I/DD Waivers in Vermont

All states: Medicaid disability services map

Vermont I/DD services at a glance

Last verified against state sources: 2026-10-28.

Who runs I/DD services in Vermont?

The Developmental Disabilities Services Division (DDSD), part of the Department of Disabilities, Aging and Independent Living (DAIL), runs developmental disabilities (DD) services in Vermont. DAIL operates these services under an agreement with the Department of Vermont Health Access (DVHA), the state Medicaid office. Since August 2025 people apply through a state contractor, Public Consulting Group (PCG), and since October 1, 2025 case management has been provided by two statewide Case Management Organizations (CMOs).

• DDSD (DAIL): sets policy, funding priorities and rates for DD services, keeps the waiting list and designates the agencies that deliver services.
• DVHA: under the Global Commitment to Health demonstration, DVHA acts as a public, managed care-like entity for Vermont Medicaid. There are no private health plans for DD services.
• Front door: the Intake and Eligibility Team at PCG, (833) 426-5668 or VTDDSDIntake@pcgus.com. Before August 11, 2025, people applied through their local Designated Agency.
• Service providers: Designated Agencies (DAs) and Specialized Service Agencies (SSAs) deliver direct services. Other providers can serve under a subcontract with a designated agency.
• Case management: two statewide CMOs, Benchmark Human Services and The Columbus Organization, took over case management from the DAs and SSAs starting October 1, 2025. The change separates case management from service delivery to meet federal conflict-of-interest rules.

What Medicaid waivers and programs serve people with I/DD in Vermont?

Vermont has no 1915(c) waiver for people with intellectual and developmental disabilities. Its Developmental Disabilities Services Home and Community-Based Services (DS HCBS) are authorized under the Global Commitment to Health demonstration, a broad Section 1115 approval from the federal government that covers most of Vermont Medicaid. Two smaller state plan programs provide case management and care coordination for people who are not getting DS HCBS.

• DS HCBS (Global Commitment to Health 1115 demonstration): serves Vermonters of all ages with an intellectual disability or autism spectrum disorder who meet clinical eligibility under the DD rules, are enrolled in Medicaid and meet a funding priority in the State System of Care Plan. Services include case management, Community Supports, Employment Supports, Home Supports (Supervised Living, In-Home Family Support, Shared Living, Staffed Living and Group Living), respite, clinical and crisis services, a Supports Broker, home modifications and remote supports. DS HCBS served 3,374 people in state fiscal year 2025 with $325.1 million in caseload funds. The current Global Commitment agreement runs from July 1, 2022 through December 31, 2027.
• Targeted Case Management for Persons with Developmental Disabilities (state plan): assessment, care planning, referral and monitoring for adults with developmental disabilities who do not have DS HCBS funding. It is provided by the CMOs and cannot be billed alongside HCBS funding. 323 people received it in state fiscal year 2025.
• The Bridge Program (state plan): care coordination for children with developmental disabilities and their families. It is delivered as an Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, so eligible children cannot be placed on a waiting list. It served 467 people in state fiscal year 2025.

Vermont also has one remaining Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), a not-for-profit home run by a community mental health agency, according to DVHA.

Does Vermont pay for I/DD services through managed care?

No private health plans are involved. DAIL pays the designated agencies directly on a standardized statewide fee schedule, so the map labels Vermont as fee-for-service. Under the Global Commitment demonstration, DVHA acts as a public, managed care-like entity, and DAIL operates DD services under an agreement with it.

• How agencies are paid: since October 1, 2025, agencies receive a bundled per-member-per-month amount for most planned services, plus fee-for-service payments for other supports. They report encounter data, and payments are reconciled each year, according to DDSD's September 2025 payment reform report. The state expected about 20 percent of people to need an exception to the standard amounts.
• Who coordinates services: the two statewide CMOs, Benchmark Human Services and The Columbus Organization, not a health plan.

Is there a waiting list for I/DD services in Vermont?

Yes. DDSD keeps a waiting list of people who are eligible for DD services but do not meet a State System of Care Plan funding priority. In state fiscal year 2025 (July 2024 to June 2025), DDSD reported 371 people waiting who did not meet a priority and 0 people waiting who did, in its annual report dated February 2026.

• How priority works: HCBS funding goes to people who meet a funding priority, for example health and safety needs, public safety, supports tied to nursing facility screening, preventing or ending an inpatient or out-of-state residential stay, and parenting supports.
• What people wait for: most often service coordination, family respite and community supports.
• Children: the Bridge Program is an EPSDT benefit, so eligible children cannot be placed on a waiting list for it.

The state fiscal year 2025 figure is the newest published count we found. For a person's status, ask PCG at (833) 426-5668 or DDSD at (802) 241-0304.

How do people apply for I/DD services in Vermont, and how are budgets set?

People apply through the Intake and Eligibility Team at PCG, which helps with the application, arranges the clinical eligibility decision and needs assessment, and explains how to choose a CMO. Adults get a Supports Intensity Scale - Adult (SIS-A) assessment that sets a support level. The budget range comes from that level, where the person lives and the state's standard rates.

• Eligibility: Vermont residency, active Medicaid for most programs, and clinical eligibility under the DD Services Regulations, including a diagnosis of intellectual disability or autism spectrum disorder. HCBS funding also requires meeting a funding priority.
• Assessment: PCG gives the SIS-A to people 16 and older. It assigns a support level from 1 to 4, plus M and B levels for extraordinary medical or behavioral needs. 3,732 SIS-A assessments had been completed since September 2022.
• Budgets and exceptions: the support level and living setting set the budget range. People whose needs fall outside the range can request an exception.
• Transition deadline: people who had not completed the SIS-A and met their new case manager by December 31, 2025 would no longer be eligible for DDSD HCBS as of January 1, 2026, according to DDSD's August 2025 transition memo.
• Self-direction: services can be agency-directed, shared-managed, self-managed or family-managed. Self-managed and family-managed services use ARIS Solutions as the fiscal/employer agent, which handles payroll, and Transition II as the supportive intermediary service organization (ISO). Since November 2024, legally responsible individuals (parents, guardians and spouses) can be paid for some supports; 81 were approved in state fiscal year 2025.

