Adult Day Care New Hampshire Medicaid: CFI Waiver and Title XX Coverage

What Adult Day Services Provide

Adult day care programs offer structured daytime supervision, activities, and meals for older adults who need monitoring during the hours their family caregiver is at work, needs respite, or simply can't provide continuous oversight. Most programs operate Monday through Friday, roughly 7 AM to 5 PM, though hours vary by location.

A typical day includes:

• Supervised socialization and recreational activities
• One or two meals plus snacks
• Health monitoring (blood pressure, medication reminders)
• Physical activity appropriate to participants' abilities
• Transportation to and from the facility (offered by many programs)

Adult day health programs — a higher level of service — add nursing oversight, physical therapy, occupational therapy, and more intensive health monitoring for participants with complex medical needs or advanced dementia.

For family caregivers who work full-time, adult day care is often the difference between keeping a parent at home and placing them in residential care. And in New Hampshire, two separate funding streams can cover the cost.

Coverage Through the CFI Waiver

The Choices for Independence (CFI) Medicaid waiver covers adult day health services as an authorized component of the participant's care plan. If your parent is enrolled in the CFI waiver, their Care Coordinator can include adult day services in the Plan of Care based on the assessed need for structured supervision, socialization, or clinical monitoring during daytime hours.

The waiver covers the full cost of the program — enrollment fees, meals, and transportation if the facility provides it. Your parent pays nothing beyond standard Medicaid cost-sharing.

CFI waiver eligibility requirements apply: nursing facility level of care (two or more ADL deficits), gross monthly income under $2,982, and countable assets under $8,500 (after the He-W 856.07 resource disregard). The full application process runs 45 to 90 days from initial ServiceLink contact to active enrollment.

Coverage Through Title XX (Social Services Block Grant)

For older adults who don't qualify for the CFI waiver — or who are waiting for their waiver application to process — the Social Services Block Grant (SSBG), also known as Title XX, provides a separate funding path for adult day care and other home-based services.

Title XX services in New Hampshire have their own income threshold: $1,645 per month per person for 2026. This is a different and lower limit than the CFI waiver's $2,982 gross income cap, and the programs operate independently.

Title XX-funded services are administered through local agencies and may include adult day care, homemaker services, and personal care assistance. The scope is narrower than the CFI waiver — Title XX doesn't cover home modifications, PERS devices, or self-directed care — but for families who need daytime supervision while the Medicaid application is pending, it fills a critical gap.

Contact your local ServiceLink office (1-866-634-9412) to determine whether Title XX-funded adult day care is available in your parent's county and whether they meet the income threshold.

What Adult Day Care Costs Without Coverage

Out-of-pocket adult day care in New Hampshire typically runs $70 to $100 per day, or roughly $1,500 to $2,200 per month for a five-day-per-week schedule. That's significantly less than full-time home care ($4,000 to $6,000/month) or assisted living, making it one of the more cost-effective options for families who need weekday coverage but can manage evenings and weekends themselves.

Some programs offer sliding-scale fees based on income, and a few accept private long-term care insurance. Call individual programs directly to ask about payment options.

Finding Programs in Your Area

Adult day care availability varies by county. More populated areas (Hillsborough, Rockingham, Merrimack) generally have multiple options. Rural counties may have one program or none within a reasonable driving distance.

Start with ServiceLink — they maintain directories of adult day care providers by region and can help you understand which programs accept CFI waiver participants, which receive Title XX funding, and which have current openings. Waitlists at individual programs are common, so begin the search early even if you don't need the service immediately.

When Adult Day Care Is the Right Fit

Adult day care works best when your parent needs supervision but not continuous one-on-one care, when they benefit from social interaction and structured activity, and when you or another family caregiver can handle evenings and overnight.

It's not a fit for parents who are bedbound, who have severe behavioral symptoms that require constant one-on-one management, or who refuse to leave the house. For those situations, in-home personal care services through the CFI waiver or a private-duty agency are more appropriate.

Many families use adult day care as one component of a broader care arrangement — day program during work hours, a personal care aide for morning and evening ADL help, and family caregiving on weekends. The CFI waiver can fund all three elements simultaneously.

The Aging in Place in New Hampshire guide covers adult day care as part of the full CFI waiver service menu and walks through the enrollment and care planning process.

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