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State program lets parents and other legally responsible individuals be paid as direct support under safeguards
Summary
The Department of Disabilities, Aging and Independent Living described a new protocol allowing legally responsible individuals to be paid for authorized in-home or community supports under Vermont's 1115 waiver; the department reported 34 arrangements and nearly 2,000 hours paid since payments began in January
Jennifer Gervigan, Developmental Disability Services Division director for the Department of Disabilities, Aging and Independent Living, briefed the Legislative Oversight and Accountability Committee on a newly approved protocol that allows legally responsible individuals — including parents and private guardians — to be paid as independent contractors to provide authorized community or in-home supports for enrolled adults under specified conditions.
"The legally responsible individual can be paid for the authorized community supports or in-home support services up to 40 hours a week," Gervigan said, describing the principal limit imposed as a safeguard by Centers for Medicare & Medicaid Services during the approval process. The protocol ties eligibility for payment to circumstances such as a lack of qualified direct support professionals, prolonged gaps in authorized services (50% or less of authorized services provided for 45 days or more), or complex medical, behavioral, or communication support needs.
The department said the arrangement was developed after public input and was approved under Vermont’s Section 1115 Medicaid waiver and Global Commitment authorities. Payments use the department’s fiscal/employer agent arrangement: legally responsible individuals are enrolled as independent contractors and paid through the state’s fiscal employer-agent software (ARRIS), with payroll controls intended to flag duplicative claims.
Gervigan described built-in quality controls: individualized review cycles for each arrangement, periodic in-home visits and disability quality reviews, opportunities for the enrolled adult to communicate privately with a service coordinator (and later conflict-free case managers), and annual reviews of appropriateness. The department said pay rates for the arrangements start at the collectively bargained minimum for independent direct support workers and are indexed to that standard; the department noted it can revise rates over time.
Department figures: the option has been available since about November 2024; as of the committee hearing there were 34 arrangements in place and nearly 2,000 paid hours since January. Of the agencies engaged, eight of 16 designated or specialized agencies have been working with families on this option; two-thirds of compensated hours were for in‑home supports rather than community supports, the department said.
Committee members asked about safeguards to prevent "double-dipping." Gervigan said the state’s payroll vendor, ARRIS, uses software controls that flag duplicate payments for the same date and time for human review. Lawmakers also asked about whether the payments produce W-2s; department staff said recipients receive 1099s (independent contractor paperwork) and tax information through ARRIS.
Legislators raised concerns about the length, notice and nature of in-home or quality-review visits; the department said visits for individuals living with family generally should provide advance notice and not be limited to a brief, one-hour interaction, and that the program will follow up on complaints about specific encounters.
The department framed the change as a formalized, monitored option rather than a broad replacement for agency-provided services. Officials said the protocol is intended to preserve person-centered choices — including for people who prefer family-provided supports for privacy or complex needs — while adding safeguards and review cycles.