What day and residential services can I/DD providers offer in Vermont?

Vermont's DS HCBS pays for two main day services, Community Supports and Employment Supports, both billed in 15-minute units. Home Supports come in five types, and Shared Living, where a person lives in a contracted provider's home, is by far the most common. Services are delivered by designated or certified DD agencies and their subcontractors, as described in the DDSD Medicaid Manual.

Day and employment services

• Community Supports: help to build skills and social connections, take part in community activities and keep relationships, provided one to one or in small groups, in the community or in a facility. Rates are set for 1:1, 2:1 and 3:1 staffing and for groups of 1:2 or 1:3. Billed in 15-minute units. We did not find a separate facility license for this service.
• Employment Supports: employment assessment, employer and job development, job training and ongoing support to keep a job, for integrated, competitive work. Rates are set for individual, 2:1 and groups of two or three. Billed in 15-minute units. Funds cannot be used for sheltered workshops or enclaves. Vermont closed its last sheltered workshop in 2002, and Act 40 of 2025 ended subminimum wage. Community Supports funding can be converted to Employment Supports.

Home Supports (residential)

• Shared Living: support for one or two people in the home of a contracted shared living provider or foster family, paid as a tax-exempt stipend. About 75 percent of people with home supports use this model. Billed monthly by support category, with an hourly add-on for extra support. Licensed (foster care license, for children) and non-licensed versions exist. We did not confirm which agency issues the license.
• Supervised Living: scheduled or drop-in hourly support for a person in their own home or apartment, less than 24 hours a day. Billed in 15-minute units.
• In-Home Family Support: hourly support for a person living in the family home. Billed in 15-minute units.
• Staffed Living: a home for one or two people staffed full time by provider staff. Billed in 15-minute units.
• Group Living: a licensed home for three to six people, staffed full time and paid at a daily rate by home size and support category. About 5 percent of Vermonters with I/DD in services live in group homes. We did not confirm which agency licenses these homes. Ask DDSD.

How are I/DD provider rates set and how do agencies enroll in Vermont?

DDSD sets one statewide fee schedule built from independent rate models by Burns & Associates, a division of Health Management Associates. The FY 2027 rate models, dated July 1, 2026, apply a 1 percent increase. Agencies provide DD services once the DAIL Commissioner designates them and they sign a DAIL Provider Agreement, and other providers can serve under subcontract.

• Rate method: the models use set assumptions for direct support wages, benefits, staff productivity, mileage, program support and administration. Examples from the FY 2027 models: Community Supports (individual) at $16.81 per 15 minutes, built on a direct support wage of $22.81 an hour. More detail is on DDSD's rate model page.
• Payment: a bundled per-member-per-month amount for most planned services, plus fee-for-service for other supports, with encounter data and a yearly reconciliation.
• Becoming a provider: Designated Agencies and Specialized Service Agencies are certified when the Commissioner designates them and they sign a DAIL Provider Agreement. Providers that are not designated can serve under a subcontract with a designated provider. See DDSD's services and providers page.
• EVV: electronic visit verification (EVV) is required for Supervised Living, Respite (15-minute and daily), In-Home Family Supports and Shared Living Hourly Supports when the service is given in the home by a worker who does not live there, according to DDSD's EVV guidance. Vermont Medicaid uses Sandata as its state-sponsored EVV system, with Gainwell Technologies bringing the data into the Medicaid claims system, according to DVHA. Claims without a matching EVV visit are denied. Claims for services outside EVV's scope use a KX or CG modifier.

What is changing next for I/DD services in Vermont?

The Global Commitment to Health 1115 agreement that authorizes Vermont's DD services runs through December 31, 2027. As of October 28, 2026, we did not find a renewal or extension request posted on the Agency of Human Services waiver page. Providers and families should watch for public notice of a renewal during 2027.

• Recent payment reform: the new payment model and conflict-free case management took effect October 1, 2025, with current services allowed to continue until December 31, 2025.
• Conflict-of-interest review: the federal Centers for Medicare and Medicaid Services (CMS) approved Vermont's conflict-of-interest plan in March 2023, with implementation by October 2025 and an evaluation period through May 2026. We did not find a published CMS decision on full compliance after that period.
• Rules and counts: the DDSD Medicaid Manual we relied on is the 2024 edition, written before payment reform, and the newest waiting list count is for state fiscal year 2025. Check DDSD for updated service definitions and a newer count.

Vermont I/DD sources

• Vermont DAIL: Developmental Disabilities Services Division
• Vermont DDSD: Apply for DD services
• Vermont DDSD: FY 2025 Annual Report (February 2026)
• Vermont DDSD: State System of Care Plan 2026 to 2028
• Vermont DDSD: Medicaid Manual (2024)
• Vermont DDSD: FY 2027 DS rate models (July 1, 2026)
• Vermont DDSD: Payment reform legislative report (September 2025)
• Vermont DDSD: Transition memo (August 26, 2025)
• Vermont DDSD: EVV guidance document
• Vermont Legislative Joint Fiscal Office: 2026 Global Commitment overview

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Developmental Disabilities vs. Mental Health: Key Differences
• Outcome Measures in Disability Services: Measuring what matters
• I/DD services in every state (map)
• Vermont EVV requirements

Page history

• October 28, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.