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CASE MANAGEMENT SERVICES PROVIDER IN VERMONT
- Fatumata Kaba
- Apr 9
- 3 min read
COORDINATING CARE, RESOURCES, AND GOALS TO HELP INDIVIDUALS WITH DISABILITIES THRIVE IN HOME AND COMMUNITY SETTINGS
Case Management Services in Vermont help individuals with disabilities, complex health needs, or age-related challenges navigate services, secure supports, and remain safely in their preferred setting. Case Managers serve as the central point of coordination between individuals, families, service providers, and state programs. Case Management is a required support under Vermont’s Home and Community-Based Services (HCBS) Waivers and is administered through the Department of Disabilities, Aging and Independent Living (DAIL) and Designated Agencies (DAs). Services must align with the individual’s person-centered support plan and focus on promoting choice, independence, and quality of life.
1. GOVERNING AGENCIES
Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Role: Oversees HCBS Waivers and contracts with Designated Agencies to deliver case management services.
Agency: Department of Vermont Health Access (DVHA)
Role: Administers Medicaid funding and enrollment for case management services.
Agency: Designated Agencies (DAs)
Role: Coordinate ISP development, approve and monitor case managers, and ensure delivery of waiver-authorized services.
2. CASE MANAGEMENT SERVICES OVERVIEW
Case Management helps individuals access the services they need by developing and overseeing an Individual Support Plan (ISP). This service ensures that participants receive appropriate supports and are empowered to direct their own care when possible.
Key responsibilities include:
Conducting functional and needs-based assessments
Developing and updating ISPs with the participant and their support team
Coordinating services (e.g., personal care, respite, therapies, employment)
Monitoring service delivery and satisfaction
Making referrals and connecting families with resources
Facilitating transitions from schools, hospitals, or institutions
Advocating for the individual’s goals and rights
Case Management is not a direct service—it is administrative, relational, and coordination-focused.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register the business with the Vermont Secretary of State
Obtain EIN and Type 2 NPI
Apply through a Designated Agency to become an affiliated Case Management provider
Complete Medicaid enrollment (if authorized to bill directly)
Maintain liability insurance and confidentiality protocols
Develop a Case Management Services Policy & Procedure Manual
Employ qualified Case Managers with education and experience in human services
4. VERMONT PROVIDER ENROLLMENT PROCESS
Step 1: Register your business and obtain EIN and NPI
Step 2: Establish affiliation with a local Designated Agency
Step 3: Submit staff qualifications and Policy Manual for approval
Step 4: Complete enrollment through DVHA if billing Medicaid
Step 5: Attend case management training required by DAIL or the DA
Step 6: Begin service delivery following ISP assignment and participant consent
5. REQUIRED DOCUMENTATION
EIN, NPI, and Articles of Incorporation
DA contract or DAIL approval (if independent agency)
DVHA enrollment documentation
Case Management Policy & Procedure Manual, including:
Intake and assessment procedures
ISP development, review, and revision timelines
Service coordination and referral processes
Recordkeeping and monitoring documentation
Participant rights, consent, and grievance handling
HIPAA compliance and confidentiality protocols
Staff supervision, continuing education, and evaluation tools
6. STAFFING REQUIREMENTS
Role: Case Manager / Service Coordinator
Requirements:
Bachelor's degree in human services, social work, psychology, or a related field
1–2 years of experience with disability services or community-based supports
Background check clearance
Strong documentation, communication, and advocacy skills
Role: Case Management Supervisor (recommended for agencies)
Requirements:
Supervisory experience and knowledge of HCBS standards
Responsible for quality assurance and staff support
All staff must complete:
DAIL- or DA-provided case management training
HIPAA and ISP documentation protocols
Client rights and incident response training
Ongoing professional development and annual reviews
7. MEDICAID WAIVER PROGRAMS
Case Management is a required service under:
Developmental Disabilities Services Waiver (DDSW)
Choices for Care (CFC) Waiver
Children’s Personal Care Services (CPCS)
Brain Injury Program
High-Tech and Medically Complex Children’s Programs
Each waiver outlines specific goals and outcomes that must be addressed in the participant’s ISP, monitored by the Case Manager.
8. TIMELINE TO LAUNCH
Phase: Business Registration & Policy Manual Development
Timeline: 2–3 weeks
Phase: DA Affiliation & Medicaid Enrollment
Timeline: 1–2 months
Phase: Staff Credentialing & Training
Timeline: 2–4 weeks
Phase: Begin Service Delivery
Timeline: Upon approval and ISP assignment from DA or DAIL
9. CONTACT INFORMATION
Vermont Department of Disabilities, Aging and Independent Living (DAIL)
Website: https://dail.vermont.gov
Department of Vermont Health Access (DVHA)
Website: https://dvha.vermont.gov
Designated Agencies Directory
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — VERMONT CASE MANAGEMENT PROVIDER
WCG assists new and expanding agencies with launching effective, compliant Case Management programs across Vermont’s Medicaid system.
Scope of Work:
DA affiliation and Medicaid enrollment support
Case Management Policy & Procedure Manual development
Intake, assessment, and ISP tracking templates
HIPAA, client rights, and consent forms
Training plans for new Case Managers
Quality assurance, documentation, and service logs
Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.
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