New Hampshire's Silent Crisis- Funding for CFI Lacking

Over 3,000 Granite Staters depend on CFI. These are low income, medically vulnerable individuals ages 18 to 102 who qualify for nursing homes. CFI enables them to remain in their own homes with help from nurses, home health aides, personal care and homemaker.

It costs the State about $17,500 per year to provide care for a CFI client at home, compared to more than $56,000 for a nursing home. CFI is a good investment.

Unfortunately, the CFI program has been underfunded for over a decade. Home care agencies that provide CFI services lose money or struggle to break even. At Ascentria we are having internal conversations about how long we can provide CFI services at the current rate. The Department of Health and Human Service’s own data shows huge gaps in the number of authorized services vs. services paid. This means that CFI clients are not receiving all the care they need. We estimate that DHHS spent $13 million less than it authorized for care in FY 18. CFI rates do not cover the full cost of training, supervision, caregiving, travel time, background checks and TB tests, Workers’ Compensation, health benefits, payroll taxes, billing and the new mandated electronic visit verification. Individuals can go to work at Market Basket, McDonalds or Walmart and receive a much higher wage.

The rate for CFI personal care services has been increased a total of 88 cents in twelve years. We ask that you build on the House Budget by adding General Fund dollars to CFI. We also ask that you fully fund Senate Bill 308. This would rebase rates and stabilize the provider network, enabling home care agencies like mine to invest in the workforce. Without rate increases, CFI clients will continue to go without their authorized services and the funds will not be used.

The people we serve can’t get to the State House to testify, but their voices matter. Tony, a 35 year old who was left paralyzed from the chest down after a logging accident- his voice matters. Ethel, who will turn 102 in a few months and wants to live her final days in the comfort of her home- her voice matters. Nathan, who is 28 years old and was told last month that he has about six months left to live because of ALS, his voice matters. The other 3,000 or more clients that rely on CFI- their voices all matter. They don’t want to burden anyone. But they need – and deserve – our help. Please tell your state representative to invest in the CFI program so that home care agencies can continue to care for these most fragile citizens.

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