Choices for Independence Waiver Renewal

New Hampshire’s Department of Health and Human Services requested input as the Bureau of Elderly and Adult Services (BEAS) began the Choices for Independence (CFI) Waiver renewal process. Every five years the Centers for Medicaid and Medicare Services (CMS) requires that the states renew their Home and Community Based Care 1915 (c) waivers.

Waiver Renewal Process

Pursuant to 42 C.F.R. §441.301(c)(6)(iii) notice is hereby given that the New Hampshire Department of Health and Human Services, as the single state Medicaid agency, intends to submit a renewal of its Section 1915(c) Choices for Independence waiver to the Centers for Medicare and Medicaid Services (CMS).

The renewal process is lengthy and included collaborative meetings with a wide range of stakeholders to gather input on the waiver. BEAS worked with the Institute on Disability (IOD) to deliver four statewide feedback session during May 2021. BEAS encouraged people to participate in the feedback sessions or to provide written input by email or mail. Sharing what has worked and what needs attention helped to inform waiver changes in the application that was available for public comment from November 1 - December 1, 2021.

This renewal is primarily a continuation of the current Choices for Independence Waiver and reflects:

  • Compliance with recently updated federal regulations
  • Service limits for selected services
  • Updated Performance Measures
  • Additional Covered Services

DHHS requested comments about the changes it is proposing in the draft 1915 (c) Choices for Independence Waiver. After receiving the public’s ideas and comments about the proposed changes, DHHS will make final decisions about what changes to make to the CFI Waiver renewal application and submit to CMS. 

Choices for Independence Waiver Information

The Choices for Independence (CFI) Waiver provides a wide range of services designed to enable eligible individuals to remain in their homes and stay active in their communities. (Adults participating in the CFI program must be at least 18 years of age, be eligible for Medicaid, and meet nursing facility level of care). Some of the supports that the CFI Program could provide to an individual include (but are not limited to):

  • In-home services to assist with eating, bathing, dressing and other personal care tasks, as well as general assistance with household tasks and preparation of nutritious meals
  • Medical equipment and home modifications to support independence
  • Respite care
  • Participant-directed and managed services
  • Supported employment

Requests for a hard copy of the current Choices for Independence (CFI) Waiver should be submitted by email or phone to:

A hard copy of the current CFI Waiver can also be picked up, with prior notice, at BEAS, which is located at:

New Hampshire Department of Health and Human Services
Bureau of Elderly and Adult Services (The Main Building)
105 Pleasant Street
Concord, NH 03301

All information regarding the Choices for Independence (CFI) Waiver renewal process will be updated on this web page throughout the feedback sessions, public comment, and CMS renewal submission process.