Long Term Care (LTC) Unit

What We Do

Vermont's Long-Term Care (LTC) Medicaid Program is called Choices for Care. Vermont’s LTC staff assist eligible Vermonters with accessing services in their chosen setting. This could be in the client’s home, an approved residential care home, assisted living facility or an approved nursing home.

There are two parts to determining Vermont LTC eligibility:

  1. Clinical eligibility which is performed by the Department of Disabilities, Aging and Independent Living (DAIL)
  2. Financial eligibility performed by the Long Term Care Unit in the Department for Vermont Health Access (DVHA)

The LTC application is usually submitted to the DVHA Long Term Care Unit and a copy is forwarded to DAIL for the clinical assessment. In addition, upon receipt of the LTC application, DVHA workers begin the financial eligibility determination process. Many applicants have complex financial histories and have hired elder law attorneys to assist them with planning and sheltering their assets. The more complicated applications take a significant amount of staff time to analyze before making a final financial eligibility determination.

Who We Serve

LTC Medicaid serves eligible Vermonters who are over 65, blind or disabled and who are in need of access to long term supports and services at home, in an enhanced residential treatment center (ERC) or nursing facility.  When Vermont Medicaid covers services for these Vermonters, the families of those Vermonters experience relief from concerns about their family member’s long-term care needs.

How We Impact

Many Vermonters cannot afford to self-pay for their long-term care (LTC) supports and services and depend upon Vermont Medicaid to enable eligible Vermonters to access necessary LTC services.  Often when family members apply for Vermont LTC Medicaid for their relative, family caregivers are struggling to meet the needs of the applicant while maintaining all of their other work and family responsibilities.  LTC staff often hear from family members who are relieved when Vermont Medicaid begins providing LTC services for the applicant.

Action Plan

The top priorities/initiatives for the LTC Unit in SFY20 are:

  • Focus on updating entire LTC Desk Procedures/Training Manual.
  • Add full time benefited positions to replace long term temporary employees
  • Deliver updated LTC eligibility training (rules, policies & business processes) to all staff.
  • Investigate if there is a software which would enable LTC to capture case data necessary for useful statistical reporting, LTC forms generation and annual ex parte review.
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