Page Reviewed / Updated - March 06, 2020
This New Hampshire Medicaid program is designed to help adults with chronic illnesses and the elderly. It does so by providing services and support for individuals that are clinically eligible for nursing home placement, but choose to remain living in the community or at home. The definition of "community" under this waiver is broad and includes many types of non-nursing home care, such as Residential Care Homes (Assisted Living), Adult Foster Care, and other types of Supportive Housing. Services and support are provided to individuals at these places of residence provided the costs of services do not exceed a certain percentage of what the costs would otherwise be if they were provided in a nursing home. A complete list of possible services is located further down this page. Most popular among them is personal care and support for home modifications to increase the participant's independence.
Choices For Independence offers participants a degree of consumer direction or self-direction in which they are able to choose some of their care service providers. This applies largely to unskilled or custodial care services. Participants are not able to hire family members, including spouses in some cases, as care providers. This waiver was formerly referred to as the Home and Community Based Care Program for the Elderly and Chronically Ill Waiver or the HCBC-ECI Waiver. This is New Hampshire's sole waiver that specifically targets the elderly population. It is under the administration of the New Hampshire Bureau of Elderly and Adult Services.
New Hampshire has complicated and frequently changing eligibility guidelines. Some of these requirements change depending on the age, level of impairment, or marital status of the applicant. What follows is current for the year 2020.
Under Choices for Independence, a large number of supports, services, and assistance are available. The purchase of some of the following goods and services can be self-directed.
The total value of the services received by a program participant cannot exceed 80% of what those services would otherwise cost were the participant to reside in a Medicaid-funded nursing home.
The administering body for this waiver is the NH Dpt. of Health and Human Services, Division of Community Based Care Services, Bureau of Elderly and Adult Services (BEAS). The waiver is available statewide and there is no waiting list for services. However, there is a cap on enrollment of approximately 3,700 individuals, which if exceeded will result in a wait list.