TITLE XII
PUBLIC SAFETY AND WELFARE

Chapter 161-I
PERSONAL CARE SERVICES

Section 161-I:1

    161-I:1 Purpose. –
I. Many individuals require assistance with eating, bathing, dressing, personal hygiene, and activities of daily living to maintain their independence and dignity. Personal care services are non-medical, hands-on supports that substitute for the loss of an individual's physical or cognitive functioning.
II. Many individuals requiring personal care services and families who have children with special health care needs want to choose who delivers personal care services and how and when these services are delivered.
III. This chapter provides individuals and families with the option of receiving personal care services, including consumer-directed services, from a home health agency or other qualified agency.

Source. 2000, 255:1, eff. June 12, 2000.

Section 161-I:2

    161-I:2 Definitions. –
In this chapter:
I. "Commissioner" means the commissioner of the department of health and human services.
II. "Consumer-directed services" means personal care services under which the eligible consumer or his or her representative is responsible for:
(a) Participating in the development of the eligible consumer's service plan;
(b) Selecting the eligible consumer's personal care services provider;
(c) Setting the terms and conditions of work;
(d) Training, supervising, and evaluating the personal care services provider; and
(e) Terminating his or her relationship with the personal care services provider.
III. "Department" means the department of health and human services.
IV. "Eligible consumer" means a child with special health care needs eligible for in-home supports or a person eligible for the home and community-based care waiver for the elderly and chronically ill.
V. "Eligible setting" means a home, apartment, residential facility, day program, or other community setting, but does not include a hospital, nursing facility, or other institutional setting.
VI. "Home health agency" means a home health care provider licensed under RSA 151.
VII. "Intermediary services" means an array of fiscal and supportive services to facilitate the delivery of consumer-directed services. Such services shall include:
(a) Fiscal intermediary services, including but not limited to:
(1) Computing of tax withholdings.
(2) Filing and depositing employment taxes.
(3) Preparing and disbursing payroll checks.
(4) Collecting and verifying worker timesheets.
(5) Processing and paying non-labor related invoices.
(6) Processing criminal background checks on prospective workers.
(7) Overseeing the verification of workers' citizenship/legal alien status.
(8) Generating standardized reports depending on program design.
(b) Supportive services, including but not limited to:
(1) Skills and advocacy training for the eligible consumer or representative.
(2) Assistance with recruiting, screening, hiring, and training personal care services providers.
(3) Creating and maintaining work registries.
(4) Assessing and reassessing service needs.
(5) Counseling and support.
(6) Monitoring consumer satisfaction.
VIII. "Legally responsible relative" means a parent of a minor child or a spouse.
IX. "Other qualified agency" means those entities authorized to offer personal care services and/or intermediary services by the department in accordance with rules adopted pursuant to RSA 541-A.
X. "Plan of care" means a state-authorized guide to the provision of services to an eligible consumer.
XI. "Personal care services" means services furnished by a personal care services provider that assist an eligible consumer in maintaining himself or herself in an eligible setting. Such services may include, but are not limited to, basic personal care and grooming, assistance with basic toileting and toileting hygiene measures, assistance with oral and topical medications, assistance with nutrition, including meal preparation, and essential household services.
XII. "Personal care services provider" means a person who:
(a) Is selected by:
(1) The eligible consumer;
(2) The eligible consumer's legal guardian;
(3) The eligible consumer's representative; or
(4) A person granted power of attorney by the eligible consumer; and
(b) Is employed by a home health agency or other qualified agency to provide personal care services; and
(c) Is not:
(1) The eligible consumer's legally responsible relative, except as authorized pursuant to RSA 161-I:3-a;
(2) The eligible consumer's legal guardian, except as authorized pursuant to RSA 161-I:3-a;
(3) The eligible consumer's representative; or
(4) A person granted power of attorney by the eligible consumer, except as authorized pursuant to RSA 161-I:3-a.
XIII. "Representative" means a person:
(a) Chosen by:
(1) The eligible consumer;
(2) The eligible consumer's legal guardian; or
(3) A person granted power of attorney by the eligible consumer; and
(b) Deemed appropriate by the department to act on behalf of the eligible consumer; and
(c) Who:
(1) Is not the personal care services provider; and
(2) Does not have a financial relationship with a home health agency or other qualified agency providing intermediary services to the eligible consumer.

Source. 2000, 255:1. 2006, 132:1, eff. July 18, 2006. 2023, 79:572, eff. July 1, 2023; 145:3, eff. Aug. 29, 2023.

Section 161-I:3

    161-I:3 Consumer Choice. – An eligible consumer in need of personal care services shall have the option to receive personal care services, including consumer-directed services, through a home health agency or other qualified agency. An individual not eligible for department programs shall have the option to receive personal care services, including consumer-directed services, through a provider of personal care certified under RSA 161-I, home health care provider, other qualified provider, or other facility licensed under RSA 151, or through a private arrangement between individuals. Such choice shall be subject to those limitations imposed by federal and state laws, rules, and regulations.

Source. 2000, 255:1. 2003, 319:158, eff. July 1, 2003.

