CHAPTER He-C 6300 GENERAL PROGRAM ADMINISTRATION
PART
He-C 6339 CERTIFICATION FOR PAYMENT
STANDARDS FOR COMMUNITY-BASED IN HOME SERVICE PROVIDERS: CHILD HEALTH SUPPORT,
HOME BASED THERAPEUTIC, THERAPEUTIC DAY TREATMENT, ADOLESCENT COMMUNITY
THERAPEUTIC SERVICES AND INDIVIDUAL
SERVICE OPTIONS - IN-HOME
Statutory Authority:
RSA 170-G:4 XVIII, RSA 170-G:5
REVISION NOTE:
Document #9263, effective 9-20-08,
adopted Part He-C 6339 relative to certification for payment standards for
community-based in-home service providers.
This part incorporated provisions from the former Part He-C 6352
entitled “Certification for Payment Standards for Community-Based Service
Providers” and made extensive changes to the wording, format, structure, and
numbering of those provisions.
Document #9263
supersedes all prior filings in the former Part He-C 6352 relative to
certification for payment standards for community-based in-home service
providers. The filings affecting the
former Part He-C 6352 include the following documents:
#4446, eff 7-1-88
#5096, eff 3-15-91,
EXPIRED 3-15-97
#7292, eff 5-24-00
#8009, eff 1-1-04
#9112, INTERIM, eff
3-24-08, EXPIRED 9-20-08
He-C 6339.01 Purpose.
(a) The purpose of this part is to
identify the qualifications and performance requirements to become a provider
of community-based in-home services for the division for children, youth and
families (DCYF) and describe in-home services that assist children and families
in remedying abusive, neglectful, delinquent, and children in need of services
(CHINS) behaviors. These services
include child health support, home based therapeutic, therapeutic day
treatment, adolescent community therapeutic services, and individual service
options in-home.
(b) The goals of in-home community
based services are to:
(1) Ensure the safety of children, families, and
communities;
(2) Improve interpersonal relationships and
communication within the family;
(3) Prevent the placement of a child in
out-of-home care;
(4) Reduce the recurrence of juvenile delinquent
or status offenses;
(5) Improve each child’s well-being in the home
and community;
(6) Stabilize the child and family by providing
therapeutic support prior to a court-ordered or voluntary placement; and
(7) Assist in preparing the family and the child
for reunification if the child is in out-of-home placement by:
a. Supporting the permanency plan of the child;
and
b. Supporting and enhancing the child’s positive
community connections.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.02 Scope. This part shall apply to community-based
in-home service providers who receive medicaid or financial reimbursement from
the department of health and human services (DHHS) for services provided to
children and families.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.03 Definitions.
(a) “Adolescent community
therapeutic services” means the implementation, coordination, and maintenance
of cases involving children in need of services and delinquents, which include
intensive monitoring, counseling, and supervision of juveniles.
(b) “Agency” means the board of
directors, executive director, and employees of an organization that is
incorporated and recognized by the NH secretary of state or another state’s
regulatory authority.
(c) “Applicant” means the entity
that is requesting certification for payment as an in-home service provider.
(d) “Certification for payment”
means the process by which the division for children, youth and families
approves the qualifications of and payment to providers of community-based
in-home service.
(e) “Child or minor” means an
individual from birth through age 20, except as otherwise stated in a specific
provision.
(f) “Child health support
services” means in-home support services for children and families through the
provision of supportive counseling, health assessment, health education,
behavioral health management, referral to resources, coordination of services,
and other supports for the purpose of improving the health and well-being of
children and other family members.
(g) “Child in need of services
(CHINS)” means “child in need of services” as defined by RSA 169-D:2.
(h) “Child protective service
worker (CPSW)” means an employee of the division for children, youth and
families who has expertise in managing cases to ensure families and children
achieve safety, permanency and well-being.
(i) “Commissioner” means the
commissioner of the department of health and human services or his or her
designee.
(j) “Community-based in-home services” means child health support,
home-based therapeutic, therapeutic day treatment, individual service options
in-home, and adolescent community therapeutic services.
(k) “Conflict of interest” means a
situation, circumstance, or financial interest, which has the potential to
cause a private interest to interfere with the proper exercise of a public
duty.
(l) “Corporal punishment” means
the deliberate infliction of pain intended to correct behavior or to punish.
(m) “Court-ordered” means a
written decree that is issued by a district, family, superior, probate, or
Supreme Court.
(n) “Department (DHHS)” means the
department of health and human services.
(o) “Direct service staff” means
employees, contractors, and volunteers who have access to children or access to
client information.
(p) “Director” means the director
of the division for children, youth and families, or the director of the
division for juvenile justice services, or designee.
(q) “Division for children, youth and families (DCYF)” means the
organizational unit of the department of health and human services that
provides services to children and youth referred by courts pursuant to RSA
169-A, RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, RSA 170-H and RSA
463.
(r) “DCYF Case plan” means the
division for children, youth and families or the division of juvenile justice
services written document, pursuant to RSA 170-G:4, III, that describes the service plan for the child
and family, and addresses outcomes, tasks, responsible parties, and timeframes
for correcting problems that led to abuse, neglect, delinquency, or child in
need of services (CHINS).
(s) “Evidence-informed practice”
means the process of treatment, which takes into account client preferences and
values, practitioner expertise, best scientific evidence, and clinical
characteristics and circumstances.
(t) “Family” means a child(ren) and an adult(s) who reside in the same
household and who have a birth, foster, step, adoptive, legal guardianship, or
caretaker relative relationship.
(u) “Founded” means a report of
abuse or neglect where the department has determined that there is a
preponderance of the evidence to believe that a child has been abused or neglected.
(v) “Home-based therapeutic
services” means the provision of intensive, short term, therapeutic
interventions in the home setting in order to strengthen the family and prevent
placement of the child(ren).
(w) “Indicator” means a measure,
for which data is available, that helps quantify the achievement of a desired
result or outcome.
(x) “Individualized education plan
(IEP)” means a child-specific plan that meets educational needs, as defined in
RSA 186-C:2, III.
(y) “Individual service options
(ISO) In-Home” means a variety of intensive therapeutic, social, and
community-based services provided or coordinated to meet the individual needs
of a child and his or her family in their residence to prevent placement or to
provide post-placement family support, or in a DCYF general foster care
setting.
(z) “Juvenile probation and parole
officer (JPPO)” means an employee of DCYF who discharges the powers and duties
established by RSA 170-G:16, and supervises paroled delinquents pursuant to RSA
170-H.
(aa) “Maltreatment” means the
emotional or physical abuse or neglect of a child.
(ab) “Medicaid prior
authorization,” means the documentation provided by DCYF indicating the
department’s responsibility for payment for medicaid eligible children.
(ac) “NH bridges” means the
automated case management, information, tracking, and reimbursement system used
by DCYF.
(ad) “NH medicaid mental health
authority” means the office of community mental health services administration,
under the division of behavioral health within DHHS.
(ae) “Non-court-ordered” means any
voluntary agreement between DCYF and a family.
(af) “Outcome” means the intended
result or consequence that will occur from carrying out a program or activity.
(ag) “Performance indicators”
means the utilization of data measurements to gauge program or activity
performance.
(ah) “Prescribing practitioner”
means a provider licensed by the New Hampshire Board of Mental Health Practice,
Board of Nursing, Board of Psychology or the Board of Medicine that provides
services identified on 42 CFR 440:130 to reduce a physical or mental disability
and aid in the restoration of a recipient to their best functional level, who demonstrates approval of a medicaid-covered in
home support services by signing the child and family’s treatment plan.
(ai) “Primary Caring Adult (PCA)”
means someone who:
(1) The child wants to be his or
her primary caring adult with whom the child may or may not live upon case
closure;
(2) Is fit to serve as the child’s
primary caring adult;
(3) Makes a
lifelong commitment to be the child’s primary source of guidance and
encouragement;
(4) Understands the child’s
current and future needs; and
(5) Is an adult other than the
child’s parent.
(aj) “Program consultant” means an
individual who meets the requirements of the individuals listed in He-C
6339.16(j)(1) or (j)(2).
(ak) “Progress report” means the
monthly written notes, specific case reports, and outcome reporting sent by the
staff of an agency that documents improvement or lack of improvement made by
the child or family toward specific goals, and may also include demographic
data and performance indicators, a summary of family contacts, modification to
the treatment plan, educational contacts with other professionals, and the
disposition of grievances.
(al) “Provider” means the agency
that serves a child or family and receives financial reimbursement from DHHS.
(am) “Quality assurance” means the
process that DCYF uses to monitor the quality and effectiveness of
community-based in-home services.
(an) “Service authorization” means
the documentation provided by DCYF indicating the division’s responsibility for
payment of community-based services for non-medicaid eligible children.
(ao) “Structured decision making
(SDM)” means a case management system utilizing a standardized, systematic
approach to manage child protection services.
(ap) “Therapeutic day treatment
services” means in-depth, short-term, outcome-oriented, therapeutic services
provided to enable a child to reside in the community.
(aq) “Treatment plan” means the
written, time-limited, goal-oriented, evidence based plan for the child and
family developed by the provider and DCYF, which is in agreement with the DCYF
case plan.
(ar) “Voluntary services” means
any voluntary, non-court ordered agreement between DCYF and a family.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.04 Application for
Enrollment and Certification for Payment Standards for Community-Based In-Home
Service.
(a) Applicants who seek initial
certification for payment standards for community-based in home service shall
contact a DCYF district office supervisor or designee and request to be
referred for certification.
(b) Each applicant to be a
provider of child health support services shall complete, sign, and submit, a
Form 2603 “Application for Certification and Enrollment of Child Health Support
Services Providers” (October 2016).
(c) Each applicant shall complete,
sign, and submit a “Statement of Affirmation” as part of Form 2603 “Application
for Certification and Enrollment of Child Health Support Service Providers”
(October 2016), that certifies the following:
“I affirm that all the information contained in this application is true,
correct, and complete to the best of my knowledge and belief. I acknowledge that the provision of false
information in the review document is a basis for denial of the continuation of
certification. I understand that DCYF has the right to review the information
contained in this review document;
I affirm that I will notify DCYF in writing within 10 days of any change
in the information contained in this review of continued certification;
By my signature below, I affirm that I have read and agree to adhere to
administrative rule He-C 6339, “Certification for Payment Standards for In Home
Community Based Service Providers.”
(d) Part C of Form 2603
“Application for Certification and Enrollment of Child Health Support Service
Providers” (October 2016) shall be completed, signed, and dated by each direct
service staff and include the following:
“I declare that all the information contained above is true, correct and
complete to the best of my knowledge and belief.
I acknowledge that the provision of false information in the application
is a basis for denial of the application.”
(e) Each submitted and signed Part
C of Form 2603 “Application for Certification and Enrollment of Child Health
Support Service Providers” (October 2016) shall have the following attestation
signed and dated by the executive director or designee:
“I certify that a criminal record check for this individual is completed and on
file at the agency.”
(f) The applicant shall provide
the following information with or in addition to Form 2603 “Application for
Certification and Enrollment of Child Health Support Service Providers”
(October 2016):
(1) A completed, signed, and dated “State of New
Hampshire Alternative W-9. (October
2016);”
(2) A current list of the board of directors
including the following for each member of the board:
a. The full name;
b. The office held;
c. The professional affiliation; and
d. The address, telephone, and email address;
(3) A copy of the organizational structure of the
program;
(4) Prescribing practitioner’s license;
(5) A copy of the professional and general
liability insurance certificate(s) for the program;
(6) A copy of the program brochure; and
(7) A copy of a current resume or curriculum vitae
of the program consultant.
(g) Each applicant for home-based therapeutic
services shall complete and submit a signed and dated Form 2604 “Application
for Certification and Enrollment of Home-based Therapeutic Service Providers”
(October 2016).
(h) A Part C of Form 2604 “Application for
Certification and Enrollment of Home-based Therapeutic Service Providers” (October
2016) shall be signed and dated by each direct service staff, and include the
following:
“I declare that all
the information contained above is true, correct, and complete to the best of
my knowledge and belief. I acknowledge
that the provision of false information in the application is a basis for
denial of the application.”
(i) Each submitted and signed Part C of Form 2604
“Application for Certification and Enrollment of Home-based Therapeutic Service
Providers” (October 2016) shall have the following attestation signed and dated
by the executive director or designee:
“I certify that a
criminal record check for this individual is completed and on file at the
agency.”
(j) The applicant shall submit a signed and dated
“Statement of Affirmation” as part of Form 2604 “Application for Certification
and Enrollment of Home-based Therapeutic Service Providers” (October 2016),
that certifies the following:
“I affirm that all
the information contained in this application is true, correct, and complete to
the best of my knowledge and belief. I
acknowledge that the provision of false information in the application is a
basis for denial of application. I
understand that DCYF has the right to review the information contained in this
application.
I affirm that I
will notify DCYF in writing within 10 days of any change in the information
contained in this application.
By my signature
below, I affirm that I have read and agree to adhere to administrative rule
He-C 6339, “Certification for Payment Standards in Home Community Based Service
Providers.”
(k) The applicant shall provide the following
information with, or in addition, to Form 2604 “Application for Certification
and Enrollment of Home-based Therapeutic Service Providers” (October 2016) in
(f) above:
(1) A copy of a completed, signed, and dated
“State of New Hampshire Alternative W-9”
(October 2016);
(2) A current list of the board of directors
including the following for each member of the board:
a. The full name;
b. The office held;
c. The professional affiliation; and
d. The address, telephone, and email address;
(3) A copy of the program organizational
structure;
(4) A copy of the prescribing practitioner’s
license;
(5) A copy of the professional and general
liability insurance certificate(s) for the program;
(6) A copy of the program brochure; and
(7) A copy of a
current resume or curriculum vitae for the program coordinator and clinical
supervisor.
(l) Each applicant for therapeutic day treatment
services shall complete and submit a signed and dated Form 2605 “Application
for Certification and Enrollment of Therapeutic Day Service Providers” (October
2016).
(m) Part C of Form 2605 “Application for
Certification and Enrollment of Therapeutic Day Service Providers” (October
2016) shall be signed and dated by each direct service staff and include the
following affirmation:
“I declare that all
the information contained above is true, correct, and complete to the best of
my knowledge and belief. I acknowledge
that the provision of false information in the application is a basis for
denial of my application.”
(n) Each submitted and signed Part C of Form 2605
“Application for Certification and Enrollment of Therapeutic Day Service
Providers” (October 2016) shall have the following attestation signed and dated
by the executive director or designee:
“I certify that a
criminal record check for this individual is completed and on file at the
agency.”
(o) The applicant shall submit a signed and dated
“Statement of Affirmation” as part of Form 2605 “Application for Certification
and Enrollment of Therapeutic Day Service Providers” (October 2016) that
certifies the following:
“I affirm that all
the information contained in this application is true, correct, and complete to
the best of my knowledge and belief. I
acknowledge that the provision of false information in the application is a
basis for denial of the application. I
understand that DCYF has the right to review the information contained in this
application.
I affirm that I
will notify DCYF in writing within 10 days of any change in the information
contained in this application.
By my signature
below, I affirm that I have read and agree to adhere to Administrative Rule
He-C 6339, “Certification for Payment Standards for In Home Community Based
Service Providers.”
(p) The applicant shall provide the following
information with, or in addition to, Form 2605 “Application for Certification
and Enrollment of Therapeutic Day Service Providers” (October 2016) in (m)
above:
(1) A completed, signed, and dated “State of New
Hampshire Alternative W-9” (October
2016);
(2) A current list of the board of directors
including the following for each member of the board:
a. The full name;
b. The office held;
c. The professional affiliation; and
d. The address, telephone, and email address;
(3) A copy of the program organizational
structure;
(4) A copy of the prescribing practitioner
license;
(5) A copy of the professional and general
liability insurance certificate(s) for the program;
(6) A copy of the program brochure; and
(7) A copy of a current resume or curriculum
vitae for the program consultant.
(q) Each applicant for adolescent community
treatment services shall complete and submit a signed and dated Form 2602 “Application
for Certification and Enrollment of Adolescent Community Treatment Service
Providers” (October 2016).
(r) Part C of Form 2602 “Application for
Certification and Enrollment of Adolescent Community Treatment Service
Providers” (October 2016) shall be signed and dated by each direct service
staff and include the following affirmation:
“I declare that all
the information contained above is true, correct, and complete to the best of
my knowledge and belief. I acknowledge
that the provision of false information in the application is a basis for
denial of the application.”
(s) Each submitted Part C of Form 2602
“Application for Certification and Enrollment of Adolescent Community Treatment
Service Providers” (October 2016) shall have the following attestation signed
and dated by the executive director or designee:
“I certify that a
criminal record check for this individual is completed and on file at the
agency.”
(t) The applicant shall submit a signed and dated
“Statement of Affirmation” as part of Form 2602 “Application for Certification
and Enrollment of Adolescent Community Treatment Service Providers” (October
2016) that certifies the following:
“I affirm that all
the information contained in this application is true, correct, and complete to
the best of my knowledge and belief. I
acknowledge that the provision of false information in the application is a
basis for denial of the application. I
understand that DCYF has the right to review the information contained in this
application.
I affirm that I
will notify DCYF in writing within 10 days of any change in the information
contained in this application.
By my signature
below, I affirm that I have read and agree to adhere to Administrative Rule
He-C 6339, “Certification for Payment Standards for In Home Community Based
Service Providers.”
(u) The applicant shall provide the following
information with, or in addition to, Form 2602 “Application for Certification
and Enrollment of Adolescent Community Treatment Service Providers” (October 2016)
in (q) above:
(1) A completed, signed, and dated “State of New
Hampshire Alternative W-9” (October
2016);
(2) A current list of the board of directors
including the following for each member of the board:
a. The full name;
b. The office held;
c. The professional affiliation; and
d. The address, telephone, and email address;
(3) The organizational structure of the program;
(4) A copy of the prescribing practitioner’s
license;
(5) A copy of the professional and general
liability insurance certificate(s) for the program;
(6) A copy of the program brochure; and
(7) A copy of a current resume or curriculum
vitae for the program supervisor.”
(v) Each applicant for individual service option
in home provider shall complete and submit a signed and dated Form 2606
“Application for Certification and Enrollment of Individual Service Options
(ISO) in Home Providers” (October 2016).
(w) Part C 2606 “Application for Certification
and Enrollment of Individual Service Options (ISO) in Home Providers” (October
2016) shall be signed and dated by each direct service staff and affirm, the
following:
“I declare that all
the information contained above is true, correct, and complete to the best of
my knowledge and belief. I acknowledge
that the provision of false information in the application is a basis for
denial of the application.”
(x) Each submitted and signed Part C of Form 2606
“Application for Certification and Enrollment of Individual Service Options
(ISO) in Home Providers” (October 2016) shall have the following attestation
signed and dated by the executive director or designee;
“I certify that a
criminal record check for this individual is completed and on file at the
agency.”
(y) The applicant shall submit a signed and dated
“Statement of Affirmation” as part of Form 2606 “Application for Certification
and Enrollment of Individual Service Options (ISO) in Home Providers” (October
2016) that certifies the following:
“I affirm that all
the information contained in this application is true, correct, and complete to
the best of my knowledge and belief. I
acknowledge that the provision of false information in the application is a
basis for denial of the application. I
understand that DCYF has the right to review the information contained in this
application.
I affirm that I
will notify DCYF in writing within 10 days of any change in the information
contained in this application.
By my signature
below, I affirm that I have read and agree to adhere to Administrative Rule
He-C 6339, “Certification for Payment Standards for In Home Community Based
Service Providers.”
(z) The applicant shall provide the following
information with or in addition to Form 2606 “Application for Certification and
Enrollment of Individual Service Options (ISO) in Home Providers” (October
2016) in (v) above:
(1) A completed, signed, and dated “State of New
Hampshire Alternative W-9” (October
2016);
(2) A current list of the board of directors
including the following for each member of the board:
a. The full name;
b. The office held;
c. The professional affiliation; and
d. The address, telephone, and email address;
(3) A copy of the organizational structure of the
program;
(4) A copy of the prescribing practitioner’s
license;
(5) A copy of the professional and general
liability insurance certificate(s) for the program;
(6) A copy of the program brochure; and
(7) A copy of a current resume or curriculum
vitae for the program.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.05 Review of
Continued Certification Compliance.
(a) Community based in-home
service providers shall complete and submit a completed, signed and dated Form
2607 “Review of Continued Certification for In-Home Community-Based Service
Providers” (October 2016), as provided by DCYF, within 30 days of receipt.
(b) Part C of Form 2607 “Review of
Continued Certification for In-Home Community-Based Service Providers” (October
2016) shall be signed and dated by each direct service staff and include the
following affirmation:
“I declare that all
the information contained above is true, correct, and complete to the best of
my knowledge and belief. I acknowledge
that the provision of false information in the application is a basis for
denial of the application.”
(c) Each submitted and signed Part
C of Form 2607 “Review of Continued Certification for In-Home Community-Based
Service Providers” (October 2016) shall have the following attestation signed
and dated by the executive director or designee:
“I certify that a criminal record check for this individual is completed an on file
at the agency.”
(d) The provider shall submit a
signed and dated “Statement of Affirmation” as part of Form 2607 “Review of
Continued Certification for In-Home Community-Based Service Providers” (October
2016) that certifies the following:
“I affirm that all the information contained in this application is true,
correct, and complete to the best of my knowledge and
belief. I acknowledge that the provision
of false information in the application is a basis for denial of the
application. I understand that DCYF has
the right to review the information contained in this application.
I affirm that I will notify DCYF
in writing within 10 days of any change in the information contained in this
application.
By my signature below, I affirm that I have read and agree to adhere to Administrative
Rule He-C 6339, “Certification for Payment Standards for In Home Community
Based Service Providers.””
(e) The provider shall provide the
following information with, or in addition to Form 2607 “Review of Continued
Certification for In-Home Community-Based Service Providers” (October 2016) in
(a) above:
(1) A copy of a resume or curriculum for the
program coordinator and the executive director;
(2) The organizational structure of the program;
(3) The resume or curriculum vitae for the
prescribing practitioner;
(4) A copy of the prescribing practitioner’s
license;
(5) A copy of the professional and general
liability insurance certificate(s) for the program;
(6) A copy of the program brochure;
(7) A current list of the board of directors
including the following for each member of the board:
a. The full name;
b. The office held;
c. The professional affiliation; and
d. The address, telephone and email address;
(8) A completed, signed, and dated “State of New
Hampshire Alternative W-9” (October
2016).
(f) Agencies that do not submit a
signed and dated Form 2607 “Review of Continued Certification for In-Home
Community-Based Service Providers” (October 2016) within 30 days of receipt
shall have their certification revoked in accordance with He-C 6339.22 and
denied payment.
(g) Renewal of certification shall be made by filing a
signed and dated Form 2607 “Review of Continued Certification for In-Home
Community-Based Service Providers” (October 2016) and shall be based on a
review and verification of the provider’s compliance with He-C 6339.14 and
specific requirements for the service provided.
(h) Review of continued
certification compliance shall occur every 5 years from date of issue.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.06 Notification of
Changes.
(a) All providers shall notify
DCYF in writing within 10 days of any change in the information contained in
the application and provide documentation of the change.
(b) Each agency shall send any new
staff information to DCYF.
(c) All providers shall submit a
copy of renewed license to DCYF within 10 days of receipt from the New
Hampshire licensing authority.
(d) The provider shall notify DCYF
of any changes in tax information and complete and submit to DCYF a completed,
signed, and dated “State of New Hampshire Alternative W-9” (October 2016) form
with its current tax information.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.07 Billing Requirements for Community-Based
In-Home Services.
(a) All providers shall be
certified and enrolled pursuant to He-C 6339.04 prior to being eligible for
reimbursement by DHHS.
(b) The provider shall not bill
DHHS for services that are to be reimbursed by another entity.
(c) Providers shall not exceed the
rates established by DCYF nor will the rates exceed those charged by the
provider for non-DCYF children and in no event shall DCYF be liable for any
payments hereunder in excess of such available and appropriate funds.
(d) The provider shall accept
reimbursement made by DHHS as payment in full for the services provided.
(e) DCYF shall determine the need
for services and the determination shall be binding on the provider.
(f) The provider, if incorporated
and if requested, shall submit to DCYF an audited financial statement prepared
by an independent licensed public accountant.
(g) The provider shall provide
services or care without discrimination as required by Title VI of the Civil
Rights Act of 1964, as amended, and without discrimination on the basis of
handicap as required by Section 504 of the Rehabilitation Act of 1973, as amended.
(h) The provider’s certification
and enrollment shall terminate upon date of sale or transfer of ownership or
close of the agency.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.08 Billing Process
for Community-Based In-Home Services.
(a) Prior to service delivery, a
provider shall obtain an authorization form, which consists of one of the
following:
(1) For medicaid eligible recipients, a ”New
Hampshire Title XIX Medicaid Program Service Authorization” from the New
Hampshire Medicaid fiscal agent or
(2) For non-medicaid eligible recipients, a Form
2110 “Service Authorization”(6/30/2008).
(b) A provider shall bill the NH
medicaid fiscal agent for medicaid eligible recipients either via paper claims
or electronic claims submission, following the directions outlined by the NH
medicaid fiscal agent, as follows:
(1) For a paper claim submission, a provider
shall complete a CMS 1500 form and mail it to the NH medicaid fiscal agent; or
(2) For electronic claim submission, a provider
shall submit an electronic claim to the NH medicaid fiscal agent.
(c) A provider shall bill the
department through NH Bridges for non-medicaid eligible recipients either via
paper claims or electronic claims submission, as specified in (d) and (e)
below.
(d) For paper claim submissions
for all services, a provider shall:
(1) Copy the Form 2110 “Service Authorization”
6/30/2008) for future billings, if the authorized service dates span a date
range;
(2) Complete and submit a copy of the Form 2110
“Service Authorization” (6/30/2008) to the department;
(e) For electronic claim
submissions, a provider shall:
(1) Request a web billing account from DHHS by
completing, signing, and submitting Form 2679 “Provider Web Billing User
Account Request Form” (October 2016);
(2) Be issued a log on and personal identification
number (PIN) by DHHS for use in accessing the web billing account; and
(3) Neither the provider nor any authorized
representative shall transfer his or her log on or PIN, or allow use of his or
her log on or PIN by any other person.
Source. (See Revision Note at part heading for He-C
6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff
9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17
He-C 6339.09 Billing Period.
(a) A provider shall bill within
one year of the date of provision of a service.
(b) Any bill received after one
year of the date of the provision of a service shall be denied pursuant to RSA
126-A:3.
(c) A provider shall submit bills
at least on a monthly basis.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.10 Billing
Discrepancies. Questions regarding
billing discrepancies shall be directed to the provider relations’ staff of the
bureau of administrative operations in DCYF.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.11 Record-Keeping and
Record Retention.
(a) A provider shall retain
records for a period of no less than 7 years after the completion date of a
provided service for each bill submitted to the department, any legally liable
county, the medicaid fiscal agent, or a private insurance company.
(b) The provider shall keep
records as are necessary to comply with RSA 170-E: 42, when applicable, and to
comply with DCYF record-keeping requirements in He-C 6339.
(c) Records shall clearly document
the extent of the care and services provided to children and families,
including attendance records when those services are charged to the department,
and information regarding any payment claimed.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.12 Quality Assurance
Activities and Monitoring of Community Based In-home Service Providers.
(a) The provider shall participate
in quality assurance activities conducted by DCYF using a variety of activities
that may include a combination of record reviews, performance data
measurements, and visits to providers.
(b) The provider shall allow an
on-site visit by DCYF which may be random or scheduled, for the purposes of:
(1) Interviewing program staff;
(2) Reviewing program documents to determine
continued compliance with He-C 6339; and
(3) Examining agency case records for DCYF
families.
(c) Providers shall ensure that clinical
records, including all progress reports, are available for inspection and
review by DCYF staff during any on-site quality assurance or monitoring visit.
(d) Service providers shall be
subject to monitoring and evaluation by DCYF through a variety of activities
that include:
(1) Queries of data that is stored on NH Bridges
case management system and the medicaid management information system (MMIS);
(2) Reviews of case record information;
(3) Data reporting from the service providers;
and
(4) Satisfaction surveys from stakeholders, such
as families, CPSWs, and JPPOs.
(e) Providers not demonstrating
compliance with the provisions of He-C 6339 shall meet with DCYF to develop an
approved corrective action plan that includes:
(1) Areas of concern or noncompliance with He-C
6339;
(2) Areas of performance needing improvement;
(3) Recommendations for corrective action or
program improvements;
(4) Determinations on corrective action
timeframes and any additional responses by the agency; and
(5) Any recommendation regarding continued
certification or revocation of certification.
(f) A service provider shall be
notified of any problems that are noted on the DCYF staff surveys that include:
(1) Negative responses concerning quality and timeliness
of service provision; and
(2) Written comments about agency performance.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.13 Reporting
Requirements.
(a) Each service provider shall:
(1) With the assistance of a DCYF representative,
if necessary, prepare an annual report of all statistical information used to
measure achievement; and
(2) Submit the annual report to DCYF no later
than 30 days following the end of the calendar year.
(b) The annual report shall
include the following information:
(1) Services provided and changes in strategies
that resulted in effective outcomes;
(2) Issues with the
service utilization and observations about shifts in the targeted service
population;
(3) Barriers discovered in the system of care;
and
(4) Proposed enhancements to performance
indicators.
(c) The provider shall submit
monthly reports on outcomes and performance data to DCYF.
(d) Data reports shall be
completed and submitted to DCYF no later than 15 days following the end of the
month.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.14 Compliance
Requirements.
(a) The provider shall comply
with:
(1) All applicable licensing and registration
requirements prior to applying for certification;
(2) The medical assistance requirements of He-W
500 and He-M 426;
(3) The statutes regarding confidentiality,
including RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:19, RSA 170-C:14,
and RSA 170-G:8-a; and
(4) The child abuse and neglect reporting
requirements of RSA 169-C:29-30.
(b) For all direct services staff,
prior to beginning their work with children, and thereafter on an annual basis,
the provider shall review the sections of RSA 169 on definitions, immunity from
liability, and persons required to report.
(c) The provider and his or her
employees shall not have a conflict of interest, as defined in He-C 6339.03(k).
(d) The provider shall maintain
both professional and general liability insurance.
(e) Whenever transportation
services are provided, the agency shall:
(1) Verify that each driver possesses a valid
driver’s license;
(2) Verify that each driver has automobile
insurance liability coverage;
(3) Conduct a motor
vehicle record check to verify that each driver has no convictions for impaired
driving or multiple motor vehicle violations; and
(4) Obtain a
criminal records check to verify that each driver has no convictions for crimes
against persons.
(f) When domestic violence is
identified as an issue for a family, each agency shall follow the “Mental
Health Domestic Violence Protocols” (2009), as prepared by the NH governor’s
commission on domestic violence and available via the Internet at http://doj.nh.gov/criminal/victim-assistance/protocols from the NH department of
justice as listed in Appendix A.
(g) The provider shall:
(1) Be an enrolled NH medicaid provider agency;
(2) Employ or
contract with a prescribing practitioner who demonstrates approval of the
medicaid-covered services by signing the child and family’s treatment plan; and
(3) Accept medicaid payment as payment in full.
(h) The provider shall bill all
third party sources of reimbursement, including private health insurance and
medicaid, prior to billing DCYF.
(i) As part of the certification
requirements, each agency shall provide to each family a written description of
their services, including:
(1) Agency staff availability to families;
(2) The services as reflected in the service
provision guidelines for each category of service; and
(3) The cost of the
service, including the parent’s obligation to re-pay a portion of service
provision, as applicable.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.15 Treatment Planning
and Progress Reports.
(a) The provider shall develop a
treatment plan for each child or family receiving their services, with input
from individuals described in (b) below.
(b) The following individuals
shall be included on the treatment team:
(1) The child, if age and developmentally
appropriate;
(2) The child’s parents;
(3) The CPSW or JPPO, or both;
(4) The prescribing practitioner;
(5) Staff members from the agency;
(6) School district personnel as determined by
the school districts if applicable; and
(7) Other persons significant to the family, who
may include:
a. Teachers;
b. Counselors;
c. Friends;
d. Relatives; and
e. Advocates and primary caring adults assigned
by the court.
(c) The treatment plan shall
include:
(1) The findings of the assessment as required
for the service being provided;
(2) An estimate by the treatment team members of
the length of service to be provided to the child and family, based upon
referral information and the agency’s assessment;
(3) The child’s permanency plan, identifying one
of the following alternatives for the child, as identified by the CPSW or JPPO:
a. Maintain in his or her own home;
b. Reunification with the family;
c. Planned permanent living arrangements;
d. Permanent relative placement;
e. Guardianship by a relative or other person;
or
f. Adoption;
(4) A concurrent plan as an alternative to the
child’s permanent plan as identified by the CPSW or JPPO; and
(5) The objectives that fall within one or more
of the following domains:
a. Safety and behavior of the child;
b. Family;
c. Medical;
d. Education; and
e. Independent living skills training, when
applicable.
(d) Each domain identified in
(c)(5) above shall address:
(1) The goals and objectives to be achieved by
the child and family;
(2) The timeframes for completion of goals and
objectives;
(3) An identification of the services that will
be provided directly or arranged for, and any measures for ensuring their
integration with the child’s activities, including identifying how the child’s
family will participate in their care;
(4) The frequency of services; and
(5) An
identification of the staff responsible for implementing the stated
interventions in the treatment plan.
(e) For cases in which
reunification is the identified goal, the treatment plan shall include:
(1) A community reintegration and transition plan
that identifies the needed supports that would enable the child to return to
his or her community; and
(2) The responsibilities of the participants for
completing steps necessary to implement the plan.
(f) The treatment plan shall be
signed and dated by the following team members, indicating they participated in
the process:
(1) The provider’s executive director or
treatment coordinator;
(2) The CPSW, JPPO, or both;
(3) When applicable for medicaid funding, the
prescribing practitioner;
(4) When age and developmentally appropriate, the
child; and
(5) The child’s parents or guardian.
(g) Revisions to the treatment
plan shall be explained in writing to any individuals of the team who are
unable to participate.
(h) The treatment plan shall be
filed in the child’s record and copies sent to:
(1) The CPSW, JPPO, or both;
(2) The child’s parent or guardian; and
(3) The prescribing practitioner.
(i) Once the treatment plan is
completed, the agency staff shall receive supervision and instruction by the
program supervisors and program consultants, if any, to assure that each
child’s treatment plan is consistently implemented.
(j) Each service provider shall
provide progress reports and outcomes data for each child in care, in
accordance with (k) below.
(k) Progress reports shall include
the following:
(1) Monthly written progress reports, which shall
be sent to the CPSW or JPPO no later than 15 days following the end of the
month; and
(2) Outcome reports, which shall be sent
electronically to the DCYF state office on a quarterly basis.
(l) Written progress reports,
court reports, and termination reports prepared by the agency shall clearly and
accurately reflect the family’s progress and be submitted on time pursuant to
RSA 169-B:5-a, RSA 169-C:12-b and RSA 169-D:4-a; as follows:
(1) Specific court reports, which
shall be sent to the court with a copy to the CPSW or JPPO no later than 5 days
before the scheduled court date, pursuant to RSA 169-B:5-a, RSA 169-C:12-b and
RSA 169-D:4-a; and
(2) Service termination reports,
which shall be sent to the CPSW or JPPO no later than 15 days following
termination.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.16 Requirements for Child Health Support
Services.
(a) The provider shall comply with sections He-C 6339.01 through He-C
6339.15 for certification compliance.
(b) Authorization for payment for
child health support services shall be pursuant to a court order, or a
non-court ordered or voluntary agreement between DCYF and the family.
(c) A provider shall not provide
services that exceed 90 days per year without prior approval from the CPSW or
JPPO.
(d) Service for an additional 90
days per year shall be authorized when the following conditions are met:
(1) The family’s problems have not
been resolved and the child remains at risk for out-of-home placement;
(2) The provider has discussed a
continuation of services with family members and the CPSW or JPPO; and
(3) The provider submits the
following information in writing to the CPSW or JPPO:
a. The reason(s) for continued
services;
b. The beginning and ending dates
for continued services;
c. The goals for the continued
period of services; and
d. The anticipated child and
family outcomes.
