Get Paid to Care for Your Elderly Parent in New Hampshire
New Hampshire's Choices for Independence (CFI) waiver lets participants self-direct their care and hire a relative, including an adult child or even a spouse, as the paid caregiver. A financial management service handles payroll, taxes, and background checks.
This guide covers what New Hampshire family caregivers need to know: the program structure, pay rates, who can be paid, eligibility, how to apply, and other programs that may supplement your income.
New Hampshire pays family caregivers $13–$22 per hour through the Choices for Independence waiver with self-directed services option within the Choices for Independence (CFI) 1915(c) HCBS Waiver. Your parent must meet a nursing-facility level of care but prefer to remain at home.
New Hampshire's Main Program: Choices for Independence waiver with self-directed services
Choices for Independence waiver with self-directed services is a self-directed option within New Hampshire's Choices for Independence (CFI) 1915(c) HCBS Waiver, which provides home and community-based care for seniors and adults with disabilities who meet a nursing-facility level of need. Under self-direction, your parent (or you as their authorized representative) can hire, train, schedule, and supervise the personal-care attendant — and that attendant can be you, an adult child.
What the Program Pays For
Authorized self-directed services typically include:
- Personal care: bathing, grooming, dressing, oral hygiene
- Toileting assistance and incontinence care
- Mobility help: transferring, positioning, ambulation support
- Meal preparation and feeding assistance
- Light housekeeping directly related to health and safety
- Medication reminders (not administration, which requires a nurse)
- Supervision for individuals with cognitive impairment, including dementia
Pay Rates Across New Hampshire
| Region | Typical Hourly Rate | Notes |
|---|---|---|
| Manchester / Nashua (Hillsborough) | $14–$22/hr | Largest population; most agency and self-directed options |
| Concord / Central NH | $13–$21/hr | State DHHS hub; CFI case management widely available |
| North Country / rural NH | $13–$20/hr | ServiceLink ADRC helps coordinate caregivers in remote areas |
Rates are set within the participant's approved plan-of-care budget and the state's limits; the figures above are typical ranges, not guarantees.
Who Can Be Paid
New Hampshire's CFI self-direction is unusually flexible and can allow a spouse, as well as an adult child or other relative, to be the paid caregiver. Always confirm the current rules with New Hampshire Department of Health and Human Services (DHHS) before you count on a specific arrangement.
Eligibility Requirements
Your Parent Must:
- Be enrolled in full New Hampshire Medicaid (not just a savings program)
- Meet the clinical criteria for a nursing-facility level of care
- Be enrolled in the Choices for Independence (CFI) 1915(c) HCBS Waiver (or its self-directed option)
- Live in New Hampshire in a community setting (not a nursing home)
- Be able to direct their own care, or have a legal/authorized representative who can
You (the Caregiver) Must:
- Be 18 years of age or older
- Meet the program's relationship rules (see above)
- Pass a criminal background check and registry search
- Complete any required caregiver orientation and training
- Be legally authorized to work in the United States
- Submit timesheets through GT Independence
How to Apply: Step-by-Step
- Apply for New Hampshire Medicaid. Apply online at nheasy.nh.gov or call 1-844-275-3447. Your parent must meet income and asset limits.
- Request a long-term-services assessment. Contact your local Medicaid or aging office to request a comprehensive functional assessment that determines whether your parent qualifies for the Choices for Independence (CFI) 1915(c) HCBS Waiver.
- Enroll in the waiver. Once deemed eligible, your parent is enrolled in the Choices for Independence (CFI) 1915(c) HCBS Waiver and assigned a case manager or care coordinator.
- Request the self-directed (CFI) option. During care planning, ask specifically for the consumer/self-directed service model and state that you, the adult child, want to be the hired caregiver.
- Enroll with GT Independence. Complete enrollment paperwork — W-4, I-9, and background authorization — so payroll, tax withholding, and timesheets are handled for you.
- Complete orientation. Finish any state-required caregiver orientation covering personal-care techniques, emergency procedures, and reporting.
- Begin care and submit timesheets. Provide care per the authorized plan and submit electronic timesheets; payroll is processed on a regular cycle with taxes withheld.
Check Your Parent's Eligibility
Our free Benefits Checker helps identify whether your parent qualifies for New Hampshire's caregiver-pay programs and other benefits.
