1. Program Definition and Services

Adult Health Services (frequently authorized as Adult Day Health or specialized community medical supports) in New Hampshire provide comprehensive healthcare, preventative monitoring, and therapeutic interventions to adults with disabilities or age-related conditions. The program aims to maintain individuals in the community, averting the need for long-term services and supports in institutional settings. Services include:

• In-Home Personal Care: Individual healthcare support delivered within the participant’s private residence or community setting (Health Monitoring and Assessment, Medication Management, Chronic Disease Management, and Care Coordination).
• Residential Personal Care: Continuous wellness oversight and physical health maintenance within a licensed community-based or day facility setting (Nutritional Support, Physical Health Maintenance, Mental Health Support, Health Education, and Documentation).

2. Regulations

The program is governed by the following regulations:

• New Hampshire Code of Administrative Rules, Part He-P 818 (Licensing Standards for Adult Day Care Centers, if utilizing a facility footprint)
• New Hampshire Code of Administrative Rules, Part He-M 517 (Medicaid-Covered HCBS Waiver Services)
• New Hampshire Board of Nursing Rules (Form He-W 500 layers governing delegated clinical tasks)
• Federal Home and Community-Based Services Settings Final Rule (42 CFR § 441.301)

3. Licensing or Certification

Providers must establish certified status through the Bureau of Elderly and Adult Services (BEAS) or the Bureau of Developmental Services (BDS). If services are delivered inside a dedicated standalone day site, the agency must secure an Adult Day Care Center License from the DHHS Health Facilities Administration under rule He-P 818.

4. Responsible State Agency

The New Hampshire Department of Health and Human Services (DHHS) operating through the Division of Long Term Supports and Services (DLTSS), the Bureau of Elderly and Adult Services (BEAS), and the Health Facilities Administration Licensing Unit is responsible for checking applications, verifying healthcare protocols, and certifying providers.

5. Application Process

The application process uses a multi-stage framework. Providers must first submit their corporate profiles and operational models directly to BEAS or BDS. After clearing preliminary bureau reviews and securing any required He-P 818 facility licenses, providers submit forms online to finalize enrollment via the New Hampshire Medicaid Provider Portal (NHMMIS.nh.gov).

6. Required Documentation

While requirements vary based on the target waiver, providers typically must submit:

• Business registration in good standing with the New Hampshire Secretary of State
• Agency policy manuals (health screening protocols, medication administration tracking, HIPAA compliance, and emergency preparedness plans)
• Staff qualifications, training logs, and active professional nursing or healthcare credentials
• Proof of broad commercial general liability and specialized professional liability/medical malpractice insurance coverages

7. Timeline for Approval

The exact timeline fluctuates based on agency capacity. Bureau programmatic evaluations, physical facility safety checks (if applicable), and final electronic NHMMIS portal screening typically take between 60 and 90 days from the submission of a complete packet.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their state business entity structure, secure an IRS Employer Identification Number (EIN), and obtain a Type 2 Organizational National Provider Identifier (NPI) mapped to adult health or community clinical care taxonomies.

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Access details for waiver invoicing rules, Electronic Visit Verification (EVV) criteria, and Medicaid billing portals are sent to qualified applicants once preliminary intake documentation is accepted by state reviewers.

10. Additional Notes

• All community operations and care sites must fully satisfy state health guidelines, participant privacy rules, and federal HCBS Settings environmental frameworks
• In-Home Personal Care services and medical treatments must be delivered directly by the certified agency's employed personnel under RN supervision
• All clinical, administrative, and direct support personnel must conduct mandatory background clearances and fingerprinting through the New Hampshire Department of Safety and clear the BEAS state abuse registry
• Providers must maintain detailed records of face-to-face health interventions, nursing logs, and clinical milestone updates for Medicaid documentation and billing

Why Choose Waiver Consulting Group?

Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.

With proven expertise, a structured process, and ongoing support, we take the guesswork out of launching your healthcare business. Whether you're a first-time entrepreneur or an established provider looking to expand, our team ensures you stay compliant, competitive, and fully operational.

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