(e) Child health support services
shall be provided for the following:
(1) Families at risk of having a child removed
from the home due to maltreatment;
(2) Young parents, including teen parents and
others who are inexperienced and struggling with their parental
responsibilities;
(3) Socially isolated families who lack
appropriate parenting role models and access to supportive services;
(4) Families in which ineffective child
management techniques are being employed and children who may be withdrawn or
depressed, aggressive, delinquent, anxious, or display self-destructive
behaviors;
(5) Families where the parents are in the home, but
temporarily are unable to effectively carry out parenting functions because of
physical or mental illness, disabilities, convalescence, substance abuse, or
complications of pregnancy;
(6) Families in which the parents’ ability to
effectively parent their children is diminished due to a preoccupation with the
care of other family members, such as a spouse, child, or a grandparent who is
chronically ill, convalescing, or permanently disabled, or when a parent has a
prolonged grief reaction over the death of a spouse, child, or other person;
(7) Families in need of help to learn how to care
for children due to lack of knowledge, emotional immaturity, or overwhelming
responsibility for many children;
(8) Families headed by grandparents or other
relatives who are overwhelmed with the responsibilities of parenting, thereby
placing the child at risk of placement in another home;
(9) Families in which the child has been placed
out of the home on a temporary basis and the parents need therapeutic
intervention to prepare for the return of the child, including help with issues
such as appropriate parenting, child management techniques, discipline,
communication skills, and anger management, as well as safety of the physical
home environment;
(10) Families who need therapeutic intervention to
avert future neglect, abuse, delinquency, status offenses, emotional
disturbances, and out-of-home placement of a child;
(11) Families who provide foster care who require
additional assistance in order to preserve the placement; and
(12) Adoptive families to preserve the family
unit.
(f) Child health support services
shall include:
(1) An initial health and behavioral health
assessment, including the following;
a. The health status of each family member;
b. A behavioral health diagnosis and treatment
received;
c. The prescription medications of each family
member; and
d. The needs of the children and parents;
(2) Addiction recovery support that includes ongoing risk assessment and
referral for substance abuse treatment, as well as supportive counseling for
those in addiction treatment programs to reduce the effects these addictions
have on parenting abilities;
(3) Family-based support that includes education,
consultation, and follow-up activities that develop and maintain family support
systems to enhance and encourage parental coping and nurturing skills,
assessment of parent and child interaction, family counseling and skill
building for parents and their children who are in an out-of-home placement, and
parenting skills instruction, including role modeling;
(4) Behavior management that includes:
a. An initial behavioral health assessment of
the family;
b. Assistance with the development and
implementation of behavior strategies for the children and parents in
conjunction with child development, including managing the child’s behavior
through appropriate discipline;
c. Education and parenting skills to inform and
prepare parents for a child’s behaviors and needs, including age appropriate
socialization skills of the child;
d. Family support focused on coping skills,
stress management, conflict resolution, and impulse control; and
e. Support family and modeling behavioral
strategies;
(5) An assessment of the family’s home health
care management and education of physical or behavioral illnesses, as well as
providing assistance to parents in implementing medical regimes as they relate
to their tasks of daily living as prescribed by their medical and behavioral
health provider;
(6) Family support with household management that
includes safety instruction to eliminate, reduce, or avoid hazards in the home;
(7) Family support with nutritional education
that includes safe food handling procedures and dietary needs of children and
family;
(8) Connections and
facility referrals to community resources and supports that includes
instruction, and assistance with accessing community agencies and services; and
(9) Parent education about age appropriate
activities, discipline and behavior modification including supervised
visitation between parent(s) and children, as ordered by the court.
(g) A provider for child health
support services shall:
(1) Review the DCYF case plan;
(2) Complete an initial behavioral health needs
assessment for the family and using information from the DCYF case plan develop
a treatment plan within 30 days of the referral;
(3) Provide a completed treatment plan to the
CPSW or JPPO within 30 days of referral;
(4) The agency shall document each family visit,
including:
a. The type of service;
b. The date of service;
c The names of the family members and other
individuals who participated;
d. The name of the agency staff who assisted the
family;
e. A brief summary of the in-home session;
f. The length of time spent with the family; and
g. The provider’s signature and the signature of
a family member and child, as is age appropriate;
(5) Retain a copy of the log of visits and
contacts in the family’s file for review during the onsite visits;
(6) Attend case planning or treatment-planning
meetings with the family as requested by the CPSW or JPPO;
(7) Discuss discharge planning needs with the
family members and the CPSW or JPPO;
(8) Discuss the reason for service termination
with the family and CPSW or JPPO;
(9) Immediately notify the CPSW or JPPO of any
significant changes in or affecting the family, such as:
a. Changes in
employment or income;
b. Housing changes including eviction notice;
c. Death or serious injury or illness of a
family member;
d. Separation of the caregivers;
e. Unplanned pregnancy;
f. Changes in patterns of school attendance;
g. Arrests;
h. Police contacts; or
i. Probation or parole violations;
(10) Provide each family with a written
description of services, as described in He-C 6339.14 including the cost of the
service and potential reimbursement by the family to the DHHS for the services
provided;
(11) Employ staff that provides evening, weekend,
and holiday coverage to meet the needs of the family;
(12) Employ child health support aides in
sufficient number to maintain a 1:6 average aide-to-family caseload ratio; not
to exceed 1:9;
(13) Provide child health support aides with
agency identification; and
(14) Have an agency policy in place regarding
missed appointments by client families.
(h) The agency shall employ or
contract with a prescribing practitioner.
(i) The agency shall employ or
contract with a program consultant who is available for consultation with child
health support aides.
(j) The program consultant
referenced in (i) above shall meet one of the following:
(1) For cases when the primary issue is physical
health, a physician, physician assistant, advanced registered nurse
practitioner (ARNP), registered nurse (RN), or licensed practical nurse (LPN);
and
(2) For cases when the primary issue is
behavioral health, licensed psychologist, licensed pastoral psychotherapist,
licensed clinical social worker, licensed clinical mental health counselor, or
licensed marriage and family therapist.
(k) The prescribing practitioner
servicing as the program consultant shall:
(1) Sign each treatment plan separately as both
the prescribing practitioner and program consultant; and
(2) Meet the definition of
prescribing practitioner.
(l) The program consultant shall
review the treatment plan no less than quarterly and document the review by
signing and dating the treatment plan.
(m) The agency shall employ child
health support aides who:
(1) Are at least 22 years of age; and
(2) Possess:
a. A bachelor’s degree from an accredited
college or university with a major study in nursing, health, psychology, social
work, sociology, education, guidance, or a related field emphasizing human
relations, physical, or behavioral health;
b. An associate’s degree from an accredited
college or university with a major study in nursing, health, psychology, social
work, sociology, education, guidance, or a related field emphasizing human
relations, physical, or behavioral health and have 2 years’ experience working
with families or other relevant human services experience; or
c. A high school diploma or general equivalency
diploma and have 4 years experience working with families or other relevant
human services experience.
(n) In addition to the requirements
in (m) above, all child health support aides shall:
(1) Complete a minimum of 20 hours per year of
in-service training, as follows:
a. At least 8 of the 20 hours shall be family
systems training; and
b. 12 hours of the overall training hours may be
provided in supervision and staff meetings that relate to general therapeutic
topics such as:
1. Substance use disorders:
2. Child abuse and neglect;
3. Labor and sex trafficking;
4. Sexual abuse;
5. Domestic and family violence;
6. Behavioral health needs of children and
families;
7. Safety planning for family members;
8. Crisis intervention techniques;
9. Early childhood screening and child
development;
10. Trauma informed practice, including screening
and evidence-based practices;
11. Treatment of any co-occurring disorders;
12. Restorative practices and delinquency
prevention;
13. Behavioral management techniques; and
14. Infant safe sleeping practices.
(o) The agency shall maintain documentation of training that includes:
a. The dates of training;
b. The names of
training sessions attended; and
c. The number of hours per training.
(p) Child health support aides
shall:
(1) Be available for immediate contact so
appointments may be scheduled or canceled; and
(2) Carry and present agency identification to
the child’s caregiver as necessary.
(q) The program supervisor shall
provide a minimum of one hour per week of individual clinical supervision for a
the child health support aide working full time and pro-rated for part time
staff to review the progress and barriers of each case, for which one session
per month may be substituted with group supervision.
(r) The
agency shall complete annual staff evaluations.
(s) Within 15 days after service
termination, the agency shall forward a report to the CPSW, JPPO or his or her
supervisor, that includes:
(1) A summary of visits and contacts with the
family, including dates, duration, and locations;
(2) A summary of the progress or lack of progress
in meeting the treatment plan, including the tasks accomplished, timeframes,
and measurable outcomes achieved;
(3) New information about the family that changes
or updates the DCYF case plan, pre-dispositional investigation, or court
report;
(4) The community resources and supports
available to the family that might be accessed in the future;
(5) Recommendation for ongoing services,
including a description of additional progress by parents that is essential to
address the needs of each child as specified in the treatment plan and how the
provider has worked with the family to assist them in accessing recommended
services; and
(6) The dated and signature of the child health
support aide and prescribing practitioner;
(t) If services are terminated prior to the 15th
day of the month, no monthly progress report shall be required for the
month. The information for the month in
which services are terminated shall be included in a discharge report.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.17 Requirements for
Home-Based Therapeutic Services.
(a) The provider shall comply with sections He-C 6339.01 through He-C
6339.15 for certification compliance.
(b) Authorization for payment for
home-based therapeutic services shall be pursuant to a court order, or a
non-court-ordered or voluntary agreement between DCYF and the family.
(c) A provider shall not provide
services that exceed 90 days per year without prior approval from the CPSW or
JPPO.
(d) Service for an additional 90
days per year shall be authorized when the following conditions are met:
(1) The family’s problems have not
been resolved and the child remains at risk for out-of home placement;
(2) The provider has discussed a
continuation of services with family members and the CPSW or JPPO; and
(3) The provider submits the
following documentation to the CPSW or JPPO:
a. The therapeutic need(s) for
continued services;
b. The beginning and anticipated
ending dates for the continued services request;
c. The goals for the continued
period of services; and
d. The anticipated child and
family outcomes.
(e) Home-based therapeutic
services shall be provided for:
(1) Families with a child who is at imminent risk
for placement;
(2) A family with a child who has returned home
or is at risk of returning to placement;
(3) Families where
the parents are temporarily unable to deal with their child-rearing
responsibilities because of a family member’s physical or mental illness,
disability, convalescence, substance use disorder, or pregnancy;
(4) Families temporarily under stress with the
care of a parent, child, or another member of the family;
(5) Families for whom child placement has been
determined necessary to ensure safety and the parents need assistance preparing
for the placement or return of the child to a safe environment;
(6) Parents who request voluntary services,
including voluntary children in need of services (CHINS) and the requested
service is not available to the family through a community service agency;
(7) Families, including those who provide foster
care services, needing assistance to strengthen and support the child’s current
placement in a foster home or a relative’s home;
(8) Families who are experiencing a crisis that
might require the removal of a child due to physical abuse or neglect by the
parent or caregiver or unlawful behaviors by the child such as school truancy,
running away, or delinquency; or
(9) Families in crisis whose child is immediately
placed in emergency care for safety reasons after the initial DCYF assessment
or due to legal or judicial intervention because of juvenile offenses, and the
family’s goal is for the child to return home with this service provided.
(f) Home-based therapeutic
services shall include:
(1) On-call 24-hour availability to families;
(2) Assessment and service planning based on the
DCYF case plan or pre-dispositional investigation report or treatment and
ongoing assessment for each child enrolled in the program;
(3) Substance use disorder recovery support that
includes ongoing risk assessment and referral for substance abuse treatment, as
well as supportive counseling for those in addiction treatment programs to
reduce the effects these addictions have on the child and parent;
(4) Family and individual counseling with family
members and persons in their immediate support system to develop or maintain
family growth and assistance necessary for independent family functioning;
(5) Assistance to parents in compliance with court orders;
(6) Crisis assistance and safety planning with
families by responding immediately to a family’s needs;
(7) Referrals and coordination to other services
and supports made with JPPO and CPSW;
(8) A written description of services, as
described in He-C 6339.14 including the cost of the service and potential
reimbursement by the family to the state for services provided;
(9) For families who need crisis assistance:
a. A face-to-face
meeting initiated within 24 hours of referral to complete an initial assessment
and develop an immediate safety plan that includes strategies for diffusing the
crisis and maintaining the safety of all family members;
b. Submit the safety plan in writing to the JPPO
or CPSW within 72 hours; and
c. If safety cannot
be assured at the face-to-face meeting, immediately develop and coordinate an
alternative safety plan with the JPPO or CPSW,
the program administrator, or DCYF field administrator or supervisor
during weekends and holidays; and
(10) For families not in need of crisis
assistance:
a. Contact the family within 48 hours of
referral, excluding weekends and holidays; and
b. Have a face-to-face meeting with the family
within 5 working days of the date of the referral to conduct an initial
assessment and develop the treatment plan; and
(11) An assessment of the needs of each child and
the parents that is based upon:
a. The information included from one of the
following:
1. The DCYF case plan, pursuant to RSA 170-G:4
III and court reports pursuant to RSA 169-B:5-a, RSA 169-C:12-b or RSA
169-D:4-a; or
2. The investigation report, pursuant to RSA
170-G:16, I or III, RSA 169-B:16, III-IV, or RSA 169-D:14, III-IV; and
b. Identification of substance use disorders,
domestic and family violence, sexual abuse, or other situations that impact the
child’s safety.
(g) When available, the CPSW or
JPPO shall be present for the initial assessment and development of the
treatment plan.
(h) Face-to-face meetings with
families shall include parents or other caregivers, the child or children, and
other family members as necessary to develop and implement the treatment plan.
(i) The therapist shall maintain
an on-going log of contacts and visits with family members and with school,
health, and other service providers including the following:
(1) The type of service;
(2) The date of service;
(3) The names of the family
members and other individuals who participated;
(4) The name of the therapist who
assisted the family;
(5) A brief summary of the in-home
session;
(6) The length of time spent with
the family; and
(7) The provider’s signature and the
signature of the family member and child.
(j) The agency shall immediately
notify the JPPO or CPSW of any significant changes in or affecting the family,
such as:
(1) Change of employment or income;
(2) Housing changes including an eviction notice;
(3) Death or serious injury or illness of a
family member;
(4) Separation of the caregivers;
(5) Unplanned pregnancy;
(6) Changes in patterns of school attendance;
(7) Arrests;
(8) Police contacts; or
(9) Violations of probation or parole.
(k) The agency shall have a policy
in place regarding missed appointments by client families.
(l) The home-based therapeutic
agency shall:
(1) Employ or contract with a
prescribing practitioner;
(2) Employ a program coordinator
who meets the following:
a. A master’s degree in social
work, psychology, education, or a related field with an emphasis in human
services;
b. Two years clinical experience
working with families, and
c. Two years supervisory or
management experience;
(3) Employ therapists who have:
a. A master’s degree with a major
in social work, counseling, psychology, or a related field and at least 2 years
of direct work experience in assisting children and families; or
b. A bachelor’s degree with a
major in social work, counseling, psychology, or a related field and at least 5
years of direct work experience in assisting children and families; and
(4) Employ case managers who meet
the following minimum qualifications:
a. A bachelor’s degree in social
work, psychology, education or a related field with an emphasis in human
services; and
b. Experience of 2 years with
children and families.
(m) The prescribing practitioner
serving as the program consultant shall:
(1) Sign each treatment plan separately as both the prescribing
practitioner and program consultant; and
(2) Meet the definition of
prescribing practitioner.
(n) Therapists and case managers
shall participate in weekly supervision that includes a discussion of each case
and a review of the progress made by each family towards the goals of the
treatment plan.
(o) The agency shall have at least
one full-time program coordinator for every 6 therapists.
(p) Program coordinators shall be
available to the therapists and case managers 24 hours a day, 7 days a week.
(q) Each therapist and case
manager shall have an annual evaluation with a copy maintained in his or her
file.
(r) Each therapist and shall
complete a minimum of 20 hours of training per year that includes topics
related to:
(1) Family systems;
(2) Substance use disorders;
(3) Child abuse and neglect;
(4) Labor or sex trafficking;
(5) Sexual abuse;
(6) Domestic and family violence;
(7) Behavioral health;
(8) Safety planning for family members;
(9) Crisis intervention techniques;
(10) Early childhood and screening and child
development;
(11) Trauma informed practice, including
evidence-based practices;
(12) Treatment of any co-occurring disorders;
(13) Behavioral management techniques; and
(14) Infant safe sleeping practices.
(s) For each therapist and case
manager, the agency shall maintain on file copies of training certificates,
signed by the trainer, that document:
(1) The names of training sessions attended;
(2) The number of hours per training; and
(3) The dates of training.
(t) The therapist’s and case
manager’s caseload shall not exceed an average of 6 families per month.
(u) The therapist and case manager
shall participate in weekly supervision that includes a discussion of the
progress made by each family.
(v) Within 15 days after service
termination, the agency shall forward to the CPSW, JPPO, or the supervisor a report that includes:
(1) A summary of visits and contacts with the
family, including dates, duration, and locations;
(2) A summary of the progress or lack of progress
in meeting the treatment plan, including the tasks accomplished, timeframes,
and measurable outcomes achieved;
(3) New information
about the family that changes or updates the DCYF case plan, pre-dispositional
investigation report, or court report;
(4) The community resources and supports
available to the family that might be accessed in the future, if needed;
(5) Recommendations for ongoing services,
including a description of additional progress by parents that is essential to
address the needs of each child, as specified in the treatment plan, and how
the provider has worked with the family to assist them in accessing recommended
services; and
(6) The date and signature of the prescribing
practitioner and therapist;
(w) If services are terminated prior to the 15th
day of the month, no monthly progress report shall not be required for the
month. The information for the month in
which services are terminated shall be included in a discharge report.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.18 Therapeutic Day
Treatment Services Programs.
(a) The provider shall comply with sections He-C 6339.01 through 6339.15
for certification compliance.
(b) Authorization for payment for
therapeutic day treatment services shall be pursuant to a court order, or a
non-court ordered or voluntary agreement between DCYF and the family.
(c) Services shall be limited to a
period of time not to exceed 180 days.
(d) Service for an additional 90
days per year shall be authorized when the following conditions are met:
(1) The family’s problems have not
been resolved and the child remains at risk for out-of-home placement;
(2) The provider has discussed a
continuation of services with family members and the CPSW or JPPO; and
(3) The provider submits the
following documentation to the CPSW or JPPO;
a. The reason(s) for continued
services;
b. The beginning and ending dates
for continued services;
c. The goals for the continued
period of services; and
d. The anticipated child and
family outcomes.
(e) Therapeutic day treatment
services shall be provided for children who are:
(1) Experiencing challenging conditions in one or
more of the following domains:
a. Developmental;
b. Psychological;
b. Social;
c. Family;
d. Cognitive;
e. Educational;
f. Behavioral;
or
g. Substance
use;
(2) At imminent risk for out-of-home placement or
actively engaged in reuniting with family and community; or
(3) In families who provide foster care who
require additional support in order to preserve the placement.
(f) Therapeutic day treatment
services shall not be a substitute for special education or other federally
required educational services.
(g) A provider for therapeutic day
treatment services shall offer the following:
(1) Assessment and service planning based on the
DCYF case plan or pre-dispositional investigation report or treatment and
ongoing assessment for each child enrolled in the program;
(2) Crisis intervention and stabilization;
(3) Evidence-based practice or best practice; and
(4) Evidence-based
psychotherapies, including individual, group, and family counseling that might
occur in a community or in-home setting;
(h) In addition to the
requirements in (g) above, programs shall offer any combination of the
following, as necessary:
(1) Vocational assessment, when specifically
requested by the CPSW or JPPO;
(2) Health education, including substance use
disorder prevention, sexual health, nutrition counseling, and physical fitness;
(3) Parent education, parent skills training, and
parent support groups;
(4) Therapeutic recreation, such as
adventure-based and experiential activities; and
(5) After
school, weekend, and school
vacation therapeutic programming.
(i) Interagency referral,
coordination, and collaboration between DCYF, education, behavioral health,
developmental disabilities, medical, and any other involved discipline shall be
a component of therapeutic day treatment services.
(j) A provider for therapeutic day
treatment services shall:
(1) Review each child and family referral,
including pertinent documentation and previous evaluations to determine
appropriateness for therapeutic day treatment;
(2) Conduct a clinical assessment within 7
working days of referral that includes an individual and family needs
assessment and a mental status examination for each child, as appropriate to
the program offering, unless current assessments or mental status examinations
have been completed within the past year and identification of the strengths
and resources of the family;
(3) Within 30 days of referral, develop and
implement an individually designed treatment plan, in conjunction with the CPSW
or JPPO and the child and parents;
(4) Provide each family with a written
description of services as described in He C 6339.14, including the cost of the
service and potential reimbursement by the family to the state for services
provided;
(5) Provide 24-hour emergency coverage, 7 days
per week for the child and family; and
(6) Maintain a record for each child and family
that includes:
a. Child and family
names, medicaid and other third party identification numbers, addresses, and
birth dates;
b. Child’s medical, social, developmental,
educational, and family history;
c. Child’s diagnosis and the name of attending
physician, psychiatrist, or psychologist;
d. DCYF case plan;
e. Child’s individual education plan, if
applicable;
f. A description of any tests ordered and
performed and their results;
g. A description of treatment, including
measurable goals and timeframes;
h. A list of any medications prescribed;
i. Plan for coordinating services with other
providers;
j. Daily progress notes indicating the services
provided to the child;
k. Monthly progress summary which identifies the
services provided and progress toward achievement of treatment goals;
l. An attendance sheet or contact log that
supports the dates and times that are billed; and
m. Discharge plan or summary that identifies the
after care plan and summarizes the case in relationship to the treatment and
plan of care.
(k) The agency shall:
(1) Employ or contract with a prescribing
practitioner;
(2) Employ or contract with a program consultant
who meets the following:
a. A master’s
degree in social work, psychology, education, or a related field with an
emphasis in human services;
b. Clinical
experience of 2 years working with families; and
c. Supervisory
or management experience of 2 years.
(3) Therapists who have:
a. A master’s degree with a major
in social work, counseling, psychology, or a related field and at least 2 years
of direct work experience assisting children and families; or
b. A bachelor’s
degree with a major in social work, counseling, psychology or a related field
and at least 5 years of direct work experience in assisting children and
families; and
(4) Employ case managers who meet
the following minimum qualifications:
a. A bachelor’s degree in social
work, psychology, education, or a related field with an emphasis in human
services; and
b. Two years of experience with
children and families.
(l) The prescribing practitioner
serving as the program consultant shall sign each treatment plan separately as
both the prescribing practitioner and program consultant.
(m) Therapists and case managers
shall participate in weekly supervision that includes a discussion of each case
and a review of the progress made by each family towards the goals of the
treatment plan.
(n) In addition to the
requirements in (k) above, the agency shall:
(1) Provide weekly clinical supervision to staff,
including a review of the treatment plan for each family;
(2) Complete annual staff evaluations;
(3) Provide 20 hours per year of mandatory
in-service training for staff that includes topics related to:
a. Family systems;
b. Substance use disorders;
c. Child abuse and neglect;
d. Labor and sex trafficking:
e. Sexual abuse;
f. Domestic
and family violence;
g. Safety planning for family members;
h. Crisis intervention techniques;
i. Early childhood
screening and child development;
j. Trauma informed practice, including evidence-based practices;
k. Treatment
of any co-occurring disorders;
l. Behavioral
management techniques; and
m. Infant safe sleeping practices;
(4) For each therapist and case manager, the agency
shall maintain on file copies of training certificates, signed by the trainer
that document:
a. The names of training sessions attended;
b. The number of hours per training; and
c. The dates
of training.
(o) The agency shall discharge the
child and family from the program when:
(1) The child and family make progress in
achieving the goals as identified in the treatment plan;
(2) The child’s behavior while in the program
requires removal and referral to more intensive residential treatment; or
(3) The child and family are unable to utilize
treatment and are referred to other services.
(p) Within 15 days after service
termination, the agency shall forward to the CPSW, JPPO, or the supervisor a
report that includes:
(1) A summary of visits and contacts with the
family including dates, duration, and locations;
(2) A summary of the progress or lack of progress
in meeting the treatment plan including the tasks accomplished, timeframes, and
measurable outcomes achieved;
(3) New information about the family that changes
or updates the DCYF case plan, pre-dispositional investigation report, or court
report;
(4) The community resources and supports
available to the family that might be accessed in the future;
(5) Recommendations for ongoing services,
including a description of additional progress by parents that is essential to
address the needs of each child as specified in the treatment plan and how the
provider has worked with the family to assist them in accessing recommended
services; and
(6) The dated signature of the prescribing
practitioner and therapist.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.19 Requirements for
Adolescent Community Therapeutic Services.
(a) The provider shall comply with sections He-C 6339.01 through He-C
6339.15 for certification compliance.
(b) Authority for payment for
adolescent community therapeutic services shall be pursuant to a court order or
any voluntary agreement between the family and DCYF.
(c) A provider shall not provide
services that exceed 90 days per year, without prior approval from the CPSW or
JPPO.
(d) Service for an additional 90
days per year shall be authorized when the following conditions are met:
(1) The family’s problems have not been resolved
and the child remains at risk for out-of-home placement;
(2) The provider has discussed a continuation of
services with family members and the CPSW or JPPO; and
(3) The provider submits the following
documentation to the CPSW or JPPO:
a. The reason(s) for continued services;
b. The beginning and ending dates for continued
services;
c. The goals for the continued period of
services; and
d. The anticipated child and family outcomes.
(e) Adolescent community
therapeutic services shall be provided to:
(1) Children who are exhibiting inappropriate
behaviors in the home, school, or community; and
(2) Children living in their own home, a
relative’s home, a guardian’s home, or foster home.
(f) Adolescent community
therapeutic services shall provide:
(1) Assessment and
service planning based on the DCYF case plan, pre-dispositional investigation
report or treatment, and ongoing assessment for each child enrolled in the
program;
(2) Strength based counseling and support that
includes multiple contacts with the child and family, school, and work sites to
monitor behavior and activities and provide instruction on job search and
maintaining employment, as specified by the treatment plan;
(3) Crisis intervention available to the child
and family to intervene, assess the safety of the environment, and prevent out
of home placement;
(4) Family intervention, including supportive
based counseling with the family to improve relationships and ease tension in
the household;
(5) Ongoing assessments for health and safety,
including drug screenings, curfew checks, school attendance, and intensive
supervision;
(6) Health and safety education, to provide
counseling and information on independent living and substance use, and
encourage the child to make positive choices;
(7) Behavior management skills training to assist
in developing and implementing behavior modification plans for the youth and
family regarding discipline, stress, and conflict issues;
(8) Information regarding community resources and
support that includes advocacy and outreach to assist children and families in
learning how to access community resources and to develop the skills to use
these services within the community and comply with court orders by:
a. Assisting the family and CPSW or JPPO in
advocating for special education services when necessary to meet the conditions
of the DCYF case plan, attending school meetings, team evaluations, and IEP
meetings regarding the child’s school performance, and role modeling how to
effectively communicate;
b. Providing information about community
resources and services, and making referrals for needed services;
c. Coordinating transportation services for
child and the family to enable participation in program activities; and
d. Consulting with attorneys as requested by the
CPSW or JPPO and attending court hearings with the child; and
(9) Therapeutic recreational services, including
individual or group activities appropriate to the age and needs of the child
and designed to:
a. Develop healthy interests;
b. Enable the program staff to assess the child
in a natural environment;
c. Teach adaptive ways to spend unstructured
time;
d. Develop social skills and peer interaction
skills;
e. Provide a positive outlet for aggressive
energy; and
f. Build self-esteem.
(g) A provider of adolescent
community therapeutic services shall:
(1) Schedule an intake meeting with the child,
family, CPSW or JPPO, caseworker, and program supervisor within 24 hours for
emergency referrals and within 5 working days of referral for non-emergency
cases;
(2) Provide each family with a written
description of services, as described in He-C 6339.14 including the cost of the
service and potential reimbursement by the family to the state for services
provided;
(3) Complete an initial assessment within 15
calendar days of the intake meeting, in conjunction with the child, family, and
CPSW or JPPO, that includes:
a. An identification of the child’s strengths;
b. The child’s responsibilities for his or her
behavior;
c. The supervision to be provided by the family;
d. The adolescent community therapeutic services
to be provided; and
(4) Complete a written treatment plan at the end
of 30 calendar days;
(5) Reassess the treatment plan and progress
toward identified goals on a monthly basis, in consultation with the child,
family, agency worker, and CPSW or JPPO to determine whether to continue
services, the duration of services, and the purposes and goals;
(6) Provide multiple contacts, by telephone and a
minimum of a one-hour face-to-face meeting each week with the child and family
as prescribed by the DCYF case plan, which may include:
a. A weekend contact with the child;
b. School attendance checks in person or by
telephone;
c. Job attendance checks in person or by
telephone; and
d. Curfew checks;
(7) Provide assistance to the family in locating
the youth in instances of failure to meet curfew or attend school or job;
(8) Provide assistance to the family with school
suspension, supervision through frequent daily telephone contacts, additional
face-to-face contacts, or in-office supervision if available;
(9) Submit copies of monthly progress reports to
the CPSW or JPPO, the youth, and family; and
(10) Maintain records for each child to include:
a. Name of family, address, and telephone
number;
b. Reasons for referral;
c. Initial assessment, which shall be completed
following the intake meeting;
d. DCYF case plan, updated at monthly progress
reviews;
e. Daily log of contacts and services to the
child and family;
f. Incident reports that describe behaviors by
the youth, with a copy submitted to the CPSW or JPPO;
g. Progress reports that contain a summary of
contacts with the youth, family and others, any mutually agreed upon changes to
the treatment plan, goals and objectives achieved by the child and family, and
specific plans for next month; and
h. Other information, such as behavioral health
and medical records.
(h) When a child or family is visited, the child
and parent, if present, shall be required to sign the contact log, and the
agency staff shall retain a copy of the log in the family’s file for review
during the on-site visits.
(i) The agency shall document each family visit
including;
(1) The type of service;
(2) The date of service;
(3) The names of the family members and other
individuals who participated;
(4) The name of the staff who assisted the
family;
(5) A brief summary of the in-home session;
(6) The length of time spent with the family; and
(7) The provision of the provider’s signature and
the signature of a family member and the child, if age appropriate.
(j) A provider for adolescent
community therapeutic services shall:
(1) Employ or contract with a prescribing
practitioner;
(2) Employ a program supervisor who:
a. Possesses a master’s degree in social work or
a related field and 2 years experience in social services; or
b. A bachelor’s degree in social sciences or a
related field and 5 years experience including at least 2 years of previous
supervisory experience;
(3) Employ adolescent therapeutic caseworkers who
possess a bachelor’s degree in social sciences or a related field;
(4) Provide 20 hours per year of mandatory
in-service training for adolescent therapeutic caseworkers including topics
related to:
a. Family systems;
b. Substance use disorders;
c. Child abuse and
neglect;
d. Labor and sex trafficking;
e. Sexual abuse;
f. Domestic and family violence;
g. Behavioral health
h. Safety planning for family members;
i. Crisis intervention techniques;
j. Early child hood screening and child
development;
k. Trauma informed practice including
evidence-based practices;
l. Treatment of any co-occurring disorders;
m. Behavioral management techniques; and
n. Infant safe sleeping practices;
(5) Maintain documentation of training, which
includes:
a. The dates of training;
b. The titles of training topics; and
c. The number of hours per training;
(6) Have an adolescent therapeutic caseworker to
child ratio of an average of no more than 1 to 7 with a maximum caseload not
exceeding 1:9;
(7) Employ staff that provide evening, weekend,
and holiday coverage to meet the needs of the family;
(8) Have on-call 24-hour availability for
families;
(9) Provide a minimum of one hour per week of
individual clinical supervision by the program supervisor with the adolescent
therapeutic caseworker to review each case progress and barriers, for which one
session per month may be substituted with group supervision; and
(10) Complete annual staff evaluations, with
copies maintained in staff files.
(k) The prescribing practitioner
serving as the program supervisor shall sign each treatment plan separately as
both the prescribing practitioner and program consultant.
(l) The agency shall:
(1) Terminate services only after consultation
and a mutual decision is reached with the child, family, and CPSW or JPPO,
based on previously determined criteria in the treatment plan;
(2) Forward a termination notification to the
CPSW or JPPO within one working day of any unplanned terminations;
(3) Abide by the following timeframes for planned
terminations:
a. Continue services for no more than 5 days to
allow for transition work if the child is placed with a family who provides
foster care, a residential facility, or secure placement facility;
b. Continue services for no more than 2 business
days, with CPSW or JPPO approval, when the child enters an emergency foster
home, respite care, relative home, or shelter care;
c. Continue services for no more than 7 days for
a child who has run away if the program continues to be actively involved with
the family and the plan is for the youth to continue to live at home;
d. Suspend services if the child and family are
on vacation or for other reasons are to be away for more than 7 days; and
e. If services continue for 7 days or less,
services shall at a minimum include daily telephone contact with the child or
family;
(4) Within 15 days after service
termination, the agency shall forward to the CPSW, JPPO, or his or her
supervisor a report that includes:
a. A summary of visits and
contacts with the family including dates, duration, and locations;
b. A summary of the progress or
lack of progress in meeting the treatment plan including the tasks
accomplished, time frames, and measurable outcomes achieved;
c. New information about the
family that changes or updates the DCYF case plan, pre-dispositional
investigation report or court report;
d. The community resources and
supports available to the family that might be accessed in the future;
e. Recommendations for ongoing
services, including a description of additional progress by parents that is
essential to address the needs of each child as specified in the treatment plan
and how the provider has worked with the family to assist them in accessing
recommended services;
f. The date and signature of the prescribing practitioner and adolescent
therapeutic caseworker;
(5) If services are terminated prior to the 15th day of the
month, no monthly progress report shall not be required for the month. The information for the month in which
services are terminated shall be included in a discharge report.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.20 Requirements for
Individual Service Options (ISO) In-Home.
(a) The provider shall comply with
sections He-C 6339.01 through He-C 6339.15 for certification compliance.
(b) Authorization for payment for
individual service options in-home shall be pursuant to a court order, or a
non-court ordered or voluntary agreement between DCYF and the family.
(c) Services shall be limited to a
period of time not to exceed 180 days, without DCYF approval.
(d) Services for an additional 90
days per year shall be authorized when the following conditions are met:
(1) The family’s problems have not
been resolved and the child remains at risk for out-of-home placement;
(2) The provider has discussed a
continuation of services with family members and the CPSW or JPPO; and
(3) The provider submits the
following information in writing to the CPSW or JPPO:
a. The reason(s) for continued
services;
b. The beginning and ending dates
for continued services;
c. The goals for the continued
period of services; and
d. The anticipated child and
family outcomes.
(e) The individual service option
(ISO) in-home agencies shall:
(1) Promote family self-sufficiency and to
connect families to supports in the community;
(2) Promote collaboration and communication with
DCYF staff and other local service providers;
(3) Serve children in their home, foster or
relative care provider, or home community;
(4) Provide or coordinate all of the services
needed for the treatment of the child and family;
(5) Receive approval from DCYF prior to placing a
child in a residential care facility for crisis stabilization; and
(6) Provide each family with a written description
of services, as described in He-C 6339.14 including the cost of the service and
potential reimbursement by the family to the state for services provided.
(f) Crisis stabilization in a
residential care facility shall not exceed 10 days per year per child.
(g) Requests for waivers pursuant to He-C 6339.21 to the 10-day limit for
residential crisis stabilization shall be submitted to the DCYF.
(h) ISO in-home services shall be
provided to families with:
(1) Abused and neglected children, CHINS, and
delinquent children; and
(2) Children between the age of birth to age 21,
who might be experiencing one or more of the following:
a. Chronic mental, emotional, physical, or
behavioral challenges;
b. Post-traumatic stress symptoms;
c. Mental health diagnosis(e);
d. Sexually reactive behaviors;
e. A history of traumatic experiences;
f. Unable to participate in local education
program;
g. Require intensive supervision and consistent
structure and might benefit from remaining home; or
h. Might need short-term, intensive residential
care.
(i) A provider of ISO in-home
services shall provide, purchase, or connect a family to services that include:
(1) Case management, treatment planning, and
service coordination;
(2) Assessment and service planning based on the
DCYF case plan or pre-dispositional investigation report and ongoing assessment
for each child enrolled in the program;
(3) Individual, group, family, and substance use
disorder counseling;
(4) In-Home
services, including:
a. Home-base therapeutic services; and
b. Child health support;
(5) Support for children who are transitioning to
a family setting;
(6) Emergency on-call 24-hour response to crises;
(7) Respite care in a licensed foster home;
(8) Crisis stabilization in a residential care
facility with prior DCYF approval;
(9) Transportation;
(10) Assisting older children to transition to
adult living situations;
(11) Identification of relatives, mentors, and
others who will support or assist the child and family;
(12) Transitional assistance from DCYF to adult
services;
(13) Coordination of medical, community mental
health, and dental care;
(14) Coordination of public or private school
education;
(15) Coordination of recreational activities;
(16) Coordination of substance use disorder
evaluations and random drug testing; and
(17) Coordination of vocational services.
(j) The ISO in-home agency shall
obtain a referral for services and its attachments.
(k) The ISO in-home agency shall
assess each family member’s needs in the home within 30 days of referral based
on:
(1) The DCYF case plan, pursuant to RSA 170-G:4
III and court report, pursuant to RSA 169-B:5-a, RSA 169-C:12-b, or RSA
169-D:4-a; or
(2) The investigation report pursuant to RSA
170-G:16, I or III, RSA 169-B:16, III-IV, or RSA 169-D:14, III-IV.
