In Vermont, regulations say that an assisted living residence must provide housing, healthcare, and personal care services for older adults. Assisted living is meant to be home-like. The state requires a private bedroom and private bath for every resident, as well as a living space and kitchen. Regulations also say that an assisted living residence must promote self-direction and active participation in decision-making. Health monitoring and medication management assistance are also required.
Vermont has a relatively older population compared to other states, roughly 18% of Vermonters are seniors. Because of this, the state offers more support to people in assisted living. For example, regulations require larger rooms in residences than in other states. Also, Vermont Medicaid has multiple programs to help pay assisted living costs, while many other states have at most one.
Special approval from the state’s Department of Disabilities, Aging, and Independent Living is required for a residence to admit people with dementia into memory care or Alzheimer’s special care units. The facility needs to show that it can handle the specialized needs of people with dementia. Requirements include a dementia-friendly physical layout, activities, and special training for staff on communicating with people who have Alzheimer’s or dementia.
There are approximately 17 memory care communities in Vermont. They range in size from apartment-complex-style to smaller home-like residences. For help finding memory care to meet your family’s needs and budget, click here.
The average cost of assisted living with memory care per month in Vermont is $6,368. Vermont is one of the more expensive states for memory care, with a monthly rate well above the national average of $5,448. New England is generally an expensive part of the country for assisted living. In Burlington, memory care costs about $7,693 per month. In other areas in Vermont, outside the Champlain valley, memory-care costs average about $6,073 per month.
Looking outside the state might be a good way to find more affordable memory care, but Vermont’s eastern neighbor New Hampshire is one of the most expensive states in the country for memory care, averaging about $7,325 per month. To the west, New York state averages much less, about $5,558 monthly, but costs vary widely there. The bottom line is that prices can be quite different in different regions of these states. Be sure to investigate all options before choosing a home, especially if cost is one of your biggest issues.
Within 14 days of moving into a Vermont assisted living community, every new resident must be evaluated using the Vermont Resident Assessment Form, which you can see here. This evaluation must be done by a registered nurse who works for the residence. Information including the ability to perform activities of daily living like eating and bathing is used to create a personalized service plan. This helps staff know how to best support and care for patients so they stay healthy and as active and engaged as possible. These service plans are then regularly updated.
The cost of evaluating might be included in the community’s base rate, or there may be a one-time community fee that covers move-in costs including the development of the service plan. This usually runs between $1,500 and $2,500.
Before moving in, any potential resident in Vermont assisted living must be provided a description of all rates and charges and an explanation of how those costs might change. There should never be surprises in billing. A disclosure form is available from any of these residences if asked for, which must include the following information:
– Services the residence can provide
– Public programs and benefits that the residence accepts or delivers
– All policies related to eviction
For memory care, the residence must provide a written statement of its philosophy as well as details on how the special needs of people with Alzheimer’s are met there. An official diagnosis of dementia is not required in Vermont for someone to move into memory care.
An assisted living residence cannot admit someone who needs full-time nursing care, or who otherwise requires a level of care that the residence can’t provide. Residents who pose a threat to themselves or others may not be admitted or may be evicted if they already moved in.
While it is possible to move into memory care on short notice in Vermont, this is usually not a good idea. Finding the right residence is a process that should take weeks or months of investigating options, taking tours, and asking questions of residents and staff before making a final decision. The person with dementia will also be able to provide more input the sooner you begin looking. Ideally, you would start the search before a move becomes necessary.
In Vermont assisted living bedrooms and living units that are larger than in most other states. Units must be at least 225 square feet, with a bed, bathroom, living space, kitchen, storage, and lockable door. All units are for a single person unless a patient chooses to have a roommate.
Regulations do not require dementia-friendly design features in memory care. Studies have shown that people with dementia can benefit from easy-to-navigate layouts, secure outdoor areas, and bright lighting and paint colors. As you investigate options, keep an eye out for these design elements and think about whether your loved one with dementia will be comfortable within the spaces.
There are no staff-to-resident ratios in Vermont assisted living. That means there must always be adequate staffing to meet the needs of every resident. All assisted living homes must have a state-certified director who is responsible for the day-to-day management of the residence. Directors must receive 20 hours of continuing education annually, in courses related to the care of residents. Anyone working directly with residents must receive at least 12 hours of training annually, covering:
– Residents’ rights
– Fire safety and emergency evacuation
– Emergency response
– Reporting abuse, neglect, or exploitation
– Communicating with residents
– Infection control
– General supervision and care guidelines
Additionally, 24 hours of continuing education is required in:
– Alzheimer’s disease
– Medication management
– Behavioral management
– Transfers (getting in and out of bed)
– Infection control
Vermont regulations say someone can be evicted for two reasons:
– Behavior that poses an immediate threat to themselves or others
– Care needs cannot be met at the residence
These are pretty vague. Still, another stipulation in Vermont assisted living is that the process for evictions must be provided in writing to potential residents. Memory care homes can create their own rules for evictions, and you must be very clear on those rules before agreeing to a move-in contract. Can someone be evicted for non-payment of bills? Is verbal abuse or aggressive behavior considered threatening? What is the process for appeal?
