2 weeks Ago
GRANITE STATE Home Health & Hospice Association represents nearly 50 agencies across the state. As the leading voice for home care and hospice providers in New Hampshire, we advocate for funding, regulatory policies, and legislation that support the direct care workforce and the essential services they provide. For years, home care providers have delivered services through Medicaid programs like Choices for Independence (CFI), Private Duty Nursing (PDN), Skilled Home Care, Hospice and Supportive Housing.
These services and their caregivers help medically complex children and adults receive quality services in the comfort of their home. In-home Medicaid services reduce emergency room visits and hospital costs by providing coverage for preventive care and early treatment, ultimately lowering overall health care spending. CFI provides essential support to older adults and people with disabilities who qualify for nursing home care but want to remain at home.
Imagine a car accident, or medical diagnosis changing your life in an instant; CFI is there to keep you at home with the support you need. Through this program, home care agencies deliver personal care, nursing, and daily assistance — helping people stay engaged in their communities while reducing the need for costly institutional care. In 2023, many of New Hampshire’s home care providers faced the risk of closure due to a severe funding shortfall in the CFI program — nearly $153 million underfunded.
As a tragic consequence, individuals were left without care, dying alone in their homes. We are grateful that our legislature took action, approving a historic rate increase to invest in CFI. It was a vital recognition that without consistent rate adjustments, we would soon find ourselves in crisis once again.
On April 10, the New Hampshire House passed a budget that directs the state Department of Health and Human Services to reduce all Medicaid provider rates by 3%, effective Jan. 1, 2026. We cannot go back.
A reduction in Medicaid rates would further destabilize an underfunded home care sector and force agencies to cut services. Without sufficient funding, vulnerable residents will lose access to home care and be forced into hospitals and nursing homes, increasing costs and creating system-wide bottlenecks. A strong home care system strengthens the entire health care system — providing care in the right place, at the right time, at the right cost.
Investing in home-based care is one of the most effective ways to strengthen New Hampshire’s health care system: It saves money. Providing care in the home costs significantly less than nursing home care, allowing resources to be used more efficiently. PDN keeps medically complex kids at home with continuous care versus a more costly hospital setting.
It meets people’s needs. Most adults want to remain at home as they age. CFI makes that possible by providing the right support in the right place.
It strengthens the workforce. Competitive wages and sustainable funding will attract and retain the caregivers we need, ensuring that home-based services remain available. Home care benefits everyone — older adults, family caregivers, health care providers, and the broader community.
Call your senators today. Ask them to oppose the 3% reduction in Medicaid provider reimbursement rates. Together, we can build a future where all Granite Staters have the support they need to live well at home.
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