Choices for Independence is the most feasible option for many people; it’s affordable and allows people to remain in the comfort of their homes with their loved ones. A lack of funding is currently preventing people from receiving this type of care.
In a 2021 survey conducted by the NH Fiscal Policy Institute (NHFPI), every single case management agency in NH indicated that an individual might not receive CFI services because there are not enough available workers to meet the overall need for services or available workers at the times when services are needed.
Based on NH Department of Health and Human Services data, the entire CFI appropriation is rarely spent. This is not because the budget is too large, it’s because agencies can’t provide the services. According to NHFPI, Choices for Independence has been underfunded by more than $153 million since 2011.
Organizations that provide these services have long been chronically underfunded, operating on marginal funding and insufficient reimbursement rates (primarily under Medicaid)—and saddled by limited staffing and growing challenges with recruitment and retention. In 2018, an analysis from the AARP Public Policy Institute showed that New Hampshire had the lowest percentage of Medicaid HCBS (Home and Community Based Services) spending as a percentage of LTSS (Long Term Services & Supports) expenditures for older people and adults with physical disabilities of any state except Kentucky.
New Hampshire caregiving is at a crisis point. This crisis will only get worse if these conditions are allowed to continue unchecked. As the state’s population ages, there will not be enough caregivers to assist all of the people in need of care.
What will you do when the time comes for you and your loved ones to search for assistance?