Updated September 4, 2026. Quick answer: unclear from New Hampshire’s own published materials whether Choices for Independence (CFI) waiver, Participant Directed and Managed Services (PDMS) option permits family pay in every case. Whether a spouse specifically qualifies is not clearly stated in the materials reviewed this session.
How New Hampshire pays a family caregiver
| Program | Choices for Independence (CFI) waiver, Participant Directed and Managed Services (PDMS) option |
|---|---|
| Can a family member be paid? | Unclear. Not stated in the materials reviewed this session. |
| Can a spouse be paid? | Not clearly addressed in the materials reviewed this session. |
Why the spouse question is different
Federal Medicaid rule treats a spouse (and a parent paying for a minor child) as a “legally responsible relative”, someone already assumed to owe the care for free, so paying them is barred by default. A state has to build an explicit exception into its waiver or state-plan option to pay a spouse at all; the rule for any other relative (an adult child, a sibling, a grandchild) is looser and usually allowed. That is why the two rows above can carry different answers on the same page.
The going rate
Not published by the state in the materials reviewed this session.
How it works
CFI is a federally approved 1915(c) waiver intended to keep aged and disabled adults out of nursing facilities. NH DHHS’s own site indexes official documents on PDMS and FMS, including a PDMS-specific rate-increase notice, indicating PDMS is a real, currently billable self-direction option within CFI, but the substance of those documents could not be read this session.
What this doesn’t answer
dhhs.nh.gov blocked every fetch attempt this session (403 Forbidden) on both HTML pages and PDFs, including the CFI HCBS overview page, the PDMS/FMS FAQ, and the CFI provider notice manual. The only primary source that could actually be opened was the federal medicaid.gov waiver listing, which confirms the waiver’s name and approval dates but says nothing about family or spousal hiring. Family-pay and spouse-pay answers, and any wage rate, are therefore marked Unclear/unverified rather than relying on secondary caregiver-site claims.
Sources
Read September 4, 2026.
Same question, other states: New Jersey · New Mexico.
Related: the private-pay caregiver-agreement rule · the household-employee tax rules once you’re being paid · what family caregiving actually costs unpaid.
General information drawn from each state’s own Medicaid agency and public program materials, not legal, tax or financial advice. Medicaid self-direction programs are administered state by state and change by budget cycle and waiver renewal; this page cannot see your own state’s current program status or your family’s eligibility. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.