(l) The agency’s assessment shall
include:
(1) Identification of the strengths and resources
of the family;
(2) Identification of alcohol or substance use
disorders, domestic or family violence, sexual abuse, or other situations that
might impact the child’s safety;
(3) A review of previously completed evaluations
and assessments, medical records, and psychological tests;
(4) A determination of immediate services needed
by the family;
(5) Identification of community or relative
resources available to the family; and
(6) A summary of treatment and service needs.
(m) The ISO in-home agency shall
provide DCYF with monthly progress reports that include:
(1) The family’s name;
(2) The name of the person completing the report;
(3) The date of the report;
(4) Improvements that are being made towards
specific goals;
(5) Summary of family contacts and progress made
towards specific goals;
(6) Changes to the treatment plan;
(7) Educational updates; and
(8) Contacts with other professionals.
(n) Progress reports shall include
the following about each child’s medical, dental, and behavioral health care:
(1) Prescriptions and current dosages;
(2) Over-the-counter medication;
(3) Dates of visits during the month being
reported;
(4) New health care issues and diagnosis;
(5) Next scheduled visits; and
(6) Name of health care practitioner and office
address.
(o) Progress reports shall be
provided to the parents or guardians, unless contraindicated by a court order,
or a request from DCYF.
(p) The ISO in-home agency shall
keep records that include a case record on each child and his or her family
that contains:
(1) The assessment used to develop the treatment
plan;
(2) The signed ISO in-home treatment plan and its
revisions;
(3) Weekly child and family progress notes;
(4) Documentation of therapeutic work with the
family; and
(5) Monthly progress reports.
(q) When a child or family is
visited, the child and parent, if present, shall be required to sign the
contact log and the agency staff shall retain a copy of the log in the family’s
file for review during the onsite visits.
(r) The agency shall document each
family visit including:
(1) The type of service;
(2) The date of service;
(3) The names of the family
members and other individuals who participated;
(4) The name of the therapist who
assisted the family;
(5) A brief summary of the in-home
session;
(6) The length of time spent with
the family; and
(7) The provision
of the provider’s signature and the signature of a family member and child.
(s) The ISO in-home agency shall:
(1) Employ or contract with a prescribing
practitioner;
(2) Employ a program coordinator who meets the
following:
a. A master’s degree in social work, psychology,
education, or a related field with an emphasis in human services;
b. Two years clinical experience working with
families, and
c. Two years supervisory or management
experience;
(3) Therapists who have:
a. A master’s degree with a major in social
work, counseling, psychology, or a related field and at least 2 years of direct
work experience in assisting children and families; or
b. A bachelor’s degree with a major in social
work, counseling, psychology or a related field and at least 5 years of direct
work experience in assisting children and families; and
(4) Employ case managers who meet the following
minimum qualifications:
a. A bachelor’s degree in social work,
psychology, education or a related field with an emphasis in human services;
and
b. Two years of experience with children and
families.
(t) The
prescribing practitioner may also serve as the program consultant as long as
they sign each treatment plan separately as both the prescribing practitioner
and program consultant.
(u) Therapist and
case managers shall participate in
weekly supervision that includes a discussion of each case and a review of the
progress made by each family towards the goals of the treatment plan.
(v) Therapists and case managers
shall complete a minimum of 20 hours of training per year that includes topics
related to:
(1) Family systems;
(2) Substance use disorders;
(3) Child abuse and
neglect;
(4) Labor and sex trafficking;
(5) Sexual abuse;
(6) Domestic and family violence;
(7) Behavioral health
(8) Safety planning for family members;
(9) Crisis intervention techniques; and
(10) Early child hood screening and child
development;
(11) Trauma informed practice including evidence-based
practices;
(12) Treatment of any co-occurring disorders;
(13) Behavioral management techniques; and
(14) Infant safe sleeping practices.
(w) The agency shall maintain
documentation of training for therapist and case managers, which includes:
(1) The dates of training;
(2) The titles of training topics;
and
(3) The number of hours per
training.
(x) Up to 5 hours of documented
supervision by a therapist may be applied towards the 20 hours of annual
training requirement for therapists and case managers.
(y) The case manager’s average
caseload shall not exceed an average of 6 families per month.
(z) The therapist’s maximum
caseload shall not exceed an average of 10 families per month.
(aa) Within 15 days after service
termination, the agency shall forward to the CPSW, JPPO, or his or her
supervisor a report that includes:
(1) A summary of visits and contacts with the
family including dates, duration, and locations;
(2) A summary of the progress or lack of progress
in meeting the treatment plan including the tasks accomplished, timeframes, and
measurable outcomes achieved;
(3) New information about the family that changes
or updates the DCYF case plan, pre-dispositional investigation, or court
report;
(4) The community resources and supports
available to the family that might be accessed in the future;
(5) Recommendation for ongoing services,
including a description of additional progress by parents that is essential to
address the needs of each child as specified in the treatment plan and how the
provider has worked with the family to assist them in accessing recommended
services; and
(6) The date and signature of the prescribing
practitioner and therapist.
(ab) If the services are terminated prior to the
15th day of the month, no monthly progress report shall not be
required for the month. The information
for the month in which services are terminated shall be included in the
discharge report.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.21 Waivers.
(a) Applicants or providers who
request a waiver of a requirement in He-C 6339 shall submit a written request
to the commissioner or his or her designee that includes the following
information:
(1) The anticipated length of time the requested
waiver will be needed;
(2) The reason for requesting the waiver;
(3) Assurance that if the waiver is granted the
quality of service and care to children and families will not be affected;
(4) A written plan to achieve compliance with the
rule or explaining how the provider will satisfy the intent of the rule, if the
waiver is granted;
(5) How the service will be affected if the
waiver is not granted;
(6) Evidence that the agency's board of directors
has approved the waiver request, such as, minutes of the board meeting
documenting that the request was approved or a signature of the board's
president or chairman; and
(7) A statement that the rule for which a waiver
is being requested is not related to compliance with the life safety code or
environmental health and safety issues, unless approved in writing by the fire
inspector, local health officer, or public health services.
(b) A waiver shall be granted if:
(1) The department concludes that authorizing
deviation from compliance with the rule from which waiver is sought does not
contradict the intent of the rule; and
(2) The alternative proposed ensures that the
object or intent of the rule will be accomplished.
(c) When a waiver is approved, the
applicant’s or provider’s subsequent compliance with the alternative approved
in the waiver shall be considered equivalent to complying with the rule from
which waiver was sought.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.22 Denial of Application and Revocation of
Provider Certification. An
application shall be denied or provider certification revoked if:
(a) DCYF determines that the state
does not have a need for the service;
(b) The applicant or provider, or
the individual acting on the applicant’s or provider’s behalf, submits
materially false information to DCYF;
(c) There has been a conviction
for a felony or any crime against a child that has not been annulled or
overturned;
(d) There has been disciplinary
action taken by a licensing body or professional society, a finding of civil
liability made for professional misconduct, or a finding of an ethical
violation made by a state or national professional association or any other
state’s regulatory board;
(e) There has been revocation of
membership on any hospital, medical, or allied health provider staff;
(f) There has been revocation of
provider status with any group or health maintenance organization;
(g) There has been revocation of
clinical privileges;
(h) There has been termination of
academic appointment by an institution;
(i) There has been cancellation of
professional or general liability insurance by the insurance company;
(j) There has been abusive or
neglectful treatment of a child as determined by any state statute;
(k) There has been a failure to
submit a completed, signed, and dated Form 2607 “Review of Continued
Certification for In-home Community based Service Providers” (October 2016)
within 30 days, pursuant to He-C 6339.05; or
(l) There has been failure to
comply with He-C 6339.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.23 Notification of
Denial or Revocation. If DCYF denies
an application or revokes certification, a letter shall be sent to the applicant
or provider by registered mail, which sets forth the reasons for the
determination.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.24 Request for Certification Reconsideration.
(a) A request for certification
reconsideration shall:
(1) Be filed within 30 days of the date of
receipt of the letter sent by DCYF;
(2) Be submitted in writing; and
(3) Be filed with the director of DCYF.
(b) The DCYF director shall uphold
or overturn the request.
(c) The applicant or provider
shall be notified of the decision, in writing by the director.
(d) The applicant or provider may
appeal the DCYF director’s decision pursuant to He-C 6339.25.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
He-C 6339.25 Appeals.
(a) Applicants or providers who
wish to appeal a decision to deny an application or revoke or suspend
certification shall file an appeal with the commissioner, pursuant to RSA
170-G:4-a.
(b) In accordance with RSA
170-G:4-a, the appeal shall:
(1) Be made in writing;
(2) Be signed and dated;
(3) State the reasons for the appeal pursuant to
RSA 170-G:4-a; and
(4) Be filed within 14 working days of the date
of receipt of written notification.
(c) Pursuant to RSA 170-G:4-a and
He-C 200, the commissioner or designee and 2 members of the DCYF advisory board shall hear the appeal.
Source. (See Revision Note at part heading for He-C 6339)
#9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by
#12136, eff 3-18-17
PART He-C 6340
CERTIFICATION PAYMENT STANDARDS FOR ADOPTIVE REPORT WRITING SERVICE
PROVIDERS
Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:5
REVISION NOTE:
Document
#9264, effective 9-20-08, adopted Part He-C 6340 relative to certification for
payment standards for adoptive report writing service providers. This part incorporated provisions from the
former Part He-C 6352 entitled “Certification for Payment Standards for
Community-Based Service Providers” and made extensive changes to the wording,
format, structure, and numbering of those provisions.
Document
#9264 supersedes all prior filings in the former Part He-C 6352 relative to
certification for payment standards for adoptive report writing service
providers. The filings affecting the
former Part He-C 6352 include the following documents:
#4446,
eff 7-1-88
#5096,
eff 3-15-91, EXPIRED 3-15-97
#7292,
eff 5-24-00
#8009,
eff 1-1-04
#9112,
INTERIM, eff 3-24-08, EXPIRED 9-20-08
He-C 6340.01 Purpose. The
purpose of this part is to identify the qualifications and performance
requirements to become a provider of adoptive report writing services, which
includes adoptive history reports and adoptive home study reports, for the
division for children, youth and families (DCYF) as required by RSA 170-G:4
XVIII and RSA 170-B:18.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16
He-C 6340.02 Scope. This part shall apply to individuals or
agencies that seek certification to receive financial reimbursement from the
department of health and human services (DHHS) for the provision of adoptive
report writing services.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16
He-C 6340.03 Definitions.
(a) “Adoptive
report writing” means adoptive history reports and adoptive home study reports.
(b) “Adoptive
history report” means the completion of a written case history, which includes
social, medical, psychological and educational information about a child who
might be adopted and the birth family.
(c) “Adoptive home study report” means the written
report of an assessment into the conditions of the adoption petitioner as
described in RSA 170-B:18, I for the purpose of ascertaining whether the
adoptive home is a suitable home for the minor child and whether the proposed
adoption is in the best interest of the minor child.
(d) “Applicant”
means the person or entity that is requesting certification for payment as an
adoptive report writing service provider.
(e) “Case plan”
means the division for children, youth and families’ (DCYF) written plan for
the child and the family which outlines how services will be provided, pursuant
to RSA 170-G: 4 III, and 42 U.S.C. 671, PART E-Federal Payments for Foster Care
and Adoption Assistance Section 471(a)(16), 475(1) and (5)(A) and (D) State
Plan For Foster Care and Adoption Assistance. This term includes “placement
plan.”
(f)
“Certification for payment” means the process by which DCYF approves the
qualifications of and reimbursement to providers of adoptive report writing
services.
(g) “Child”
means “child” as defined in RSA 170-E:25:I or “child” as defined in RSA 169-C:3
or “child” as defined by RSA 169-D:2.
(h) “Child
protective service worker (CPSW)” means an employee of DCYF who is specially
trained to work with families referred to the DCYF pursuant to RSA 169-C, RSA
170-B, RSA 170-C, and RSA 463.
(i) “Commissioner”
means the commissioner of the New Hampshire department of health and human
services, or his or her designee.
(j) “Conflict
of interest” means any circumstance, situation, or financial interest which has the potential
to cause a private interest to directly or indirectly affect, influence, or
interfere with the performance of the duties of a provider or his or her
employee as a provider for the Division for Children, Youth and Families.
(k)
“Department” means the New Hampshire department of health and human
services (DHHS).
(l) “Director”
means the director of the division for children, youth, and families, or his or
her designee.
(m) “Division
for children, youth, and families (DCYF)” means the organizational unit of the
department of health and human services that provides services to children and
youth referred by courts pursuant to RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, and RSA 463.
(n) “Juvenile
probation and parole officer (JPPO)” means an employee of DCYF who exercises
the powers and duties as provided for in RSA 170-G: 16, and supervises paroled
delinquents pursuant to RSA 170-H.
(o) “NH
bridges” means the automated case management, information, tracking, and
reimbursement system used by DCYF.
(p) “Provider” means
the individual or agency that receives financial reimbursement from the
department for adoptive report writing services.
(q) “Structured
analysis family evaluation (SAFE)” means the copyrighted structured home study
methodology and evidence based forms obtained through the Consortium for
Children by providers who have been trained and certified in their use.
(r) “Service
authorization” means the documentation provided by DCYF indicating the
division’s responsibility for payment of community based services.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16
He-C 6340.04 Compliance
Requirements.
(a) Providers
shall comply with:
(1) The confidentiality statutes of RSA 169-B:35,
RSA 169-C:25, RSA 169-D:25, RSA 170-B:23, RSA 170-C:14, and RSA 170-G:8-a; and
(2) The child abuse and neglect reporting
requirements of RSA 169-C:29-30.
(b) Providers
and his or her employees shall not have a conflict of interest as defined in
He-C 6340.03(i).
(c) Failure to
comply with the rules of this chapter shall result in:
(1) Denial of an applicant pursuant to He-C
6340.16;
(2) Revocation of certification for payment of a
provider pursuant to He-C 6340.16; or
(3) Denial of reimbursement.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16
He-C 6340.05 Application
Process For Payment Standards For Adoptive Report Writing Services.
(a) Applicants
who seek initial certification for payment for adoptive report writing services
shall contact DCYF and request certification.
(b) The DCYF
shall assess the need for services based on the following criteria:
(1) The number of children and families who
require services exceeds the available community resources;
(2) A specialized service is necessary to meet
the unique needs of children and families, and there are no currently certified
providers who can provide the specialized services; and
(3) Any other case circumstance which requires
the provision of services pursuant to a court order.
(c) If there is
a need for a service based on (b) above, DCYF shall forward an application
packet to the applicant which includes:
(1) Form 2608 “Application For Enrollment Of
Adoptive Report Writing Providers”(November 2016);
(2) A “State of New Hampshire Alternate W-9
FORM”;
(3) A copy of He-C 6340; and
(4) A copy of Form 1790 “Adoptive History Part I
and Part II” (March 2015, PD 15-04) .
(d) Each
applicant shall complete the Form 2608 “Application for Enrollment of Adoptive
Report Writing Providers” (November 2016) which includes:
(1) A statement
indicating whether the applicant is currently listed in any child abuse and
neglect state registry as having abused or neglected a child, and if so, the
dates and reasons;
(2) A statement
indicating whether the applicant has been convicted of a felony or any crime against a person and if so, the name
of the court, the details of the offense, the date of conviction and the
sentence imposed;
(3) An up to date resume or curriculum
vitae;
(4) Names and addresses of 2 individuals
who have known the applicant for at least one year and who can verify
professional experience and expertise.
(e) The
applicant shall sign and date the application.
(f) The
applicant’s signature shall constitute an acceptance of the terms below:
(1) The provider has read and understands He-C
6340 and shall adhere to the rules as an enrolled provider;
(2) The information contained in the application
is true and correct to the best of the applicant's knowledge; and
(3) The applicant agrees that DCYF has the authority
to verify the information contained in the application.
(g) Within 30
calendar days of receipt, the applicant shall complete and return the following
documents to DCYF:
(1) Form 2608 “Application for Enrollment of
Adoptive Report Writing Providers” (November 2016);
(2) An up to date resume or curriculum vitae;
(3) If applying for certification as an adoptive
home study report writer, verification of SAFE certification;
(4) If applying for certification as an adoptive
home study report writer, a sample of an adoptive home study report written by
the applicant; and
(5) The “State of New Hampshire Alternate W-9
FORM-”.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.08)
He-C 6340.06 Requirements
for Adoptive History Reports.
(a) Providers
for adoptive history reports who DHHS has identified as needed shall:
(1) Possess a bachelor’s degree and have 2 years
of experience in writing reports for child protection services;
(2) Submit a current resume that lists education
and experience at the time of application and at review of continued
certification compliance;
(3) Submit names and phone numbers of 2
individuals who can verify professional experience and expertise, unless waived
pursuant to He-C 6340.15;
(4) Have experience using computer hardware and
software; and
(5) Participate in adoptive history report
writing training provided by DCYF, unless waived pursuant to He-C 6340.15.
(b) A Form 1790
”Adoptive History Part I and Part II” (March 2015, PD 15-04) shall be completed with information for the
birth parents and the adoptive child when identified in the case file.
(c) Providers
shall:
(1) Be responsible for all materials and supplies
needed to write the report;
(2) Within 60 days of assignment, submit a paper
copy and an electronic copy of the report to the CPSW or JPPO; and
(3) Maintain all case information confidential,
pursuant to RSA 169-C:25.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.05)
He-C 6340.07 Requirements
for Adoptive Home Study Reports.
(a) Providers
for adoptive home study reports shall:
(1) Possess a bachelor’s degree and have 2 years
of experience in writing reports for child protection services;
(2) Submit a resume that lists the required
education and experience to DCYF at the time of application and at review of
continued certification compliance;
(3) Be employed and
supervised by a child placing agency operating pursuant to He-C 6448;
(4) Have experience using computer hardware and
software;
(5) Possess a SAFE certification;
(6) Provide verification of the SAFE
certification;
(7) Provide a statement signed and dated
by the SAFE supervisor indicating that he or she agrees to supervise the
individual applicant during the SAFE home study report writing process.
(b) Providers
shall write an adoptive home study report in compliance with SAFE certification
evidence based methodology, including at a minimum, the following information
relating to:
(1) The adoptive parent(s);
(2) Other members of the household;
(3) Members of the extended family;
(4) Health and safety checks;
(5) The adoptive parent(s)’s motivation for
adoption;
(6) The adoptive home and community;
(7) The adoptive parent applicant(s)’s profile;
(8) Adoptive family life style;
(9) Adoptive family legal and financial
responsibilities;
(10) The 10 items of the psychosocial inventory:
a. History of the applicant(s);
b. Personal characteristics of the applicant(s);
c. History;
d. Marital or domestic partnership relationship;
e. Sons, daughters, and others residing in the
adoptive home;
f. Extended family relationships;
g. Physical and social environment of the
adoptive home;
h. General parenting;
i. Specialized parenting; and
j. Adoption or foster care issues; and
(11) Conclusions;
(12) Placement considerations; and
(13) SAFE adoption home study report
recommendations.
(c) Providers
shall:
(1) Be responsible for all materials and supplies
needed to write the report;
(2) Within 60 days of assignment, submit a paper
copy and an electronic copy of the report to the CPSW or JPPO; and
(3) Maintain all case information confidential
pursuant to RSA 169-C:25.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16
He-C 6340.08 Preliminary
Information Needed for Adoptive Report Writing Services.
(a) Providers
shall provide adoptive history report writing only when they have the following
information:
(1) Date of request;
(2) Name of DCYF staff member requesting the
report, the district office, telephone number, and email;
(3) Names of the birth parents and child(ren);
(4) Reasons or need for referral, including
presenting problems and history of involvement with DCYF, as applicable;
(5) Type of services requested;
(6) Dates and duration for requested services;
(7) Dates that reports are needed for court
hearings; and
(8) Any data or information from the DCYF case
plan or pre-dispositional investigation that is applicable to service
provision.
(b) Providers shall provide adoptive home study report
writing only when they have the following information:
(1) Date of request;
(2) Name of DCYF staff member requesting the
report, the district office, telephone number, and email;
(3) Type of services
requested;
(4) Date the completed report is needed;
(5) Name of prospective adoptive parents,
address, telephone number, and email;
(6) The “Pre-Adoptive/Foster Care Financial
Statement” Form 1728 (November, 2016), and the “SAFE Questionnaire 1 - Single
Applicant” (2015) or “SAFE Questionnaire 1 - Couple Applicant” (2015) received
from the prospective adoptive parents; and
(7) The ”Child’s Information Sheet” Form 2267
(January 2015), and “Child/Youth Matching Profile” Form 1784 (November 2016),
and any additional information the CPSW has to share about the identified
prospective adoptive child that is applicable to service provision.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.07)
He-C 6340.09 Compliance
During Certification.
(a) Prior to
the start of service delivery, a provider shall be certified and enrolled as a
provider of adoptive report writing services.
(b) Providers
shall provide services without discrimination as required by Title VI of the
Civil Rights Act of 1964, as amended, and without discrimination on the basis
of handicap as required by Section 504 of the Rehabilitation Act of 1973, as
amended.
(c) The provider shall notify DCYF in writing within
10 days of any change in the information contained in the application and
provide documentation of the change as applicable.
(d) The
provider shall notify DCYF of any changes in tax information and complete and
submit to DCYF a signed “State of New Hampshire Alternate W-9 Form” with current
tax information.
(e) Providers shall submit to DCYF an audited
financial statement prepared by an independent licensed public accountant, if
requested.
(f) Continuance
of certification shall be based on surveys of department staff utilizing the
provider.
(g) The
provider’s certification and enrollment shall terminate upon date of sale or
transfer of ownership or close of the agency.
(h) Providers
shall be subject to a review of continued certification compliance every 3
years from the date of issue.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.04)
He-C
6340.10 Billing Process for Adoptive
Report Writing Services.
(a) “Service
Authorization” Form 2110 (6/30/2008) shall be requested by the DCYF case
manager.
(b) The
provider shall submit to the department a completed ”Service Authorization”
Form 2110 (6/30/2008) signed and dated by the provider and the authorized
individual.
(c) Providers
shall bill the department through NH Bridges via paper claims or electronic
claims submission solely for actual hours worked.
(d) Providers shall access web account at least
every 90 days or the account will be deactivated.
(e) Providers shall notify DCYF when a user no
longer requires access to the application;
(f) All
invoices and billing submitted shall:
(1) Be completed in accordance with He-C
6340.10;
(2) Be true and accurate;
(3) Be subject
to recovery by DHHS if determined to be inaccurate or fraudulent; and
(4) If submitted via web-billing, shall be
submitted with the provider’s agreement that:
a. The
information obtained via the provider web-billing application remains confidential
and is used solely for the purposes of administering DCYF services; and
b. The provider
is responsible for his or her employee’s use of the provider web-billing
application.
(g) For paper
claim submission, a provider shall:
(1) Copy the “Service Authorization” Form 2110
(6/30/2008) for future billings if the authorized service dates span a date
range;
(2) Forward the completed and signed “Service
Authorization” Form 2110 (6/30/2008) to DHHS for adoptive history report which
includes a certification that the service was provided as specified and that
the service claimed is an original claim; and
(3) Attach an invoice with the provider’s
original signature to the “Service Authorization” Form 2110 (6/30/2008) that
details dates and the number of hours spent on the report.
(h) For
electronic claims submission, a provider shall:
(1) Request a web billing account from DHHS by
completing, signing, and submitting Form 2679 “Provider Web Billing User
Account Request Form” (November 2016);
(2) Be issued a log on and a personal
identification number (PIN) by DHHS for use in accessing the web billing
account; and
(3) Select the recipient(s) and timeframe(s) for
which they wish to submit claims from their list of approved service
authorizations.
(i) The handwritten signature in (g) above or
personal identification number (PIN) if web billing pursuant to (h) above shall
be submitted to DHHS and shall certify that:
(1) The billing was completed in accordance with
this section;
(2) The invoice includes only those hours for which services
were provided;
(3) The billing is true and accurate;
(4) Any payment made for inaccurate or fraudulent billing
will be recovered by DHHS;
(5) If web-billing, that information obtained via
the provider web billing application is confidential and can be used solely for
the purposes of administering DCYF services;
(6) The provider shall notify DCYF when a user no longer
requires access to the application;
(7) The provider is responsible for their employee’s use of
the provider web billing application; and
(8) The provider understands that he or she must
access web account at least every 90 days or the account will be
deactivated.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.12)
He-C 6340.11 Billing
Period.
(a) Providers
shall bill within one year of service provision.
(b) Any bill
received for payment one year or more after service date shall be denied
pursuant to RSA 126-A:3.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12069, eff 12-6-16 (from He-C 6340.13)
He-C 6340.12 Billing
Discrepancies. Providers who have a
billing discrepancy shall contact DCYF, bureau of administrative operations,
provider relations staff for assistance.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.14)
He-C 6340.13 Record
Retention.
(a) Providers
shall retain records in a secure location for a period of not less than 7 years
after the completion date of services provided, supporting each bill submitted
to the department.
(b) Records
shall be subject to random and retrospective review by DHHS to determine the
presence and extent of billing errors.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.15)
He-C 6340.14 Quality
Assurance Activities. Providers
shall be subject to review by DCYF to determine the quality of services
pursuant to RSA 170-G:4 XVIII, including a random, retrospective examination
of adoptive history reports and adoptive
home study reports.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.16)
He-C 6340.15 Waivers.
(a) Applicants
or providers who request a waiver of a requirement in He-C 6340 shall submit a
written request to the Administrator of Community and Family Support, which
includes the following information:
(1) The rule number for which the waiver is being
requested;
(2) The anticipated length of time the requested waiver will be
needed;
(3) The reason for requesting the waiver;
(4) Assurance that if the waiver is granted the quality of
services will not be affected;
(5) A written plan to achieve compliance with the rule or
a written plan explaining how the provider will satisfy the intent of the rule,
if the waiver is granted; and
(6) How the service will be affected if the waiver is
not granted.
(b) A waiver
shall be granted if:
(1) The department concludes that authorizing
deviation from compliance with the rule from which waiver is sought does not
contradict the intent of the rule; and
(2) The alternative proposed ensures that the object
or intent of the rule will be accomplished.
(c) When a
waiver is approved, the applicant’s or provider’s subsequent compliance with
the alternative approved in the waiver shall be considered equivalent to
complying with the rule from which waiver was sought.
(d) The
applicant or provider shall be notified in writing by the department of the
waiver decision.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.17)
He-C 6340.16 Denial
of Application and Revocation of Certification.
(a) An
application shall be denied or provider certification revoked if:
(1) DCYF or determines that the state does not
have a need for the service;
(2) The applicant or provider, or the individual acting on the
applicant’s or provider’s behalf, submits materially false information to DCYF;
(3) The provider has been convicted of a felony or any crime
against a child;
(4) There has been abusive or neglectful
treatment of a child as determined by any state statute; or
(5) There has been failure to comply with He-C
6340.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.18)
He-C 6340.17 Notification
of Denial or Revocation. If DCYF
denies an application or revokes certification, a letter shall be sent to the
applicant or provider by registered mail, which sets forth the reasons for the
determination.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.19)
He-C 6340.18 Request
for Certification Reconsideration.
(a) A request for certification reconsideration shall:
(1) Be filed within 30 days of the date of receipt of the
letter sent by DCYF described in He-C 6340.17;
(2) Be submitted in writing; and
(3) Be filed with the director of DCYF.
(b) The DCYF
director shall uphold or overturn the request pursuant to He-C 6340.18.
(c) The
applicant or provider shall be notified, in writing, of the decision by the
director.
(d) The
applicant or provider may appeal the DCYF director’s decision pursuant to He-C
6340.19.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (formerly He-C 6340.20)
He-C 6340.19 Appeals.
(a) Applicants
or providers who wish to appeal DCYF’s decision to deny or revoke certification
shall file an appeal with the commissioner, pursuant to RSA 170-G:4-a.
(b) The appeal
shall:
(1) Be made in writing;
(2) Be signed and dated;
(3) State the reasons for the appeal pursuant to RSA
170-G:4-a; and
(4) Be filed within 14 days of the date of
written notification by the director of DCYF, pursuant to RSA 170-G:4-a.
(c) Pursuant to
RSA 170-G:4-a and He-C 200, the commissioner or designee and 2 members of the
DCYF advisory board shall hear the appeal.
Source.
(See Revision Note at part heading for He-C
6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (formerly He-C 6340.21)
PART
He-C 6341 CERTIFICATION PAYMENT STANDARDS FOR
Communication Access SERVICE PROVIDERS
Statutory Authority:
RSA 170-G:4 XVIII, RSA 170-G:5
REVISION NOTE:
Document
#9392, effective 3-1-09, adopted Part He-C 6341 relative to certification
payment standards for interpreter service providers. This part incorporated provisions from the
former Part He-C 6352 entitled “Certification for Payment Standards for
Community-Based Service Providers” and made extensive changes to the wording,
format, structure, and numbering of those provisions.
Document
#9392 supersedes all prior filings in the former Part He-C 6352 relative to
certification payment standards for community-based behavioral health service
providers. The filings affecting the
former Part He-C 6352 include the following documents:
#4446, eff 7-1-88
#5096, eff 3-15-91, EXPIRED 3-15-97
#7292, eff 5-24-00
#8009, eff 1-1-04
#9112, INTERIM, eff 3-24-08, EXPIRED
9-20-08
He-C 6341.01
Purpose. The purpose
of this part is to identify the qualifications and compliance requirements to
become a provider of communication access services for the division for
children, youth and families (DCYF) to meet the communication access needs of
individuals who are deaf, have hearing loss, are blind, have vision loss, are
deaf-blind, have speech disabilities, or have limited English proficiency (LEP)
when the criteria for the department wide contract for communication access
services requiring the presence of DHHS staff are not met.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New.
#12684, eff 11-30-18
He-C 6341.02 Scope. This part shall apply to individuals
or agencies that seek certification to receive financial reimbursement from the
department of health and human services (DHHS) for the provision of
communication access services for DCYF related business that involves the
child(ren) or family, and any other community-based agency or provider
participating in the case.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18
He-C 6341.03 Definitions.
(a) “Agency” means the board of directors,
executive director, and employees of an organization that is incorporated and
recognized by the NH secretary of state or another state’s regulatory
authority.
(b) “Applicant” means the person or entity that
is requesting certification for payment as a communication access service
provider.
(c) “Certification for payment” means the process
by which DCYF approves the qualifications of and payment to providers of
communication access services.
(d) “Child or minor” means an individual from
birth through age 20, except as otherwise stated in a specific provision.
(e) “Child protective service worker (CPSW)”
means an employee of the division for children, youth and families who has
expertise in managing cases to ensure families and children achieve safety,
permanency, and well-being.
(f) “Commissioner” means the commissioner of the
department of health and human services or his or her designee.
(g) “Communication access services” means spoken
language interpretation and translation services, American sign language (ASL),
communication access real time (CART), and emerging technologies, such as video
remote interpretation and other assistive technology services, to meet the
communication needs of individuals who are deaf, have hearing loss, are blind,
have vision loss, are deaf-blind, have speech disabilities, or have limited
English proficiency (LEP).
(h) “Conflict of interest” means any situation,
circumstance, or financial interest which has the potential to cause a
provider’s private interest to directly or indirectly affect, influence, or
interfere with the performance of his or her duties as a provider for the
division for children, youth and families.
(i) “Deaf person” means “deaf person” as defined
in RSA 521-A:1 II.
(j) “Department (DHHS)” means the department of
health and human services.
(k) “Director” means the director of the division
for children, youth, and families, or his or her designee.
(l) “Division for children, youth, and families
(DCYF)” means the organizational unit of the department of health and human
services that provides services to children and youth referred by courts
pursuant to RSA 169-A, RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C,
RSA-170-H, and RSA 463.
(m) “Interpreter” means “interpreter” as defined
in RSA 326-I:2, VI.
(n) “Juvenile
probation and parole officer (JPPO)” means an employee of DCYF who discharges the powers and duties established by
RSA 170-G:16, and supervises paroled delinquents pursuant to RSA 170-H.
(o) “Limited English Proficiency (LEP)” means
individuals who have a limited ability to read, speak, write, or understand
English.
(p) “NH bridges” means the automated case
management, information, tracking, and reimbursement system used by the
division for children, youth and families.
(q) “Provider” means the individual or agency that
serves a child or family and receives financial reimbursement from the
department.
(r) “Quality assurance” means the process that
DCYF uses to monitor the quality and effectiveness of communication access services.
(s) “Service authorization” means the
documentation provided by DCYF indicating the division’s responsibility for
payment of community-based services for non-medicaid eligible children.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18
He-C 6341.04 Compliance
Requirements.
(a) Providers shall comply with:
(1) All
applicable licensing requirements from state licensing authorities prior to
applying for certification;
(2) The
confidentiality statutes of RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA
170-B:23, RSA 170-C:14, and RSA 170-G:8-a;
(3) The child
abuse and neglect reporting requirements of RSA 169-C:29-30;
(4) The billing
requirements described in He-C 6341.10; and
(5) The billing
process described in He-C 6341.11.
(b) Providers and any employees shall not have a
conflict of interest, as defined in He-C 6341.03(g).
(c) Providers shall maintain liability insurance.
(d) Failure to comply with the rules of this
chapter shall result in:
(1) Denial of
an applicant pursuant to He-C 6341.17;
(2) Revocation
of certification for payment of a provider pursuant to He-C 6341.17; or
(3) Denial of
reimbursement pursuant to He-C 6341.18 (b).
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18
He-C 6341.05 Requirements
for Communication Access Services for Individuals Who Are Deaf, Have Hearing
Loss, or Are Deaf-Blind. A
provider of communication access services for individuals who are deaf or have
hearing loss shall:
(a) Demonstrate linguistic competency and
proficiency in both English and another language/modality and the demonstrated
ability to accurately relay information in both languages or modalities
fluently;
(b) Be 18 years of age or older;
(c) Be licensed by the NH board of licensure of
interpreters for the deaf and hard of hearing and approved under the NH department of education (DOE), pursuant to
RSA 326-I, or any other state’s licensing authorities and maintain a current
license or certification by the Registry of Interpreters for the Deaf, Inc.;
(d) Have the ability to interpret visually or
tactilely for individuals who are deaf or have hearing loss including:
(1) American
sign language;
(2) Certified
deaf interpretation;
(3) Oral
interpretation;
(4) Tactile
interpretation for the deaf/blind;
(5) Cued speech
interpretation; and
(6)
Communication access real time services;
(e) Contact the CPSW or JPPO prior to service
delivery to discuss confidentiality, case information, court dates, and court
protocols;
(f) Keep all assignment-related information
confidential;
(g) Have the ability to interpret the message
impartially by conveying the content and intent of the message using language
most readily understood by the person(s) whom they serve;
(h) Understand and acknowledge interpreter ethics
and client confidentiality needs and abide by the code of professional ethics
standards contained in Int 500;
(i) Provide services through a variety of methods
of communication assistance, including:
(1) Face to
face in person interpretation;
(2) In person
communication access real time services;
(3) Remote communication
access real time services; and
(4) Emerging
technologies, such as video remote interpretation, as generally accepted in
practice;
(j) Be a qualified note taker; and
(k) Have the ability to provide written materials
or a printed script of stock speech.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18
He-C 6341.06 Requirements
for Communication Access Services for Individuals Who Are Blind or Have Vision
Loss.
(a) A provider of
communication access for individuals who are blind, have vision loss, or are
deaf-blind shall:
(1) Demonstrate linguistic
competency and proficiency in both English and another language/modality and
the demonstrated ability to accurately relay information in both languages or
modalities fluently;
(2) Be at least 18 years of age;
(3) Have the ability to interpret for individuals
who are blind, have vision loss, or are deaf-blind including:
a. Being a qualified reader,
someone who is able to read effectively, accurately, and impartially, using any
necessary specialized vocabulary; and
b. Providing information in large print,
braille, or electronically for use with a computer screen-reading program, or
an audio recording of the printed information;
(4) Contact the CPSW or JPPO prior to service
delivery to discuss confidentiality, case information, court dates, and court
protocols;
(5) Keep all assignment-related information
confidential;
(6) Have the ability to interpret the message
impartially by conveying the content and intent of the message using language
most readily understood by the person(s) whom they serve; and
(7) Understand and acknowledge interpreter ethics
and client confidentiality needs and abide by the code of professional ethics
standards contained in Int 500.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18
He-C 6341.07
Requirements for Communication Access Services for Individuals Who Have
Speech Disabilities.
