Many seniors in New Hampshire prefer to spend their later years in their own home.  While long-term care facilities provide necessary care, they do not replicate the comforts of home.  Aging in place, however, can present its own challenges.  Daily routines like cooking, bathing, and managing household chores will often require additional support.

There are several home care options available to Granite Staters, but exploring these options can feel overwhelming.   Familiarizing yourself with and understanding the state resources available can make the goal of aging in place achievable.   

Choices for Independence Program

The Choices for Independence Program (CFI) is a New Hampshire Medicaid waiver program created specifically for older adults and individuals with physical disabilities who meet the clinical standards for nursing facility placement but prefer to receive care in their homes or community settings.   Rather than paying the significant costs associated with a long-term care facility, CFI funds several in-home services, covering a wide range of needs, including: 

  • Personal care and home health aides: Hands-on support with essential daily activities such as bathing, dressing, eating, and mobility. 
  • Homemaker services: Light housekeeping, laundry, meal preparation, and grocery shopping. 
  • Home modifications and adaptive equipment: Installation of safety equipment like wheelchair ramps, grab bars, and widened doorways. 
  • Adult day services and respite: Structured social programs for seniors, providing crucial breaks for family caregivers. 
  • Home-delivered meals: Essential nutrition through local programs like Meals on Wheels. 

Qualifying for choices for independence

Eligibility for CFI is determined by medical need and financial status. 

  1. Medical eligibility: An applicant must undergo a Medical Eligibility Determination (MED) assessment conducted through the state to confirm that they require a level of care equivalent to what a nursing home provides. 
  2. Financial eligibility: Because CFI is funded through Medicaid, applicants must meet specific state income and asset guidelines.  Countable asset thresholds will vary depending on marital status and other factors.  

By working with a case manager, participants can also choose a “participant-directed” option, allowing them or a designated family member to recruit and hire their own personal care attendants rather than relying strictly on agency staffing.

Staffing and support

While the CFI program provides vital coverage, Granite Staters should prepare for local operational challenges. Home health agencies statewide face ongoing recruitment hurdles, which can sometimes lead to delays in securing assigned caregivers. To bridge these gaps, local non-profits, volunteer driver networks, and community senior centers play an important role alongside state-funded care. Combining family support, community resources, and public programs often creates the most resilient care network.

Getting Started

If you are considering home care in New Hampshire, starting early is key:

  • Contact ServiceLink: ServiceLink acts as New Hampshire’s Aging and Disability Resource Center (ADRC). Their counselors offer free, impartial guidance to walk you through the CFI application process, assess eligibility, and connect you with local support. 
  • Gather records: Prepare documentation regarding monthly income, bank accounts, medical history, and current physical needs to streamline the Medicaid review.
  • Consult your local assessor or DHHS office: Applications can also be initiated directly online via the NH Easy portal (nheasy.nh.gov) or at a regional Department of Health and Human Services office. 

While the CFI program provides many options to assist seniors with aging in place, legal and financial considerations vary by individual.  You should consult with an estate planning or elder law attorney to ensure your specific plan aligns with your goals.  

Laura Dudziak is an attorney at the New Hampshire law firm Upton & Hatfield, LLP.