New Hampshire · children's waiver
In-Home Supports (IHS) Waiver for Children with Developmental Disabilities in New Hampshire
The In-Home Supports waiver pays for in-home residential habilitation, including personal care, for children and young adults from birth through age 21 who have a developmental disability and significant medical or behavioral needs and live with their family. Services are family-directed through the local area agency. A parent can be paid for in-home residential habilitation only when the child's needs and the family's situation meet specific tests, and the area agency is then the parent's employer.
Also called: IHS waiver · In-Home Supports waiver · He-M 524 · in home residential habilitation · NH children's DD waiver · BDS in-home supports
Who do you care for?
Quick facts
- Pay
- Not published
- Adult children & other relatives
- Yes
- Spouse
- Not right now
- Parent of a minor child
- Sometimes
- Waitlist
- possible
Who qualifies for In-Home Supports (IHS) Waiver for Children with Developmental Disabilities
- Birth through age 21, living at home with family, and not yet graduated or exited from school (He-M 524.03).
- Found eligible for developmental services by an area agency (He-M 503 for ages 3–21, He-M 510 for under age 3).
- Eligible for New Hampshire Medicaid.
- Has 2 or more factors that make care harder, such as needing constant supervision for safety, self-injurious or destructive behavior, or very little sleep, or one child factor plus one parent factor such as a single caregiving parent or a parent over 59.
- Meets institutional level of care and is not receiving another home and community based waiver.
Who can be paid as the caregiver
- Adult children & other relatives Yes
- families may pick providers they already know, such as extended family or neighbors, if they meet He-M 524 provider qualifications.
- Spouse Not right now
- He-M 524.26 bars payment to the spouse of the person receiving services.
- Parent of a minor child Sometimes
- a parent can be paid for in-home residential habilitation only if the child's care needs exceed peers (or involve complex medical care) and the parent cannot find qualified providers or the care threatens the parent's job (He-M 524.26(k)).
- Living together
- the child must live at home with their family to qualify.
Who employs the caregiver: Family-directed through the area agency. All In-Home Supports are directed and managed by the individual or their representative (usually the parent), and the area agency is the employer for parents paid to provide in-home residential habilitation.
Spouse rules differ by program — see spouse pay in New Hampshire.
How much In-Home Supports (IHS) Waiver for Children with Developmental Disabilities pays
Not published. No hourly wage for paid parents or relatives is published. The area agency submits an individualized budget that the Bureau of Developmental Services approves, and pays the parent as their employer for the hours in the service agreement. The 2021–2025 waiver set an annual cap of $35,000 per participant; a cap for the current waiver period was not found.
Hours and budget: The area agency builds an individualized budget with line items for each service, and the Bureau of Developmental Services decides cost-effectiveness and gives prior authorization. When a parent is paid, the number of hours is written into the service agreement. The 2021–2025 waiver capped total services at $35,000 per year, with separate limits on some services.
Compare with other New Hampshire programs on the New Hampshire caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
IHS is a capped 1915(c) waiver and services require Bureau of Developmental Services budget approval; current wait times are not published on the pages reviewed.
How to apply for In-Home Supports (IHS) Waiver for Children with Developmental Disabilities
- Contact the area agency that serves your town and ask for an intake for developmental services.
- The area agency decides eligibility for developmental services and helps you apply for Medicaid if your child does not have it.
- The area agency sends the Bureau of Developmental Services a functional screen and an Individual/Parent Factors form within 3 business days of eligibility.
- Work with your service coordinator on a service agreement and budget; if you want to be paid as the parent, ask that the parent payment conditions be documented.
- The Bureau of Developmental Services approves the budget and prior authorization before paid services start.
- NH DHHS Bureau of Developmental Services · 603-271-5034 · official site
- Community Support Network (area agency directory) · 603-229-1982 · official site
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In-Home Supports (IHS) Waiver for Children with Developmental Disabilities questions
Can parents get paid to care for a disabled child in New Hampshire?
Sometimes, under the In-Home Supports waiver. A parent can be paid for in-home residential habilitation when the child's care needs go well beyond peers or involve complex medical care, and the parent either cannot find qualified providers or the child's care threatens the parent's job.
What counts as not being able to find a provider?
He-M 524 lists examples such as living in a rural area, a child's needs being too intense to keep staff, needing evening or weekend coverage, no agency being available, or no providers who share the family's culture.
Who employs a parent who is paid?
The area agency is the employer for parents paid to provide in-home residential habilitation, and it submits the parent payment request to the Bureau of Developmental Services for approval.
Can grandparents or other relatives be paid?
Yes. The family can choose providers it already knows, such as extended family or neighbors, as long as they meet the provider qualifications. A spouse of the person served and, with limited exceptions, anyone under 18 cannot be paid.
How old can my child be?
From birth through age 21, as long as they live at home with family and have not graduated or left school.
Is there a dollar limit?
The 2021–2025 waiver capped services at $35,000 per year, with some home or vehicle changes allowed above the cap with approval. Ask your area agency what limit applies now.
Sources: gc.nh.gov · dhhs.nh.gov · gc.nh.gov · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most New Hampshire caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in New Hampshire — pick yours for the local picture.
Across the line
States that border New Hampshire
Each state writes its own rules, and they differ more than people expect — a spouse who can be paid on one side of the line often cannot be on the other.