You asked about (1) a New Hampshire program that provides in-home care for children with serious chronic illness and (2) HB 5934 (2001), which would have established an in-home care program in Connecticut.

NEW HAMPSHIRE

Like Connecticut, New Hampshire provides in-home medical care to children with complicated medical conditions under a federal "Katie Beckett" Medicaid waiver. While we could find no other New Hampshire program that provides in-home care to such children, we found several that support their families.

The Katie Beckett waiver allows children with severe disabilities who would otherwise require institutional care to be eligible for community- and home-based care under the Medicaid program regardless of their parents' income. In addition to standard Medicaid medical services (e. g. , physician's services, prescription drugs, and medical equipment), waiver participants receive case management services, which include client assessment, care coordination, and monitoring.

Several other New Hampshire programs serve children with chronic, severe medical problems and their families, but they do not provide in-home care. A "medical home" program uses a care coordinator in eight participating pediatric medical practices throughout the state to (1) help the families of such children and their primary medical providers create a care plan for medical and related services, (2) obtain necessary specialist referrals, (3) work with insurers to obtain coverage and payment, and (4) coordinate services with other agencies (e. g. , schools). The Hood Center for Children and Families at the Dartmouth-Hitchcock Medical Center administers the program.

The Hood Center also administers the Partners in Health program, which helps families advocate for their children, access resources, and navigate health care and education systems. The Center subcontracts with 13 lead agencies, each of which employs a family service coordinator (FSC), administers a small, flexible funds pool to respond to individual family needs (e. g. childcare, recreation, therapy), and houses a consumer-led family council. The FSC helps families (1) identify their needs and develop individual plans for their children; (2) identify, connect with, and use support services; and (3) evaluate these services.

New Hampshire's Council for Children and Adolescents with Chronic Health Conditions advises and collaborates with the departments of Health and Human Services, Education, and Insurance on policy and program development. Among other activities, the council helped develop a guaranteed collateral loan program through the Bank of New Hampshire. Families can borrow to pay for medical services and equipment, modify their homes to accommodate their children's medical needs, or consolidate debt. As of September 30, 2001, 32 families had borrowed about $ 70,000.

HB 5934

HB 5934 required the Department of Children and Families (DCF), in consultation with the Children's Commission, to establish a pilot program to provide home care for children with "involved medical needs" whose parents could not provide them with adequate care. Pediatric nurses were to staff the program. In testimony on the bill before the Children's Committee, DCF Deputy Commissioner Thomas Gilman said the department licensed six permanent family residences that cared for 32 medically fragile children and was planning to open a four-bed group home in Cheshire for this population. Elaine Reynolds, a nurse, testified that there was a significant shortage of foster families licensed to care for these children.

The Children's Committee favorably reported the bill to the Human Services Committee, which then reported it to the Appropriations Committee. That committee took no further action.

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