(a) A provider of
communication access for individuals who have speech disabilities shall:
(1) Demonstrate linguistic
competency and proficiency in both English and another language/modality and
the demonstrated ability to accurately relay information in both languages or
modalities fluently;
(2) Be at least 18 years of age;
(3) Have the ability to interpret for individuals
who have speech disabilities, including:
a. Being a qualified speech to speech
transliterator, a person trained to recognize unclear speech and repeat it
clearly;
(4) Contact the CPSW or JPPO
prior to service delivery to discuss confidentiality, case information, court
dates, and court protocols;
(5) Keep all assignment-related information
confidential;
(6) Have the ability to interpret the message
impartially by conveying the content and intent of the message using language
most readily understood by the person(s) whom they serve; and
(7) Understand and acknowledge interpreter ethics
and client confidentiality needs and abide by the code of professional ethics
standards contained in Int 500.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18
He-C 6341.08 Requirements
for Spoken (Foreign) Language Communication Access Services.
(a) A provider of spoken foreign language
communication access services shall:
(1) Demonstrate
linguistic competency and proficiency in both English and another language
including passing scores for languages that have national examinations or
certifications, along with sensitivity to the culture of individuals needing
communication assistance with the demonstrated ability to accurately relay
information in both languages, fluently;
(2) Be 18 years
of age or older;
(3) Have
successfully completed a minimum of 60 hours of a certified interpretation
training program and, where possible, completed either medical interpretation
and/or legal interpreter certificate training; and submit a resume that lists
education and experience at the time of application;
(4) Submit
names and addresses of 2 references who can verify professional experience and
expertise;
(5) Have the
ability to interpret orally or in writing linguistic information for those who
speak a foreign language or have limited English proficiency;
(6) Contact the CPSW or JPPO prior to service delivery
to discuss confidentiality, case information, court dates, and court protocol;
(7) Keep all
assignment-related information confidential;
(8) Have the
ability to interpret the message impartially by conveying the content and
intent of the message using language most readily understood by the person(s)
whom they serve;
(9) Understand
and acknowledge interpreter ethics and client confidentiality needs, and abide
by the code of professional ethics standards in Int 500 of the board; and
(10) Provide
services through a variety of methods of communication assistance, including:
a. Face to face in person interpretation;
b. In person communication access real time services;
c. Remote communication access real time
services; and
d. Emerging technologies, such as video
remote interpretation, as generally accepted in practice.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18
He-C 6341.09 Application
Process for Payment Standards for Communication Access Services.
(a) Applicants who
seek initial certification for payment for communication access services shall
contact a DCYF district office supervisor
or designee and request to be referred for certification.
(b) The DCYF
district office supervisor or DCYF community based services certification
specialist shall assess the need for communication access services, based on
the following criteria:
(1) The number
of children and families who require services exceeds the available community
resources;
(2) A
specialized service is necessary to meet the unique needs of children and
families, and there are no currently certified providers who can provide the
specialized service; or
(3) Any other
case circumstance which requires the provision of services pursuant to a court
order.
(c) If there is a
need for a service based in (b) above, DCYF shall forward an application packet
to the applicant which includes:
(1) Form 2609 “Application for Certification and
Enrollment of Communication Access Service Providers” (November 2018 Edition);
(2) A “State of New Hampshire Alternate W-9”
(October 2016 Edition); and
(3) A copy of He-C 6341.
(d) Each individual
or agency applicant shall complete, sign, date and submit Form 2069
“Application for Certification and Enrollment of Communication Access Service
Providers” (November 2018 Edition), and provide the following:
(1) A copy of
the individual applicant’s licenses to practice communication access services
or for agency applicants, a master list that includes the name, type of
license, and the date of license expiration for each staff member providing
communication access services;
(2) A resume or
curriculum vitae for each individual applicant, or if agency applicant, the
executive director;
(3) A program
brochure, if available;
(4) A
completed, signed, and dated, “State of New Hampshire Alternate W-9” (October
2016 Edition); and
(5) For an
individual applicant for foreign language communication access services, the
names and addresses of 2 references who can verify professional experience and
expertise.
(e) In addition to
the information requested in (d) above, the applicant shall complete, sign,
date, and submit Part F “Statement of Affirmation” of Form 2609 “Application
for Certification Enrollment of Communication Access Service Providers” (November
2018 Edition), that states:
(1) I have reviewed Administrative Rule He-C 6341
and will adhere to the rules as an enrolled provider. I understand that DCYF
has the right to verify information contained in this application; and
(2) I understand and agree that any individual or
agency providing services with whom I employ or subcontract will have a current
and valid license for the service being provided.
(f) In addition to
the information requested in (c) and (d) above, an individual applicant and
agency applicant staff member, who provides communication access services,
shall complete, sign, date, and submit Part E “Information” of Form 2609
“Application for Certification Enrollment of Communication Access Service
Providers” (November 2018 Edition), that states:
“I declare that all the information contained above is
true, correct and complete to the best of my knowledge and belief. I
acknowledge that the provision of false information in the application is a
basis for denial of the application.”
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18
He-C 6341.10 Review
of Continued Certification Compliance.
(a) Each
individual or agency applicant shall complete, sign, date, and submit Form
2609R “Application for Continued Certificate and Enrollment of Communication
Access Service Providers” (November 2018 Edition) as provided by DCYF, within
30 days of receipt and provide the following:
(1) A copy of the individual applicant’s licenses
to practice communication access services or for agency applicants, a master
list that includes the name, type or license and the date of license expiration
for each staff member providing communication access services; and
(2) A completed, signed, and dated “State of New
Hampshire Alternate W-9” (October 2016 Edition).
(b) In addition to
the information requested in (a) above, an individual applicant or agency
applicant staff member who provides communication access services shall
complete, sign, date, and submit Parts B, C, and D that includes the following
declaration:
“I declare that all the information
contained above is true, correct and complete to the best of my knowledge and
belief. I acknowledge that the provision
of false information in the application is a basis for denial of the
application”.
(c) In addition to
the information requested in (a) and (b) above, the individual applicant or
agency applicant shall complete, sign, date, and submit Part E “Statement of
Affirmation” of Form 2609R “Application for Continued Certification Enrollment
of Communication Access Service Providers” (November 2018 Edition), that
states:
“I declare that all the information contained above is true, correct and
complete to the best of my knowledge and belief. I acknowledge that the provision of false
information in the application is a basis for denial of the application”
(d) Providers who
fail to submit Form 2609R “Application for Continued Certification and
Enrollment of Communication Access Service Providers” (November 2018 Edition)
within 30 days of receipt shall have their certification revoked in accordance
with He-C 6341.17 and be denied payment.
(e) Continuance of
certification shall be based on a review and verification of the provider’s
compliance with He-C 6341.
(f) Review of
continued certification compliance shall occur every 3 years from the date of
issue.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18
New. #12684, eff 11-30-18 (formerly He-C 6341.08)
He-C 6341.11 Notification
of Changes.
(a) Providers shall
notify DCYF in writing within 10 days of any change in the information
contained in the application or recertification and provide documentation of
the change.
(b) At the time of
expiration of mandatory state licenses, the provider shall submit a copy of the
renewed license to DCYF within 10 days of receipt from the licensing authority.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18 (formerly He-C 6341.09)
He-C 6341.12 Billing
and Rate Requirements for Communication Access Services.
(a) Providers shall
be certified prior to the start of service delivery, as a provider of services
to children and families.
(b) Providers shall not bill DCYF for services
that are to be reimbursed by any other entity.
(c)
Providers shall be reimbursed at a rate equivalent to the department’s
current communication access contract or any subsequent contract that might be
entered into by the department.
(d) The rates established pursuant to He-C 6341
are contingent upon the availability and continued appropriation of sufficient
funds for this purpose, and in no event shall DCYF be liable for any payments
hereunder in excess of such available and appropriated funds.
(e) Providers shall
accept agreed upon payments made by DCYF as payments in full for the services
it provides.
(f) DCYF shall
determine the necessity of care and services and the determination shall be
binding on the provider.
(g) Providers shall
notify DCYF of any changes in tax information by submitting to DCYF a
completed, signed, and dated “State of New Hampshire Alternate W-9” (October
2016 Edition)with current tax information.
(h) Providers shall
provide services or care without discrimination as required by 42 U.S.C 2000d
et. seq., as amended, and without discrimination on the basis of handicap as
required by 29 U.S.C. 794, as amended.
(i) The agency
provider’s certification shall terminate upon date of sale or transfer of
ownership or close of the agency.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18 (formerly He-C 6341.10)
He-C 6341.13 Billing
Process for Communication Access Services.
(a) Providers shall
request Form 2110 “Service Authorization” (June 2008 Edition) from DCYF prior
to service delivery.
(b) Services
provided without Form 2110 “Service Authorization” (June 2008 Edition), shall not be paid.
(c) Providers shall
bill the department through NH Bridges via paper claims or electronic claims
submission.
(d) For paper claim
submission, a provider shall:
(1) Copy Form 2110 “Service Authorization” (June 2008
Edition), for future billings if the authorized service dates span a date
range;
(2) Forward the
completed and signed Form 2110 “Service Authorization” (June 2008 Edition) to
the department; and
(3) Attach an
invoice to the Form 2110 “Service Authorization” (June 2008 Edition) that
details dates and number of hours interpreting services were provided.
(e) For electronic claims submission, a provider
shall:
(1) Request a web billing account from DHHS by
submitting a completed, signed, and dated Form 2679 “Provider Web Billing User
Account Request Form” (February 2017 Edition) that includes the following
certification statements:
“I understand that provider billing requirements are
governed by administrative rules (He-C 6339, He-C 6340, He-C 6348, He-C 6350,
He-C 6914) which is incorporated herein by reference and I agree to abide by
these requirements.”;
“I understand and agree that as a provider, I am
responsible for any and all billing invoices submitted by me or on my behalf by
my authorized representative, whether user is an employee authorized as a
billing representative or authorized billing representative of a management
service company.”;
“I understand and agree that any payments made which
are based on inaccurate or fraudulent billing, whether submitted by me or by my
authorized user will be recovered from me by DHHS.”;
“I understand and agree that it is my responsibility
to notify the Division for Children, Youth, and Families by contacting Provider
Relations when a user no longer required access to the web billing
application.”;
“I understand that by submitting an invoice via the
Provider Web Billing Application I am certifying that the invoice is true and
accurate.”;
“I understand and agree that information obtained via
the Provider Web Billing Application is confidential and can be used solely for
the purposes of administering Division for Children, Youth, and Families (DCYF)
Services.”;
“I understand and agree that I am responsible for my
authorized representative, employee, and/or any management service company’s
use of the Provider Web Billing Application.”; and
“I understand and agree that I must access my web
account at least every ninety (90) days or my account will be de-activated.”; and
(2) Be issued a
log in and personal identification number (PIN) by DHHS for use in accessing
the web billing account.
(f) Neither the provider of any authorized
representative shall transfer his or her log in or PIN or allow use of his or
her log in or PIN by any other person.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18
New. #12684, eff 11-30-18 (formerly He-C 6341.11)
He-C 6341.14 Billing
Period.
(a) Providers shall
bill within one year of service provision.
(b) Bills received
for payment one year or more after the service date shall be denied pursuant to
RSA 126-A:3.
(c) Providers shall
submit bills at least on a monthly basis.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18 (formerly He-C 6341.12)
He-C 6341.15 Billing
Discrepancies. Questions regarding
billing discrepancies shall be directed to the provider relations’ staff of the
bureau of administrative operations in DCYF.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18 (formerly He-C 6341.13)
He-C 6341.16 Billing
Record Retention. Providers shall retain records for a period of not
less than 7 years after the completion date of services provided, supporting
each bill submitted to the department.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18
New. #12684, eff 11-30-18 (formerly He-C 6341.14)
He-C 6341.17 Quality
Assurance Activities.
(a) Providers
shall be subject to quality assurance reviews conducted by DCYF.
(b) Providers
shall allow:
(1) Scheduled or unscheduled on-site visits by
DCYF;
(2) Interviews with program staff; and
(3) A review of program documents to determine
continued compliance with He-C 6341.
(c) Providers shall ensure records, including all
billing records, are available for inspection and review by DCYF staff during
any on-site quality assurance visit.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18 (formerly He-C 6341.15)
He-C 6341.18 Waivers.
(a) Applicants who
request a waiver of a requirement in He-C 6341 shall submit a written request
to the commissioner or his or her designee, which includes the following
information:
(1) The reason for requesting the waiver;
(2) The anticipated length of time the requested
waiver will be needed;
(3) Assurance that if the waiver is granted the
quality of services to children youth and families will not be affected;
(4) A written plan to achieve compliance with the
rule or explaining how the provider will satisfy the intent of the rule, if the
waiver is granted;
(5) How the service will be affected if the
waiver is not granted; and
(6) The signature of the person requesting the
waiver.
(b) A waiver shall
be granted if:
(1) The department concludes that authorizing
deviation from compliance with the rule from which waiver is sought does not
contradict the intent of the rule or conflict with statute; and
(2) The alternative proposed ensures that the
object or intent of the rule will be accomplished.
(c) When a waiver is
approved, the applicant’s or provider’s subsequent compliance with the
alternative approved in the waiver shall be considered equivalent to complying
with the rule from which waiver was sought.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18 (formerly He-C 6341.16)
He-C 6341.19
Denial of Application and Revocation of Certification; Denial of
Reimbursement.
(a) An application shall be denied or provider certification revoked if:
(1) DCYF
determines that the state does not have a need for the service;
(2) The
applicant or the individual acting on the applicant’s or provider’s behalf,
submits materially false information to DCYF;
(3)
There has been a conviction for a felony or any crime by the applicant
or provider against a child that has not been annulled or overturned;
(4) The
applicant or provider knowingly retained an employee for whom there has been a
conviction for a felony or any crime against a person;
(5) There has
been abusive or neglectful treatment of a child by the applicant or provider as
determined by any state statute;
(6) There has
been disciplinary action taken by a licensing body or professional society, a
finding of civil liability made for professional misconduct, or a finding of an
ethical violation made by a state or national professional association or any
other state’s regulatory board on the applicant or provider that has not been
annulled or overturned;
(7) The
applicant or provider has failed to submit a review form within 30 days; or
(8) The
applicant or provider has failed to comply with He-C 6341.
(b)
Reimbursement shall be denied to a provider if DCYF determines any of
the conditions of He-C 6341.18 (a) (2) through (8) have occurred.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18 (formerly He-C 6341.17)
He-C 6341.20 Notification
of Denial or Revocation.
(a) If DCYF
denies an application for certification or revokes an existing certification,
DCYF shall send notice of the denial or revocation to the applicant or provider
by certified mail.
(b) The notice
shall:
(1) Inform the
applicant or provider of the facts or conduct upon which DCYF bases its action;
(2) Advise the
applicant or provider of their right to request reconsideration of DCYF’s
decision pursuant to He-C 6341.20; and
(3) In the case of an existing certification,
inform the provider that the revocation shall not take effect until the
provider has had an opportunity through an appeal, pursuant to RSA 170-G:4-a
and He-C 6341.21, to show compliance with all lawful requirements for retention
of the certification.
Source. (See Revision Note at part heading for He-C
6341) #9392, eff 3-1-09, EXPIRED: 3-1-17
New. #12535, INTERIM, eff 5-24-18, EXPIRED:
11-20-18
New. #12684, eff 11-30-18 (formerly He-C 6341.18)
He-C
6341.21
Request for Certification Reconsideration.
(a) A request
for certification reconsideration shall:
(1) Be filed
within 30 days of the date of receipt of the letter sent by DCYF;
(2) Be
submitted in writing; and
(3) Be filed
with the director of DCYF.
(b) The DCYF director shall grant or deny the
request, pursuant to He-C 6341.18.
(c) The applicant
or provider shall be notified of the decision, in writing by the director.
(d) The applicant
or provider may appeal the DCYF director’s decision pursuant to He-C 6341.21.
Source. #12684, eff 11-30-18 (formerly He-C 6341.19)
He-C 6341.22 Appeals.
(a) Applicants or providers who wish to appeal
DCYF’s decision shall file an appeal pursuant to RSA 170-G: 4-a with the
commissioner.
(b) The appeal shall be:
(1) Made in
writing and state the reasons for the appeal pursuant to RSA 170-G:4-a;
(2) Filed
within 14 working days of the date of receipt of written notification; and
(3) Signed and
dated.
(c) Pursuant to RSA 170-G:4-a and He-C 200, the
commissioner or designee and 2 members of the DCYF advisory board shall hear
the appeal.
Source. #12684, eff 11-30-18 (formerly He-C 6341.20)
PART He-C 6342
CERTIFICATION PAYMENT STANDARDS FOR CHILD IN HOME CARE SERVICE PROVIDERS
- EXPIRED
Statutory Authority:
RSA 170-G:4, XVIII; RSA 170-G:5
REVISION NOTE:
Document #9265, effective 9-20-08,
adopted Part He-C 6342 relative to certification for payment standards for
child in-home service providers. This
part incorporated provisions from the former Part He-C 6352 entitled
“Certification for Payment Standards for Community-Based Service Providers” and
made extensive changes to the wording, format, structure, and numbering of
those provisions.
Document
#9265 supersedes all prior filings in the former Part He-C 6352 relative to
certification for payment standards for child in-home service providers. The filings affecting the former Part He-C
6352 include the following documents:
#4446, eff 7-1-88
#5096, eff 3-15-91, EXPIRED 3-15-97
#7292, eff 5-24-00
#8009, eff 1-1-04
#9112,
INTERIM, eff 3-24-08, EXPIRED 9-20-08
He-C
6342.01 - 6342.17
Source.
(See Revision Note at part heading for He-C
6342) #9265, eff 9-20-08, EXPIRED: 9-20-16
PART He-C 6343 CERTIFICATION PAYMENT STANDARDS FOR
TRANSPORTATION SERVICE PROVIDERS
Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:5
REVISION NOTE:
Document
#9390, effective 3-1-09, adopted Part He-C 6343 relative to certification
payment standards for transportation service providers. This part incorporated provisions from the
former Part He-C 6352 entitled “Certification for Payment Standards for
Community-Based Service Providers” and made extensive changes to the wording,
format, structure, and numbering of those provisions.
Document
#9390 supersedes all prior filings in the former Part He-C 6352 relative to
certification payment standards for community-based behavioral health service
providers. The filings affecting the
former Part He-C 6352 include the following documents:
#4446, eff 7-1-88
#5096,
eff 3-15-91, EXPIRED 3-15-97
#7292,
eff 5-24-00
#8009,
eff 1-1-04
#9112,
INTERIM, eff 3-24-08, EXPIRED 9-20-08
He-C
6343.01 Purpose. The purpose of this part is to identify the
qualifications and performance requirements to become a provider of community
based transportation services for the division for children, youth and families
(DCYF) and describe transportation services that assist children and families
in remedying abusive, neglectful, delinquent, and child in need of services
(CHINS) behaviors.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff
3-26-19
He-C
6343.02 Scope. This part shall apply to community based
transportation service providers who receive financial reimbursement from the
DCYF for services provided to children and families.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19
He-C
6343.03 Definitions.
(a) “Accompanied
transportation services” means transportation of children and approved adults
to and from appointments or educational programs as approved by the child’s
local education agency.
(b) “Agency” means the board of directors,
executive director, and employees of an organization that is incorporated and recognized by the NH secretary of
state or by another state.
(c) “Applicant” means
the person or entity that is requesting certification for payment as a
transportation service provider.
(d) “Caregiver” means an individual who is
providing care for the child(ren).
(e) “Certification
for payment” means the process by which DCYF approves the qualifications of,
and payment to providers of transportation services.
(f) “Child or minor” means an individual from
birth through age 20, except as otherwise stated in a specific provision.
(g) “Child protective service worker (CPSW)”
means an employee of DCYF who has expertise in managing child protection cases to ensure families and children achieve
safety, permanency and well-being.
(h) “Child in need of services (CHINS)” means
“child in need of services” as defined by RSA 169-D:2, II.
(i) “Commissioner”
means the commissioner of the department of health and human services or his or
her designee.
(j) “Conflict
of interest” means any situation, circumstance, or financial interest, which
has the potential to cause a provider’s private interest to directly or
indirectly affect, influence, or interfere with the performance of his or her
duties as a provider for DCYF.
(k) “Department”
means the department of health and human services.
(l) “Destination
provider” means the individual, social service agency, or other family support
service provider that a child is being transported to or returning from.
(m) “Director”
means the director of DCYF or his or her designee.
(n) “Division for
children, youth, and families (DCYF)” means the organizational unit of the
department of health and human
services that provides services to children and youth referred by courts
pursuant to RSA 169-A, RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C,
RSA 170-H and RSA 463.
(o) “Educational transportation service” means the
transportation of children from their residence or other setting to their
school placement and back to their residence or other setting as approved by
DCYF.
(p) “Foster
Care” means the supervised 24-hour substitute care of a child placed away from
their parent or legal guardian for whom the State has placement and care
responsibility. This includes family foster homes, relative homes, pre-adoptive
homes, shelters, and residential facilities.
(q) “Juvenile
probation and parole officer (JPPO)” means an employee of DCYF who discharges the powers and duties established by
RSA 170-G:16, and supervises paroled delinquents pursuant to RSA 170-H.
(r) “Medically
necessary” means reasonably calculated to prevent, diagnose, correct, cure,
alleviate, or prevent the worsening
of conditions that endanger life, cause pain, result in illness or infirmity,
threaten to cause or aggravate a handicap, or cause physical deformity or
malfunction, and no other equally effective course of treatment is available or
suitable.
(s) “NH bridges” means
the automated case management, information, tracking, and reimbursement system
used by DCYF.
(t) “Outcome” means the intended result or
consequence that occurs from carrying out a program or activity.
(u) “Performance indicators” means the
utilization of data measurements to gauge program or activity performance.
(v) “Private vehicle transportation services”
means transportation of children and families to and from non-medicaid support
services via a provider’s own vehicle.
(w) “Provider” means the individual or agency
that serves a child or family and receives financial reimbursement from the
department.
(x) “Public transportation services” means transportation
services arranged through a travel agency to children and families to and from
support services.
(y) “Quality assurance” means the process that
DCYF use to monitor the quality and effectiveness of community-based
transportation services.
(z)
“Relative care” means the
placement of a child, who has a legal relationship with DCYF, in a home in
which one of the responsible caregivers is a person related to the child.
(aa) “Secure transportation services” means
transportation of children in law enforcement vehicles, who are considered to
be at risk of flight from custody, present significant behavior management
issues, or exhibit harmful behaviors toward themselves or others, and who
require physical restraint while being transported.
(ab) “Service authorization” means the
documentation provided by DCYF indicating the division’s responsibility for payment of community-based services.
(ac) “Service reports”
means a written report that includes demographic and performance indicators.
(ad) “Support services”
means services that assist families in remedying the circumstances attributed
to abuse and neglect, delinquency, and CHINS behaviors.
(ae) “Transport aide”
means an individual age 21 or older, employed by an accompanied transportation
service provider who accompanies a child, and approved adult(s), to and from
appointments and remains on-site with child during the appointment.
(af) “Travel Agency” means an agency engaged in selling and arranging
transportation, accommodations, tours, and trips for travelers.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19
He-C
6343.04 Requirements
for Accompanied Transportation Services.
(a) Accompanied transportation service providers
shall:
(1) Be an enrolled NH medicaid
provider;
(2) Be an agency, not an
individual;
(3) Employ a program coordinator
who shall:
a. Have a bachelor’s degree in a
social services discipline or related field or 5 years’ experience in providing
direct service to families;
b. Have one year of experience
in a supervisory capacity, as confirmed by a copy of a resume;
c. Recruit, hire, train, and
supervise the transport aides;
d. Receive referrals from DCYF;
e. Assign transport aides to
provide transportation services;
f. Communicate service changes
to staff, as needed;
g. Conduct program staff
meetings at least monthly with each aide to review the status of referrals and
transportation activities, and to address any problems or barriers;
h. Report any concerns or
difficulties immediately to CPSW and JPPO;
i. Be available 5 days a week
during DCYF business hours; and
j. Have a pool of available
transport aides who are available 7 days a week to provide services at times
that best serve children and families;
(4) Have a written plan for
providing services when a transport aide cannot provide the scheduled service;
(5) Employ transport aides who
shall:
a. Be at least 21 years of age;
b. Have at minimum, a high
school diploma or equivalency;
c. Possess a valid driver’s
license;
d. Provide proof that their
vehicle is registered in accordance with RSA 261:40 and inspected in accordance
with RSA 266:1;
e. Provide proof of current
automobile liability insurance that includes coverage for accidental injury and
death, and coverage for the transporting of another;
f. Have no convictions for
impaired driving or multiple motor vehicle violations;
g. Have no conviction for a
felony or crime against persons;
h. Have no founded cases of
child abuse or neglect;
i. Not drive under the influence
of alcohol or drugs pursuant to RSA 265-A;
j. Submit to yearly drug and alcohol testing as
determined by the program coordinator except for newly hired transport aides
who shall be tested within 6 months from date of hire then yearly thereafter;
k. Not provide service in excess
of 12 hours in a 24 hour period; and
l. Not be related to any service
recipient or any member of the service recipients family for whom they provide
the service;
(6) The provider shall maintain a copy of the
following for each transportation aide in the aide’s personnel file:
a. Current driver’s license;
b. Automobile liability insurance;
b. Motor vehicle record;
c. Criminal record report; and
d. Central registry check.
(7) Have written personnel
policies which are available for inspection at the time of a quality assurance
review as described in He-C 6343.21;
(8) Conduct and document annual
staff performance evaluations and training logs making them available for
inspection at the time of a quality assurance review;
(9) Have a written policy in
place regarding missed appointments by client families which includes notifying
the CPSW or JPPO immediately, followed by a written report within 24 hours,
when a parent or child fails to show up for a scheduled transport;
(10) Maintain records available
for inspection during quality assurance reviews, as described in He-C 6343.20;
(11) Provide transport aides
with a written itinerary for each trip that includes but is not limited to:
a. The name of the child and the
caregiver;
b. The name of the driver who is
picking up the child;
c. The name of the driver who is
returning the child, if different from the pick-up driver;
d. The date, time, and pick up
location;
e. The destination;
f. The destination provider;
g. The time of the scheduled
appointment or visit;
h. The estimated time of return
to the child’s caregiver; and
i. A field for the signature of
the caregiver upon pick up;
(12) Review with the transport
aide, prior to beginning work with children and annually thereafter, RSA 169-C,
specifically sections on definitions, immunity from liability, and persons
required to report, for all employees and volunteers, who have access to
children, prior to beginning their work with children;
(13) Provide transport aides
with:
a. Ten hours of training during
their first 6 months of employment which includes training relating to accepted
transportation practices, personal safety, child safety, and behavior
management; and
b. Fifteen hours of training
annually that includes topics relating to accepted transportation practices,
personal safety, child safety, cultural sensitivity, behavior management, safe
driving education, and indicators of child abuse and neglect;
(14) Maintain training records
that include trainer signed certificates or letters of attendance that specify
dates, hours, and training topics that are available at the time of quality
assurance reviews or monitoring; and
(15) Notify DCYF within 24
hours of any transportation aide’s motor vehicle infraction or arrest that
would result in the inability to lawfully operate a vehicle in NH.
(b) The transport aide, referenced in (a)(5)
above, shall:
(1) Have a means of
communication so appointments can be scheduled or canceled;
(2) Carry and present identification
to the child’s caregiver and to destination providers;
(3) Not be responsible for
transferring information between a child’s parent or caregiver and the service
provider, CPSW, JPPO, or parent being visited;
(4) Maintain professional
behavior while transporting children;
(5) During vehicle operation:
a. Comply with RSA 263 regarding
drivers and licenses;
b. Comply with RSA 265:107-a regarding child passenger restraints
required during vehicle operation; and
c. Ensure that all vehicle occupants
use safety restraints pursuant to RSA 265:107-a and that passengers under the
age of 12 are secured in the back seat of the vehicle;
(6) Notify the CPSW or JPPO
immediately, followed by a written report within 24 hours, of any injury that
occurs during a trip or visit, such as a traffic accident or if the youth was
assaultive or attempted to run away; and
(7) Maintain a file on each
child served which includes:
a. Referral information about
the child;
b. Transport logs with the name
of the transport aide and driver;
c. Log of service provision including service dates, pick up and return
locations, the signature of the caregiver, or destination provider, mileage,
highway tolls, and parking fees, for billing substantiation;
d. Copies of required reports to
be submitted to DCYF;
e. Billing records; and
f. Family related information
and correspondence for other providers.
(c) The provider shall:
(1) Be registered with the
secretary of state prior to applying for certification;
(2) Comply with the medical
assistance requirements of He-W 500 and He-M 426;
(3) Comply with the
confidentiality statutes of RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA
170-B:23, RSA 170-C:14, and RSA 170-G:8-a; and
(4) Comply with the child abuse
and neglect reporting requirements of RSA 169-C:29-30.
(d) The provider and his or her employees shall
not have a conflict of interest as defined in He-C 6343.03(j).
(e) The provider shall maintain liability
insurance.
(f) Failure to comply with the rules of this
chapter shall result in:
(1) Denial of an applicant
pursuant to He-C 6343.24;
(2) Revocation of certification
for payment of a provider pursuant to He-C 6343.24; or
(3) Denial of reimbursement.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19
He-C 6343.05 Requirements for Educational
Transportation Services.
(a) Educational transportation service providers
shall:
(1) Be approved by the child’s
local education agency;
(2) Have an exemption as a
licensed foster parent pursuant to He-C 6347;
(3) For agencies, be certified
as an accompanied transportation service provider according to He-C 6343.04; or
(4) Be certified for private vehicle
transportation services according to He-C 6343.06.
(b) Individual applicants for educational
transportation services approved by a child’s local education agency shall;
(1) Complete and submit to the department Form 2615 “Application for
Certification and Enrollment of Private Vehicle or Educational Transportation
Service Providers” (January 2019) and include documentation of approval by a
local education agency to DCYF; and
(2) Include an updated approval
from the local education agency annually after the original application; and
(3) Comply with the provisions of He-C 6343.06 and He-C 6343.11.
(c)
Individual applicants for educational transportation services with an
exemption for foster care licensing shall:
(1) Provide notification of foster care licensing to the DCYF
community-based services specialist;
(2) Maintain foster care
licensing according to He-C 6347 to maintain certification for educational
transportation services; and
(3) Comply with
the provisions of He-C 6343.06 and He-C 6343.11.
(d)
Agency applicants for educational transportation services certified as
accompanied transportation providers shall comply with the provisions of He-C
6343.04 and He-C 6343.09.
(e)
Applicants for educational transportation services certified as private
vehicle transportation providers shall comply with the provisions of He-C
6343.06 and He-C 6343.11.
(f) Failure to comply with the rules of this
chapter shall result in:
(1) Denial of an applicant pursuant to He-C 6343.24; or
(2) Revocation of certification for payment for an existing
provider pursuant to He-C 6343.24.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19
He-C 6343.06
Requirements for Private Vehicle Transportation Services.
(a) An individual who provides transportation
services, including individuals who provide foster and relative care, via his
or her own vehicle shall:
(1) Possess a valid driver’s
license;
(2) Maintain automobile insurance
liability coverage for the transportation of others;
(3) Have no conviction for
impaired driving or multiple motor vehicle violations;
(4) Not drive under the influence of alcohol or
drugs pursuant to RSA 265-A;
(5) During vehicle operation,
ensure that all vehicle occupants use safety restraints pursuant to RSA
265:107-a and that passengers under the age of 12 are secured in the back seat
of the vehicle;
(6) Submit documentation to DCYF
for He-C 6343.06 (a)(1) through (3) above, which shall include copies of
driver’s licenses, automobile liability insurance policies, and motor vehicle
records as well as a completed NH department of safety, division of state
police Form DSSP 256 “Criminal History Record Information Release Authorization
Form”, and a completed and notarized Form 2503, “DCYF Central Registry Name
Search Authorization” at the time of application and re-certification;
(7) Comply with:
a. Licensing requirements
pursuant to RSA 263, and registration requirements pursuant to RSA 261, prior
to applying for certification;
b. The medical assistance
requirements of He-W 500 and He-M 426;
c. The confidentiality statutes
of RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:23, RSA 170-C:14, and
RSA 170-G:8-a;
d. The child abuse and neglect
reporting requirements of RSA 169-C:29-30; and
e. RSA 265:107-a, child
passenger restraints required;
(8) Review RSA169-C,
specifically sections on definitions, immunity from liability, and persons
required to report for all employees and volunteers, who have access to
children prior to beginning their work with children and annually thereafter;
(9) Not have a conflict of
interest as defined in He-C 6343.03(j);
(10) Maintain a log of service provision including service dates,
pick up and return locations, the signature of the provider, or destination
provider, mileage, highway tolls, and parking fees for billing substantiation;
and
(11) Be at least 18 years old.
(b) Private vehicle transportation service
providers shall not be reimbursed for transporting his or her own children or
other household family members not associated with the DCYF case.
(c)
Private vehicle transportation service providers shall notify DCYF
within 24 hours of any motor vehicle infraction or arrest that would result in
the inability to lawfully operate a vehicle in NH.
(d) Failure to comply with the rules of this
chapter shall result in:
(1) Denial of an applicant
pursuant to He-C 6343.24;
(2) Revocation of certification
for payment of a provider pursuant to He-C 6343.24; or
(3) Denial of reimbursement.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.07)
He-C 6343.07 Requirements for Public
Transportation Services.
(a) Travel agencies who
arrange public transportation services shall:
(1) Be registered with the NH
secretary of state and submit proof of such to DCYF; and
(2) Comply with licensing and
registration requirements prior to applying for certification if applicable.
(b) Failure to comply with the rules of this
chapter shall result in:
(1) Denial of an applicant
pursuant to He-C 6343.24;
(2) Revocation of certification
for payment of a provider pursuant to He-C 6343.24; or
(3) Denial of reimbursement.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.08)
He-C
6343.08 Requirements for Secure
Transportation Services.
(a) Secure transportation services shall be
provided for children who:
(1) Are before the court as
runaways, escapees, or absconders pursuant to the interstate compact on
juveniles, RSA 169-A;
(2) Are before the court
adjudicated as delinquent children pursuant to RSA 169-B;
(3) Are before the court
adjudicated as children in need of services pursuant to RSA 169-D;
(4) Are considered to be at risk
of flight from custody;
(5) Exhibit safety concerns
regarding themselves or others; or
(6) Require physical restraint
while being transported, as applicable.
(b) Providers of secure transportation services
shall:
(1) Use law enforcement
personnel to transport children;
(2) Maintain custody of
court-transported children until the court releases custody of the child from
law enforcement or are otherwise relieved by court security or other authorized
personnel;
(3) Use only trained officers
who are certified by the NH police standards and training council;
(4) Maintain a copy of certification
by the NH police standards and training council in the provider’s personnel
file, which shall be available for review at the time of an on-site quality
assurance monitoring visit;
(5) Use only county or municipal
law enforcement department secure vehicles assigned by that department for the
secure transportation of juveniles; and
(6) Maintain records to
substantiate billing which shall be available for inspection and include:
a. A log of transports;
b. Pick up location,
destination, time, and date;
c. Name of officer transporting;
d. Name of JPPO;
e. Name of child transported;
f. Mileage; and
g. Any incidents that occurred
such as, traffic accidents, if the youth was assaultive or attempted to run
away.
(c) Failure to comply with the rules of this
chapter shall result in:
(1) Denial of an applicant
pursuant to He-C 6343.24; or
(2) Revocation of certification
for payment for an existing provider pursuant to He-C 6343.24.
Source. (See Revision Note at part
heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New.
#12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19
New.
#12750, eff 3-26-19 (formerly He-C
6343.09)
He-C 6343.09 Application
Process For Payment Standards For Accompanied Transportation Services.
(a)
Applicants who seek initial certification for payment standards for
accompanied transportation services shall contact a DCYF district office supervisor or designee and request to
be referred for certification.
(b) The DCYF district office supervisor or DCYF
community, family, and program support certification specialist shall assess
the need for services, based on the following criteria:
(1) The number of children and
families who require services exceeds the available community resources;
(2) A specialized service is
necessary to meet the unique needs of children and families, and there are no
currently certified providers who can provide the specialized service; or
(3) Any other case circumstance
which requires the provision of services pursuant to a court order.
(c) If there is a need for a service based on (b)
above, DCYF shall forward an application packet to the applicant which
includes:
(1) Form 2614 “Application for Certification and Enrollment of
Accompanied or Agency Educational Transportation Service Providers”
(March2019)”;
(2) A “State of New Hampshire
Alternate W-9” (October 2016); and
(3) A copy of He-C 6343.
(d)
Each applicant shall complete and submit Form 2614“Application for Certification and Enrollment of Accompanied or
Agency Educational Transportation Service Providers” (March 2019) to DCYF
within 30 days of receipt, together with all the attachments in He-C
6343.09(c).
(e)
Each agency staff member listed in Part C: “Agency Staff” shall sign and
date Part D: “Staff Information” of Form 2614 “Application for Certification
and Enrollment of Accompanied or Agency Educational Transportation Service
Providers” (March 2019) certifying the following:
“I declare that all
the information contained above is true, correct and complete to the best of my
knowledge and belief. I acknowledge that the provision of false information in
the application is basis for denial of the application.”