Check Eligibility NowOther Programs That May Pay New Hampshire Family Caregivers
VA Veteran-Directed Care & PCAFC
If your parent is a veteran enrolled in VA healthcare, the Veteran-Directed Care program provides a monthly budget that can pay family caregivers, and the Program of Comprehensive Assistance for Family Caregivers (PCAFC) offers a monthly stipend for eligible primary caregivers. Contact the caregiver support coordinator at your parent's VA medical center or call 1-855-260-3274.
Personal Care Agreement (Private Pay)
If your parent does not qualify for Medicaid, a formal written Personal Care Agreement lets them pay you from their own funds at fair-market rates. Drafted with an elder-law attorney, it must be prospective and reasonable — and it keeps payments from being treated as "gifts" during the Medicaid 5-year look-back.
State Respite & Caregiver Support
Through the National Family Caregiver Support Program, New Hampshire's Area Agencies on Aging fund respite, training, and counseling. These rarely pay ongoing wages but reduce your out-of-pocket costs. Find your local agency through the Eldercare Locator (1-800-677-1116) or 1-866-634-9412.
Tax Implications for Family Caregivers
- W-2 wages: The financial management agency issues you a W-2; federal income tax, Social Security, and Medicare are withheld.
- IRS Notice 2014-7: If you live in the same home as your parent (the Medicaid waiver participant), your self-directed wages may be excludable from federal gross income. Consult a CPA before filing — see IRS guidance on Medicaid waiver payments.
- Earned Income Tax Credit: These wages count as earned income and may qualify you for the EITC.
Maintain daily logs of services provided — date, time in, time out, and a brief description. Medicaid audits self-directed arrangements, and accurate records protect both you and your parent.
What New Hampshire Caregivers Are Actually Earning
At 30 hours per week and about $17 per hour, you would earn roughly $2,210 per month. At 40 hours per week and $22 per hour, earnings reach about $3,813 per month — around $45,760 per year before taxes.
For comparison, a nursing home costs far more per year, and agency home care runs roughly $30–$40 per hour. A self-directed arrangement lets your parent receive care from someone they trust, while you earn income that partially replaces what you may have given up to provide care.
Contact Information
- New Hampshire Department of Health and Human Services (DHHS): www.dhhs.nh.gov/programs-services/medicaid | 1-844-275-3447
- Apply for Medicaid: nheasy.nh.gov
- State aging services: www.servicelink.nh.gov | 1-866-634-9412
- Eldercare Locator (find local help): eldercare.acl.gov | 1-800-677-1116
- Medicaid (federal): medicaid.gov
Frequently Asked Questions
Family caregivers under New Hampshire's CFI waiver typically earn about $13 to $22 per hour. The participant's individual budget and the financial management agency set the exact wage, and a fiscal intermediary handles taxes and payroll.
Choices for Independence (CFI) is New Hampshire's 1915(c) Medicaid HCBS waiver for adults who need a nursing-home level of care but want to stay at home. It provides personal care, homemaker, and other supports and includes a self-directed option.
Often yes. CFI's self-direction is one of the more flexible waivers and can allow a spouse, adult child, or other relative to be the paid caregiver. Eligibility is confirmed through the case manager and financial management agency.
The Choices for Independence (CFI) waiver is the New Hampshire Medicaid program that pays family caregivers. Through its participant-directed option, the person receiving care can employ a qualified relative.
Apply online at NH EASY (nheasy.nh.gov) or contact your local Aging and Disability Resource Center (ServiceLink) at 1-866-634-9412 for help. You can also call the DHHS Customer Service Center at 1-844-275-3447.
Yes. A parent with dementia who qualifies for the CFI waiver can self-direct services and choose an adult child as the paid caregiver. The parent must meet Medicaid financial limits and a nursing-home level-of-care need.
Related Guides
- How to Get Paid to Care for Your Parent (National Overview)
- How to Apply for Medicaid for an Elderly Parent
- Caregiver Tax Deductions 2026
- VA Benefits for Elderly Parents
- Power of Attorney for an Elderly Parent
- Medicaid Spend-Down Rules
This guide is general information, not legal or financial advice. Program names, pay rates, and eligibility rules change and vary by county — confirm details with New Hampshire Department of Health and Human Services (DHHS). Sources: www.dhhs.nh.gov · www.servicelink.nh.gov.