As home-based care becomes a priority for more families across New Hampshire, many are searching for programs that allow aging or disabled loved ones to remain safely at home rather than in a nursing facility. One of the most flexible and family-centered options available today is New Hampshire’s Medicaid-funded Adult Family Care (AFC) Program, offered through the Choices for Independence (CFI) Waiver.
AFC allows eligible adults to receive daily support from someone they already know and trust while caregivers receive tax-free compensation for the care they provide. It creates a structured, supportive, and compassionate living arrangement that helps families stay together while easing the financial and emotional strain that caregiving often brings.
This guide breaks down how the AFC Program works, who qualifies, and why it has become a vital resource for thousands of families across New Hampshire.
What Is New Hampshire’s Adult Family Care (AFC) Program?
The Adult Family Care Program is a Medicaid-funded service under the CFI Waiver for adults who need help with daily living tasks and want to live in a supportive home environment rather than a nursing home.
Under the AFC model:
- A caregiver lives with the client full-time.
- The caregiver provides non-medical daily assistance and round-the-clock supervision.
- A Medicaid-approved agency offers training, monthly monitoring, and oversight.
- The caregiver receives tax-free financial compensation through the agency.
Unlike shift-based home care where aides rotate in and out, AFC focuses on stability, safety, and deep personal connection. Adults receive support from someone they trust, while caregivers benefit from structure and professional guidance. This arrangement is especially valuable for individuals who prefer to age in place, maintain independence, and avoid institutional settings.
Who Oversees the AFC Program in New Hampshire?
New Hampshire’s Department of Health and Human Services (DHHS) oversees the CFI Waiver, authorizes AFC services, and ensures that all care aligns with state regulations. Funding comes from New Hampshire Medicaid.
Approved agencies such as Family Support Services deliver the program, conduct assessments, train caregivers, develop care plans, and manage monthly oversight. This collaboration ensures consistent, safe, and high-quality in-home support for eligible adults.
How the AFC Program Works (Explained Simply)
The AFC Program functions as a partnership between the client, the caregiver, an oversight agency, and New Hampshire Medicaid.
1. The client and caregiver must live in the same home
The caregiver can move in with the client, or the client can move in with the caregiver.
2. Caregivers provide daily non-medical assistance
This includes help with:
- Bathing, dressing, and grooming
- Meal preparation
- Mobility support
- Toileting assistance
- Medication reminders
- 24/7 supervision, safety checks, and emotional support
3. Agencies provide monthly oversight and support
Agencies ensure the home environment is safe, create personalized care plans, and make sure the caregiver has the training and guidance they need.
4. Caregivers receive tax-free compensation
Payments help reduce the financial burden many families face when providing full-time care, allowing caregivers to focus fully on supporting their loved one.
Top Benefits of the AFC Program for Clients
New Hampshire’s AFC Program helps adults remain in a comfortable, safe environment while receiving personalized support tailored to their needs.
1. Stay at Home Instead of a Facility
The program helps adults remain in familiar surroundings and avoid placement in nursing homes.
2. Care From Someone They Know and Trust
Caregivers may be family members, friends, or spouses—anyone except a legal guardian.
This improves emotional comfort and reduces anxiety.
3. Personalized, One-on-One Care
Clients receive consistent, individualized attention—not shift-based or rotating support.
4. Continuous 24/7 Supervision
Round-the-clock oversight reduces risks such as falls, missed medications, or unattended emergencies.
5. Medicaid-Funded Support Reduces Financial Stress
Clients receive high-quality care without the cost of private home care or assisted living.
Top Benefits of the AFC Program for Caregivers
Caregiving is rewarding, but it can also be financially, physically, and emotionally demanding. AFC gives families meaningful support.
1. Tax-Free Financial Compensation
Caregivers are paid monthly for the essential support they provide.
2. Ability to Care for a Loved One Full-Time
Families no longer need to choose between caregiving and financial stability.
3. Professional Training and Support
Agencies offer training, monthly check-ins, and guidance so caregivers never feel alone in the process.
4. Reduced Stress and Burnout
Structured oversight and secure compensation help reduce pressure on caregivers.
5. Stronger Family Bonds
Living together and providing care often strengthens emotional connections.
6. No Medical Certification Required
Caregivers only need compassion, reliability, and the ability to support daily needs.
Eligibility Requirements for the AFC Program in New Hampshire
Client Eligibility
To qualify, the client must:
- Be a New Hampshire resident
- Be 18 years or older
- Require assistance with one or more Activities of Daily Living (ADLs) such as bathing, dressing, mobility, eating, or toileting
- Be eligible for New Hampshire Medicaid under the CFI Waiver
- Agree to live in the same home as the caregiver
Caregiver Eligibility
Caregivers must:
- Be 21 years or older
- Live full-time with the client
- Be a family member, friend, or spouse (but not a legal guardian)
- Be willing and able to provide daily care and 24/7 supervision
- Pass all background and safety checks conducted by the agency
Why New Hampshire’s AFC Program Matters for Families
AFC fills a major gap in long-term care, especially in rural areas where facility-based options are limited. It gives families a meaningful way to stay together while ensuring that vulnerable adults receive the support they need.
This program helps families by:
- Keeping loved ones out of nursing homes
- Ensuring consistent, relationship-focused daily care
- Offering financial relief for caregivers
- Supporting independence and dignity for adults needing assistance
- Maintaining family unity and emotional stability
For many households, AFC is not just a program, it’s a lifeline that allows families to remain connected while receiving structured, professional support.
How to Apply for New Hampshire AFC Program
If you believe you or your loved one may qualify, the next step is to contact a Medicaid-approved AFC provider. The agency will:
- Conduct an eligibility screening
- Complete assessments for the senior
- Verify caregiver qualifications
- Develop a physician-approved care plan
- Begin compensation once all requirements are met
Family Support Services can help guide families through every step of this process.
Final Thoughts
New Hampshire’s Adult Family Care Program is one of the most compassionate and practical long-term care solutions available. It allows adults who need daily support to live safely at home with someone they trust while caregivers receive meaningful financial assistance and professional oversight.
For families navigating long-term care decisions, AFC offers:
- Emotional comfort
- Financial stability
- Professional guidance
- A dignified alternative to institutional care
If you or a loved one may qualify, an approved agency can walk you through the steps, complete the required assessments, and help you begin receiving support as soon as possible.
Family care deserves support. AFC delivers it.
