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DDS Payment Reform

In March 2020, due to the uncertainties related to the COVID-19 pandemic, the Department of Disabilities, Aging and Independent Living (DAIL) decided that activities related to Developmental Disabilities Services Payment Reform that involved provider agencies would be suspended.  This allowed both providers and the State to focus their energies and resources on the delivery of critical services for individuals and families during the pandemic.  All DDS Payment Reform meetings were cancelled, except the April 3 Advisory Committee meeting which was used to report on the status of the project work to date.

In July 2020, DAIL leadership determined that, although the pandemic continues, there was capacity at the State to resume some components of the project.  The first priorities to resume were continuing work on Encounter Data and reissuing a Request for Proposal (RFP) for an independent organization to conduct needs assessments for individuals in DDS.  An update regarding the Encounter Data work is included in the minutes of the October 8, 2020 Encounter Data Workgroup meeting.

DAIL posted the RFP for an independent organization to conduct needs assessments for individuals in DDS on September 16, 2020.  On September 25, 2020, Vermont Care Partners sent a letter to the state with concerns and questions regarding moving forward with the RFP.  Below is a link to the letter and DAIL’s response to the concerns and questions.  These are being shared so that all stakeholders with an interest in this topic have the information regarding DAIL’s plans for how the needs assessment will be used in the short term and how the information gathered from needs assessment will be used as a building block for the future payment model. 

VT Care Partner's Letter to the State regarding the Needs Assessment RFP

DAIL's Letter to VT Care Partners in response to their concerns of the Needs Assessment RFP

DAIL's Response to VT Care Partners request to pause the rollout of the Supports Intensity Scale-Adults (SIS-A)




The Department of Disabilities, Aging, and Independent Living (DAIL), in partnership with the Department of Vermont Health Access (DVHA), is working on a major Payment Reform initiative for Developmental Disabilities Services (DDS) Home and Community-Based Services (HCBS).  The overall goal of this project is to create a transparent, effective, and administrable payment model for developmental disabilities (DD) services that aligns with the Agency of Human Service's (AHS) broader payment reform and health care reform goals. One of the major objectives of the reform is to comply with the State's agreement with the federal Centers for Medicare & Medicaid Services (CMS) to develop a plan to coordinate payment and delivery of Medicaid HCBS services within the State's delivery reform efforts for health care.  Another major objective is to increase transparency and accountability of DD services, as recommended by the Office of the Vermont State Auditor

A group of provider agencies and other stakeholders (recipients of services, family members, and representatives of advocacy organizations) have been meeting with the State since January 2018 to redesign how to pay and account for services.  The DDS Payment Reform Statewide Advisory Committee is the conduit of information from the DDSD Payment Reform project to and from the people they represent.  More information on the DDS Payment Reform Statewide Advisory Committee

In November 2018, three new workgroups were added to this effort:

Standardized Assessment Workgroup: This workgroup is focused on the adoption of a uniform, standardized assessment tool for determining what services individuals need.  The workgroup will review assessment tool options, considerations of transitioning to a new tool and the process for implementation.  More information for the DDS Payment Reform Standardized Assessment Workgroup.

Payment Model Workgroup: This workgroup is focused on designing the payment mechanism by which providers are paid to provide services.  They will consider payment model options and implications for providers and people receiving services.  They will provide input for planning and implementation of a new payment model. More information for the DDS Payment Reform Payment Model Workgroup

Encounter Data Workgroup: This workgroup is focused on how provider agencies report to the State information about services delivered to individuals.  It has been determined that the provider agencies will be reporting services through the Medicaid Management Information System. This workgroup will provide input into the implementation of this new process. More information for the DDS Payment Reform Encounter Data Workgroup

For questions or more information about this initiative, contact Clare McFadden at


DDS Payment Reform Initiative - Webinar of 11/06/18


Meeting Schedule and Locations
All in person meetings of the DDS Payment Reform Statewide Advisory Committee and workgroup meetings will be held at the Waterbury State Office Complex, 280 State Drive, Waterbury VT.  Meeting attendees may attend in person or may call into the conference call number for that workgroup.  Members of the public are welcome to attend; a public comment period will be available at the end of each meeting.    

Meeting Participants attending the meetings in person:

  • Must confirm their attendance with the State representative at least 5 days prior to the meeting date, but no earlier than 2 weeks prior.
  • Must bring State issued ID to show to the complex security (such as a driver’s license)
  • Plan to arrive at least 10-15 minutes early to allow time for check-in with security.  This is very important for meetings that are held in the secured areas of the complex, as a staff person will meet everyone in the lobby of the complex and escort them to the conference room.  

Note:  Meetings are subject to change; verification of upcoming meetings is recommended.