Before agreeing to a move-in contract, you need to know the answers to these and any other questions related to evictions. Get the answers in writing, because unfair evictions are a major problem in assisted living nationwide. If your loved one has received an eviction notice and you need to know the next steps, click here.
Vermont Medicaid’s Global Commitment to Health Waiver provides financial help for costs including assisted living. Vermont Medicaid is also known as Green Mountain Care. The goal of the waiver is to keep people who need nursing-home-level care from moving into a more expensive nursing home. To receive Global Commitment funds, a person must be Medicaid-eligible—including monthly income in 2022 under $1,166 if you live outside Chittenden County (the county including Burlington), and under $1,266 if you live inside Chittenden. Other programs in Vermont have been wrapped into the Global Commitment to Health program in recent years. This includes the Choices for Care Waiver and the state’s PACE program. Benefits available to patients in memory care include funds to cover the costs of help with activities of daily living, transportation, medical assistance devices, and more. Further information is available on the state’s website.
Vermont’s Medicaid recipients who need extra supervision, but don’t require full-time nursing care, may be eligible for the Assistive Community Care Service program. This is a program that provides funds to cover expenses including some in assisted living. The benefits can include health monitoring, case management, and help with activities of daily living. Consumer direction of services is not available under this program, meaning the state guides care providers. A person must already be enrolled in Medicaid to receive help under this program. Click here to enroll. Contact your nearest Vermont Agency of Human Services office to apply.
This program under Vermont Medicaid or Green Mountain Care is for people who cannot live alone and need a little extra help staying out of more expensive nursing homes. The Attendant Services Program is meant to keep people in their homes, but the state will consider applicants who live in assisted living communities (including those with memory care). Eligibility requirements are considered more lenient for this program than the Medicaid programs above. That means someone who makes more than the income limit may still be eligible for benefits. This is a self-directed benefit, so recipients have a say in how they will use the funds to pay for care. Help with activities of daily living is among the benefits. For more information, click here. To apply, contact the Vermont Department of Disabilities, Aging, and Independent Living.
Veterans are statistically more likely to develop dementia. Among the reasons for this is that traumatic brain injuries and posttraumatic stress disorder lead to a higher probability of developing the condition. The VA offers many benefits for Alzheimer’s and dementia and different pension types.
There are three types of VA Pensions available. The benefits change annually and are valid from December 2022 to December 2023. The benefits (and their maximum allowance) are as follows:
1) Basic Pension – This benefit is also known as a death pension. It is for veterans and surviving spouses who are aged or disabled. The qualifying disability does not need to be related to their military service. On an annual basis, the Basic Pension pays:
– Veterans without spouses or children up to $16,073
– Veterans with dependent spouses or children up to $21,001
– Surviving spouses without dependent children up to $10,756
2) Aid & Attendance – Abbreviated as A&A, this is an important program for veterans and their surviving spouses who require assistance with activities of daily living. This means they need assistance with activities like bathing, dressing, and eating. A&A is particularly helpful for people with dementia, especially in the middle and later stages of the disease, when the need for more assistance becomes necessary. A&A is intended to help with the long-term care costs of adult day care, in-home care, assisted living, memory care, and skilled nursing. Based on an individual’s need and the progression of the disease, most of these additional services that support your loved one will become necessary. Annually, the A&A pays:
– Veterans without spouses or children a maximum of $26,751
– Veterans with dependent spouses or children a maximum of $31,713
– Surviving spouses without dependent children a maximum of $17,191
3) Housebound – For veterans and surviving spouses who are permanently disabled and unable to leave their homes, making them require additional assistance. The definition of “home” can include assisted living, memory care, and nursing home. The Housebound pension, like the A&A pension, is meant to help cover long-term care costs. Annually, the Housebound pays:
– Veterans without spouses or children a maximum of $19,598
– Veterans with dependent spouses or children a maximum of $24,562
– Surviving spouses without dependent children a maximum of $13,145
There is one veterans’ home in Vermont. The Vermont Veterans’ Home is located in Bennington, in the southwestern corner of the state. It is a facility that provides long-term residential care for veterans. In addition to nursing home care and assisted living, memory care is provided in a certified Alzheimer’s unit. Neighboring states also have veterans’ homes. Your loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, New York has five homes statewide. Additionally, Massachusetts has two facilities and New Hampshire has one. More info.
1) Eldercare loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for a VA pension to be approved or waiting to sell a home. More on bridge loans for memory care.
2) Tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that can include assisted living costs.
3) A reverse mortgage can be an option for a married person moving into memory care, if their spouse continues to live in the home. However, if the spouse moves from their home, the reverse mortgage becomes due.