Vermont Choices for Care: Evaluation of Years 1-8

Thursday, May 1, 2014

In October 2005, Vermont implemented Choices for Care (CFC), an 1115 research and demonstration waiver that allowed the state to enhance its efforts to make long-term services and supports as available in the community as in institutional settings. The purpose of CFC is to ensure that older adults and people with disabilities have access to long-term services and supports in a setting of their choice. To achieve this goal, CFC encompasses the entire continuum of long-term services and supports including home and community-based services (HCBS), nursing facilities, and Enhanced Residential Care (ERC) settings.  

In 2012, the evaluation team at UMass Medical School, in collaboration with Vermont, revised the CFC evaluation plan to focus on specific outcomes for which data are available and that are actionable, have policy relevance, and encompass the continuum of settings (including nursing facilities and ERCs).  

Choices for Care enrollment grew in year eight. Overall data indicate that CFC improved or maintained positive gains in many domains including information dissemination, access related to types and amount of supports, effectiveness in terms of serving participants in the community, experience with care, certain aspects of quality of life, waiting lists, budget neutrality, health outcomes and service array and amounts. Even as there were achievements and successes in CFC, there are a few domains in which there were decreases including information dissemination, access related to timeliness of services, effectiveness related to service coordination and person-centered planning, experience with care related to problem resolution, and waiting list related to individuals in the Moderate Needs Group.