Welcome home: expanding home and community based care for older adults in new hampshire - in 2019, new hampshire (NH)'S median age was 42.9, making IT the third-oldest state in the country

NH has one of the fastest-growing populations of older adults nationally (18.5%) yet is far behind others in offering a balanced system of care. NH's spending on home and community-based services (HCBS) as a percent of spending on long-term services and supports (LTSS) for older people and adults with physical disabilities in 2019 was 14%, far below the national average of 45%. In calendar year 2021, among 10,223 adults (age 18 and older) who received LTSS funded by medicaid in nursing facilities (NFS) or at home through HCBS, 47% received them at home. Over the past two decades, the new hampshire department of health and human services (NH dhhs) has leveraged multiple federal funding opportunities to advance LTSS system reform, including earlier rounds of money follows the person (MFP) funding to establish the NH community passport program (CPP) in 2007. CPP helped nearly 300 individuals transition from nursing homes to community settings between 2007-2015. Today, the choices for independence (CFI) waiver program, which helps older adults and adults with chronic illnesses to continue living independently, continues CPP's mission of transitioning individuals from institutional settings to home and community-based settings. With new MFP demonstration funding, NH's bureau of elderly and adult services (BEAS) will accelerate progress, use lessons learned from prior MFP efforts, and build on the momentum created towards home and community-based services by the pandemic. Funding will support a 16-month planning process (october 2022 to december 2023) and three years of implementation (january 2024 through december 2026). BEAS will hire a full-time MFP project director and full-time MFP data and quality analyst. The project director will convene an MFP consultative group of internal and external stakeholders to support the planning and implementation of the MFP demonstration. The center on aging and community living (CACL) at the university of new hampshire will be contracted to support the system assessment and GAP analysis of HCBS and facilitate a process to develop an MFP operational protocol (OP). The OP will be a clear plan for using funds to advance state rebalancing strategies, including direct service workforce challenges, i.e., workforce capacity, recruitment, retention, and training needs. The OP will also outline a strategy for identifying and enrolling participants, including partnering with and training transition coordination and housing support providers. Also, the OP will outline how BEAS will collaborate with providers and ensure services are delivered in a person-centered, coordinated fashion and will leverage cross-agency collaboration with state and local housing agencies, community-based organizations, social service agencies, aging/disability networks, and HCBS beneficiaries. 1- new hampshire: 2020 long-term services and supports state scorecard data, aarp during the planning phase, NH dhhs will use MFP funds to engage technical experts and build its capability to assess HCBS system capacity and determine what additional providers or services are needed, particularly for self-directed services and equitable care for historically underserved communities. This process will include identifying racial, ethnic, and other disparities and developing partnerships and strategies to address them. BEAS will also contract with CACL for technical support with data and evaluation throughout the grant, including implementing the national core indicators - aging and disability (NCI-ad). This consumer experience survey collects and maintains valid and reliable person-reported data concerning the impact of a state's publicly funded LTSS on the quality of life and outcomes of participants. 2- national core indicators for aging and DI