(f) Each
Part D: “Agency Staff” of Form 2614 “Application for Certification and
Enrollment of Accompanied or Agency Educational Transportation Service
Providers” (March 2019) shall be signed and dated by the executive director or
designee, certifying the following:
“I certify that a:
Current criminal
records check for this individual is completed and on file at the agency;
Current copy of the
individual’s Department of Motor Vehicle Report is on file at the agency;
Current copy of the
individual’s driver’s insurance is on file at the agency.”
(g) Each applicant shall sign and date Part F:
“Authorization/Statement of Understanding” as part of Form 2614 “Application
for Certification and Enrollment of Accompanied or Agency Educational
Transportation Service Providers” (March 2019) certifying the following:
“I have reviewed the Administrative Rules He-C 6343 and will adhere to
the rules as a certified provider. I
authorize the NH Division for Children, Youth and Families (DCYF) to conduct a
certification for payment review to determine the program’s compliance with
Administrative Rules He-C 6343. I further understand that DCYF has the right to
verify information contained in this application. The information contained in this application
is correct to the best of my knowledge. I acknowledge that the provision of
false information in the application is a basis for denial of the application.”
(h)
In addition to the requirements in (c)-(g) above, applicants shall
submit the following:
(1) A resume or
curriculum vitae for the program coordinator;
(2) A copy of the agency’s organizational
structure;
(3) A copy of their budget;
(4) A program brochure, if available;
(5) A statement indicating whether the applicant
or any direct service staff:
a. Has ever had their automobile or general
liability insurance canceled;
b. Has ever been convicted of a felony or any
crime against a person and if so, the name of the court, the details of the
offense, the date of conviction and the sentence imposed;
c. Has ever been subject to disciplinary action
by a licensing body or professional society, been found civilly liable for
professional misconduct, or found to have committed an ethical violation by a
state or national professional association or any other state’s regulatory
board, and if so, the name of the licensing body or professional society, the
reasons, dates, and results; and
d. Is currently listed in any child abuse and
neglect state registry as having abused or neglected a child, and if so, the
dates and reasons;
(6) A written description of the agency’s no show
and cancellation policy;
(7) A written description of the agency’s quality
assurance plan including the method of handling client complaints;
(8) The agency’s record keeping and confidentiality
policies;
(9) Description of what is provided to the transportation
aides for agency identification; and
(10) A written description of services that
includes the cost of the service and the parent’s obligation to repay a portion
of the service provision.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly
He-C 6343.10)
He-C
6343.10 Application
Process For Payment Standards For Educational Transportation Services.
(a) Applicants who seek initial certification for
the provision of educational transportation services shall contact a DCYF district office
supervisor or designee and request to be referred for certification.
(b) The DCYF district
office supervisor or DCYF community, family, and program support certification
specialist shall assess the need for services, based on the following criteria:
(1) The number of children and
families who require services exceeds the available community resources;
(2) A specialized service is
necessary to meet the unique needs of children and families, and there are no
currently certified providers who can provide the specialized service; or
(3) Any other case circumstance
which requires the provision of services pursuant to a court order.
(c) If there is a need for a service based on (b)
above, DCYF shall:
(1) Verify existing documentation and
certification(s) for applicants asserting they meet one of the requirements of
He-C 6343.05(a);
(2) Follow the provisions of
He-C 6343.11
for applicants meeting the requirements of 6343.05(a)(1), (2) or (4); or
(3) Follow
the provisions of He-C 6343.09 for applicants meeting the requirements of 6343.05(a)(3).
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.11)
He-C
6343.11 Application Process For Payment Standards For Private
Vehicle Transportation Services.
(a) Individual applicants who seek initial
certification for the provision of private transportation services shall
contact a DCYF district office supervisor or designee and request to be
referred for certification.
(b) The DCYF district office supervisor or DCYF
community, family, and program support certification specialist shall assess
the need for services, based on the following criteria:
(1) The number of children and
families who require services exceeds the available community resources;
(2) A specialized service is
necessary to meet the unique needs of children and families, and there are no
currently certified providers who can provide the specialized service; or
(3) Any other case circumstance
which requires the provision of services pursuant to a court order.
(c) If there is a need for a service based on (b)
above, DCYF shall forward an application packet to the applicant which
includes:
(1) Form 2615 “Application for
Certification and Enrollment of Private Vehicle or Educational Transportation
Service Providers”;
(2) A “State of New Hampshire
Alternate W-9”;
(3) A NH department of safety, division of state police Form DSSP 256
“Criminal History Record Information Release Authorization Form” for the
provider unless the provider is a licensed foster care provider;
(4) A Form 2503 “DCYF Central
Registry Name Search Authorization” for the provider unless the provider is a
licensed foster care provider; and
(5) A copy of He-C 6343.
(d) Each
applicant shall complete and submit Form 2615 “Application for Certification and Enrollment of Private Vehicle or Educational Transportation
Service Providers” (March 2019) to DCYF within 30 days of receipt, together
with all the attachments in He-C 6343.11(g).
(e) Each applicant shall sign and date Part C:
“Applicant Information” of Form 2615 “Application for Certification and
Enrollment of Private Vehicle or Educational Transportation Service Providers”
(March 2019) certifying the following:
“I declare that all the information contained above is true, correct
and complete to the best of my knowledge and belief. I acknowledge that the provision of false
information in the application is a basis for denial of the application.”
(f) Each applicant shall sign and date Part D:
“Authorization/Statement of Understanding” of Form 2615 “Application for
Certification and Enrollment of Private Vehicle or Educational Transportation
Service Providers” (March 2019) certifying the following:
“I have reviewed the Administrative
Rule He-C 6343, Certification for Payment Standards for Transportation Service
Providers and will adhere to the rules
as a certified provider. I authorize the
NH Division for Children, Youth and Families (DCYF) to conduct a certification
for payment review to determine the program’s compliance with Administrative
Rule He-C 6343, Certification for Payment Standards for Transportation Service
Providers. I further understand that
DCYF has the right to verify information contained in this application.
The information contained in this application is
correct to the best of my knowledge. I
acknowledge that the provision of false information in the application is a
basis for denial of the application.”
(g) Each applicant shall submit the following
with Form 2615 “Application for Certification and Enrollment of Private Vehicle
or Educational Transportation Service Providers” (March 2019):
(1) A completed “State of New
Hampshire Alternate W-9” (October 2016);
(2)
A completed and notarized Form 2503 “DCYF Central Registry Name Search
Authorization”, (February 2017) or Authorization for DCYF to obtain. This will
not be required if the applicant is currently licensed as a foster care
provider under He-C 6347;
(3) A completed NH department of safety, division of state police DSSP
256 “Criminal History Record Information Release Authorization Form” This will not be
required if the applicant is currently licensed as a foster care provider under
He-C 6347; and
(4) A copy of the provider’s
motor vehicle record from the NH department of safety, division of motor
vehicles.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.13)
He-C 6343.12 Application
Process For Payment Standards For Public Transportation Services.
(a) Applicants who seek initial certification for
payment standards for public transportation services shall contact a DCYF
district office supervisor or designee and request to be referred for
certification.
(b) The DCYF district office supervisor or DCYF
community, family, and program support certification specialist shall assess
the need for services, based on the following criteria:
(1) The number of children and
families who require services exceeds the available community resources;
(2) A specialized service is
necessary to meet the unique needs of children and families, and there are no
currently certified providers who can provide the specialized service; or
(3) Any other case circumstance
which requires the provision of services pursuant to a court order.
(c) If there is a need for a service based on (b)
above, DCYF shall forward an application packet to the applicant which shall
include:
(1) Form 2616 “Application for
Certification and Enrollment of Public Transportation Service Providers” (March
2019);
(2) A “State of New Hampshire
Alternate W-9” (October 2016); and
(3) A copy of He-C 6343.
(d) Each applicant shall complete and submit Form
2616 “Application for Certification and Enrollment of Public Transportation
Service Providers” (March 2019) to DCYF within 30 days of receipt, together
with proof of registration with the New Hampshire secretary of state.
(e) Each applicant shall sign and date Part C:
“Authorization/Statement of Understanding” of Form 2616 “Application for
Certification and Enrollment of Public Transportation Service Providers” (March
2019) certifying following:
“I have reviewed the Administrative Rules He-C 6343 and will adhere to
the rules as a certified provider. I authorize the NH Division for Children,
Youth and Families (DCYF) to conduct a certification for payment review to
determine the program’s compliance with Administrative Rules He-C 6343. I
further understand that DCYF has the right to verify information contained in
this application.
The information contained in this application is correct to the best of
my knowledge, I acknowledge that the provision of false information in the
application id s basis for denial of the application.”
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.14)
He-C
6343.13 Application
Process For Payment Standards For Secure Transportation Services.
(a) Applicants who seek initial certification for
payment standards for secure transportation services shall contact a DCYF
district office supervisor or designee and request to be referred for
certification.
(b) The DCYF district office supervisor or the
DCYF community, family, and program support certification specialist shall assess
the need for services based on the following criteria:
(1) The number of children and
families who require services exceeds the available community resources;
(2) A specialized service is
necessary to meet the unique needs of children and families, and there are no
current certified providers who can provide the specialized service; and
(3) Any other case circumstance
which requires the provision of services pursuant to a court order.
(c) If there is a need for services based on the
criteria in (b) above, DCYF shall forward an application packet to the
applicant, which shall include:
(1) Form 2613 “Application for
Certification and Enrollment of Secure Transportation Service Providers” (March
2019);
(2) A “State of New Hampshire
Alternate W-9” (October 2016); and
(3) A copy of He-C 6343.
(d) Each applicant shall submit a completed Form
2613 “Application for Certification and Enrollment of Secure Transportation
Service Providers” (March 2019) to DCYF within 30 days of receipt, together with
a completed “State of New Hampshire Alternate W-9” (October 2016).
(e) Each applicant shall
sign and date Part B: “Authorization/Statement of Understanding” of Form 2613
“Application for Certification and Enrollment of Secure Transportation Service
Providers” (XXXXX 2019) certifying the following:
“I have reviewed
the Administrative Rules He-C 6343 and will adhere to the rules as a certified
provider. I authorize the NH Division for Children, Youth and Families
(DCYF) to conduct a certification for payment review to determine the program’s
compliance with Administrative Rules He-C 6343. I further understand that DCYF
has the right to verify information contained in this application.
The information contained in this application is correct to the best
of my knowledge. I acknowledge that the provision of false information in the
application is a basis for denial of the application.”
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.15)
He-C
6343.14 Review of Continued
Certification Compliance.
(a) Transportation service providers shall
complete and submit Form 2616R “Review of Continued Certification for
Transportation Service Providers” (March 2019) as provided by DCYF within 30
days of the receipt.
(b) Part C of Form 2616R “Review of Continued
Certification for Transportation Service Providers” (March 2019) shall be
signed and dated by each direct service staff of accompanied transportation
services providers certifying the following affirmation:
“I declare that all the information contained above is true, correct,
and complete to the best of my knowledge and belief. I acknowledge that the provision of false
information in the application is a basis for denial of the application.”
(c) Each Part C of Form 2616R “Review of
Continued Certification for Transportation Service Providers” (March 2019)
submitted by an accompanied transportation service provider agency shall have
the following attestation signed and dated by the program coordinator or
executive director:
“I certify that a criminal record check for this individual is
completed an on file at the agency.”
(d) The provider shall sign and date Part D
“Statement of Affirmation” of Form 2616R “Review of Continued Certification for
Transportation Service Providers” (March 2019) certifying the following:
“I have reviewed the Administrative
Rule He-C 6343 Certification for Payment Standards for Transportation Service
Providers and will adhere to the rules
as a certified provider. I authorize the
NH Division for Children, Youth and Families (DCYF) to conduct a certification
for payment review to determine the program’s compliance with Administrative
Rule He-C 6343, Certification for Payment Standards for Transportation Service
Providers. I further understand that
DCYF has the right to verify information contained in this application.
The information
contained in this application is correct to the best of my knowledge. I acknowledge that the provision of false
information in the application is a basis for denial of the application.”
(e) Each applicant shall submit the following
with Form 2616R “Review of Continued Certification for Transportation Service
Providers” (March 2019):
(1) A “State of New Hampshire
Alternate W-9” (October 2016);
(2) A Current list of the Board
of Directors that shall include the following information of each person:
a. Full Name;
b. Office held;
c. Professional affiliation;
d. Address; and
e. Telephone number;
(3) Automobile and general
liability insurance certificates; and
(4) Resume or curriculum vitae
for the program coordinator or executive director.
(f) Renewal of certification shall be made by
filing a signed and dated Form 2616 “Review of Continued
Certification for Transportation Service Providers” (March 2019) and shall be
based on a review and verification of the provider’s compliance with He-C 6343
and the specific requirements for the certification of Transportation Service
provided.
(g) Providers who fail to submit a review form
within 30 days of receipt shall have their certification revoked in accordance
with He-C 6343.24 and be denied payment.
(h) Continuance of
certification shall be based on a review and verification of the provider’s
compliance with service requirements.
(i) Review of continued certification compliance
shall:
(1) Occur every 5 years from the
date of issue for:
a. Accompanied transportation
service providers;
b. Public transportation service
providers; and
c. Secure transportation service
providers; and
(2) Occur every year for private
vehicle transportation service providers with the exception of a foster parent
licensed through He-C 6347 who is also certified as a private vehicle
transportation service provider. Continued certification review shall coincide
with renewal of their foster care license.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.16)
He-C
6343.15 Notification of Changes.
(a) For the period of certification, the provider
shall notify DCYF in writing within 10 days of any change in the information
contained in the application or recertification application and provide documentation
of the change.
(b) At the time of expiration of mandatory state
driver’s licenses, private vehicle transportation providers shall submit a copy
of the renewed license to DCYF.
(c) Failure to notify DCYF of any change shall
result in revocation of certification in accordance with He-C 6343.24 and
denied payment.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.17)
He-C 6343.16
Billing Requirements for Transportation Services.
(a) Providers
shall be certified as a provider of transportation services
and authorized to provide the services by a CPSW or JPPO.
(b)
The provider shall not bill DCYF for services that are to be
reimbursed by any other entity.
(c)
Medicaid-enrolled providers providing medicaid-covered services shall
not be reimbursed by DCYF.
(d)
Providers shall accept payments in full for non-medicaid services it
provides and in no event shall DCYF be liable for any payments in excess of
available and appropriated funds.
(e)
DCYF shall determine the need for services and the determination shall
be binding on the provider.
(f)
Providers shall notify DCYF within 10 business days of any changes in
tax information by completing and submitting an updated “State of New Hampshire
Alternate W-9” (October 2016) with current tax information.
(g)
Providers shall provide services or care without discrimination as
required by 42 U.S.C 2000d, et seq., as amended, and without discrimination on
the basis of handicap as required by 29 U.S.C 794, as amended.
(h)
The provider’s certification shall terminate upon date of sale or
transfer of ownership or close of the agency.
(i)
Billing for private vehicle service providers shall be for mileage,
highway tolls, and parking fees for authorized transportation at rates
determined by the DHHS rate setting unit.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.18)
He-C
6343.17 Billing Process for
Transportation Services.
(a) Providers shall request a service authorization form prior to
service delivery.
(b) Services provided without service authorization shall not be
paid.
(c) Accompanied and educational transportation service
providers shall bill DHHS for non-medicaid eligible recipients and services via paper claims.
(d) All other transportation service providers shall bill DHHS for
non-medicaid eligible recipients and services via
paper claims or electronic claims submission.
(e) For paper claims submission, a provider shall complete and submit to the
department a copy of Form 2110 “Service Authorization” (October 2016) for
future billings if authorized service dates span a date range.
(f) For electronic claims submission, a provider shall request a web billing
account from DHHS by completing and submitting Form 2679 “Provider Web Billing
User Account Request Form” (October 2016).
(g) Both the user and the user’s supervisor, if
the user is an employee, shall sign the form described in (f) certifying the
following:
“I understand that provider billing requirements are governed by
administrative rules (He-C 6339,
He-C 6340, He-C 6348, He-C 6350, He-C 6914) which is incorporated herein by
reference and I agree to abide by these requirements.”;
“I understand and agree that as a provider, I am responsible for any
and all billing invoices submitted
by me or on my behalf by my authorized representative, whether user is an
employee authorized as a billing representative or authorized billing
representative of a management service company.”;
“I understand and agree that any payments
made which are based on inaccurate or fraudulent billing, whether submitted by
me or by my authorized user will be recovered from me by DHHS.”;
“I understand and agree that it is my responsibility to notify the
Division for Children, Youth, and Families by contacting Provider Relations when a user no
longer required access to the web billing application.”;
“I understand that by submitting an
invoice via the Provider Web Billing Application I am certifying that the
invoice is true and accurate.”;
“I understand and agree that information
obtained via the Provider Web Billing Application is confidential and can be
used solely for the purposes of administering Division for Children, Youth, and
Families (DCYF) Services.”;
“I understand and agree that I am
responsible for my authorized representative, employee, and/or any management
service company’s use of the Provider Web Billing Application.”; and
“I understand and agree that I must
access my web account at least every ninety (90) days or my account will be
de-activated.”;
(h) After the provider complies with (f) above,
the DHHS shall issue to the provider a log on and personal identification
number (PIN) for use in accessing the provider web billing user account.
(i) The provider or any authorized
representative, shall not transfer his or her log on or PIN, or allow use of
his or her log on or PIN by any other person.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.19)
He-C 6343.18 Billing Period.
(a) A provider shall bill within one year of service provision.
(b) Any bill received for payment
one year after service date shall be denied pursuant to
RSA 126-A:3.
(c) Providers shall submit bills at least on a monthly basis.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.20)
He-C 6343.19 Billing Discrepancies. Questions regarding billing discrepancies
shall be directed to the provider relations’ staff of the bureau of
administration operations in DCYF.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.21)
He-C 6343.20 Record-Keeping and Record Retention.
(a)
Providers shall retain records for a period of no less than 7 years
after the completion date of a provided service for each bill submitted to the
department, the medicaid fiscal agent or a private insurance company.
(b)
Records shall clearly document the extent of the care and
services provided to children and families, when those services are charged to
the department, and information regarding any payment claimed.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.22)
He-C
6343.21 Quality Assurance Activities of
Transportation Service Providers.
(a) Providers shall be subject to quality
assurance reviews conducted by DCYF to determine the quality of services pursuant to RSA 170-G:4, XVIII, using a
variety of activities that may include a combination of record reviews,
performance data measurements, and visits to providers.
(b) For the purposes of assessing
compliance and for quality assurance reviews, providers shall allow:
(1) Scheduled or unscheduled
on-site visits by DCYF;
(2) Interviews with
providers and program staff; and
(3) A review of program
documents to determine continued compliance with He-C 6343 including all
service reports.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.23)
He-C
6343.22 Monitoring of Accompanied Transportation
Service Providers.
(a)
Providers shall submit an annual report to DCYF no later than 30 days
following the end of the calendar year.
(b)
The annual report shall include the following information:
(1) Service provided and
changes in strategies that resulted in effective outcomes;
(2) Issues with the service utilization and observations about
shifts in the targeted service population;
(3) Barriers discovered in
the system of care;
(4) Proposed enhancements to
performance indicators,
(5) Training topics
presented over the past year for transportation aides; and
(6) Annual statistics for:
a. The number of referrals
received;
b. The number of referrals
serviced; and
c. The number of referrals not
serviced and the reason for not servicing.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.24)
He-C
6343.23 Waivers.
(a)
Applicants or providers who request a waiver of a requirement in He-C
6343 shall submit a written request to the commissioner or his or her designee
that includes the following information:
(1) The reason for requesting the waiver;
(2) The anticipated length of time the requested
waiver will be needed including permanent waivers;
(3) Assurance that if the waiver is granted the
quality of service and care to children, youth and families will not be
affected;
(4) A written plan to achieve compliance with the
rule or explaining how the provider will satisfy the intent of the rule, if the
waiver is granted;
(5) How the service will be affected if the
waiver is not granted;
(6) Evidence that
the agency's board of directors has approved the waiver request, such as,
minutes of the board meeting documenting that the request was approved or a
signature of the board's president or chairman;
(7) A statement that the rule for which a waiver
is being requested is not related to compliance with the life safety code or
environmental health and safety issues, unless approved in writing by the fire
inspector, local health officer, or public health services; and
(8) The signature of the person requesting the
waiver.
(b)
A waiver shall be granted if:
(1) The department concludes that authorizing
deviation from compliance with the rule from which waiver is sought does not
contradict the intent of the rule and the rule does not conflict with statute;
and
(2) The
alternative proposed ensures that the object or intent of the rule will be
accomplished.
(c)
When a waiver is approved, the applicant’s or provider’s subsequent
compliance with the alternative approved in the waiver shall be considered
equivalent to complying with the rule from which waiver was sought.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.25)
He-C 6343.24 Denial of Application and Revocation of
Certification.
(a) An application shall be denied or provider
certification revoked if:
(1) DCYF determines that the state does not have a need for
the service;
(2) The applicant or provider, or
the individual acting on the applicant’s or provider’s behalf, submits
materially false information to DCYF;
(3) The provider knowingly retained
an employee for whom there has been a conviction for a felony or any crime
against a person;
(4) The provider has been convicted
of a felony or any crime against a person, which has not been annulled or
overturned;
(5) There has been disciplinary
action taken against a provider by a licensing body or professional society, a
finding of civil liability made for professional misconduct, or a finding of an
ethical violation made by a state or national professional association or any
other state’s regulatory board, which has not been annulled or overturned;
(6) There has been a
cancellation of insurance by the provider’s insurance company;
(7) There has been abusive or
neglectful treatment of a child by a provider as determined by any state
statute;
(8) The foster care provider has
had their foster care license revoked;
(9) A local education agency has
revoked authorization for an educational transportation service provider;
(10) The provider fails to
submit a copy of renewed driver’s license at the time of expiration; or
(11) The provider fails to comply with He-C 6343.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.26)
He-C
6343.25 Notification of Denial or
Revocation.
(a) If DCYF
denies an application for certification or revokes an existing certification,
DCYF shall send notice of the denial or revocation to the applicant or provider
by certified mail.
(b) The notice
shall:
(1) Inform the applicant or
provider of the facts or conduct upon which DCYF bases its action;
(2) Advise the applicant or
provider of their right to request reconsideration of DCYF’s decision pursuant
to He-C 6343.26; and
(3) In the case of an existing
certification, inform the provider that the revocation shall not take effect
until the provider has had an opportunity through an appeal, pursuant to RSA
170-G:4-a and He-C 6343.27, to show compliance with all lawful requirements for
retention of the certification.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.27)
He-C
6343.26 Request for Certification
Reconsideration.
(a) A request
for certification reconsideration shall:
(1) Be filed within 30 days of the date of receipt of the letter sent by DCYF;
(2) Be submitted in writing; and
(3) Be filed with the director
of DCYF.
(b) The DCYF director shall grant or deny the request pursuant to He-C 6343.27.
(c) The applicant or provider shall be notified
of the decision, in writing by the director.
(d) The applicant or provider may appeal the DCYF
director’s decision pursuant to He-C 6343.27.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.28)
He-C
6343.27 Appeals.
(a) Applicants or providers who wish to appeal
DCYF’s decision shall file an appeal pursuant to RSA 170-G:4-a with the
commissioner.
(b) The appeal
shall be:
(1) Made in writing and state
the reasons for the appeal pursuant to RSA 170-G:4-a;
(2) Filed within 14 working days
of the date of receipt of written notification; and
(3) Signed and dated;
(c) Pursuant to RSA 170-G:4-a and He-C 200, the
commissioner or designee and 2 members of the DCYF advisory board shall hear the appeal.
Source. (See Revision Note at part heading for He-C
6343) #9390, eff 3-1-09, EXPIRED: 3-1-17
New. #12592, INTERIM, eff 7-26-18, EXPIRED:
1-22-19
New. #12750, eff 3-26-19 (formerly He-C 6343.29)
PART He-C 6344
CERTIFICATION PAYMENT STANDARDS FOR COMMUNITY-BASED BEHAVIORAL HEALTH SERVICE PROVIDERS
Statutory Authority:
RSA 170-G:4 XVIII, RSA 170-G:5
REVISION NOTE:
Document
#9311, effective 11-5-08, adopted Part He-C 6344 relative to certification
payment standards for community-based behavioral health service providers. This part incorporated provisions from the
former Part He-C 6352 entitled “Certification for Payment Standards for
Community-Based Service Providers” and made extensive changes to the wording,
format, structure, and numbering of those provisions.
Document
#9311 supersedes all prior filings in the former Part He-C 6352 relative to
certification payment standards for community-based behavioral health service
providers. The filings affecting the
former Part He-C 6352 include the following documents:
#4446, eff 7-1-88
#5096, eff 3-15-91, EXPIRED 3-15-97
#7292, eff 5-24-00
#8009, eff 1-1-04
#9112, INTERIM, eff 3-24-08, EXPIRED
9-20-08
He-C 6344.01 Purpose. The purpose of this part is to identify the
qualifications and performance requirements to become a provider of
community-based behavioral health services for the division for children, youth
and families (DCYF) and describe the array of behavioral health services
related to improving child and family functioning regarding situations
involving abuse, neglect, delinquency, and Children in Need of Services
(CHINS).
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08, ss by #12206, eff 6-10-17
He-C 6344.02 Scope. This part shall apply to community-based behavioral
health service providers for DCYF who receive financial reimbursement from the
department of health and human services (DHHS) for services provided to
children and families.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08, ss by #12206, eff 6-10-17
He-C 6344.03 Definitions.
(a) “Applicant”
means the entity that is requesting certification for payment as a behavioral
health service provider.
(b) “Division
of behavioral health (DBH)” means the organizational unit of the department
health and human services established pursuant to RSA 135-C:6.
(c) “Case plan”
means the division for children, youth and families written document, pursuant
to RSA 170-G:4, III, that describes the service plan for the child and family,
and addresses outcomes, tasks, responsible parties, and timeframes for
correcting problems that led to abuse, neglect, delinquency, or child in need
of services (CHINS).
(d)
“Certification for payment” means the process by which DCYF approves the
qualifications of and payment to providers of community-based behavioral health
services.
(e) “Child”
means an individual from birth through age 20, except as otherwise stated in a
specific provision. The term includes
“minor”.
(f) “Child in
need of services (CHINS)” means “child in need of services” as defined by RSA
169-D:2.
(g) “Child
protective service worker (CPSW)” means an employee of the division for
children, youth and families who has expertise in managing cases to ensure
families and children achieve safety, permanency and well-being.
(h) “Cognitive
Behavioral Therapy (CBT)” means a psychotherapy based on modifying everyday thoughts and behaviors,
with the aim of positively influencing emotions. The cognitive model of managing emotional
responses encourages the development of specific goals that are measurable and
quantifiable.
(i)
“Commissioner” means the commissioner of the department of health and
human services or his or her designee.
(j) “Community
mental health program (CMHP)” means a program operated by the state, city,
town, or county, or a community-based New Hampshire nonprofit corporation for
the purpose of planning, establishing, and administering an array of
community-based, mental health services pursuant to He-M 403 and as defined in
RSA 135-C:2, IV.
(k)
“Community-based behavioral health services” means behavioral health
services certified by DCYF pursuant to RSA 170-G:4 XVIII.
(l) “Conflict
of interest” means a situation, circumstance, or financial interest, which has
the potential to cause a private interest to interfere with the proper exercise
of a public duty.
(m) “Crisis
intervention services” means short term in or out of home services designed to
stabilize children and families in emergent situations.
(n) “Department
(DHHS)” means the department of health and human services.
(o)
"Diagnostic evaluation" means psychological testing or
psychosocial assessment to determine the nature and cause of a child or
family’s dysfunction including mental status, child development, family
history, and recommendations for treatment.
(p) “Director”
means the director of the division for children, youth, and families or
designee.
(q) “Division for children, youth, and families
(DCYF)” means the organizational unit of the department of health and human
services that provides services to children and youth referred by courts
pursuant to RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, and RSA 463.
(r)
“Educationally identified child” means “child with a disability'' as defined in RSA
186-C:2 namely, “any person 3 years of age or older but less than 21 years of age
who has been identified and evaluated by a school district according to rules
adopted by the state board of education and determined to have an intellectual
disability, a hearing impairment including deafness, a speech or language
impairment, a visual impairment including blindness, an emotional disturbance,
an orthopedic impairment, autism, traumatic brain injury, acquired brain
injury, another health impairment, a specific learning disability,
deaf-blindness, multiple disabilities, or a child at least 3 years of age but
less than 10 years of age, experiencing developmental delays, who because of
such impairment, needs special education or special education and related
services. The term "child with a disability'' shall include a child ages
18 to 21, who was identified as a child with a disability and received services
in accordance with an individualized education program but who left school
prior to his or her incarceration, or was identified as a child with a
disability but did not have an individualized education program in his or her
last educational institution.”
(s)
“Evidence-informed practice” means the process of treatment, which takes
into account client preferences and values, practitioner expertise, best
scientific evidence and clinical characteristics and circumstance.
(t) “Family
therapy” means evidence-informed treatment involving family members and a
therapist when treatment is focused on ameliorating conditions that impair
family functioning.
(u) “Group
outpatient counseling” means the use of evidenced-informed psychotherapeutic or
counseling techniques in the treatment of a group, most of whom are not related
by blood, marriage, or legal guardianship in a community setting.
(v) “Individual
outpatient therapy” means the use of evidenced-informed psychotherapeutic or
counseling techniques in the treatment of an individual on a one-to-one basis
in a community setting.
(w) “Juvenile
probation and parole officer (JPPO)” means an employee of DCYF who discharges
the powers and duties established by RSA 170-G: 16, and supervises paroled
delinquents pursuant to RSA 170-H.
(x) “Licensed
alcohol and drug counselor (LADC)” means a person licensed by the state of New
Hampshire board of licensing for alcohol and other drug use professionals according
to RSA 330-C to practice substance use counseling as a LADC.
(y) “Licensed
practitioner” means a psychiatrist, advanced registered nurse practitioner,
psychiatric nurse, psychologist, pastoral psychotherapist, independent clinical
social worker, clinical mental health counselor, substance use counselor, or
marriage and family therapist holding a state license to practice in their
respective field.
(z) “Managed
care organization (MCO)” means an organization, contracted with the Department,
that combines the functions of health insurance, delivery of care, and
administration.
(aa) “Master
licensed alcohol and drug counselor (MLDAC)” means a person licensed by the
state of New Hampshire board of licensing for alcohol and other drug use
professionals according to RSA 330-C to practice substance use counseling as a
MLDAC.
(ab) “NH
bridges” means the automated case management, information, tracking, and
reimbursement system used by DCYF.
(ac) “NH mental
health authority” means the bureau of mental health services administration,
under the division of behavioral health within DHHS.
(ad) “Outcome”
means the intended result or consequence that will occur from carrying out a
program or activity.
(ae)
“Prescribing practitioner” means a provider licensed by the New
Hampshire board of mental health practice, board of nursing, board of medicine, or the board of
phycologists that provides services identified in 42 CFR 440:130 to reduce a
physical or mental disability and aid in the restoration of a recipient to
their best functional level.
(af) “Private
provider” means an individual behavioral health practitioner who is a sole
practitioner or who is employed by an
agency, excluding CMHP’s, and provides services to a child or family and
receives financial reimbursement from DHHS.
(ag) “Program”
means the community mental health program.
(ah) “Provider”
means the individual, agency or program that serves a child or family and
receives financial reimbursement from DHHS.
(ai) “Progress
report” means the written document, submitted on a regular basis to DCYF by the
behavioral health provider, which includes a summary of contacts and data
documenting outcomes of the child and family specific treatment goals, dates of
service, awareness of the permanency goal and congruence with case plan.
(aj)
"Psychotherapy” means face-to-face clinical intervention or
assessment and monitoring necessary to determine the course and progress of
therapy for individuals or families that:
(1) Is based on
evidence-informed psychological treatment principles;
(2) Has as its
purpose the improvement of interpersonal and self-care skills, psychological
understanding, or a change in behavior(s), or any combination of these;
(3) Is provided
by a professional qualified pursuant to He-M 426.08(h)-(l);
(4) Is
monitored through the clinical record; and
(5) Is based on
an individual service plan.
(ak) “Quality
assurance” means the process that DCYF use to monitor the quality and
effectiveness of community-based behavioral health services.
(al)
“Re-approval” means the division of behavioral health’s process of
conducting a comprehensive quality assurance and compliance evaluation for all
community mental health programs that generates a re-approval report.
(am) “Service
authorization” means the form provided by DCYF indicating the division’s
responsibility for payment of community-based services for non-medicaid
eligible children.
(an)
“Trauma-informed service system” means a system in which all parties
involved recognize and respond to the impact of traumatic stress on those who
have contact with the system including children, caregivers, and service
providers. A trauma-informed service system reinforces trauma awareness,
knowledge, and skills in the organizational cultures, practices, and policies
of all those who are involved with the child, using the best available science,
to facilitate and support the recovery and resiliency of the child and family.
(ao) “Treatment
plan” means the written, time-limited, goal-oriented, evidence-informed plan
for the child and family developed by the provider and DCYF, which is in
agreement with the case plan.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17
He-C 6344.04 Categories
and Descriptions of Community-Based Behavioral Health Services:
(a) Behavioral
health providers shall include:
(1) Private
providers of behavioral health services; and
(2) CMHP.
(b) All
behavioral health services shall include clinical assessments, diagnostic
evaluations, and treatments which derive from attachment and trauma theory and
which are evidence- informed practices.
(c) The
evaluator shall determine a child and family’s level of functioning and
recommend the appropriate clinical interventions.
(d) Diagnostic
evaluations and assessments shall include:
(1) Mental
status exam;
(2) Current
developmental status;
(3) Impact of
trauma on current level of functioning;
(4) Identifying
strengths and risk factors;
(5) Assessment
of capacity for healthy attachment;
(6) Any
appropriate standardized psychological or neuropsychological tests; and
(7) A detailed
report submitted to the CPSW or JPPO.
(e) Therapeutic
intervention services shall include:
(1) Individual
intervention based on evidence-informed treatments.
(2) Family
intervention based on evidence-informed treatment models of family therapy; or
(3) Group
interventions based on evidence-informed treatment interventions involving 2 to
10 individuals and a therapist when the focus of the group is ameliorating
conditions that impair functioning; especially as a result of trauma and
attachment issues or exposure to family or domestic violence.
(f)
Certification of providers shall be determined by reviewing the
documentation provided in He-C 6344.07 through He-C 6344.10 and a review of
training and experience in the following services:
(1) Diagnostic
evaluations which shall include:
a. Behavioral
consultation;
b. Child
psychiatry evaluation;
c. Competency
evaluation;
d.
Developmental evaluation;
e. Domestic or
family violence evaluation;
f. Dual
diagnosis of:
1. Mental
health and substance use; or
2. Behavioral
health and developmental challenges;
g. Fire-setting
evaluation;
h.
Neuropsychiatry evaluation;
i.
Neuropsychological evaluation;
j.
Psychological evaluation;
k.
Psycho-sexual risk evaluation;
l. Sexual abuse
victim or perpetrator evaluation; and
m. Forensic
evaluation;
(2) Family
therapy;
(3) Group
outpatient therapy; and
(4) Individual
outpatient therapy.
(g)
Comprehensive assessments or evaluations for substance use disorders and
treatment shall include:
(1) Individual
interventions based on evidence-informed treatment models of age-appropriate
treatment for substance use disorders;
(2) Family interventions based on evidence-informed
models of family interventions for substance use disorders;
(3) Group interventions based on evidence-informed
interventions involving 2 or more individuals and a therapist when the focus of
the group is treating substance use disorders or enhancing recovery; and
(4) Crisis
intervention services.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17
He-C 6344.05 Compliance
Requirements for Private Providers.
(a) Private
providers shall comply with:
(1) All
applicable licensing and registration requirements prior to applying for
certification;
(2) The medical
assistance requirements of He-W 500 and He-M 426;
(3) The
statutes regarding confidentiality, including RSA 169-B:35, RSA 169-C:25, RSA
169-D:25, RSA 170-B:19, RSA 170-C:14, and RSA 170-G:8-a; and
(4) The child
abuse and neglect reporting requirements of RSA 169-C:29-30.
(b) All
providers, prior to beginning their work with children, and thereafter on an
annual basis, shall review the sections of RSA 169 on definitions, immunity
from liability and persons required to report.
(c) Private
providers shall not have a conflict of interest, as defined in He-C 6344.03.
(d) Private
providers shall maintain professional and general liability insurance.
(e) When
domestic or family violence is identified as an issue for a family, each
private provider shall follow the “Mental Health Domestic Violence Protocols,”
1996, prepared by the NH governor’s commission on domestic violence and
available directly from the NH department of justice or on-line as listed in
Appendix A.
(f) The
provider shall provide services or care without discrimination as required by
42 U.S.C 2000d et seq., as amended, and without discrimination on the basis of
handicap as required by 29 U.S.C 794, as amended.
