPR/First Aid certification (required for aides)

7. MEDICAID WAIVER PROGRAMS

Home Health services may also be integrated into:

Choices for Care (CFC) Waiver – Skilled nursing and therapies for older adults and adults with physical disabilities

Children with High-Tech Needs Program – Pediatric-focused care

Brain Injury Program – In-home skilled rehabilitation support

Developmental Disabilities Services Waiver – In specific medically complex cases

All services must be tied to a physician’s order and included in the participant’s Individual Support Plan or Plan of Care.

8. TIMELINE TO LAUNCH

Phase: Entity Formation & Policy Manual Development
Timeline: 2–4 weeks

Phase: State Licensing & CMS Certification
Timeline: 3–6 months

Phase: Medicaid Enrollment & Staff Credentialing
Timeline: 1–2 months

Phase: Service Launch
Timeline: Begins upon DLP licensure, Plan of Care approval, and referral authorization

9. CONTACT INFORMATION

Vermont Division of Licensing and Protection (DLP)
Website: https://dlp.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT HOME HEALTH CARE PROVIDER
WCG helps agencies navigate licensing, CMS certification, and Medicaid enrollment to successfully launch compliant Home Health Care programs across Vermont.

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Scope of Work:

DLP licensing and CMS survey preparation

DVHA and Medicare provider enrollment support

Policy & Procedure Manual creation (CMS-aligned)

Staff credentialing trackers and supervision logs

Plan of Care templates and documentation tools

Infection control systems and emergency protocols

HIPAA, safety, and incident response compliance resources

MEAL & NUTRITION SERVICES PROVIDER IN VERMONT
DELIVERING NUTRITIOUS MEALS AND DIETARY SUPPORT TO PROMOTE HEALTH, WELLNESS, AND INDEPENDENCE FOR MEDICAID WAIVER PARTICIPANTS

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Meal & Nutrition Services in Vermont ensure that individuals who are unable to prepare meals due to disability, age, or medical conditions receive adequate nutrition to support their well-being. These services are essential in helping participants remain in their homes and communities while preventing malnutrition, hospitalization, or institutional care.

Covered under Vermont’s Medicaid Home and Community-Based Services (HCBS) Waivers, Meal & Nutrition Services may include meal preparation, home-delivered meals, nutrition counseling, and individualized dietary support. Oversight is provided by the Department of Disabilities, Aging and Independent Living (DAIL), with coordination through Designated Agencies (DAs) or Specialized Services Agencies (SSAs).

1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Authorizes nutrition services under HCBS Waivers and monitors service standards.

Agency: Department of Vermont Health Access (DVHA)
Role: Administers Medicaid provider enrollment and reimbursement.

Agency: Designated Agencies (DAs) / Specialized Services Agencies (SSAs)
Role: Coordinates Individual Support Plans (ISPs), approves service delivery, and ensures compliance.

2. MEAL & NUTRITION SERVICES OVERVIEW

Meal & Nutrition Services provide dietary support to individuals who cannot reliably shop for, prepare, or access nutritious meals. Services may be tailored to specific dietary needs and must align with ISP goals.

Covered services may include:

Home-delivered meals (hot, frozen, or shelf-stable)

Meal preparation in the home

Menu planning based on dietary restrictions

Grocery shopping assistance (if part of meal prep)

Basic nutrition education and support

Dietary assessments and tracking (when provided by a licensed professional)

Meal services must align with USDA dietary standards and comply with food safety and sanitation guidelines.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Vermont Secretary of State

Obtain EIN and Type 2 NPI

Contract with a DA/SSA for waiver service delivery or apply through DAIL

Maintain liability insurance and food safety protocols

Acquire a food service license from the Vermont Department of Health (if preparing meals in bulk or commercially)

Develop a Meal & Nutrition Services Policy & Procedure Manual

Ensure compliance with HIPAA and safe food handling regulations

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain EIN and NPI
Step 2: Apply to provide services through a DA/SSA or DAIL
Step 3: Obtain food service license (if applicable)
Step 4: Enroll with DVHA for Medicaid billing (if billing directly)
Step 5: Submit staffing plan, food handling certifications, and Policy Manual
Step 6: Begin services upon ISP approval and meal plan authorization

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI

DA/SSA agreement or DAIL authorization

Food service license and inspection reports (if required)

Medicaid enrollment confirmation (if applicable)

Meal & Nutrition Services Policy & Procedure Manual, including:

Meal planning and delivery protocols

Sanitation and food storage procedures

Staff food safety certifications

Menu documentation aligned with USDA or physician guidelines

Client rights, HIPAA compliance, and grievance policies

Tracking logs for deliveries and dietary compliance

Incident reporting and emergency response protocols

6. STAFFING REQUIREMENTS

Role: Meal Preparation Staff / Kitchen Worker
Requirements:

Food safety training and certification (e.g., ServSafe)

Background check clearance

Knowledge of dietary needs and meal portioning

Role: Delivery Driver (for home-delivered meals)
Requirements:

Valid driver’s license and clean record

Food handling training

Route tracking and HIPAA compliance

Optional Role: Licensed Dietitian / Nutritionist
Responsibilities:

Provide dietary consultations and assess participant nutrition needs

Assist with medical meal planning and ISP documentation

All staff must complete:

HIPAA and confidentiality training

Food safety and infection control training

Emergency delivery procedures and incident response training

Client interaction and respectful communication best practices

7. MEDICAID WAIVER PROGRAMS

Meal & Nutrition Services may be included in:

Choices for Care (CFC) Waiver – Core service for adults with functional limitations

Developmental Disabilities Services Waiver (DDSW) – On a case-by-case basis for individuals unable to prepare meals

Brain Injury Program – May include structured nutrition support as part of rehabilitation

Pediatric High-Tech Waiver – If meal planning or preparation is included in caregiver support

All services must be authorized in the ISP and meet the participant’s functional or health-related nutritional needs.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Food Safety Compliance
Timeline: 2–3 weeks

Phase: DA/SSA Contracting & Medicaid Enrollment
Timeline: 1–2 months

Phase: Kitchen/Facility Licensing & Staff Training
Timeline: 4–6 weeks

Phase: Service Launch
Timeline: Begins upon ISP approval and delivery scheduling

9. CONTACT INFORMATION

Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov

Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov

Vermont Department of Health – Food & Lodging Program
Website: https://www.healthvermont.gov

Designated Agencies Directory
Website: https://mentalhealth.vermont.gov/services/designated-agencies

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WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT MEAL & NUTRITION SERVICES PROVIDER
WCG assists startups and community organizations in launching efficient, compliant meal programs that meet Vermont Medicaid requirements and promote health for vulnerable populations.

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Scope of Work:

DA/SSA and DVHA enrollment support

Meal & Nutrition Policy & Procedure Manual development

Food safety and sanitation checklists

Delivery logs, meal tracking sheets, and service notes

HIPAA, grievance, and emergency documentation

Dietitian consultation forms and ISP-aligned nutrition tracking