1. Program Definition and Services

Homemaker Services in New Hampshire provide non-medical assistance with essential household tasks to individuals with disabilities, chronic illnesses, or age-related conditions. The program functions as an in-home stabilization model designed to maintain a clean, safe, and comfortable living environment, allowing individuals to retain their autonomy and remain in their homes. Services include:

• In-Home Personal Care: Routine household maintenance and domestic support tasks executed directly inside the participant's primary private residence (Light Housekeeping, Vacuuming, Dusting, Trash Removal, and Laundry/Linen Care)
• Residential Personal Care: Essential life management assistance and community-facing domestic tasks organized to support independent living structures (Meal Planning and Preparation, Grocery Shopping, Essential Household Errands, Home Safety Hazard Checks, and Light Organization Support)

2. Regulations

The program is governed by the following regulations:

• New Hampshire Code of Administrative Rules, Part He-P 809 (Home Health Care Providers) or Part He-P 820 (Personal Care Service Agencies), as applicable
• New Hampshire Code of Administrative Rules, Part He-M 517 (Medicaid-Covered HCBS Care and Documentation Rules)
• New Hampshire Revised Statutes Annotated (RSA) 151:21-b (Home Care Clients' Bill of Rights)
• Federal Home and Community-Based Services Settings Final Rule (42 CFR § 441.301)

3. Licensing or Certification

Providers must achieve certified provider status through the Bureau of Developmental Services (BDS) or the Bureau of Elderly and Adult Services (BEAS). Depending on whether the agency provides hands-on personal care alongside homemaker duties, the organization may also require licensure as a Personal Care Service Agency (PCSA) or Home Health Care Provider from the DHHS Health Facilities Administration.

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 Bureau of Developmental Services (BDS), is responsible for reviewing provider credentialing, verifying agency compliance manuals, and certifying active providers.

5. Application Process

The application process uses a multi-stage review framework. Providers submit their operational policies, corporate registrations, and staff credentialing frameworks directly to the designated BEAS or BDS waiver enrollment units. Following programmatic approval and agency clearance, the provider completes electronic registration through 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 (participant intake protocols, household safety checks, incident reporting mechanisms, and infection control measures)
• Staff background clearances, health screenings, and baseline training certification logs
• Proof of corporate commercial general liability, professional liability, and statutory workers' compensation insurance coverages

7. Timeline for Approval

The exact timeline fluctuates based on agency capacity. Preliminary state programmatic screening, policy evaluation, background verification, and final electronic NHMMIS portal deployment typically take between 60 and 90 days from the submission of a complete documentation 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 homemaker, personal care, or home health social service taxonomies.

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Access instructions for Individual Service Agreement (ISA) mapping, billing codes, electronic visit verification (EVV) onboarding, and Medicaid reimbursement rules are provided after initial intake materials clear state review.

10. Additional Notes

• Homemaker services are strictly non-medical and must focus entirely on baseline environmental support; tasks must align precisely with the participant's authorized Individualized Service Plan (ISP)
• All household safety inspections, nutritional meal planning, and chore assistance must be delivered directly by the certified agency's qualified, employed field staff
• Every administrative coordinator, supervisor, and field homemaker must clear mandatory criminal background checks and state registry screenings through the New Hampshire Department of Safety
• Providers must maintain robust records detailing completed home visits, time-tracked service logs, and client receipt histories for Medicaid auditing and compliance monitoring

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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