Current Updates as of 8/3/2021

Managed Long-Term Services and Supports

Vermont Flag

On June 30, 2021, the Vermont Agency of Human Services submitted a renewal application for the Global Commitment to Health 1115 demonstration waiver. The application proposes a five-year extension of the demonstration in which the Department of Vermont Health Access (DVHA) would transition into a public risk-bearing managed care organization (MCO) for the state’s Medicaid population. Beginning January 1, 2022, DVHA will cover long-term services and supports in a rebalancing effort. The transition of DVHA into an MCO is expected to incentivize the development and implementation of innovative care models that produce value and strengthen care coordination and population health management capabilities.

(Source: VT Global Commitment to Health 1115 Demonstration Renewal Application; 6-30-2021)

Past Updates

Vermont Choices for Care—Section 1115 Demonstration Waiver

The Vermont long-term care §1115 demonstration, known as “Choices for Care,” is a statewide initiative to rebalance long-term care services through managing nursing facility admissions and increasing community-based options. The demonstration does not include children or individuals receiving institutional services through Intermediate Care Facilities for persons with Mental Retardation (ICF/MR). Choices for Care created an entitlement to Home and Community-Based Services (HCBS) for individuals with the highest need for services and also implemented a person-centered assessment and options counseling process to identify what services would be needed to enable individuals to remain in their own homes. The state also implemented the Program of All-inclusive Care for the Elderly (PACE) in two locations, one of which is rural. (Source:
Fact Sheet
Current Approval Document (9/21/2010)

State Demonstration to Integrate Care for Dual Eligible Individuals (Withdrawn)

The proposed demonstration would have included full benefit dual eligibles, including those with intellectual/developmental disabilities. The now-withdrawn proposal originally would have implemented statewide under a capitated payment model starting January 1, 2014. Vermont’s duals demo would not have included PACE participants (approximately 120 people). (Source: Demonstration Proposal)
State website on the demonstration

As of March 2014, the state has withdrawn its Demonstration Proposal and no longer plans to participate in the demonstration. (Source: Kaiser Family Foundation Duals Demonstration Proposal Status Map, March 2014)

Health Homes

On March 4, 2014, CMS approved the state’s first Health Home State Plan Amendment, effective July 1, 2013. The Health Home program targets beneficiaries in nine counties receiving medication assisted therapy for opioid dependency. (Source: CMS Health Home Proposal Status website, 3/2014; website; Approved Health Home SPA, 7/2/2013)

On April 10, 2014, CMS approved the state’s second Health Home SPA, effective January 1, 2014. The Health Home program targets beneficiaries in five additional counties receiving medication assisted therapy for opioid dependency. (Source: CMS Health Home Proposal Status website, 6/2014; Approved Health Home SPA, 4/10/2014)