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Choices for Independence (CFI) Waiver Renewal
The Choices for Independence (CFI) Waiver is one of four Home and Community Based Services (HCBS) 1915c Waivers operated by the Department of Health and Human Services, serving approximately 3,500 NH elders and individuals with physical disabilities annually.

The previous CFI Waiver expired on June 30, 2017. The current CFI waiver was approved by the Centers for Medicare and Medicaid Services (CMS) in June 2017 and will be in effect from July 1, 2017 through June 30, 2022.

As part of the CFI waiver renewal process, the following steps were undertaken:

  • January 27, 2017: Complete a first draft of the CMS 1915c Waiver Renewal Application and make the draft public
  • January 27- February 28, 2017: Hold public hearings and accept public/stakeholder input on the Waiver Renewal Application
  • February 28, 2017-March 30, 2017: Integrate the public/stakeholder input into the final draft of the Waiver Renewal Application
  • March 30, 2017: Submit the Waiver Renewal Application to CMS
  • March 30, 2017- June 30, 2017: CMS Reviews Waiver Renewal Application
  • July 1, 2017: CMS Approval and 5 Year Renewal

NH DHHS chose to enhance the CMS-required public input process by holding CFI Waiver “Listening Sessions” to elicit public/stakeholder input during November and December of 2016. View comments, oral and written, received by the Department Adobe Acrobat Reader Symbol.

Five Listening Sessions were held and 58 stakeholders took part in the sessions. The following themes emerged:

  • Concerns regarding workforce capacity and its impact on services. A suggestion was made to allow flexibility so that different services could be substituted when there is a workforce shortage of providers for a specific service category;
  • Recommendations for streamlining the eligibility and redetermination processes, consideration of a 3 month retroactive service coverage to address timeliness of initial eligibility and redeterminations and implementation of presumptive eligibility;
  • Feedback supporting the revision of services offered on the waiver, including participant directed services, transportation and PT, OT and Speech Therapy in excess of state plan limits;
  • Recommendation to implement components of the NH DD and NH ABD waivers in the CFI waiver: for example participant managed and directed services and support to individuals who wish to self-direct their services;
  • Suggestions regarding increased access to Adult Medical Day Services including when someone lives in Adult Family Care or Kinship Care; and,
  • Recommendations for aligning the provision of personal care services and non-medical transportation services.

Many of the recommendations made in the Listening Sessions were integrated into the Waiver Renewal Application. Specific waiver enhancements and changes have been summarized Adobe Acrobat Reader Symbol. Due to the number of changes and additions, the Department recommends reviewing the summary statement to see change highlights.

NH DHHS received additional helpful suggestions and input during the formal public hearing period and made additional changes to the Renewal Application as a result of this input.

These CFI Waiver Public Input Hearings were held:

  • February 8, 2017 from 10am-12noon
    Brown Auditorium
    New Hampshire Department of Health and Human Services
    129 Pleasant Street
    Concord, NH 03301
  • February 9, 2017 from 1pm-3pm
    Brown Auditorium
    New Hampshire Department of Health and Human Services
    129 Pleasant Street
    Concord, NH 03301
  • February 15, 2017 from 5:30pm-7:30pm
    Brown Auditorium
    New Hampshire Department of Health and Human Services
    129 Pleasant Street
    Concord, NH 03301

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New Hampshire Department of Health and Human Services
129 Pleasant Street | Concord, NH | 03301-3852


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