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Vermont - Housing Stabilization — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

Vermont's Family Supportive Housing (FSH) program, overseen by the Agency of Human Services (AHS), funds Pre-Tenancy Support Services and Tenancy Sustaining Services under Medicaid provider type T47. Agencies must secure a direct contract or grant agreement with the Department for Children and Families (DCF) before Gainwell Technologies will process a Medicaid enrollment application.

Approved providers bill a per-member per-month (PMPM) rate for housing search, landlord mediation, and retention planning. The enrollment sequence requires first obtaining state programmatic approval, followed by submitting a Group Enrollment application through the Provider Management Module (PMM) using specialty code S55.

1. Service Definition and Scope

Vermont defines this service under the Family Supportive Housing (FSH) umbrella, splitting it into Pre-Tenancy Support Services and Tenancy Sustaining Services. These services provide long-term intensive home-based service coordination and case management to help families experiencing homelessness transition into and maintain permanent housing.

The scope includes housing search assistance, application help, landlord mediation, and retention planning. It does not cover the cost of room and board or direct rent payments.

2. Regulatory and Oversight Agencies

The Vermont Agency of Human Services (AHS) and its Department for Children and Families (DCF) oversee the programmatic elements of the Family Supportive Housing program. They issue the initial approvals and manage the grant or contract relationships with providers.

Medicaid enrollment and claims processing are handled by Gainwell Technologies, which operates the Provider Management Module (PMM) on behalf of the Department of Vermont Health Access (DVHA).

3. Gatekeeping Prerequisites: Who Can Even Apply

Vermont does not allow open, standalone Medicaid enrollment for Family Supportive Housing services without prior state authorization. An agency must first be selected and approved by the Department for Children and Families (DCF) to operate an FSH program.

This requires a formal contract or grant agreement with AHS/DCF. Without this executed agreement, any application submitted to the Medicaid Provider Management Module under provider type T47 will be rejected.

4. Licensure and Certification Requirements

Vermont does not issue a distinct facility or agency license specifically for "Housing Stabilization" or "Family Supportive Housing." Instead, providers operate under the certification and contractual standards set forth by their DCF grant agreement.

Agencies must maintain standard business registrations with the Vermont Secretary of State and adhere to the programmatic guidelines outlined in the FSH program manual.

5. Medicaid Provider Enrollment

Once DCF approval is secured, agencies must enroll as a Group through the Vermont Medicaid Provider Management Module (PMM). The application requires specific coding to ensure claims route correctly for FSH services.

Providers must select Provider Type T47 (Family Supportive Housing) and Specialty S55 (Permanent Supportive Housing). The taxonomy code required is 171M00000X (Case Manager/Care Coordinator).

6. Staffing, Training and Background Checks

Staff delivering FSH services must meet the qualifications outlined in the DCF contract, typically requiring experience in case management, social work, or housing navigation. Paraprofessionals may be utilized if supervised by a qualified professional.

All staff must undergo standard Vermont background checks, including the Adult Abuse Registry, Child Abuse Registry, and state criminal history checks before providing direct services.

7. Documentation, Policies and Records

Providers must maintain comprehensive records for each family served, documenting the housing search process, landlord interactions, and retention plans. These records must align with the billing units submitted to Medicaid.

Agencies are required to have policies covering client rights, grievance procedures, incident reporting, and data privacy (HIPAA) as stipulated by their AHS contract.

8. Billing, Rates and Claims

FSH services are billed on a Per-Member Per-Month (PMPM) basis using the HCPCS code H0044. Providers must submit claims electronically through the Gainwell Technologies portal or via an approved clearinghouse.

Before submitting live claims, new providers must complete a Trading Partner Agreement and successfully submit a test claim with the VT EDI Coordinator.

9. Approval Sequence and Timeline

The approval process begins with securing a grant or contract from DCF, which is dependent on state funding cycles and RFP schedules. This initial phase can take several months.

Once the contract is awarded, the Medicaid enrollment through the PMM typically takes 30 to 60 days, followed by the EDI testing phase which adds another 1 to 2 weeks.

10. Common Denials and Survey Findings

Applications to the PMM are most frequently denied if the agency attempts to enroll as a T47 provider without an existing DCF contract on file. The system will reject unauthorized applicants.

During audits, common findings include billing the PMPM rate without sufficient documentation of the required minimum monthly contacts, or failing to update the housing retention plan as the client's situation changes.

11. Key Contacts and Resources

Providers should direct programmatic inquiries to the Department for Children and Families (DCF) and enrollment or billing questions to Gainwell Technologies.

The EDI Coordinator is the primary contact for setting up electronic claims submission and completing the required test claims.

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