Section 161-I:3-a

    161-I:3-a Authorization of Legally Responsible Relative, Guardian, or Person Granted Power of Attorney. – The department may authorize reimbursement to a legally responsible relative, a guardian, or a person granted power of attorney by the eligible consumer, who provides personal care to an eligible consumer with special health care needs residing at home. Such reimbursement shall occur only when the department determines that the needs of the eligible consumer, the unavailability of appropriate providers or suitable alternative care services, and cost efficiencies make utilization of a legally responsible relative, guardian, or person granted power of attorney by the eligible consumer, for the provision of such services necessary and appropriate. Reimbursement shall be limited to care that is medically necessary due to specific health needs and shall not be made for care generally expected and provided by a legally responsible relative, guardian, or person granted power of attorney by the eligible consumer. The department shall not authorize reimbursement to a legally responsible relative, guardian, or person granted power of attorney by the eligible consumer, until a plan and rules adopted pursuant to RSA 541-A, are reviewed and approved by the oversight committee on health and human services, established in RSA 126-A:13.

Source. 2006, 132:2, eff. July 18, 2006. 2019, 287:3, eff. July 1, 2019. 2023, 79:573, eff. July 1, 2023; 145:4, eff. Aug. 29, 2023.

Section 161-I:4

    161-I:4 Department Responsibilities. –
I. The department shall develop personal care services for department programs that authorize personal care services. Eligible consumers shall be afforded the option to receive their personal care services through a home health agency or other qualified agency and/or a consumer-directed services program.
II. The department shall develop a process for allowing a representative to act on the behalf of an eligible consumer.
III. The department shall develop intermediary services for eligible consumers using consumer-directed services.
IV. Coverage of personal care services under department programs shall be subject to the availability of appropriated funds.
V. Nothing in this section shall be construed to change the personal care program for the severely disabled as set forth in RSA 161-E.
VI. [Repealed.]

Source. 2000, 255:1, eff. June 12, 2000. 2021, 122:43, II, eff. July 9, 2021.

Section 161-I:5

    161-I:5 Personal Care Services Provider Training. – Any personal care services provider serving an eligible consumer shall be required to undergo training as required by rule, pursuant to RSA 541-A.

Source. 2000, 255:1, eff. June 12, 2000.

Section 161-I:6

    161-I:6 Plans of Care and Service Delivery Oversight. – All eligible consumers shall have a plan of care that details the provision of personal care services. The delivery of personal care services, as outlined in the plan of care, to an eligible consumer shall be monitored by a case manager either employed or contracted by the department. Should the delivery of personal care services to an eligible consumer necessitate specialized oversight, this shall be outlined in the plan of care and such oversight of the personal care services provider shall be arranged by the case manager.

Source. 2000, 255:1, eff. June 12, 2000.

Section 161-I:6-a

    161-I:6-a Criminal Record Check Required. –
I. Every applicant selected for employment with an other qualified agency, as defined in RSA 161-I:2, IX, shall submit to the employer a public criminal history record information authorization form, as provided by the division of state police, which authorizes the release of his or her public criminal history record information to the facility pursuant to RSA 106-B:14; provided, that the scope of employment includes the provision of services in a client's home or otherwise involves direct contact with a client.
II. The other qualified agency shall submit the public criminal history record information authorization form to the division of state police after an applicant accepts a conditional offer of employment. The other qualified agency shall review the results of the public criminal criminal history record information check before making a final offer of employment. An employee shall not begin work before the final offer of employment is made.
III. (a) Upon receipt of a public criminal history record information authorization form from an other qualified agency, the division of state police shall conduct a public criminal history record information check pursuant to RSA 106-B:14 and provide the results to the other qualified agency.
(b) The cost of criminal conviction record checks for such applicants shall be borne by the other qualified agency provided that the other qualified agency may require an applicant to pay the actual costs of the criminal conviction record check.
IV. (a) The provisions of this section shall apply to any agency providing temporary or per diem staff to an other qualified agency. The agency shall not offer the services of any person until the agency has reviewed the criminal history of the employee.
(b) The cost of criminal history record checks for such temporary or per diem staff shall be borne by the agency providing temporary or per diem staff to an other qualified agency, provided that the agency providing per diem staffing may require the selected applicant for employment to pay the actual costs of the criminal conviction record check.
V. The provisions of this chapter shall not apply to any person who is licensed by the board of nursing pursuant to RSA 326-B.

Source. 2003, 185:2, eff. July 1, 2003. 2019, 297:5, eff. July 1, 2019.

Section 161-I:7

    161-I:7 Rulemaking. –
The commissioner shall adopt rules, pursuant to RSA 541-A, relative to:
I. Criteria for approving home health or other qualified agencies to offer personal care services, including but not limited to:
(a) Qualifications and training of providers.
(b) Oversight of providers.
(c) Service definition.
(d) Reporting requirements.
(e) Record-keeping.
(f) Personnel requirements.
(g) Care planning.
(h) Service delivery oversight.
(i) Scope of service.
(j) Quality assurance measures.
(k) Structure of the business entity.
II. The provision of personal care services by personal care services providers, including the provision of consumer-directed personal care services.
III. The provision of intermediary services by a home health agency or other qualified agency to facilitate the delivery of consumer-directed personal care services.
IV. The use of a representative in consumer-directed services.
V. Guidelines for state-authorized plans of care.
VI. Criteria for the authorization of reimbursement of a parent for the provision of personal care services pursuant to RSA 161-I:3-a.

Source. 2000, 255:1. 2006, 132:3, eff. July 18, 2006.

Commission to Study the Shortage of Nurses and Other Skilled Health Care Workers for Home Health Care Services and Post-Acute Care Services

Section 161-I:8

    161-I:8 Repealed by 2016, 252:2, eff. Nov. 1, 2016. –