1. Program Definition and Services

Personal Care Services in New Hampshire provide essential assistance with daily living activities for individuals with disabilities, chronic illnesses, or age-related conditions. The program aims to maintain individuals' autonomy within their private residences or community settings, eliminating the need for long-term institutionalization or nursing facility placement. Services include:

• Activities of Daily Living (ADLs) Support: Hands-on assistance or cueing with critical personal care, including bathing, grooming, oral care, dressing, weight-bearing transfers, and toileting hygiene.
• Instrumental Activities of Daily Living (IADLs) Support: Non-medical household maintenance, including light housekeeping, laundry, grocery shopping, healthy meal preparation, and non-skilled medication reminders.

2. Regulations

The program is governed by the following regulations:

• New Hampshire Code of Administrative Rules, Part He-P 822 (Home Care Service Provider Agencies Licensing Rules)
• New Hampshire Code of Administrative Rules, Part He-P 809 (Personnel and Personal Care Definitions)
• New Hampshire Revised Statutes Annotated (RSA) Chapter 151:2-b (Residential Care and Health Facility Licensing)
• Federal Home and Community-Based Services Settings Final Rule (42 CFR § 441.301)

3. Licensing or Certification

Providers must obtain a Home Care Service Provider Agencies (HCSPA) License from the Health Facilities Administration within the New Hampshire Department of Health and Human Services (DHHS) before operating or billing for agency-based personal care.

4. Responsible State Agency

The New Hampshire Department of Health and Human Services (DHHS), utilizing operational oversight from the Bureau of Elderly and Adult Services (BEAS) and the Bureau of Developmental Services (BDS), is responsible for reviewing applications, conducting safety compliance checks, and licensing personal care providers.

5. Application Process

The application process requires submitting a comprehensive paper or digital license packet to the DHHS Health Facilities Administration along with the required licensing fee. Once the HCSPA agency license is officially secured, providers complete their enrollment online through the electronic New Hampshire Medicaid Provider Portal (NHMMIS.nh.gov).

6. Required Documentation

While specific documentation requirements vary based on the target waiver, providers typically need to submit:

• Proof of corporate registration in good standing with the New Hampshire Secretary of State
• An Agency Policy and Procedure Manual detailing client intake, service scheduling, emergency response, and detailed infection control measures
• Comprehensive background authorization packets for all corporate officers, administrators, and owners
• Certified documentation of staff qualification screening protocols, including sample employee training files
• Proof of general liability and professional liability insurance coverage that meets or exceeds the state minimum limits

7. Timeline for Approval

The exact timeline for approval fluctuates based on agency capacity. The Health Facilities Administration typically takes 60 to 90 days to process, review, and issue the baseline HCSPA agency license once a complete packet is received.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their business entity structure (such as an LLC or Corporation) with the state, secure an IRS Employer Identification Number (EIN), and obtain a Type 2 Organizational National Provider Identifier (NPI) configured with home care or personal assistance taxonomies.

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Access details to state-approved billing frameworks and rule orientations are sent to qualified applicants once preliminary license materials are formally accepted by DHHS agents.

10. Additional Notes

• Under He-P 822 and He-P 809 rules, any direct personal care employee must complete a minimum of an 8-hour structured training program covering transfers, bathing, feeding, and dressing before providing un-supervised care. The clinical portion of this training must be led by a licensed nurse or professional.
• All owners, agency administrators, and direct-care employees must clear a multi-tiered background check process, including a New Hampshire Department of Safety criminal history run, BEAS Registry check, and a Bureau of Elderly and Adult Services abuse registry verification.
• Personal care services are billed on a strict fee-for-service quarter-hour (15-minute) unit rate structure, which mandates the use of Electronic Visit Verification (EVV) systems to record clock-in and clock-out markers directly from client homes.
• Providers must interface with New Hampshire's designated statewide Managed Care Organizations (MCOs) to secure secondary network contracts once their core Fee-For-Service Medicaid ID has been approved.

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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