State Offers Federal Money To Increase Options To Delay Or Deter Nursing Home Care

By Annmarie Timmins, New Hampshire Bulletin

The state is pursuing two projects aimed at increasing services that would allow people who qualify for a nursing facility to remain at home if that is their choice, one at the county level and the other statewide.

The goal of both is to delay or defer admission to institutional care, which is more expensive for counties and the state, and may not be the first choice for some people.

One project would give a New Hampshire county federal funding to coordinate or enhance services within the community for people who qualify for Medicare and Medicaid. Services could include transportation, social services, physical therapy, meals, home care, or adult day care.

It’s in the counties’ best interest to enable people to get care in their homes or the community because it costs them much less. The counties finance a significant portion of the required funding match for federal Medicaid money, while the state covers a small percentage of these costs.

In fiscal year 2021, the average number of Medicaid recipients in nursing facilities each month totaled 3,624, at an annual state budget appropriation of $355.6 million, according to the New Hampshire Fiscal Policy Institute. During that same year, slightly more people, 3,795, were receiving in-home or community-based services through Medicaid-funded Choices for Independence Program at a much lower annual budget appropriation of $72.1 million.

Counties “are a stakeholder in balancing the system and are a huge component of how our system is set up, and we want them to play a role in how we might help with the growing need for long-term care and not just focus on nursing facility care,” said Wendi Aultman, chief at the department’s Bureau of Elderly and Adult Services.

Counties each run just one nursing home. Aultman said the federal money will help them create alternative options for residents who need long-term care.

The department has given counties until Aug. 25 to submit a proposal.

For its second initiative, the department wants to conduct a feasibility study to determine its capacity to develop those same types of community-based services and health care at the state level for Medicaid and Medicare holders. According to its requests for proposals, those services range from dentistry and adult day care to medical care and telehealth services.

The department wants the feasibility study to also determine the cost of increasing those services.

“We need to do that work ahead of time in order to determine whether or not we need to ask for some additional funds from our state in order to operationalize it so it will set us up for success,” she said.

The department has given vendors interested in conducting the study until Aug. 23 to submit a proposal.

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