CFI Medicaid Waiver

Choices for Independence (CFI) Waiver Home Care in New Hampshire

NH Care Center is an enrolled Choices for Independence (CFI) Waiver provider. We serve New Hampshire residents who qualify for nursing-home level of care but want to stay home, with both medical and non-medical services under one license, one team, and one care plan.

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What is the CFI Waiver?

Choices for Independence (CFI) is New Hampshire's Medicaid 1915(c) Home and Community Based Services Waiver, administered by the NH Department of Health and Human Services through the Bureau of Adult and Aging Services (BAAS). It is a nursing-home diversion program — designed to give Medicaid-eligible adults the option to receive long-term care services at home or in the community instead of in a nursing facility.

Authoritative reference: NH DHHS — Home and Community Based Care

Who qualifies for the CFI Waiver?

To enroll in CFI, an applicant must meet three eligibility tracks — clinical, financial, and program. A trained RN completes a Medical Eligibility Assessment to determine clinical eligibility, and the Bureau of Family Assistance (BFA) determines financial eligibility.

Clinical eligibility

A trained RN completes a Medical Eligibility Assessment (MEA). Generally, applicants must need help with two or more Activities of Daily Living (ADLs) such as bathing, dressing, eating, toileting, transferring, or continence. The standard is "Nursing Facility Level of Care."

Financial eligibility

Income and asset limits are set by federal and state Medicaid rules. The Bureau of Family Assistance (BFA) determines financial eligibility. Planning strategies are available for applicants who are slightly over the limits.

Program eligibility

Applicants must be 18 or older. Because CFI is not an entitlement, there may be a waitlist depending on state slot availability.

What CFI covers with NH Care Center

Under the CFI Waiver, NH Care Center can deliver a full range of authorized in-home services as part of your care plan, including:

  • Personal care — bathing, dressing, grooming, toileting, transferring, mobility support
  • Homemaking — meal preparation, light housekeeping, laundry, errands
  • Companionship & supervision — particularly for clients with dementia or fall risk
  • Respite care — scheduled relief for family caregivers
  • Skilled nursing — RN assessments, medication management, chronic disease monitoring, post-hospital care coordination
  • RN supervisory visits — required by NH home health care regulations; included with all CFI cases

Specific services authorized in your care plan are determined by your CFI Case Manager based on your assessed needs.

How to get started with CFI Waiver home care

  1. 1

    Contact your local Aging and Disability Resource Center (ADRC)

    Formerly known as ServiceLink. ADRC options counselors are the entry point for CFI and can walk you through eligibility, the application, and what to expect. Statewide toll-free: 1-866-634-9412. ADRC directory

  2. 2

    Apply through NH Easy

    You can apply online for long-term care Medicaid at NH Easy. Your ADRC options counselor can help you complete the application. Apply at NH Easy

  3. 3

    Complete the clinical and financial assessments

    A trained RN completes the Medical Eligibility Assessment (MEA). The Bureau of Family Assistance determines financial eligibility. Combined, this process typically takes 45 to 90 days.

  4. 4

    Get assigned a Case Manager and develop a care plan

    Once approved, you'll be assigned a CFI Case Manager who works with you to develop a person-centered care plan based on your medical needs and what matters most to you.

  5. 5

    Choose NH Care Center as your provider

    You have the right to choose your service provider. Tell your Case Manager you'd like NH Care Center to deliver your services — we coordinate directly with them from there. If you're already approved and want to switch providers, the same process applies.

Already approved for the CFI Waiver?

If you or your loved one has already been approved for the CFI Waiver and is currently choosing a provider — or wants to switch providers — call us directly. We coordinate with your assigned Case Manager and can begin services quickly once a care plan is in place.

Request a consultation (603) 224-0036

Frequently asked questions

The complete process — application, clinical assessment, financial determination — typically takes 45 to 90 days. Financial determination alone can take 45 days. We recommend starting the application as soon as a need is identified, since enrollment is not retroactive.

Yes, in most cases. A primary residence is generally an excluded asset for long-term care Medicaid eligibility, with limits set by federal and state rules. Speak with an Aging and Disability Resource Center (ADRC) options counselor or an elder law attorney for guidance on your specific situation.

CFI is not an entitlement program, which means there can be a waitlist depending on state funding and slot availability. Your ADRC options counselor or your assigned BAAS contact can tell you whether slots are currently available in your county.

CFI offers Participant Directed and Managed Services (PDMS), which allows participants to hire a friend or qualifying relative (such as an adult child) as a paid caregiver, with a financial management services agency handling payroll. PDMS is one of several CFI service models — your Case Manager can walk you through whether it's right for your family.

Yes. CFI authorizes a specific number of hours and services per week. If your family needs more support than CFI authorizes, you can pay privately for additional hours through NH Care Center — without changing agencies or care teams.

CFI authorizes a range of services including skilled nursing, personal care, homemaking, respite, adult day services, and home modifications, depending on your assessed needs and care plan. NH Care Center is licensed to deliver both medical (RN-led) and non-medical services, so we can cover most CFI-authorized service categories under one provider.

Your CFI Case Manager develops your care plan and authorizes services. We work directly with them — sharing schedules, RN visit notes, and any changes in condition — so they have a complete picture of how care is going. You don't have to be the messenger between us.

CFI care plans are reviewed regularly and can be adjusted as needs change. Because we deliver both companionship and skilled nursing under the same license, you don't have to switch agencies when acuity increases. We notify your Case Manager when we observe changes that may warrant a care-plan update.

Yes. Many CFI participants are also Medicare beneficiaries. The programs cover different things — Medicare typically pays for short-term skilled care after a hospitalization (provided by a Medicare-certified home health agency), and CFI funds ongoing personal care, homemaking, and respite at home. NH Care Center is currently completing Medicare certification; until that is final, we coordinate seamlessly with Medicare-certified agencies on behalf of our CFI clients who need short-term Medicare-funded skilled care, and we resume care under your CFI plan once the Medicare episode ends.

Ready to talk?

We'll listen to what your family needs, walk you through CFI eligibility and timing, and help you understand whether CFI is the right starting point. No obligation, no pressure — just honest answers from a local, family-owned agency.

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