(g) Private
providers shall:
(1) Be an
enrolled NH medicaid provider;
(2) Accept
medicaid payment as payment in full;
(3) Submit
their medicaid number to DCYF; and
(4) Participate
with one or more of the NH managed care organizations (MCO).
(h) The
requirement in (g)(1) above shall be waived if the provider holds only a LADC
license.
(i) Private providers shall verify recipient
eligibility for and bill all third party sources of reimbursement, including
private health insurance, and medicaid, or MCO, prior to billing DCYF.
(j) Private
providers shall request prior authorization for services in advance for
recipients covered by third party insurance.
(k) Private
providers shall request prior authorization for psychotherapy services for
medicaid or MCO eligible recipients requiring more than 12 visits per fiscal
year as outlined in He-W 530.
(l) Private
providers shall submit a monthly progress report to CPSW or JPPO.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17
He-C 6344.06 Compliance
Requirements for CMHP.
(a) CMHP
providers shall comply with:
(1) All applicable
licensing and registration requirements prior to applying for certification;
(2) The medical
assistance requirements of He-W 500 and He-M 426;
(3) The
statutes regarding confidentiality, including RSA 169-B:35, RSA 169-C:25, RSA
169-D:25, RSA 170-B:19, RSA 170-C:14, and RSA 170-G:8-a;
(4) The child
abuse and neglect reporting requirements of RSA 169-C:29-30; and
(5) DCYF
requirement for a master’s degree and 2 years post graduate experience to be
assigned to all cases.
(b) For all
employees and volunteers who have access to children, prior to beginning their
work with children, and thereafter on an annual basis, the provider shall
review the sections of RSA 169 on definitions, immunity from liability and
persons required to report.
(c) The CMHP
and their employees shall not have a conflict of interest, as defined in He-C
6344.03.
(d) CMHP shall
maintain professional and general liability insurance.
(e) When
domestic violence is identified as an issue for a family, each agency shall follow
the “Mental Health Domestic Violence Protocols,” 1996, as prepared by the NH
governor’s commission on domestic violence and available directly from the NH
department of justice or online as listed in Appendix A.
(f) The
provider shall provide services or care without discrimination as required by
42 U.S.C 2000d, et. seq, as amended, and without discrimination on the basis of
handicap as required by 29 U.S.C 794, as amended.
(g) The CMHP
shall:
(1) Be an
enrolled NH Medicaid and MCO provider that meets the following requirements:
a. A
prescribing practitioner shall demonstrate approval of the Medicaid-covered
services by signing the child and family’s treatment plan; and
b.
Medicaid-covered services shall be authorized for children who are:
1. Medicaid
eligible, either as categorically or medically needy; and
2. Under the
age of 21 years;
(2) Private
providers shall verify recipient eligibility for and bill all third-party
sources of reimbursement, including private health insurance and medicaid or
MCO, prior to billing DCYF.
(3) Accept
Medicaid payment as payment in full for services provided; and
(4) Have a
current contract with the DBH and shall not be an individual provider.
(h) All CMHP
shall comply with the service provisions outlined in He-M 426.
(i) Each CMHP
shall submit a quarterly progress reports for each client to the CPSW or JPPO.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17
He-C 6344.07 Application
Process For Payment Standards For Private Providers of Community-Based
Behavioral Health Services.
(a) Applicants
who seek initial certification for payment standards for community-based
behavioral health services shall only be referred by a DCYF district office
supervisor or designee.
(b) If the
request is approved, DCYF shall forward an application packet to the applicant,
which includes:
(1) A Form 2617
“Application For Certification And Enrollment Of Private Behavioral Health
Service Providers” (October 2016);
(2) “State of
New Hampshire Alternate W-9 Form”; and
(3) A copy of
He-C 6344.
(c) Each
applicant shall complete, sign, date, and submit a Form 2617 “Application For
Certification And Enrollment Of Private Behavioral Health Service
Providers”(October 2016); and the following information:
(1) A signed and dated
“Statement of Affirmation” as part of Form
2617 “Application For Certification And Enrollment Of Private Behavioral Health
Service Providers” (October 2016) that states the following:
“I have reviewed Administrative Rule He-C 6344 and
will adhere to the rules as an enrolled provider. I understand that DCYF has the right to
verify information contained in this application”;
“I will notify DCYF in writing within ten business
days of any change to the information contained in this application”;
“I understand and agree that any individual whom
provides services or agency that I subcontract with will have a current and
valid license for the service being provided”; and
“The information contained in this application is
correct to the best of my knowledge”.
(2) The applicant shall provide the following
information with, or in addition to, Form 2617 “Application For Certification
And Enrollment Of Private Behavioral Health Service Providers”(October 2016) in
(1) above:
a. A copy of
the applicant’s state license to practice or operate;
b. A completed,
signed, and dated “State of New Hampshire Alternate W-9 Form”;
c. A resume or curriculum vitae; and
d. A sample of
a treatment plan.
(d) In addition
to the information requested in (c) above, the applicant shall complete, sign,
date, and submit the attestation in Part E of Form 2617 “Application For
Certification And Enrollment Of Private Behavioral Health Service Providers”
(October 2016) that states:
“I declare that all the information contained above is
true, correct and complete to the best of my knowledge and belief. I acknowledge that the provision of false
information in the application is a basis for denial of the application”.
(e) Each applicant shall
complete, sign, date, and submit a “Statement of Affirmation” as part of Form 2617 “Application For Certification And
Enrollment Of Private Behavioral Health Service Providers” (October 2016) that states the
following:
“I have reviewed Administrative Rule He-C 6344 and
will adhere to the rules as an enrolled provider. I understand that DCYF has the right to
verify information contained in this application”;
“I will notify DCYF in writing within ten business
days of any change to the information contained in this application”;
“I understand and agree that any individual whom
provides services or agency that I subcontract with will have a current and
valid license for the service being provided”; and
“The information contained in this application is
correct to the best of my knowledge”.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.08)
He-C 6344.08 Application
Process For Payment Standards For CMHP Providers.
(a) CMHP’s
shall be contracted for services through the DBH.
(b) CMHP’s
shall provide a copy of a “State of New Hampshire Alternate W-9 Form” to the
DCYF certification specialist within 30 days of receipt.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from he-C 6344.09)
He-C 6344.09 Review
of Continued Certification Compliance for Private Providers.
(a) Private
providers shall complete, sign, date, and submit a Form 2617R “Certification
Renewal - Private Behavioral Health Providers” (October 2016), as provided by
DCYF, within 30 days of receipt and include the following information:
(1) A completed,
signed, and dated “Statement of Affirmation” as part of Form 2617R “Certification
Renewal - Private Behavioral Health Providers” (October 2016) that states the
following:
“I have reviewed Administrative Rule He-C 6344 and
will adhere to the rules as an enrolled provider. I understand that DCYF has the right to
verify information contained in this application”;
“I will notify DCYF in writing within 10 business days
of any change to the information contained in this application”;
“I understand and agree that any individual whom
provides services or agency that I subcontract with will have a current and
valid license for the service being provided”; and
“The information contained in this application is
correct to the best of my knowledge.”
(2) The applicant
shall provide the following information with, or in addition to, Form 2617R
“Certification Renewal - Private Behavioral Health Providers” (October 2016):
a. License to
practice or operate; and
b. “State of
New Hampshire Alternate W-9 Form”.
(3) In addition to the
information requested in (a) and (b) above the applicant shall complete, sign, date, and submit the attestation in Part C of Form 2617R
“Certification Renewal - Private Behavioral Health Providers” (October 2016)
that states:
“I declare that all the information contained above is
true, correct and complete to the best of my knowledge and belief. I acknowledge that the provision of false
information in the application is a basis for denial of the application.”
(b) Private
providers who fail to complete and submit a Form 2617R “Certification Renewal -
Private Behavioral Health Providers” (October 2016) within 30 days of receipt
shall have their certification revoked in accordance with He-C 6344.23 and be
denied payment.
(c) Continuance
of certification shall be based on a review and verification of the provider’s
compliance with He-C 6344.
(d) Private
provider applicants shall submit a copy of the documentation required by the
appropriate state licensing board or boards to DCYF at the time of license
renewal to DCYF.
(e) Private
provider applicants shall submit a copy of their renewed license to DCYF.
(f) Review of
continued certification shall coincide with the date of expiration of the
private provider’s applicable state licensing board(s).
(g) In the
event of dual licensing the date of the earliest license expiration will be
used.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.11)
He-C 6344.10 Review
of Continued Certification Compliance for CMHP Providers.
Renewals for CMHP providers shall occur every 5 years
and coincide with the date of the re-approval report completed by the DBH.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.12)
He-C
6344.11 Notification of Changes for
Private Providers. The private
provider shall:
(a) Notify DCYF
in writing within 10 business days of any change in the information contained
in the application and changes to the items required by He-C 6344.07 (c)(1) -
(3) above, and provide documentation of the change; and
(b) Submit a
copy of the renewed license, at the time of expiration of mandatory state
licenses to DCYF within 10 days of receipt from the licensing authority.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.14)
He-C 6344.12 Notification
of Changes for CMHP Providers. All
providers shall comply with the requirements of He-M 403 with regard to any
changes.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.15)
He-C 6344.13 Billing
Requirements for Community-Based Behavioral Health Services.
(a) All
providers of community-based behavioral health services shall:
(1) Be
certified prior to the start of service delivery;
(2) Not exceed
the rates established by DCYF nor shall the rates exceed those charged by the
provider for non-DCYF children and families;
(3) Not bill
DCYF for services that are to be reimbursed by any other entity including third
party insurance or Medicaid; and
(4) Accept
payments made by DCYF as payments in full for the services it provides.
(b) DCYF shall
determine the need for services and the determination shall be binding on the
provider.
(c) The
provider shall notify DCYF of any changes in tax information and complete and
submit to DCYF a signed “State of New Hampshire Alternate W-9 Form” with
current tax information.
(e) The
provider shall provide services or care without discrimination as required by
42 U.S.C 2000d et. seq., as amended, and without discrimination on the basis of
handicap as required by 29 U.S.C 794, as amended.
(f) The
provider’s certification terminates upon date of sale or transfer of ownership
or close of the provider agency.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.17)
He-C 6344.14 Billing
Process for Community-Based Behavioral Health Services.
(a) All
providers shall bill all third party sources of reimbursement, including
private health insurance and Medicaid and Medicaid MCO, prior to billing DCYF.
(b) All
providers shall bill the NH Medicaid fiscal agent or Medicaid MCO for Medicaid
eligible recipients following the processes outlined by the NH Medicaid fiscal
agent.
(c) The
provider shall request and obtain from DCYF a service authorization form for
services not billable to Medicaid, Medicaid MCO or private insurance prior to
service delivery.
(d) A provider
shall bill the DCYF through NH Bridges for non-Medicaid eligible recipients either
via paper claims or electronic claims submission.
(e) For paper
claim submissions, a provider shall copy the service authorization form for
future billings, if the authorized service dates span a date range.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.18)
He-C 6344.15 Billing
Period.
(a) A provider
shall bill within one year of the date of provision of a service.
(b) Bills
received after one year from the date of service shall be denied pursuant to
RSA 126-A:3.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.19)
He-C 6344.16 Billing
Discrepancies. Questions regarding
billing discrepancies billed via NH Bridges shall be directed to the provider
relations’ staff of the bureau of administrative operations in DCYF. All other questions shall be directed to
either Medicaid or the private insurance company.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.20)
He-C 6344.17 Record-Keeping
and Record Retention.
(a) Records
shall be retained for a period of no less than 7 years after the completion
date of a provided service for each bill submitted to the department, the
Medicaid fiscal agent or a private insurance company.
(b) The
provider shall keep records as are necessary to comply with RSA 170-E: 42, when
applicable, and to comply with DCYF record-keeping requirements in He-C 6344.
(c) Records
shall clearly document the extent of the care and services provided to children
and families, including attendance records when those services are charged to
the department, and information regarding any payment claimed.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.21)
He-C 6344.18 Monitoring
and Quality Assurance Activities for Private Behavioral Health Providers.
(a) Private
providers shall participate in quality assurance activities conducted by DCYF
using a variety of activities that may include a combination of record reviews,
performance data measurements and visits to the provider.
(b) Private
providers shall allow DCYF, to conduct quality assurance reviews which shall
include:
(1)
Interviewing the private provider;
(2)
Interviewing children and families served;
(3) Reviewing
provider documents, to include:
a. The
evidence-informed treatment modalities used;
b. The
treatment outcomes achieved and the length of time in treatment; and
c. The
providers treatment plan to assure that it agrees with the DCYF case plan; and
(4) Examining
case records to determine continued compliance with He-C 6344.
(c) Private
providers shall ensure that clinical records, including all progress reports,
are available for inspection and review by DCYF.
(d) Private
providers shall be monitored and evaluated by DCYF through a variety of
activities including:
(1) Monthly
queries of data that is stored on NH Bridges case management system and the
Medicaid management information system;
(2) Reviews of
case record information; and
(3)
Satisfaction surveys from stakeholders, such as families, CPSW and
JPPOs.
(e) Private
providers shall be notified of any problems that are noted on the DCYF staff
surveys that include:
(1) Negative
responses concerning quality and timeliness of service provision; and
(2) Written comments
about private provider performance.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.22)
He-C 6344.19 Service
Limitations.
(a) Medicaid
recipients shall be subject to the service limits described in He-W 530.
(b)
Non-Medicaid recipients shall be limited to 12 visits per year.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.25)
He-C 6344.20 Treatment
Planning and Progress Reports.
(a) The
treatment plan for each child or family receiving services shall include input
from the individuals described in (b) below.
(b) The
following individuals shall be included on the treatment team:
(1) The child,
if age and developmentally appropriate;
(2) The child’s
parents;
(3) The CPSW or
JPPO, or both;
(4) The
prescribing practitioner;
(5) School
district personnel; and
(6) Unless
otherwise ordered by the court, other persons as requested by the child and
family, including:
a. Teachers;
b. Counselors;
c. Friends;
d. Relatives;
and
e. Advocates
assigned by the court.
(c) The initial
clinical treatment plan shall be written within 30 days of intake approval for
extension and reviewed quarterly thereafter and shall include:
(1) The
findings of the provider’s assessment;
(2) An estimate
by the treatment team members of the length of service to be provided to the
child and family, based upon referral information and the provider’s
assessment;
(3) The child’s
permanency plan, as identified by the CPSW or JPPO:
(4) A concurrent
plan as an alternative to the child’s permanent plan as identified by the CPSW
or JPPO; and
(5) The goals
and objectives for the child and family that shall address one or more of the
following domains identified in the plan:
a. Safety and
behavior;
b. Emotional
well-being;
c.
Interpersonal relationships;
d. Family
community connections;
e. Physical
health;
f. Mental
health;
g. Education;
and
h. Independent
living skills training, if applicable.
(d) Each domain
identified in (c)(5) above shall address:
(1) The
specific goals and objectives to be achieved by the child and family;
(2) The
timeframes for completion of goals and objectives;
(3) An
identification of:
a. The
behavioral health services to be provided directly to the child and family,
b. The
frequency and duration of services, and
c. Any measures for ensuring their integration with
the child’s activities, including identifying how the child’s family, relative
family or foster family will participate in their treatment; and
(4) An
identification of the person responsible for implementing the stated
interventions in the treatment plan.
(e) For cases
in which reunification is the identified permanency goal, the treatment plan
shall include:
(1) A community
reintegration and transition plan identifying the behavioral health supports
for the child to return to his or her community; and
(2) The
transfer of behavioral health services to the appropriate certified providers
in the child’s community of origin, if necessary.
(f) The
provider’s treatment plan shall be signed and dated by the provider and the
following team members, indicating they participated in the process:
(1) The CPSW,
JPPO, or both;
(2) The
prescribing practitioner;
(3) The child,
when age and developmentally appropriate; and
(4) The child’s
parent(s) or guardian.
(g) Treatment
plan revisions shall be explained in writing to all team members.
(h) The
treatment plan and any revisions shall be filed in the child’s DCYF case file
and copies sent to:
(1) The CPSW,
JPPO, or both;
(2) The child’s
parent(s) or guardian;
(3) The
prescribing practitioner; and
(4) The foster
or placement provider, if participating.
(i) Once the
treatment plan is completed, the provider shall receive supervision by the
prescribing practitioner.
(j) Each
provider shall provide reports to DCYF, as follows:
(1) Progress
reports every month;
(2) Any reports
required by the court pursuant to RSA 169-B:5-a, RSA 169-C:12-b and 169-D:4-a;
and
(3) Service
termination reports, which shall be sent the CPSW or JPPO no later than 10 days
following termination.
(k) The
progress reports shall clearly and accurately reflect the child and family’s
progress regarding measurable treatment plan goals and objectives.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.26)
He-C 6344.21 Service
Limitations Extensions.
(a) Medicaid
recipients shall be subject to the service limits described in He-W 530.
(b)
Non-Medicaid recipients shall be limited to 12 visits per year.
(c) The provider’s
requests to extend the service limit shall be made in writing 30 days prior to
the expiration of benefits.
(d) Written
request made pursuant to (c) above shall be submitted to the CPSW and JPPO and
include the following:
(1) Provider
name, address, telephone number, and medicaid provider number;
(2) Recipient
name, address, telephone number;
(3) The type of
service being requested;
(4) Initial
assessment as described in He-C 6344.20 (c);
(5) A copy of
the providers treatment plan as described in He-C 6344.20 (c);
(6)
Identification of:
a. The progress
and measurable outcomes of treatment to date;
b. The
prognosis including the likelihood of achieving anticipated outcomes in the
future; and
c. The need for
any availability of other services; and
(7) The
duration of the requested extension.
(e) Extensions
shall be time-limited and based on the needs of the child and family.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17
He-C 6344.22 Waivers.
(a) Applicants
or providers who request a waiver of a requirement in He-C 6344 shall submit a
written request to the commissioner or his or her designee that includes the
following information:
(1) The
anticipated length of time the requested waiver will be needed;
(2) The reason
for requesting the waiver;
(3) Assurance
that if the waiver is granted the quality of service and care to children and
families will not be affected;
(4) A written
plan to achieve compliance with the rule or explaining how the provider will
satisfy the intent of the rule, if the waiver is granted; and
(5) How the
service will be affected if the waiver is not granted.
(b) A waiver
shall be granted if:
(1) The
department concludes that authorizing deviation from compliance with the rule
from which waiver is sought does not contradict the intent of the rule; and
(2) The
alternative proposed ensures that the object or intent of the rule will be
accomplished.
(c) When a
waiver is approved, the applicant’s or providers subsequent compliance with the
alternative approved in the waiver shall be considered equivalent to complying
with the rule from which waiver was sought.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.27)
He-C 6344.23 Denial
of Application and Revocation of Private Provider Certification. An application for private provider
certification shall be denied or certification revoked if:
(a) DCYF
determines that the state does not have a need for the service;
(b) The
applicant or provider, or the individual acting on the applicant’s or
provider’s behalf, submits materially false information to DCYF;
(c) There has
been a conviction for a felony or any crime against a person that has not been
annulled or overturned;
(d) There has
been disciplinary action taken by a licensing body or professional society, a
finding of civil liability made for professional misconduct, or a finding of an
ethical violation made by a state or national professional association or any
other state’s regulatory board;
(e) There has
been revocation of membership on any hospital, medical, or allied health
provider staff;
(f) There has
been revocation of provider status with any group or health maintenance
organization;
(g) There has
been revocation of clinical privileges;
(h) There has
been termination of academic appointment by an institution;
(i) There has
been cancellation of professional or general liability insurance by the
insurance company;
(j) There has
been abusive or neglectful treatment of a child as determined by any state
statute;
(k) There has
been a failure to submit a review form within 30 days; or
(l) There has
been failure to comply with He-C 6344.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.28)
He-C 6344.24 Denial
of Application and Revocation of a CMHP Provider Certification. An application for CMHP provider
certification shall be denied or certification revoked if:
(a) There has
been failure to comply with He-C 6344;
(b) There has
been failure to comply with He-M 426; and
(c) There has
been termination of the contract with the DBH.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.29)
He-C 6344.25 Notification
of Denial or Revocation.
(a) If DCYF
denies an application for certification or revokes an existing certification,
DCYF shall send notice of the denial or revocation to the applicant or provider
by certified mail.
(b) The notice
shall:
(1) Inform the
applicant or provider of the facts or conduct upon which DCYF bases its action;
(2) Advise the
applicant or provider of their right to request reconsideration of DYCF’s
decision pursuant to He-C 6344.26; and
(3) Inform an
existing provider that the revocation shall not take effect until the provider
has had an opportunity through an appeal, pursuant to RSA 170-G:4-a and He-C 6344.27,
to show compliance with all lawful requirements for retention of the
certification.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.31)
He-C 6344.26 Request
for Certification Reconsideration.
(a) A request
for certification reconsideration shall:
(1) Be filed
within 30 days of the date of receipt of the letter sent by DCYF;
(2) Be submitted
in writing; and
(3) Be filed
with the director of DCYF.
(b) The DCYF
director shall uphold or overturn the request pursuant to He-C 6344.07.
(c) The
applicant or provider shall be notified of the decision, in writing by the
director.
(d) The
applicant or provider may appeal the DCYF director’s decision pursuant to He-C
6344.27.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.32)
He-C 6344.27 Appeals.
(a) Applicants
or providers who wish to appeal DCYF’s decision to deny an application or
revoke a certification shall file an appeal pursuant to RSA 170-G:4-a with the
commissioner.
(b) The appeal
shall:
(1) Be made in
writing;
(2) Be signed
and dated;
(3) State the
reasons for the appeal pursuant to RSA 170-G:4-a; and
(4) Be filed
within 14 working days of the date of receipt of written notification pursuant
to RSA 170-G:4-a.
(c) The appeal
shall be heard pursuant to RSA 170-G:4-a and He-C 200 by the commissioner or
designee and 2 members of the DCYF advisory board.
Source. (See Revision Note at part heading for He-C
6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.33)
PART He-C 6346 CERTIFICATION FOR
PAYMENT STANDARDS FOR RECREATION
SERVICE PROVIDERS
Statutory Authority: RSA 170-G:4
XVIII, RSA 170-G:5
REVISION NOTE:
Document #9312, effective 11-5-08,
adopted Part He-C 6346 relative to certification for payment standards for
recreation service providers. This part
incorporated provisions from the former Part He-C 6352 entitled “Certification
for Payment Standards for Community-Based Service Providers” and made extensive
changes to the wording, format, structure, and numbering of those provisions.
Document
#9312 supersedes all prior filings in the former Part He-C 6352 relative to
certification for payment standards for recreation service providers. The filings affecting the former Part He-C
6352 include the following documents:
#4446,
eff 7-1-88
#5096,
eff 3-15-91, EXPIRED 3-15-97
#7292,
eff 5-24-00
#8009,
eff 1-1-04
#9112,
INTERIM, eff 3-24-08, EXPIRED 9-20-08
He-C 6346.01 - He-C
6346.19
Source. (See Revision Note at part heading for He-C
6346) #9312, eff 11-5-08, EXPIRED: 11-5-16
PART He-C 6347 CERTIFICATION FOR
PAYMENT STANDARDS FOR FOSTER CARE SERVICE CREDENTIALS
Statutory Authority: RSA 170-G:4
XVIII, RSA 170-G:5
REVISION NOTE:
Document
#9266, effective 9-20-08, adopted Part He-C 6347 relative to certification for
payment standards for foster care services.
This part incorporated provisions from the former Part He-C 6352
entitled “Certification for Payment Standards for Community-Based Service
Providers” and made extensive changes to the wording, format, structure, and
numbering of those provisions.
Document
#9266 supersedes all prior filings in the former Part He-C 6352 relative to
certification for payment standards for foster care services. The filings affecting the former Part He-C
6352 include the following documents:
#4446, eff 7-1-88
#5096, eff 3-15-91, EXPIRED 3-15-97
#7292, eff 5-24-00
#8009, eff 1-1-04
#9112, INTERIM, eff 3-24-08, EXPIRED
9-20-08
PART He-C 6347 CERTIFICATION FOR
PAYMENT STANDARDS FOR FOSTER FAMILY CARE SERVICE CREDENTIALS
He-C 6347.01 Purpose. The purpose of this part is to identify the
qualifications and
procedures to become credentialed to provide specific foster family care
services for the division for children, youth and families (DCYF).
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20
He-C 6347.02 Scope. This part shall apply to foster parents who
receive stipends twice per month based
on a daily rate per age of the child from the department of health and human
services (DHHS) based on credentials for foster family care services provided
to children.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20
He-C 6347.03 Definitions.
(a) “Adolescent care ” means a category of foster family
care where the care of adolescents, age 14-21 years with specialized needs, provided by
foster parents that have been recruited, selected, and trained to serve this
specialized population.
(b) “Agency” means a
child-placing agency or a child care institution, pursuant to RSA 170-E.
(c) “Assessment Care” means a category of foster family care where
during the initial placement of a child in care, the foster parent will support an evaluation
of the child and birth family’s placement and treatment needs for a period of
60 days.
(d) “Case plan” means the DCYF
written plan for the child and the family which outlines how services will be
provided, pursuant to RSA 170-G: 4 III,
42 U.S.C. 671,), and 42 U.S.C. 675.
(e) “Certification” means the
approval of payment by DCYF to a foster parent for the category of care for
which the foster parent has a credential.
(f) “Child” means:
(1) “Child” as defined in RSA
170-E:25, I, namely “any person under 21 years of age.” The term includes “youth”; or
(2) For the purposes of
compliance with RSA 126-U, “child” as defined in RSA 126-U:1, I, namely, “a
person who has not reached the age of 18 years and who is not under adult
criminal prosecution or sentence of actual incarceration resulting therefrom,
either due to having reached the age of 17 years or due to the completion of
proceedings for transfer to the adult criminal justice system under RSA
169-B:24, RSA 169-B:25, or RSA 169-B:26. ‘Child’ also includes a person in
actual attendance at a school who is less than 22 years of age and who has not
received a high school diploma.” The term includes “youth.”
(g) “Child protective service
worker (CPSW)” means an employee of DCYF who has expertise in managing cases to
ensure families and children achieve safety, permanency, and well-being referred to the department
pursuant to RSA 169-C, RSA 170-B, RSA 170-C, and RSA 463.
(h) “Commissioner” means the
commissioner of the department of health and human services or his or her
designee.
(i) “Credential” means the
approval to provide a category of foster family care including general care,
emergency care, crisis care, assessment care, adolescent care, respite care, specialized
care, or supplemental care.
(j) “Crisis care” means a category of foster family care
accessible for court-ordered placement outside of DCYF’s normal operating hours
for a period not to exceed 5 calendar days.
(k) “Department (DHHS)” means
the New Hampshire department of health and human services.
(l) “Division for children,
youth and families (DCYF)” means the organizational unit of DHHS that provides
services to children and youth referred by courts pursuant to RSA 169-A, RSA
169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, RSA 170-H, and RSA 463.
(m) “Emergency care” means a category of foster family care where an
unplanned placement is made in a foster family home and services are provided
to a child in care for a period not to exceed 10 calendar days.
(n) “Foster parent” means an
individual who has a license or permit for foster family care. This includes the term “provider”.
(o) “General care” means a
credential for foster family care where shelter, supervision, and support
services are provided.
(p) “Juvenile probation and
parole officer (JPPO)” means an employee of DCYF who exercises the powers and
duties established by RSA 170-G:16, and supervises paroled delinquents pursuant
to RSA 170-H.
(q) “Parent” means “parent” as
defined in RSA 169-C:3, XXI, namely, “‘mother’, ‘father’, ‘adoptive parent”,
but such term shall not include a parent as to whom the parent-child
relationship has been terminated by judicial decree or voluntary relinquishment”.
(r) “Primary caring adult” means
an adult other than a child’s parent who the child chooses and the court
appoints to make a lifelong commitment to be the child’s primary source of
guidance and encouragement, and understands the child’s current and future
needs.
(s) “Quality assurance” means
the process that DCYF uses to monitor the quality and effectiveness of foster family
care services.
(t) “Respite care” means a category of foster family care where
substitute care is provided by a licensed foster parent who provides temporary
overnight relief of child care responsibilities for the parent or for the
substitute care provider for children in foster family care programs.
(u) “Specialized care” means a category of foster family care where
shelter, supervision, and support services are provided to children identified
as needing specialized care, by foster parents who have met the additional
training and care requirements.
(v) “Supplemental care” means a category of foster family care where
daily stipends are made, based on the intensity of care and services provided
by foster parents for a specific child residing in foster family care who
requires more than general care or specialized care.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; amd by #9514, eff 7-18-09; ss by #11181, INTERIM, eff
9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20
He-C 6347.04 Compliance
Requirements.
(a) The foster parent shall
comply with:
(1) All licensing requirements
per He-C 6446; and
(2) The requirements
of He-C 6347 as applicable to the type of foster family care credential the
foster parent has obtained or is seeking.
(b) Failure to comply with He-C
6347 shall result in:
(1) Denial of a credential
pursuant to He-C 6347.23;
(2) Termination of certified
credential pursuant
to He-C 6347.23; or
(3) Denial of reimbursement.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20
He-C 6347.05 Categories of Foster Family Care Requiring a Credential.
(a) A separate foster family credential shall be
required for the following categories of foster family care:
(1) General care;
(2) Respite care;
(3) Specialized care;
(4) Emergency care;
(5) Crisis care;
(6) Assessment care;
(7) Adolescent care; and
(8) Supplemental
care.
(b) Foster family care providers
may provide additional foster care services through a child-placing agency as
identified in He-C 6355, including individual service option, therapeutic, and
staffed foster care.
(c) All individuals licensed
pursuant to He-C 6446 shall have the credential to provide general foster
family care and respite care in order to be reimbursed for the established rate
in He-C 6423 for that care.
(d) Any individual licensed pursuant to He-C 6446
shall request certification for reimbursement at the established rate in He-C
6423 for emergency care provided that the individual has a credential and is in
compliance with He-C 6347.08.
(e) Any individual
licensed pursuant to He-C 6446 shall request certification for reimbursement at
the established rate in He-C 6423 for crisis care provided that the individual
has a credential and is in compliance with He-C 6347.09.
(f) Any individual licensed pursuant to He-C 6446
shall request certification for reimbursement at the established rate in He-C
6423 for assessment care provided that the individual has a credential and is
in compliance with He-C 6347.10.
(g) Any individual licensed pursuant to He-C 6446
shall request certification for reimbursement at the established rate in He-C
6423 for adolescent care provided that the individual has a credential and is
in compliance with He-C 6347.11.
(h) Any individual licensed
pursuant to He-C 6446 shall request certification for reimbursement at the
established rate in He-C 6423 for specialized care provided that the individual
has a credential and is in compliance with He-C 6347.07.
(i) Foster parents shall be
certified for supplemental care based on the actual costs for a specific child
in compliance with He-C 6347.12.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20
He-C 6347.06 Utilizing
Respite Care Credentials.
(a) A foster parent shall
provide respite care to children who are:
(1) Living with parents or other
relatives; or
(2) In out-of-home care
settings.
(b) Respite care shall be
provided in order to:
(1) Provide temporary overnight
relief to parents, relatives, or foster parents;
(2) Allow other foster parents
to attend an overnight training or conference;
(3) Allow other foster parents
to take a vacation, if the child is unable to accompany the family;
(4) Prevent placement disruption
of a child; or
(5) Provide a temporary foster
family care setting to a child who is placed in a residential treatment
program, in accordance with the child’s case plan.
(c) A foster parent providing respite care shall not be eligible for reimbursement for respite care unless prior
approval was granted or supported in the child’s case plan by a DCYF
administrator when:
(1) A child has already received
the maximum of 14 days of respite care service per state fiscal year; or
(2) Respite care has been provided for
more than 3 consecutive days.
(d) A foster parent providing
respite care shall involve the caregiver and the child, if age and
developmentally appropriate, in planning and making arrangements for the care
of the child during respite care, including:
(1) Visits and contacts;
(2) Medical information and
authorization;
(3) Work and emergency telephone
numbers; and
(4) Beginning and ending dates
and times of respite care.
(e) When a child is in an
out-of-home setting, both the out-of-home provider and the foster parent
providing respite care shall be eligible to receive reimbursement for the care
of the child for the days in which the child receives respite care, with the
exception of foster care programs under He-C 6355 which include respite care as
a part of the foster care service requirements.
Source. (See Revision Note at part heading for He-C 6347)
#9266, eff 9-20-08; rpld by #9514, eff 7-18-09
New. #12134, eff 3-18-17; ss by #13055, eff
6-16-20
He-C 6347.07 Requirements for Specialized Care Credential.
(a) In addition to being in
compliance with He-C 6446, a foster parent seeking a specialized care
credential shall:
(1) Have at least one year of
experience as a foster parent;
(2) Provide one written
reference from a professional, such as a currently licensed foster parent,
physician, therapist, or teacher who has personal knowledge of the foster
parent’s ability to observe and assess children’s behavior;
(3) Provide one written
reference from a CPSW or a JPPO who is familiar with the foster parent’s
experience with children in foster care;
(4) Attend 21 hours of
DCYF-approved training for specialized care, which includes topics relating to:
a. Introduction to specialized
care that includes the following topics:
1. Foster care as a family
support service;
2. The role of the foster parent in case assessment and planning;
3. How to clearly describe the
behaviors of children; and
4. The importance of
establishing case objectives and action steps to achieve those objectives;
b. Behavior management;
c. Handling sexualized
behaviors;
d. Caring for children with
developmental disabilities;
e. Caring for children with
emotional disabilities; and
f. Working with the primary
families to encourage the family members to remain active participants in the
life of the child; and
(5) Have sufficient experience
and education, as demonstrated through compliance with He-C 6446.16 through
He-C 6446.19 to care for a child with special needs.
(b) A foster parent providing
specialized care shall complete a minimum of 24 hours of in-service training
during the 2 year licensing period pursuant to He-C 6446.14(k), 12 hours of
which shall be related to the special needs of the child in care or as approved
by the DCYF to enable the foster parent to strengthen or develop competencies
to meet the needs of child(ren) in care.
(c) A foster parent providing
specialized care shall:
(1) Keep and maintain detailed
records on each child in care, including:
a. A detailed description of the
placement:
b. A description of the visits
between the family with the child in care and the CPSW or JPPO; and
c. A description of other
appointments kept by the child in care; and
(2) By the 15th of each month,
complete and submit to the CPSW or JPPO a monthly report including the
following about the child in care:
a. The name and birth date of
the child:
b. The date of placement of the
child in the foster home;
c. The name of the child’s CPSW
or JPPO;
d. Observations of the child’s
behavior and attitudes, any incidents requiring restraint or seclusion
reportable under RSA 126-U:7-a, and relationship with members of the foster
family;
e. Health care information;
f. Involvement with
psychotherapy or counseling;
g. School attendance and
performance;
h. Court action during the
month; and
i. Any other information related
to the health, safety, or educational progress of the child, including
indications of improvement and areas of concern.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20 (formerly He-C 6347.07)
He-C 6347.08 Requirements for Emergency Care Credential.
(a) In addition to being in
compliance with He-C 6446, a foster parent seeking an emergency care credential
shall attend in its entirety 6 hours of DCYF-approved training associated with
emergency care that includes information on how to assist children through
traumatic separation from their family while learning how to manage anger and
transition.
(b) A foster parent providing
emergency care shall complete and submit to the CPSW or JPPO a written report
within 15 days of the departure of the child in emergency care from the foster
home that includes but is not limited to the following:
(1) A detailed description of
the placement;
(2) A description of the visits
between the family with the child in care and the CPSW or JPPO;
(3) A description of other
appointments attended by the child in care;
(4) Observations of the behavior
and attitude of the child in care including any incidents requiring restraint or seclusion
reportable under RSA 126-U:7-a; and
(5) Other information about the
child that would be helpful to the case manager for the purposes of case
planning.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20
He-C 6347.09 Requirements for Crisis Care Credential. A foster parent providing emergency care
pursuant to He-C 6347.08 shall be invited to provide crisis care via a
recommendation from a DCYF staff member or a child-placing agency staff member
responsible for licensing foster care providers.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20
He-C 6347.10 Requirements for Assessment Care Credential.
(a) In addition to being in
compliance with He-C 6446, a foster parent seeking an assessment care credential
shall:
(1) Have at least one year of
experience as a foster parent;
(2) Provide one written
reference from a professional, such as a currently licensed foster parent,
physician, therapist, or teacher who has personal knowledge of the foster
parent’s ability to observe and assess children’s behavior;
(3) Provide one written
reference from a CPSW or a JPPO who is familiar with the foster parent’s
experience with providing foster care, to include a description of the foster
parent’s knowledge of the NH foster care system, other substitute care options,
and services and resources available in the foster parent’s community; and
(4) Complete 6 hours of DCYF
approved training related to assessment care, including information on:
a. Observing and assessing
children’s behavior;
b. Record keeping; and
c. The foster parent’s role in
case planning.
(b) A foster parent providing
assessment care shall complete a minimum of 24 hours of in-service training
during the 2-year licensing period, pursuant to He-C 6446.14(k), 16 hours of
which shall be related to the development of skill and competency to assess the
behavior of children in care or as approved by the licensing agency to enable
the foster parent to strengthen or develop competencies to meet the needs of
child(ren) in care.
(c) A foster parent providing
assessment care shall provide enhanced support for the evaluation of a child
placed in their home by:
(1) Providing transportation for
the child to appointments and visits to meet his or her case plan goals for
permanency and well-being; and
(2) Attending:
a. Scheduled monthly meetings
with DCYF staff and the child in the
home; and
b. Treatment team meetings,
school meetings, including Individualized Education Program (IEP) meetings,
family assessment and inclusive reunification review meetings, and court
reviews.
(d) A foster parent providing
assessment care shall keep and maintain detailed records on each child in care,
which includes documentation of the following:
(1) All work with the family of
the child in care to maintain communication and to gather data for court
reports and the case plan;
(2) All appointments and collateral contacts of the child in care;
(3) Daily observation of the behavior patterns and episodes of the
child in care, including any incidents requiring restraint or seclusion
reportable under RSA 126-U:7-a;
(4) At least one foster parent providing full-time, 24 hours per day of
supervision of the child; and
(5) The foster parent’s
attendance of the licensing agency’s case planning meetings concerning the
child.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20
He-C 6347.11 Requirements for Adolescent Care Credential.
(a) In addition to being in
compliance with He-C 6446, a foster parent seeking an adolescent care
credential shall:
(1) Have at least one year of
experience as a foster parent;
(2) Provide one written reference from
a professional, such as a currently licensed foster parent, physician,
therapist, or teacher who has personal knowledge of the foster parent’s ability
to observe and assess adolescent behavior;
(3) Provide one written
reference from a CPSW or a JPPO who is familiar with the foster parent’s experience and knowledge of working
with adolescent children in foster care; and
(4) Complete 22 hours of DCYF-approved
pre-service training related to adolescent care, including information on:
a. Introduction to being an
adolescent foster home;
b. Caring for adolescents;
c . Understanding adolescent development and attachment; and
d. The foster parent’s role in
future planning and preparing youth for adulthood.
(b) A foster parent providing
adolescent care shall complete a minimum of 24 hours of in-service training
during the 2year licensing period, 12 hours of which shall focus on enabling
the foster parent to strengthen or develop competencies to meet the needs of
the youth in their care.
(c) A foster parent providing
adolescent care shall provide enhanced support for a youth placed in his or her
home by:
(1) Providing modeling and
instruction to the youth on adult living preparation including:
a. The development of life
skills;
b. The process to identify and
access resources;
c. Assisting the youth in
gaining employment and volunteer opportunities;
d. Assisting the youth in
applying to college or a career training program and with other aftercare
planning as needed;
e. Supporting the youth
participating in extracurricular activities and opportunities for the DCYF’s
adolescent program sponsored activities; and
f. Assisting the youth with
transition and post care planning at least 6 months before the youth will leave
foster care;
(2) Implementing the adult
living preparation process in consultation with the CPSW or JPPO and the youth
by:
a. Completing the DHHS
curriculum for preparing youth for adulthood with the youth; and
b. Developing an adult living
preparation plan with the youth by completing and submitting the “Adult Living
Preparation Plan” Form 1695 (January 2015 edition), signed by both the provider
and the youth;
(3) Ensuring that the youth has
opportunities and supports to meet his or her case plan goals for permanency,
including but not limited to:
a. The opportunity to make
positive connections with family, friends, and community members including a
commitment to a long-term relationship and connection to the youth beyond the
DCYF closure of the youth’s case or when the youth attains the age of 18 years
or 21 years if jurisdiction is extended pursuant to RSA 170-E:53; and
b. Collaborating with the CPSW
or JPPO and the court in identifying a primary caring adult for the youth, if
the court-ordered permanency goal is another planned permanency living
arrangement, in compliance with the New Hampshire circuit court’s “Protocols
Relative to RSA 169-C Post- Permanency Hearings for Older Youth with a
Permanency Plan of Another Planned Permanent Living Arrangement (APPLA)”
available at
https://www.courts.state.nh.us/fdpp/Protocols-Relative-to-RSA-169-C.pdf;
(4) Supporting the foster
children’s bill of rights as set forth in RSA 170-G:21 by signing and
submitting to DCYF Form 1960 “Bill of Rights for New Hampshire Youth in Care”
(August 2015 edition);
(5) Providing care and
supervision for no more than 2 youths who require adolescent foster care
services at any one time; and
(6) Participating in planning
for the youth in care by attending:
a. Scheduled monthly meetings
with DCYF staff and the youth in the home;
b. Treatment team meetings,
school meetings, including individualized education program meetings, family assessment and inclusive
reunification review meetings, and court reviews; and
c. The youth’s 90 day transition
meeting as requested by the youth.
(d) DCYF with the assistance of the youth and the
foster parent providing adolescent care shall complete the documentation for
the adult living preparation plan as follows:
(1) The “Needs Assessment for
Adult Living,” Form 1690 (January 2015) within 30 days of placement. The
completed, dated, and signed form shall be dated and signed by the youth and
the youth’s CPSW or JPPO;
(2) A life skills assessment
provided by DCYF within 30 days of placement;
(3) A career assessment provided
by DCYF, within 60 days of placement;
(4) The “Adult Living
Preparation Plan,” Form 1695 (January 2015), submitted within 60 days of
placement and updated annually thereafter, which shall incorporate the results
of the career assessment in (3) above and any follow-up tasks to be completed
by the youth or member of the treatment team. The completed form shall be
signed and dated by the youth and the foster parent; and
(5) The “Post Care Plan” Form
1984 (June 2020), 30 days prior to the youth’s 18th birthday, or within 30 days
of the youth’s planned discharge if the youth will not discharge upon the
youth’s 18th birthday. The completed
form shall be signed and dated by the youth, the youth’s CPSW or JPPO, and any
other individual who has reviewed the form such as the parent and placement
provider.
(e) If acting as the current placement provider,
a foster parent providing adolescent care shall complete necessary
documentation as follows:
(1) Track daily living skill
acquisition, and school and employment attendance;
(2) By the 10th of each month,
complete and submit to the CPSW or JPPO a written monthly report on the
progress of the youth towards the goals established in the “Adult Living
Preparation Plan,” Form 1695 (January 2015); and
(3) For each calendar month,
complete a Form 1969 “Monthly National Youth in Transition Database (NYTD)
Checklist” (June 2020) and submit to the CPSW or JPPO, documenting support
provided for the NYTD categories as follows:
a. Academic support;
b. Budget and financial
management;
c. Career preparation;
d. Employment programs and
vocational training;
e. Family support and healthy marriage education;
f. Health education and risk
prevention;
g. Housing education and home
management;
h. Mentoring; and
i. Post-secondary educational
support.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20 (formerly He-C 6347.07)
He-C 6347.12 Requirements for Supplemental Foster Care Credential.
(a) A foster parent who is in
compliance with He-C 6446 shall be provided the supplemental care credential
for a child already in his or her care, when it is demonstrated that the
child’s behaviors, conditions, and needs require a level of care that exceeds
general care or specialized care.
(b) The areas shall be related
to the child’s assessed behaviors, conditions, and needs, and to the resources
that the foster parent shall be required to bring to the care of the child in
placement, in accordance with his or her case plan.
(c) In order to qualify for
supplemental care reimbursement, the assessed child behaviors, conditions, and
needs shall include a gap in at least one of the following criteria:
(1) Behavior towards self,
others, and animals, and role performance which includes but is not limited to
an assessment of:
a. The child’s overt, daily
actions toward self and others;
b. The child’s age and
developmental stage; and
c. The type and degree of trauma
experienced by the child;
(2) Medical, psychological, and
developmental complicating condition which includes an assessment of the
child’s physical, emotional, and psychological well-being;
(3) Caregiver resources,
including an assessment of the knowledge, skills, and abilities of the foster
parent to meet the needs of the child;
(4) The extent of required
visitation between the child, parent, or others to achieve reunification or
another permanency goal; or
(5) Accessible community resources.
(d) The daily stipend to a
foster parent certified for reimbursement for supplemental care shall be
directly related to the estimated out-of-pocket costs to the foster parent in
order to meet the needs of the child or expectations of the case.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20 (formerly He-C 6347.08)
He-C 6347.13
Certification Process For
Foster Family Care Credentials.
(a) All foster parents shall be licensed pursuant
to He-C 6446 prior to seeking certification for reimbursement to provide a
category of foster family care.
(b) Foster parents shall contact a DCYF resource
worker or designee and request to be certified after completing the
prerequisite training requirements.
(c) If a foster parent’s license is managed by a
child-placing agency other than DCYF, the agency shall contact the foster care
manager with the request to be certified on behalf of the foster parent who has completed the prerequisite training requirements.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20 (formerly He-C 6347.09)
He-C 6347.14 Length of
Certification. Certification for reimbursement to provide a
category of care shall
expire at the same time as the existing foster care license expiration, unless the
license and credential are renewed pursuant to He-C 6446.15 and He-C 6347.15
respectively.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20 (formerly He-C 6347.10)
He-C 6347.15 Renewal of Certification.
(a) Pursuant to RSA
170-E:32, a foster parent shall file for renewal of the foster care license 3
months prior to the expiration date of the foster family care license.
(b) The foster
parent shall renew his or her foster family care license pursuant to He-C
6446.15 and verify ongoing training requirements for continued certification
for reimbursement to provide a category of foster family care.
(c) Based on
qualifications and performance that conforms to He-C 6347 and He-C 6446, the foster parent’s license and foster family care credential shall be
renewed.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20 (formerly He-C 6347.11)
He-C 6347.16 Notification of Changes. For the period of certification, the foster
parent shall notify DCYF in writing of any changes, pursuant to He-C 6446.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20 (formerly He-C 6347.12)
He-C 6347.17 Billing Requirements for Foster Care Services.
(a) Foster parents shall be
certified with the foster family care credential prior to billing for the
provision of a credentialed service.
(b) The foster parent shall not
bill DCYF for services that are to be reimbursed by any other entity.
(c) The foster parent shall
accept payments made by DCYF as payments in full for the services it provides.
(d) DCYF shall determine the
necessity of care and services and the determination shall be binding on the
foster parent.
(e) The foster parent shall
notify DCYF of any changes in tax information and complete and submit to DCYF a
signed “State of New Hampshire Alternate W-9” Form (October 2016) with current
tax information. When completing this form the foster parent shall be
considered a service provider or other provider when choosing his or her
principle activity.
(f) The foster parent shall
provide services or care without discrimination as required by Title VI of the
Civil Rights Act of 1964, as amended, and without discrimination on the basis
of handicap as required by Section 504 of the Rehabilitation Act of 1973, as
amended.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20 (formerly He-C 6347.13)
He-C 6347.18 Billing Process for Foster Care Services.
(a) DHHS shall issue
reimbursements to foster parents for general care, specialized care, assessment
care, or adolescent care services provided to a child at the rate established
in He-C 6423.
(b) DCYF shall issue board and
care invoices to foster parents to submit to DHHS for reimbursement of
emergency care and crisis care services provided to a child.
(c) Prior to service delivery
for respite care or supplemental care, a foster parent shall obtain a “Service
Authorization” Form 2110 (June 2008 edition) from the CPSW or JPPO.
(d) Respite care and supplemental care services shall not be paid
unless DHHS receives a signed and dated “Service Authorization” Form 2110 (June
2008 edition) from the foster parent.
(e) When requesting a stipend
for respite care or supplemental care services, a foster parent shall:
(1) Copy the “Service Authorization” Form 2110 (June 2008 edition) for
future billing, if the authorized service dates span a date range; and
(2) Forward the completed and
signed “Service Authorization” Form 2110 (June 2008 edition) to DHHS.
(f) The handwritten signature in
(e)(2) above shall be submitted to DHHS and shall certify that the foster
parent agrees:
(1) The billing was completed in
accordance with this section;
(2) The invoice includes only
the days and overnights for which services were provided;
(3) The billing is true and
accurate; and
(4) Any payment made for inaccurate
or fraudulent billing will be recovered by DHHS.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20 (formerly He-C 6347.14)
He-C 6347.19 Billing Period.
(a) A foster parent shall bill within one year of
service provision.
(b) Any bill received for payment one year after
service date shall be denied pursuant to RSA 126-A:3.
(c) A foster parent shall submit bills at least
on a monthly basis.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20 (formerly He-C 6347.15)
He-C 6347.20 Billing Discrepancies. Foster parents who have a billing discrepancy
shall contact the provider relations’ staff of DHHS’s office of finance for
assistance by:
(a) Email at provider.relations@dhhs.state.nh.us;
(b) Telephone at (800) 852-3345, ext. 4954 or (603) 271-4954; or
(c) Mail:
DCYF-Provider Relations
The Department of Health and Human Services
129 Pleasant Street
Concord, NH 03301.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff
9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20
(formerly He-C 6347.16)
He-C 6347.21 Quality Assurance Activities.
(a) The foster parent shall
submit to a biennial review to determine the quality of services pursuant to
RSA 170-G:4 XVIII which includes, but is not limited to:
(1) The foster parents continued
compliance with He-C 6446 and He-C 6347;
(2) Services provided to the
child;
(3) The outcomes achieved for
the child in care;
(4) Progress towards the child’s
permanency goals;
(5) An interview with foster
parents; and
(6) An interview with the child
in care, if age appropriate.
(b) The biennial review
described in (a) above shall coincide with the renewal date of the foster
parent’s foster family care license.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20
(formerly He-C 6347.17)
He-C 6347.22 Waivers.
(a) Foster parents who request a
waiver of the requirement in He-C 6347 shall submit a written request to the
commissioner of the department of health and human services or his or her
designee, which includes the following:
(1) The reason for requesting
the waiver of
the requirement in a specific credential;
(2) The anticipated length of
time the requested waiver will be needed;
(3) Assurance that if the waiver
is granted the quality of service and care to children, youth, and families
will not be affected;
(4) A written plan to achieve
compliance with the rule or explaining how the foster parent will satisfy the
intent of the rule if the waiver is granted;
(5) The number and ages of
children who will be affected by the requested waiver; and
(6) The signature of the person
requesting the waiver.
(b) A CPSW or JPPO shall request
a waiver on behalf of a foster family if a specific credential is needed to
adequately provide for the needs and circumstances of a specific child or
sibling group.
(c) Request for a waiver of any
of the provisions of RSA 170-E, or any other rules referred to in this part or
of any other state agencies, shall not be permitted.
(d) Request for a waiver shall
be denied when:
(1) The request does not comply
with (a) above;
(2) The department finds that
approval of the requested waiver will jeopardize the health or safety of the
child(ren) in care;
(3) The department finds that approval
of the requested waiver will impair the foster parent’s ability to adequately
care for the child(ren) in care; or
(4) The department finds that
the written plan described in (a)(4) above does not satisfy the intent of the
rule as an alternative to complying with the rule.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17 (formerly He-C 6347.23) ; ss by #13055, eff 6-16-20
(formerly He-C 6347.18)
He-C 6347.23 Denial or Termination of Credential
Certification. A request for certification
for reimbursement for a category of care for which the foster parent has an
initial or renewed credential shall be denied, or certification terminated, if:
(a) The foster parent is no
longer licensed pursuant to He-C 6446;
(b) The foster parent or the
individual acting on the foster parent’s behalf, submits materially false
information to DCYF; or
(c) There has been a failure by
the foster parent to comply with He-C 6446 or He-C 6347.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20) (formerly He-C 2347.19)
He-C 6347.24 Notification of
Denial or Termination.
(a) If DCYF denies an
application request for certification or terminates an existing foster family
care credential, DCYF shall send notice of the denial or termination to the
foster parent by certified mail.
(b) The notice shall:
(1) Inform the foster parent of
the facts or conduct upon which DCYF bases its action;
(2) Advise the foster parent of
their right to request reconsideration of DCYF’s decision through informal
dispute resolution pursuant to He-C 6347.25; and
(3) In the case of an existing
certification, inform the foster parent that the termination shall not take
effect until the foster parent has had an opportunity through an appeal,
pursuant to RSA 170-G:4-a and He-C 6347.26, to show compliance with all lawful
requirements for retention of the credential.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by
#11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17; ss
by #13055, eff 6-16-20 (formerly He-C 6347.20)
He-C 6347.25 Request for Informal Dispute Resolution.
(a) DCYF shall offer an
opportunity for informal dispute resolution to any foster parent who disagrees
with a denial or termination of a credential, provided that the foster parent
submits a written request for an informal dispute resolution:
(1) The informal dispute
resolution shall be requested in writing by the foster parent no later than 14 days from the date the notice
was issued by DCYF;
(2) DCYF shall review the
evidence presented and provide a written notice to the foster parent of its decision; and
(3) An informal dispute resolution
shall not be available for any foster parent against whom DCYF has initiated
action to revoke a license or deny a renewal license.
(b) The foster parent may appeal
DCYF’s decision pursuant to He-C 6347.26.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20 (formerly He-C 6347.21)
He-C 6347.26 Appeals.
(a) Administrative appeals of
DHHS decisions to terminate or deny a foster family care credential shall be
conducted in accordance with RSA 170-E:37, RSA 541-A, He-C 200, and this
section.
(b) Appeal requests shall be
filed within 10 days of the date of the notice of action.
(c) Parties to any
administrative hearing who are aggrieved by the decision of the departmental
hearings officer may request a reconsideration in accordance with He-C 206, or
may file an appeal of the decision with the superior court, in accordance with
the provisions of RSA 170-E:37.
(d) Parties who are aggrieved by
the decision of the hearings officer to deny the request for a reconsideration,
or with the hearings officer’s decision after a rehearing has been conducted,
may appeal the decision to the superior court, in accordance with the
provisions of RSA 170-E:37.
Source. (See Revision Note at part heading for He-C
6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17;
ss by #12134, eff 3-18-17 (formerly He-C 6347.23); ss by #13055, eff 6-16-20
(formerly He-C 6347.22)
PART
He-C 6348 CERTIFICATION PAYMENT
STANDARDS FOR HEALTH CARE AND LABORATORY SERVICE PROVIDERS
Statutory Authority:
RSA 170-G:4 XVIII, RSA 170-G:5
REVISION NOTE:
Document #9267, effective 9-20-08,
adopted Part He-C 6348 relative to certification for payment standards for
medical/dental service providers. This
part incorporated provisions from the former Part He-C 6352 entitled
“Certification for Payment Standards for Community-Based Service Providers” and
made extensive changes to the wording, format, structure, and numbering of
those provisions.
Document
#9267 supersedes all prior filings in the former Part He-C 6352 relative to
certification for payment standards for medical/dental service providers. The filings affecting the former Part He-C
6352 include the following documents:
#4446,
eff 7-1-88
#5096,
eff 3-15-91, EXPIRED 3-15-97
#7292,
eff 5-24-00
#8009,
eff 1-1-04
#9112,
INTERIM, eff 3-24-08, EXPIRED 9-20-08
He-C 6348.01 Purpose. The
purpose is to identify the qualifications and compliance requirements to become
a provider of health care or laboratory services for the division for children,
youth and families (DCYF).
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17
He-C 6348.02 Scope.
This part shall apply to health
care or laboratory service providers who receive financial reimbursement from
DCYF for services provided to children and parents involved with DCYF pursuant
to a court order.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17
He-C 6348.03 Definitions.
(a) “Agency” means the board of directors,
executive director, and employees of an organization that is incorporated and
recognized by the NH secretary of state.
(b) “Applicant” means the
person or entity that is requesting certification for payment as a health care
or laboratory service provider.
(c) “Certification for payment” means the process
by which DCYF approves the qualifications of and reimbursement to providers of
health care or laboratory services.
(d) “Child” means “child” as defined in RSA
170-E:25, 1 or “child” as defined in RSA 169-C:3 or “child” as defined by RSA
169-D:2.
(e) “Commissioner” means the commissioner of the
New Hampshire department of health and human services or designee.
(f) “Court order” means a written decree that is
issued by a district, family, superior, probate, or Supreme Court.
(g) “Department (DHHS)” means the department of
health and human services of the state of New Hampshire.
(h) “Division for children,
youth, and families (DCYF)” means the organizational unit of the department of
health and human services that provides services to children and youth referred
by courts pursuant to RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C,
and RSA 463.
(i) “Health care” means preventive or corrective
medical, dental, and psychiatric diagnostic and treatment services provided to
Medicaid ineligible children.
(j) “Laboratory” means the testing facility
authorized by the State of New Hampshire to screen human specimens for presence
of a drug, or drug group, or its metabolites, or other court-ordered laboratory
testing that does not qualify for payment by Medicaid.
(k) “NH bridges” means the automated case
management, information, tracking, and reimbursement system used by DCYF.
(l) “Parent” means an individual who has a birth,
adoptive, or step-parent relationship to a child.
(m) “Provider” means the individual or agency
that provides healthcare or laboratory services to a child or parent and receives financial
reimbursement from DHHS.
(n) “Service authorization” means the
documentation provided by DCYF indicating DHHS’s responsibility for payment of
healthcare and laboratory services provided that do not qualify for payment by
Medicaid.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17
He-C 6348.04 Requirements for Provider of Health Care
and Laboratory Services Enrollment.
(a) DCYF shall authorize payment for preventative
or corrective health care services for children ineligible for Medicaid,
pursuant to a court order.
(b) DCYF shall authorize payment for Medicaid
ineligible laboratory services pursuant to a court order.
(c) Prior to applying for
certification, a provider shall be licensed or registered as required by the
state licensing entity, and shall
maintain compliance with all applicable New Hampshire rules and laws including:
(1) For dentists
and dentistry, comply with RSA 317;
(2) For
physicians, including psychiatrists and surgeons, comply with RSA 329;
(3) For
hospitals and clinics, comply with RSA 151;
(4) For
optometrists, comply with RSA 327;
(5) For
chiropractors, comply with RSA 316-A;
(6) For
pharmacists and pharmacies, comply with RSA 318;
(7) For
podiatrists, comply with RSA 315;
(8) For
radiologists, comply with RSA 329;
(9) For
emergency medical services, comply with RSA 151;
(10) For
laboratory testing services providers, comply with RSA 151:2; and
(11) For any
other health care providers, comply with their respective New Hampshire law or
rule.
(d) Prior to applying for certification, any out
of state provider shall be licensed or registered as required by the state
licensing entity, and shall maintain compliance with all laws and rules to be
authorized to practice in his or her state.
(e) All providers shall comply with:
(1) The
confidentiality statutes of RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA
170-B:23, RSA 170-C:14, and RSA 170-G:8-a;
(2) The child
abuse and neglect reporting requirements of RSA 169-C:29-30; and
(3) All
applicable provisions of the health insurance portability and accountability
act (HIPAA).
(f) A provider of health
care services shall meet medical assistance requirements of He-W 500 and He-M
426.
(g) The provider and his or her employees and
subcontractors shall not have a conflict of interest, as defined in RSA
21-G:21, II.
(h) The provider shall maintain general and
professional liability insurance.
(i) Laboratory services shall be provided by a
laboratory service which holds a current New Hampshire license pursuant to RSA
151:2. The laboratory service shall
subcontract only to a laboratory service provider which has a valid New
Hampshire license or is licensed in the state in which it operates.
(j) Failure to comply with the rules of this
chapter shall result in:
(1) Denial of
an applicant pursuant to He-C 6348.13;
(2) Revocation
of certification for payment pursuant to He-C 6348.13; or
(3) Denial of
reimbursement.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17
He-C 6348.05 Application
for Payment Process for Providers of Health
Care and Laboratory Services.
(a) Providers of health care services providing a
service to a Medicaid ineligible child pursuant to a court order shall apply
for certification for payment from DCYF.
(b) Providers of laboratory services providing a Medicaid
ineligible service to a child or parent pursuant to a court order shall apply
for certification for payment from DCYF.
(c) DCYF shall forward an application packet to the
providers which includes:
(1) A Form 2619 “Application for Certification of
Health Care and Laboratory Service Providers”(September 2016 );
(2) An
“Alternate W-9 FORM –CIS (10/97)”; and
(3) A copy of
He-C 6348.
(d) Applicants shall return a signed and dated
Form 2619 “Application for Certification of Health Care and Laboratory Service
Providers" (September 2016) to DCYF.
(e) The applicant shall provide a copy of the
verification of his or her state regulatory license or authorization to
practice.
(f) The applicant’s signature on the application
shall constitute an acceptance of the terms below:
(1) The
provider has read and understood He-C 6348; and
(2) The
information contained in the application is true and correct to the best of the
applicant's knowledge; and
(3) That all
employees providing services to the child or parent are licensed and authorized
to practice by the appropriate licensing entity in the provider’s state.
(g) The applicant shall complete and return the
application within 30 calendar days to the DCYF provider relations together
with the alternate W-9 and the appropriate verification.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17
He-C 6348.06 Renewal of Certification and Notification
of Changes for Enrolled Providers of Health Care and Laboratory Services.
(a) Health care and laboratory providers shall
submit to DCYF a current copy of the verification of licensure by the
appropriate state licensing board(s) at
the time of license renewal.
(b) Providers shall submit a copy of any renewed
license verification to DCYF within 10 calendar days of its receipt.
(c) Review of continued certification shall
coincide with the date of expiration of the health care or laboratory
provider’s license.
(d) For the period of certification, the provider
shall notify DCYF in writing within 10 calendar days of any change in the
information contained in the application and provide documentation of the
change.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17
He-C 6348.07 Billing Requirements for Providers of
Health Care and Laboratory Services.
(a) Providers shall be certified as a provider of
health care or laboratory services and enrolled on NH bridges.
(b) Provider shall not bill DCYF for services
that are to be reimbursed by any other entity.
(c) Providers shall accept payments made by DCYF
as payments in full for the services it provides.
(d) Providers shall notify DCYF of any changes in
tax information and complete and submit to DCYF a signed Alternate W-9 Form
–CIS (10/97) with current tax information.
(e) Providers shall provide services or care
without discrimination as required by Title VI of the Civil Rights Act of 1964,
as amended, and without discrimination on the basis of handicap as required by
Section 504 of the Rehabilitation Act of 1973, as amended.
(f) The provider’s certification and enrollment
shall terminate upon date of sale or transfer of ownership or close of the
agency.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17
He-C 6348.08 Billing Process for Providers of Health
Care and Laboratory Services.
(a) A provider shall receive a service
authorization form for each time a service is provided.
(b) A provider shall bill the department through
NH Bridges for health care services to Medicaid ineligible children and
Medicaid ineligible laboratory services via paper claims.
(c) For paper claim submissions, a provider
shall:
(1) Copy the
service authorization for future billings, if the authorized service dates span
a date range; and
(2) Forward the
completed and signed service authorization to DCYF with an invoice attached.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17
He-C 6348.09 Billing Period.
(a) Providers shall bill within one year of
service provision.
(b) Any bill received for payment one year or
more after service date shall be denied pursuant to RSA 126-A:3.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17 (from He-C 6348.15)
He-C 6348.10 Billing Discrepancies. Questions regarding billing discrepancies
shall be directed to the provider relations’ staff of the bureau of
administrative operations.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17 (from He-C 6348.16)
He-C 6348.11 Record Retention.
(a) A provider shall retain records supporting
each bill submitted to DCYF for a period of no less than 7 years after the
completion date of services provided.
(b) Records shall clearly document the extent of
care and services provided to the children and families, and any information
regarding any payment claimed.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17 (from He-C 6348.17)
He-C 6348.12 Monitoring
of Enrolled Providers for Health Care
and Laboratory Services.
(a) The provider shall allow random or scheduled
on-site visits by DCYF, for the purposes of reviewing program documents to
determine continued compliance with He-C 6348 regarding the specific child for
which the provider is enrolled.
(b) Need for the service shall be reviewed by
DCYF, pursuant to RSA 170-G:4 VI and RSA 170-G:4 XVIII.
(c) DCYF shall review communications provided by
licensing bodies, regulatory boards, and professional associations for
disciplinary actions, or findings of civil liability, professional misconduct,
or ethical violation by an enrolled provider.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17
He-C 6348.13 Denial of Application or Revocation of
Certification. An application for
certification shall be denied or provider certification revoked if:
(a) DCYF determines that the state does not have
a need for the service;
(b) The provider, if enrolled with NH Medicaid,
loses Medicaid enrollment;
(c) The applicant or provider, or the individual
acting on the applicant’s or provider’s behalf, submits materially false
information to DCYF;
(d) There has been a conviction for a felony or
any crime against a child that has not been annulled or overturned;
(e) There has been disciplinary action taken by a
licensing body or professional society, a finding of civil liability made for
professional misconduct, or a finding of an ethical violation made by a state
or national professional association or any other state’s regulatory board;
(f) There has been revocation of membership on
any hospital, medical, or allied health provider staff;
(g) There has been revocation of provider status
with any professional health care or laboratory group or health maintenance
organization;
(h) There has been revocation of clinical
privileges;
(i) There has been termination of academic
appointment by an institution;
(j) There has been
cancellation of professional or general liability insurance by the insurance
company;
(k) There has been abusive or neglectful
treatment of a child as determined by any state statute; or
(l) There has been failure to comply with He-C
6348.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17 (from He-C 6348.21)
He-C 6348.14 Notification of Denial or Revocation.
(a) If DCYF denies an application for
certification or revokes an existing certification, DCYF shall send notice of
the denial or revocation to the applicant or provider by certified mail.
(b) The notice shall:
(1) Inform the
applicant or provider of the facts or conduct upon which DCYF bases its action;
and
(2) In the case
of an existing certification, inform the provider that the revocation shall not
take effect until the provider has had an opportunity through an appeal,
pursuant to RSA 170-G:4-a and He-C 200, to show compliance with all lawful
requirements for retention of the certification.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17 (from He-C 6348.22)
He-C 6348.15 Appeals.
(a) Applicants or providers who wish to appeal a
decision to deny an application or revoke certification shall file an appeal
with the commissioner, pursuant to RSA 170-G:4-a.; and
(b) In accordance with RSA 170-G:4-a the appeal
shall:
(1) Be made in
writing;
(2) Be signed
and dated;
(3) State the
reasons for the appeal pursuant to RSA 170-G:4-a; and
(4) Be filed
within 14 working days of the date of receipt of written notification.
Source. (See Revision Note at part heading for He-C
6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17 (from He-C 6348.24)
PART He-C 6349 CERTIFICATION PAYMENT STANDARDS FOR LICENSED
AND LICENSE EXEMPT CHILD CARE SERVICE PROVIDERS
Statutory Authority:
RSA 170-G:4 XVIII, RSA 170-G:5
REVISION NOTE:
Document
#9268, effective 9-20-08, adopted Part He-C 6349 relative to certification for
payment standards for child care services providers. This part incorporated provisions from the
former Part He-C 6352 entitled “Certification for Payment Standards for
Community-Based Service Providers” and made extensive changes to the wording,
format, structure, and numbering of those provisions.
Document
#9268 supersedes all prior filings in the former Part He-C 6352 relative to
certification for payment standards for child care services providers. The filings affecting the former Part He-C
6352 include the following documents:
#4446,
eff 7-1-88
#5096,
eff 3-15-91, EXPIRED 3-15-97
#7292,
eff 5-24-00
#8009,
eff 1-1-04
#9112,
INTERIM, eff 3-24-08, EXPIRED 9-20-08
He-C 6349.01 Purpose. The purpose of this part is to identify the
qualifications and performance requirements to become a provider of licensed
and licensed exempt child care services for the division for children, youth
and families (DCYF) and the division for juvenile justice services (DJJS) and
describe licensed and licensed exempt child care services.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.02 Scope.
This part shall apply to licensed
and licensed exempt child care service providers who receive financial
reimbursement from the department of health and human services (DHHS) for
services provided to children and families.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.03 Definitions.
(a)
“Agency” means the board of directors, executive director, and employees
of an organization that is incorporated and recognized by the NH secretary of
state.
(b)
“Applicant” means the person or entity that is requesting certification
for payment as a child care service provider.
(c)
“Case plan” means the division for children, youth and families or the
division or juvenile justice services written document, pursuant to RSA
170-G:4, III, that describes the service plan for the child and family, and
addresses outcomes, tasks, responsible parties, and timeframes for correcting
problems that led to abuse, neglect, delinquency, or child in need of services
(CHINS).
(d)
“Certification for payment” means the process by which DCYF approves the
qualifications of and payment to
providers of child care services.
(e)
“Child or minor” means an individual from birth through age 20, except
as otherwise stated in a specific provision.
(f)
“Child care services” means the care and supervision of a child away
from the child’s home and apart from the child’s parents.
(g)
“Child protective service worker (CPSW)” means an employee of the
division for children, youth and families who has expertise in managing cases
to ensure families and children achieve safety, permanency and well-being.
(h)
“Commissioner” means the commissioner of the department of health and
human services or his or her designee.
(i)
“Conflict of interest” means a situation, circumstance, or financial
interest, which has the potential to cause a private interest to interfere with
the proper exercise of a public duty.
(j)
“Corporal punishment” means the deliberate infliction of pain intended
to correct behavior or to punish.
(k) “Court-ordered” means a written decree that
is issued by a district, family, superior, probate, or Supreme Court.
(l)
“Department (DHHS)” means the department of health and human services.
(m)
“Director” means the director of the division for children, youth, and
families or his or her designee.
(n)
“Division for children, youth, and families (DCYF)” means the
organizational unit of the department of health and human services that
provides services to children and youth referred by courts pursuant to RSA
169-C, RSA 170-B, RSA 170-C and RSA 463.
(o)
“Division for juvenile justice services (DJJS)” means the organizational
unit of the department of health and human services that provides supervision
and services to children and youth referred by courts or the juvenile parole
board pursuant to RSA 169-B, RSA 169-D and RSA 170-H.
(p)
“Founded” means a report of abuse or neglect where the department has
determined that there is a preponderance
of the evidence to believe that a child has been abused or neglected.
(r)
“Licensed,” means an authorization granted by the commissioner to
provide one or more types of child care services.
(s)
“Licensed exempt” means a child care provider who is not required to be
licensed in accordance with RSA 170-E.
(t)
“NH bridges” means the automated case management, information, tracking,
and reimbursement system used by DCYF.
(u)
“Provider” means the individual or agency that serves a child or family
and receives financial reimbursement from DHHS.
(v)
“Quality assurance” means the process that DCYF uses to monitor the
quality and effectiveness of child care services.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.04 Licensed And Licensed Exempt Child Care
Compliance Requirements.
(a) The provider shall comply with:
(1) All applicable licensing and registration
requirements prior to applying for certification;
(2) The statutes regarding confidentiality,
including RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:19, RSA 170-C:14,
and RSA 170-G:8-a;
(3) The child abuse and neglect reporting
requirements of RSA 169-C 29-30; and
(4) Billing requirements and process described in
He-C 6349.11 and He-C 6349.12.
(b)
The provider, their employees and any volunteers prior to beginning
their work with children and thereafter
on an annual basis shall review sections of RSA 169 on definitions, immunity
from liability and persons required to report.
(c)
The provider and their employees shall not have a conflict of interest
as defined in He-C 6349.03(i).
(d)
The provider shall maintain professional and general liability
insurance.
(e)
A licensed provider shall:
(1) Comply with He-C 4000, NH child care agency
licensing rules; and
(2) Submit a copy of the child care license to
DCYF at the time of application for certification and review of continued
certification compliance for payment.
(f)
Child care services shall be provided for children who are ages birth
through 12, unless in the case plan
it is determined that a child up to age 17 needs child care, including:
(1) Children in foster care who:
a. Need socialization;
b. Need care during non-school hours; or
c. Require full time court-ordered child care in
a licensed care setting while their foster parents are working;
(2) Children who remain in the parents’ home and
the family is involved in a founded report of abuse or neglect, pursuant to RSA
169-C:3 XIII-a;
(3) Children who remain in the parents’ home and
child care is provided to prevent child abuse or neglect to rehabilitate the
family, or to reunite the family; and
(4) Children who are diagnosed by a physician,
psychiatrist or psychologist as being physically, mentally or emotionally
handicapped and who do not meet the requirements for an educationally disabled child, pursuant to RSA 186-C:2.
(g) A licensed foster parent shall not provide or
be reimbursed for child care services for foster children or other children who reside on a full-time basis in
his or her foster home unless they meet the provisions of He-C 6446.
(h)
Each provider for child
care services shall:
(1) Provide a safe and healthy environment and be
able to recognize and prevent hazards to the child’s health and safety;
(2) Provide regular activities including
nutritious meals, snacks, rest, toileting, and indoor and outdoor play
appropriate to the age level of the child in care;
(3) Support the child’s behavior with positive
guidance and limits;
(4) At no time use corporal punishment;
(5) Not associate punishment with food, rest or
toilet training;
(6) Ensure that sound health practices are
followed;
(7) Maintain a valid driver’s license and have no
alcohol or other drug related driving convictions for each provider who
transports children to child care activities;
(8) Maintain a file at the child care site on
each child that includes the following information:
a. Parent’s or guardian’s name, address, and
telephone number;
b. Child’s name, age, atypical behaviors,
routines, medical history, and special medical considerations;
c. Emergency information for reaching a parent
or substitute caregiver;
d. The names of persons authorized to take the
child from the child care environment; and
e. DCYF service authorization forms and
corresponding billing records.
(9) Maintain attendance records which reflect the
dates and hours attended by each child;
(10) Support the child’s relationship with parents
or caregivers by regularly sharing information about the needs and progress of
the child in care;
(11) Support the case plan by sharing information
on the child’s progress with DCYF; and
(12) Submit to a child abuse and neglect state
registry and state criminal records check pursuant to RSA 170-E:3-a and
170-E:7.
(i)
Failure to comply with the rules of this chapter shall result in:
(1) Denial of an applicant pursuant to He-C
6349.18;
(2) Revocation of certification for payment of a
provider pursuant to He-C 6349.18; or
(3) Denial of reimbursement.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.05 Requirements for Licensed Child Care Services.
(a)
A provider for child care services shall be:
(1) A family child care home or family group care
home licensed pursuant to RSA 170-E:2 IV (a) and RSA 170-E:3 IV (b);
(2) A group child care agency or center-based
care licensed pursuant to RSA 170-E:2 IV(c) and RSA 170-E:3 IV(d); or
(3) An individual located in another state who
meets the licensing requirements of that state for a child care provider.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.06 Requirements for Licensed Exempt Child
Care Services.
(a)
In addition to the requirements in He-C 6349.04, a license-exempt
provider shall:
(1) Care for no more than 3 unrelated children,
regularly for any part of the day, but less than 24 hours;
(2) Be at least 16 years of age;
(3) Be able to communicate his or her needs and
the needs of the child in an emergency;
(4) Be in good health and have been examined by a
licensed physician within one year prior to applying for certification as a
child care provider, and submit the medical information statement as described
in He-C 6349.08, verifying health status from a medical professional at the
time of application for certification and at review of continued compliance;
(5) Provide the names of references, at the time
of application for certification, from 3 unrelated individuals who are familiar
with the provider’s experience in caring for children;
(6) Agree that, at the time of application for
certification and at review of continued certification compliance for payment,
DCYF shall submit his or her name and the names of household members who have
contact with children to the department of safety for a criminal records check,
pursuant to RSA 170-E:3-a;
(7) Agree that, at the time of application for
certification and recertification for payment, DCYF shall submit his or her
name and the names of household members who have contact with children to the
DCYF child abuse and neglect central registry, and to the central registry in
any other state where the applicant, provider, or household member has resided
in the previous 5 years, to determine whether there has been a founded child
abuse and neglect report, pursuant to RSA 170-E:3-a and RSA 169-C:3 XIII-a;
(8) Agree to allow a CPSW or JPPO or to visit
during the application process to ensure that the home provides a healthy,
clean, and safe environment for the care of children;
(9) Agree to allow
an inspection and approval by the local fire or health officials if an
environmental risk to the child is identified by the CPSW/JPPO during the
visit;
(10) Agree to allow a CPSW or JPPO to visit,
during the time a child receives child care, to observe the child and assure
compliance with He-C 6349; and
(11) Agree to allow a CPSW or JPPO to visit during
operating hours when DCYF receives a complaint
about the provider’s compliance with He-C 6349.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.07 Application Process For Payment Standards
For Licensed Child Care Services.
(a)
Applicants who seek initial certification for payment standards for
child care services shall contact a DCYF/DJJS district office supervisor or
designee and request to be referred for certification.
(b)
The DCYF/DJJS district
office supervisor or DCYF certification specialist shall assess the need for
services, based on the following criteria:
(1) The number of children and families who
require services exceeds the available community resources;
(2) A specialized service is necessary to meet
the unique needs of children and families, and there are no currently certified
providers who can provide the specialized service; and
(3) Any other case circumstance which requires
the provision of services pursuant to a court order.
(c)
If there is a need for a service based on (b) above, DCYF/DJJS shall
forward an application packet to the applicant which includes:
(1) An “Application For Certification of Licensed
Child Care Service Providers”;
(2) An “Alternate W-9”;
(3) A “Licensed Provider Agreement”; and
(4) He-C 6349.
(d)
Each applicant and household member shall provide a statement
indicating:
(1) Whether the applicant or any employee has
ever been subject to disciplinary action by a licensing body or professional
society, been found civilly liable for professional misconduct, or found to
have committed an ethical violation by a state or national professional
association or any other state’s regulatory board, and if so, the name of the
licensing body or professional society, the reasons, dates, and results.
(2) Whether the applicant or any employee is
currently listed in any child abuse and neglect state registry as having abused
or neglected a child, and if so, the dates and reasons.
(e)
The applicant shall sign the application.
(f)
The applicant’s signature
shall constitute an acceptance of the terms below:
(1) The provider has read and understood He-C
6349;
(2) DCYF shall review financial information
submitted for reimbursement for services provided to children and families; and
(3) The information contained in the application
is true and correct to the best of the applicant's knowledge.
(g)
Each applicant shall complete and return the application within 30 days
to the DCYF certification specialist together
with the following documents specified in He-C 6349.07(c) above:
(1) The “Licensed Provider Agreement”; and
(2) The “Alternate W-9”.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.08 Application
Process For Payment Standards For Licensed Exempt Child Care Services.
(a)
Applicants who seek initial
certification to provide child in home care services shall contact a DCYF or
DJJS district office supervisor or designee and request to be referred for
certification for payment.
(b)
The DCYF/DJJS district
office supervisor or DCYF certification specialist shall assess the need for
services, based on the following criteria:
(1) The number of children and families who
require services exceeds the available community resources;
(2) A specialized service is necessary to meet
the unique needs of children and families, and there are no currently certified
providers who can provide the specialized service; and
(3) Any other case circumstance which requires
the provision of services pursuant to a court order.
(c)
If there is a need for a service based on (b) above, DCYF/DJJS shall
forward an application packet to the applicant
which includes:
(1) An “Application For Certification of Licensed
Exempt Child Care service Providers”;
(2) A “Licensed-Exempt Provider Agreement”;
(3) An “Alternate W-9”;
(4) He-C 6349;
(5) A “Medical information Statement”;
(6) A “Service Provider Reference”;
(7) A “Criminal Record Release Authorization” for
the provider and all household members 17 years of age and older; and
(8) A “Central Registry Name Search
Authorization” for the provider and all household members 10 years of age and
older.
(d)
If the individual whose name has been submitted for a criminal
background check has been convicted of crimes against a minor or an adult or is
the subject of a founded report of child abuse or neglect, the department shall conduct an
investigation pursuant to He-C 6920.10 to determine whether the individual
poses a threat to the safety of children.
(e)
Each applicant and
household member shall provide a statement indicating:
(1) Whether the applicant or any household member
has ever been subject to disciplinary action by a licensing body or
professional society, been found civilly liable for professional misconduct, or
found to have committed an ethical violation by a state or national
professional association or any other state’s regulatory board, and if so, the
name of the licensing body or professional society, the reasons, dates, and
results; and
(2) Whether the applicant or any household member
is currently listed in any child abuse and neglect state registry as having
abused or neglected a child, and if so, the dates and reasons.
(f)
The applicant shall sign
the application.
(g)
The applicant’s signature
shall constitute an acceptance of the terms below:
(1) The provider has read and understood He-C
6349;
(2) DCYF shall review financial information
submitted for reimbursement for services provided to children and families; and
(3) The information contained in the application
is true and correct to the best of the applicant's knowledge.
(h)
Each applicant shall complete and return the application within 30 days
to the DCYF certification specialist together
with the following documents specified in He-C 6349.08(c):
(1) The alternate W-9;
(2) The licensed-exempt provider agreement;
(3) A “Medical information Statement”;
(4) A “"Service Provider Reference”;
(5) The criminal record release authorization
form; and
(6) The central registry name search
authorization.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.09 Review of Continued Certification Compliance.
(a)
All providers shall
complete a review form, as provided by DCYF, within 30 days of the receipt.
(b)
Providers that do not
submit a review form within 30 days of receipt shall have their certification
revoked in accordance with He-C 6349.18 and denied payment.
(c)
Continuance of
certification shall be based on a review and verification of the provider’s
compliance with service requirements.
(d)
Review of continued
certification compliance shall occur every 2 years from the date of issue for licensed-exempt providers and shall
coincide with the licensing date for licensed providers.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.10 Notification of
Changes.
(a)
For the period of certification, all providers shall notify DCYF in
writing within 10 days of any change in the information contained in the application
and provide documentation of the change.
(b)
At the time of expiration of mandatory state licenses, the provider
shall submit a copy of the renewed license to DCYF within 10 days.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.11 Billing Requirements for License and
Licensed-Exempt Child Care Provider Services.
(a)
Prior to the start of
service delivery, providers shall be certified and enrolled as a provider of
licensed or licensed-exempt child care services.
(b)
Providers shall not
exceed the rates established in He-C 6910.15 nor shall the rates exceed those charged by the provider for
non-DCYF/DJJS children.
(c)
Providers shall not bill
DCYF/DJJS for services that are to be reimbursed by any other entity.
(d)
Providers shall accept
payments made by DCYF/DJJS as payments in full for the services it provides.
(e)
DCYF/DJJS shall determine the necessity of care and services and the
determination shall be binding on the provider.
(f) The provider
shall notify DCYF of any changes in tax information and complete and submit to
DCYF a signed alternate W-9 form with current tax information.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.12 Billing Process for Licensed and Licensed
Exempt Child Care Services.
(a) A provider shall bill DHHS via paper claims
on a bi-weekly basis utilizing the “Child Care Services Authorization” form or
on a weekly basis through NH Bridges on the automated billing system.
(b) For paper claim submission, the provider
shall:
(1) Complete the number of hours the child
attended each day during the billing period and enter the total amount charged
in the anticipated payment field; and
(2) Complete the provider signature and mail the
completed invoice to:
DHHS, Data
Management Unit
PO Box 2000
Concord NH 03301-2000
(c) For electronic claim submission, the provider
shall:
(1) Be approved and authenticated to submit
claims via web billing and have received a logon and password access to
provider web billing; and
(2) Select the recipient(s) and timeframe(s) for
which they wish to submit claims from their list of approved service authorizations.
(d)
Absent units shall be paid only when the following conditions are met:
(1) Other families are billed for absent units;
(2) The child care facility was open for business
during the time the absence was claimed;
(3) The child was scheduled to attend on the day
the absence was claimed; and
(4) If a child is enrolled part time, the number
of units billed for an absent day shall be the number of hours the child was
scheduled for that day.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.13 Billing Period.
(a)
Providers shall bill
within one year of service provision.
(b)
Any bill received for
payment one year or more after service date shall be denied pursuant to RSA
126-A:3.
(c)
A provider shall submit
bills at least on a monthly basis.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.14 Billing Discrepancies. Questions
regarding billing discrepancies shall be directed to the provider relations’ staff of the bureau of
administrative operations in DCYF.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.15 Record-Keeping and Record Retention.
(a)
A provider shall retain records for a period of no less then 7 years
after the completion date of services
provided for each bill submitted
to the department.
(b)
The provider shall keep records as are necessary to comply with RSA
170-E:42, when applicable, and to comply with DCYF/DJJS record keeping
requirements in He-C 6349.
(c)
Records shall clearly
document the extent of the care and service provided to the families, including
attendance records when those
services are charged to the department, and information regarding any payment
claimed.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.16 Quality Assurance Activities.
(a)
Providers shall be
subject to quality assurance reviews conducted by DCYF and DJJS using a variety
of activities such as a
combination of record reviews, performance data measurements and visits to
providers.
(b)
Providers shall allow an on-site visit by DCYF or DJJS, which may be
random or scheduled, for the purposes of:
(1) Interviewing providers;
(2) Interviewing children and families served;
(3) A review of service billing records; or
(4) Reviewing provider documents to determine
continued compliance with He-C 6349.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.17 Waivers.
(a)
Applicants or providers who request a waiver of a requirement in He-C
6349 shall submit a written request
to the commissioner or his or her designee that includes the following
information:
(1) The reason for requesting the waiver;
(2) The anticipated length of time the requested
waiver will be needed;
(3) Assurance that if the waiver is granted the
quality of service and care to children, youth and families will not be
affected;
(4) A written plan to achieve compliance with the
rule or explaining how the provider will satisfy the intent of the rule, if the
waiver is granted; and
(5) How the service will be affected if the
waiver is not granted.
(b)
A waiver shall be granted if:
(1) The department concludes that authorizing
deviation from compliance with the rule from which waiver is sought does not
contradict the intent of the rule; and
(2) The alternative proposed ensures that the
object or intent of the rule will be accomplished and shall not affect the
health and safety of the child.
(c)
When a waiver is approved, the applicant or provider shall be considered
in compliance with the rule from which waiver was sought.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.18 Denial of Application Or Revocation of
Certification.
(a)
An application shall be denied or certification revoked if:
(1) DCYF determines that the state does not have
a need for the service;
(2) The applicant or provider, or the individual
acting on the applicant’s or provider’s behalf, submits materially false
information to DCYF;
(3) The applicant or any household member has
been convicted of a felony or any crime against a child that has not been
annulled or overturned;
(4) There has been disciplinary action taken by a
licensing body or professional society, a finding of civil liability made for
professional misconduct, or a finding of an ethical violation made by a state
or national professional association or any other state’s regulatory board;
(5) There has been cancellation of liability
insurance by the insurance company;
(6) There has been abusive or neglectful
treatment of a child as determined by any state statute; and
(7) There has been failure to comply with He-C
6349.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.19 Notification of Denial or Revocation.
(a)
If DCYF denies an application for certification or
revokes an existing certification, DCYF shall send notice of the denial or
revocation to the applicant or provider by certified mail.
(b) The notice shall:
(1)
Inform the applicant or provider of the facts or conduct upon which DCYF
bases its action;
(2) Advise the applicant or provider of their
right to request reconsideration of DCYF’s decision pursuant to He-C 6347.21;
and
(3) In the case of an existing certification,
inform the provider that the revocation shall not take effect until the
provider has had an opportunity through an appeal, pursuant to RSA 170-G:4-a
and He-C 6347.23, to show compliance with all lawful requirements for retention
of the certification.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.20 Request for
Certification Reconsideration.
(a)
A request for
certification reconsideration shall:
(1) Be filed within 30 calendar days of the date
of receipt of the letter sent by DCYF;
(2) Be submitted in writing; and
(3) Be filed with the director of DCYF.
(b)
The DCYF director shall
uphold or overturn the request pursuant to He-C 6349.
(c)
The applicant or provider shall be notified of the decision, in writing
by the director.
(d)
The applicant or provider
may appeal the DCYF director’s decision pursuant to He-C 6349.21.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
He-C 6349.21 Appeals.
(a)
Applicants or providers who wish to appeal DCYF’s decision shall file an
appeal pursuant to RSA 170-G:4-a with
the commissioner.
(b) In accordance with RSA 170-G:4-a, the appeal
shall:
(1) Be made in writing;
(2) Be signed and dated;
(3) State the reasons for the appeal pursuant to
RSA 170-G:4-a; and
(4) Be filed within 14 working days of the date
of written notification pursuant to RSA 170-G:4-a.
(c)
Pursuant to RSA 170-G:4-a
and He-C 200, the commissioner or designee and 2 members of the DCYF advisory
board shall hear the appeal.
Source. (See Revision Note at part heading for He-C
6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17
PART He-C 6350 CERTIFICATION FOR PAYMENT STANDARDS FOR
RESIDENTIAL TREATMENT PROGRAMS
Statutory Authority: RSA 170-G:5
He-C
6350.01 Scope.
(a) Certification pursuant to RSA 170-G:4, XVIII,
shall apply to residential treatment programs receiving funds from the department
for residential care and treatment provided to children and the related
services provided to families.
(b) A residential treatment program that is not
funded by the department shall not have its rights to operate or serve children
affected by He-C 6350 et seq. and RSA 170-G:4-a.
Source. #4442, eff 7-1-88; amd by #4906, eff 8-10-90,
EXPIRED 8-10-96
New. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
He-C
6350.02 Definitions.
(a) “Absconder” means a runaway, as defined in
(al) below, who also has a petition under the juvenile justice statutes RSA
169-B or RSA 169-D and who, with the intent to avoid legal process or
authorized control, meets at least one of the following:
(1)
Fails to report for probation or parole supervisions;
(2)
Fails to report for conditional release supervision;
(3)
Hides, conceals or absents him/herself; or
(4) Has departed the jurisdiction
without permission of the supervising authority, court, or juvenile parole and
probation officer (JPPO), and whose whereabouts might be unknown.
(b) “Adult living preparation” means a process of
assessing, planning, and supporting youth through the transition from childhood
through adolescence and into independence and adulthood. This term includes
“independent living.”
(c) “Agency” means the board of directors,
executive director, and employees of an organization that is:
(1)
Operating a residential treatment program at a residential facility;
(2)
Incorporated and recognized by the secretary of state in which it is
operating; and
(3)
Providing an identifiable system of social service interventions designed
for an individual child or groups of children.
(d) “Applicant” means the person or entity that
is requesting certification of a residential treatment program.
(e) “Case plan” means the division for children,
youth and families’ (DCYF) written plan for the child and the family which
outlines how services will be provided, pursuant to RSA 170-G:4, III, and 42
U.S.C. 671, PART E-Federal Payments for Foster Care and Adoption Assistance
SECTION 471(a)(16), 475(1) and (5)(A) and (D) State Plan For Foster Care and
Adoption Assistance. This term includes
“placement plan.”
(f) “Certification for payment” means the process
by which DCYF approves the operation of and payment to residential treatment
programs.
(g) “Child” means:
(1)
“Child” as defined in RSA 170-E:25, I.
The term includes “youth” and “resident”; or
(2)
For the purposes of compliance with RSA 126-U, “child” as defined in RSA
126-U:1, I, namely, “a person who has not reached the age of 18 years and who
is not under adult criminal prosecution or sentence of actual incarceration
resulting therefrom, either due to having reached the age of 17 years or due to
the completion of proceedings for transfer to the adult criminal justice system
under RSA 169-B:24, RSA 169-B:25, or RSA 169-B:26. ‘Child’ also includes a person in actual
attendance at a school who is less than 22 years of age and who has not
received a high school diploma.” The
term includes “youth” and “resident.”
(h) “Child protective services worker (CPSW)”
means the DCYF representative who has expertise in managing cases resulting
from concerns of child abuse and/or neglect to ensure families and children
achieve safety, permanency, and well-being.
(i) “Clinical coordinator” means a staff member
employed by the residential treatment program responsible for administrative
oversight of the clinical services provided at the program. This term includes
“treatment coordinator.”
(j) “Clinical staff” means individuals who have a
master’s degree in a clinical field such as social work, marriage and family
therapy, psychology, guidance counseling, or a degree which would make one
eligible for a license from the NH board of mental health practice or NH board
of psychologists.
(k) “Commissioner” means the commissioner of the
NH department of health and human services, or his or her designee.
(l) “Connection” means an individual who the
child identifies as an important relationship and who is supported by the
treatment team for maintaining the child’s permanency plans.
(m) “Department” means the NH department of
health and human services.
(n) “Direct care staff” means the residential
treatment program’s staff who are included in the staff to child ratio,
including, but not limited to, child care workers, supervisors, and recreational
staff.
(o) “Division for children, youth and families
(DCYF)” means the organizational unit in the department of health and human
services which includes, but is not limited to, child protective services and
juvenile justice services.
(p) “Executive director” means the individual
responsible for the daily administration of a residential treatment program.
(q) “Facility” means the physical plant or
structures, permanent or temporary, on the grounds of the licensed premises.
(r) “Family” means the individuals to whom the
child is related legally or biologically, such as, but not limited to, parents,
siblings, grandparents, aunts, and uncles.
(s) “Family workers” mean individuals funded by
the department to work directly with the families of children in residential
placement on reunification issues or in establishing a family’s optimum level
of functioning and contact with their child.
(t) “Full time employee” means personnel who work
a minimum of 37.5 hours a week.
(u) “Human services” means helping people in
areas which include:
(1)
Education;
(2)
Mental health;
(3)
Recreation;
(4)
Child care;
(5)
Medical services;
(6)
Law enforcement;
(7)
Corrections; and
(8)
Social services.
(v) “Incident” means:
(1)
Resident behavior that is extreme, including, but not limited to,
behavior that is assaultive, destructive, self-injurious, or self-destructive;
(2)
Any behavior leading to physical intervention or seclusion of a
resident; or
(3)
An occurrence involving an accident or injury, or requiring outside
agency involvement.
(w) “Juvenile Detention Alternatives Initiative
(JDAI) Services” means a temporary, court-ordered residential service available
to law enforcement officers and JPPOs to provide emergency care and supervision
through a DCYF certified provider for youth charged with a delinquent offense.
JDAI services are an alternative to secure detention pursuant to RSA 169-B:2,
II.
(x)
“Juvenile parole and probation officer (JPPO)” means the DCYF representative
who has expertise in managing cases resulting from concerns of delinquency or
children in need of services (CHINS) to ensure families and children achieve
safety, permanency, and well-being.
(y) “License” means “license” as defined in RSA
170-E:25, XI, or pursuant to RSA 151.
(z) “Measurable” means the systematic process of
gathering quantitative or qualitative information to show progress or change,
and achievement of a goal or objective.
(aa) “NH bridges” means the case management,
tracking, and automated billing system used by DCYF for children who are in
out-of-home placement and for whom the department has a legal responsibility.
(ab) “Permanency” means the process to ensure a
child has a safe, stable environment with a life-long relationship with a
nurturing caregiver to establish the foundation for a child’s healthy
development.
(ac) “Physical intervention” means a behavioral
management technique through which staff uses the minimum amount of physical
contact on a child which is necessary for the circumstances. This term includes “physical management.” Physical intervention might be reportable
under RSA 126-U.
(ad) “Policies” means written guidelines,
practices, and procedures specifying the current and future actions to be taken
that direct the operation of the residential treatment program.
(ae) “Prescribing practitioner” means any of the
following state licensed health care providers that provide services identified
in 42 CFR 440.130 to reduce a physical or mental disability and in the
restoration of a recipient to his or her best functional level:
(1)
Health care providers licensed in accordance with RSA 326-B;
(2)
Physicians;
(3)
Physician assistants; and
(4)
Any practitioner licensed by the NH board of mental health practice or
NH board of psychologists.
(af) “Program philosophy” means the underlying
theory, or set of ideas, which guides the beliefs and principles of the program
and the services the program provides.
(ag) “Progress reports” means the written notes
sent to DCYF and parents by the staff of a residential treatment program which
document the residential services being provided to the child.
(ah) “Quality assurance” means the process that
DCYF staff use to monitor, support, and provide technical assistance to
residential treatment programs to assist in their ability to comply with He-C
6350 and He-C 6420.
(ai)
“Reasonable and prudent parent standard” means a standard characterized by
careful and sensible parental decisions made by a caregiver for a child in
foster care, that maintain the health, safety, and best interests of the child
or youth while encouraging the emotional and developmental growth of the child
through participation in extracurricular, enrichment, cultural, and social
activities as defined by SSA 475(10)(A) and any subsequent amendments thereto.
(aj) “Rehabilitative and restorative services”
means interventions provided including any medical or remedial services
recommended by a physician or other prescribing practitioner within the scope
of the residential treatment program’s practice to reduce a physical or mental
disability and restore a recipient to their best functional level.
(ak) “Residential treatment program (program)”
means the model and implementation of services to meet the treatment and
supervision needs of the children per RSA 170-G:4, XVIII, and provide 24 hour
care of children 365 days a year including all of the employees therein, and is
one of the following categories of certification:
(1)
Assessment treatment program;
(2)
Intensive treatment program;
(3)
Intermediate treatment program;
(4)
Nursing home;
(5)
Rehabilitation program;
(6)
Shelter care program; and
(7)
Substance abuse treatment program.
(al) “Restraint” means “restraint” as defined in
RSA 126-U:1, IV.
(am) “Runaway” means a child who has failed to
return to his or her placement, has hid, or concealed him or herself without
permission of his or her legal custodian, residential treatment program, or
supervising authority. A runaway might
also be an absconder.
(an) “Seclusion” means “seclusion” as defined in
RSA 126-U:1, V-a.
(ao) “Short-term” means a program operated through
a residential facility that is intended to provide services to a child for 60
days or less.
(ap) “Staff secure” means a residential treatment
program that provides high levels of supervision and individualized care 24
hours a day to children through the use of a staff to child ratio of one staff
to 5 children or lower and awake night staff in each building used for child
care, and can include short-term interventions that require one staff member to
care for one child in order to assist the child through a behavior or emotional
crisis or physical interventions to prevent runaways.
(aq) “Staff to child ratio” means the number of
direct care staff funded by the department to ensure the necessary resources
are available to deliver services and provide supervision to children
consistent with He-C 4001.
(ar) “Staff supervision” means an administrative and
educational process used in residential treatment programs to help child care
workers and clinical staff develop and refine their skills so that they are
able to provide quality care and treatment.
(as) “Treatment plan” means the residential
treatment program’s written, time-limited, goal-oriented, therapeutic plan
developed for the child and family by the treatment team which includes the
strategies to address the issues that brought the child into placement and is
consistent with rehabilitative and restorative services.
(at) “Treatment team” means the individuals
outlined in He-C 6350.13 including at a minimum the child,
parent(s)/guardian(s), residential treatment program clinical staff,
prescribing practitioner, and DCYF staff.
Source. #4442, eff 7-1-88, EXPIRED 7-1-94
New. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15;
amd by #12609, eff 8-23-18
He-C
6350.03 Length of Certification. Certification shall be valid for one year
from the date issued, unless certification is voluntarily surrendered by the
residential treatment program, the facility closes, or certification is revoked
by the department pursuant to He-C 6350.08.
Source. #4442, eff 7-1-88, EXPIRED 7-1-94
New. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
He-C
6350.04 Reimbursement.
(a) Billing shall begin on the day of admission
and continue through the day of discharge, as follows:
(1)
DCYF shall only reimburse a certified residential treatment program for
a child as long as there is no concurrent payment for placement being made to
another residential treatment program, with the exception of the day of
admission and/or the day of discharge pursuant to (a) above; and
(2)
The residential treatment program shall bill for the day of admission
when a child is admitted to the residential treatment program directly from a
Juvenile Detention Alternatives Initiative (JDAI) service or assessment
treatment program. If the child is admitted to the same residential treatment
program that provided the JDAI service or assessment treatment program, the
residential treatment program shall not bill for the day of discharge from the
JDAI service or assessment treatment program.
(b) If a child has an identified managed care
organization, the residential treatment program shall only accept the child if
the residential treatment program is enrolled with that child’s managed care
organization.
(c) The residential treatment program may
subcontract with other human services providers as long as the service is
included in the child’s treatment plan and the treatment plan has been signed
by the DCYF staff member responsible for the child’s case.
(d) Any residential subcontractor used on a
temporary or long-term basis shall operate with a current license in accordance
with RSA 170-E or RSA 151, as applicable.
(e) DCYF shall not be responsible for payments
made by a residential treatment program to a subcontractor for services
provided in accordance with (c) above.
(f) Residential treatment programs shall not
request additional contracts for residential treatment services identified
within this rule.
(g) In the event that a child is a runaway, is
committed or detained at Sununu Youth Services Center, or is admitted to an
in-patient psychiatric or acute care hospital, the residential treatment
program may bill through the day that the youth runs away, is committed or
detained at the Sununu Youth Services Center, or is admitted to the in-patient
psychiatric or acute care hospital.
(h) If agreed upon by the residential treatment
program and DCYF, the residential treatment program from which the youth ran
away or absconded may readmit the youth within 10 business days from the date
the youth ran away or absconded in compliance with He-C 6350.32. Readmission
within 10 business days shall not negate the billing requirement identified in
(g) or (a) above.
Source. #4442, eff 7-1-88, EXPIRED 7-1-94
New. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff 10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
He-C
6350.05 Application Process for
Certification and Procedures for Renewal of Certification.
(a) Any residential treatment program licensed in
accordance with RSA 170-E or RSA 151, or from another state, that seeks
certification in accordance with He-C 6350 shall request application Form 2601
“Certification for Payment Application – Residential Programs” (July 2018) from
DCYF and be supported by a need identified by DCYF in accordance with RSA
170-G:4.
(b) The application form in (a) above shall be
completed, signed, and dated by the residential treatment program’s executive
director, or designee, affirming the following:
(1)
“I have reviewed the Administrative Rules He-C 6350 and He-C 6420 and
will adhere to the rules as a certified provider. I authorize the NH Division for Children,
Youth and Families (DCYF) to conduct a certification for payment review to
determine the program’s compliance with Administrative Rules He-C 6350 and He-C
6420. I further understand that DCYF has the right to verify information
contained in this application.”; and
(2)
“The information contained in this application is correct to the best of
my knowledge.”
(c) The completed application form in (a) above
shall be returned to DCYF within 90 days of receipt.
(d) The applicant shall provide the following
information with, or in addition to, the application form in (a) above:
(1)
An electronic copy of the program description, including a description
of the services provided to children and their families, as well as a
description of the daily milieu, and how the program promotes the safety,
permanency, and well-being of children and their families,
including any specialized services that are supported by any certifications
and/or accreditations;
(2)
The name, office held, professional affiliation, address, and telephone
numbers of each person on the program’s board of directors, including whether
or not the board member is a present or past recipient of the agency’s
services;
(3)
Evidence that the board of directors has approved the certification
request which may include, but is not limited to, minutes of the board meeting
documenting that the request was approved or a signature of the board’s
president;
(4)
The names of the residential staff/child care personnel within the
program;
(5)
A copy of the program’s license and/or operational approval, in accordance
with the following:
a.
For programs in
b. For programs outside of
(6)
A electronic copy of a completed Form 2426 “Residential Resource Guide
Provider Form” (January 2015);
(7)
A copy of the general liability insurance certificate for the program;
(8)
An organizational chart, personnel titles, job descriptions, and the
corresponding credentials which document the education and experience
requirements in He-C 6350.11, as applicable.
This shall include identification of who in the program is responsible
for implementation of reasonable and prudent parent Standard;
(9)
For programs in New Hampshire which operate and maintain approval as a
non-public school per Ed 400 and a private provider of special education per Ed
1100, a copy of their approval from the
NH state board of education;
(10) For programs outside of New Hampshire with
education programs, documentation of educational certification from the
corresponding state’s regulatory agency(ies);
(11) A description of the staff development and
training processes; and
(12) An electronic copy of the program’s policies
required by He-C 6350.10 and any other policies maintained by the program.
(e) For residential treatment programs that are
seeking re-certification, the executive director shall be notified in writing
by DCYF of the need to re-apply for certification of the residential treatment
program 4 months prior to the expiration date of the current certification.
(f) The executive director or designee shall
complete, sign, and date Form 2601R “Certification for Payment Renewal
Application – Residential Programs” (July 2018), affirming the following:
(1)
“I have reviewed the Administrative Rules He-C 6350 and He-C 6420 and
will adhere to the rules as a certified provider. I authorize the NH Division
for Children, Youth and Families (DCYF) to conduct a certification for payment
review to determine the program’s compliance with Administrative rules He-C
6350 and He-C 6420. I further understand
that DCYF has the right to verify information contained in this application.”;
and
(3)
“The information contained in this application is correct to the best of
my knowledge.”
(g) The completed application form in (f) above
shall be returned to DCYF within 30 days of receipt.
(h) The applicant shall provide the following
information with, or in addition to, the renewal application form in (f) above:
(1)
An electronic copy of the updated program description, including a
description of the services provided to children and their families, as well as
a description of the daily milieu, and how the program promotes the safety,
permanency, and well-being for children and families, including any specialized
services that are supported by any certifications and/or accreditations;
(2)
The name, office held, professional affiliation, address, and telephone
number of each person on the program’s board of directors, including whether or
not the board member is a past or present recipient of the agency’s services;
(3)
The names of the residential staff/child care personnel hired since last
the certification period;
(4)
The names of the executive director, assistant director, if applicable,
and clinical coordinator, including identification of who in the program is
responsible for implementation of reasonable and prudent parent standard;
(5) A copy of the program’s license
and/or operational approval, in accordance with the following:
a.
For programs in
b. For programs outside of
(6)
A copy of the general liability insurance certificate for the program;
(7)
For programs in New Hampshire which operate and maintain approval as a
non-public school per Ed 400 and a private provider or special education per Ed
1100, a copy of their approval from the NH state board of education;
(8)
Programs outside of
(9)
Programs in
Source. #4442, eff 7-1-88; amd by #4906, eff 8-10-90;
amd by #5122, eff 4-25-91, EXPIRED 4-25-97
New. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15;
amd by #12609, eff 8-23-18
He-C
6350.06 Departmental Visits and
Quality Assurance.
(a) DCYF shall conduct quality assurance reviews
for each residential treatment program, consisting of the following:
(1)
An annual review of the renewal application as described in He-C
6350.05;
(2)
An annual analysis of the referral data, statistics, and outcomes;
(3)
An on-site visit conducted within the first year of a residential
treatment program’s operation;
(4)
For currently certified residential treatment programs, an on-site visit
once every 2 years;
(5)
A technical assistance visit in the year where an on-site visit does not
occur; and
(6)
Ongoing quality assurance and collaboration as needed throughout the
year.
(b) Should it be determined during any
departmental visit or quality assurance contact that there are areas of
non-compliance with He-C 6350, DCYF shall require the residential treatment
program to submit a plan of correction within 30 days of the date of receipt of
the notice of non-compliance.
Source. #4442, eff 7-1-88; amd by #4906, eff 8-10-90;
amd by #5122, eff 4-25-91, EXPIRED 4-25-97
New. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
He-C
6350.07 Waivers.
(a) Applicants and residential treatment programs
that request a waiver of a requirement in He-C 6350 shall submit a written
request to DCYF, including the following information:
(1)
The rule number for which the waiver is being requested;
(2)
The anticipated limited length of time the requested waiver will be
needed;
(3)
The reason for requesting the waiver;
(4)
How the residential treatment program will provide for quality care of
the children;
(5)
A written plan to achieve compliance with the rule for the limited
length of time requested, detailing how the residential treatment program will
satisfy the intent of the rule if the waiver is granted;
(6)
How the children and/or families will be affected if the waiver is not
granted;
(7)
A statement attesting that the request is not out of compliance with the
program’s licensing requirements in RSA 170-E:31 or RSA 151:5; and
(8)
Evidence that the residential treatment program’s board of directors or
governing body which provides program oversight has approved the waiver
request, which shall include, but is not limited to, minutes of the board
meeting documenting that the request was approved or an approval by the board’s
president or designee.
(b) When a waiver request is submitted, the
residential treatment program shall not act until a decision by DCYF is made on
the request.
(c)
A request for a waiver shall be approved if:
(1)
DCYF finds that approval of the requested waiver will not jeopardize the
quality of care provided to children;
(2)
DCYF finds that approval of the requested waiver will not be a violation
of a state law;
(3)
DCYF finds that the request is time-limited;
(4)
DCYF finds that the approval of the requested waiver will not contradict
the intent of the rule; and
(5)
DCYF finds that the applicant or residential treatment program has an
alternative plan for complying with the rule in accordance with (a)(5) above.
(d) A request for a waiver shall be denied if any
of the grounds for approval in (c) above are not met.
Source. #4442, eff 7-1-88, EXPIRED 7-1-94
New. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
He-C
6350.08 Denial and Revocation of
Certification and Process for Administrative Appeals.
(a) The department shall deny an application for
certification for payment when it determines that the applicant does not
demonstrate compliance with He-C 6350 or has had their license denied, revoked,
or suspended in accordance with RSA 170-E:35 or RSA 151.
(b) Certification for payment shall be revoked if
the department determines that the residential treatment program has failed to
comply with the provisions of this He-C 6350, RSA 170-E, RSA 151, or the
licensing body that governs the out-of-state residential treatment program.
(c) Certification for payment shall be terminated
if a residential treatment program notifies the department that they will no
longer be accepting admissions to their program.
(d) Certification for payment shall be denied or
terminated if the department has determined that there is no need for
certification of the residential treatment program pursuant to RSA 170-G:4,
XVIII.
(e) Revocation of payment shall include the end
of the program’s credentials from the NH Bridges payment system and the
recoupment of unused funds, if applicable.
(f) If DCYF denies or revokes certification for
payment, a letter shall be sent by certified mail to the applicant or certified
residential treatment program, which sets forth the reasons for the
determination.
(g) The denial or revocation shall become final
10 business days after receipt of the letter referenced in (f) above, unless
the applicant or certified residential treatment program requests a hearing
pursuant to RSA 170-G:4-a or RSA 151:8, II.
(h) Pursuant to RSA 170-G:4-a, RSA 151:8, II, RSA
541-A, and He-C 200, individuals who wish to appeal a decision to deny their
application or revoke their certification shall file an appeal with the
commissioner within 10 business days of the date of the letter or other written
notification of the action.
(i) The appeal shall:
(1)
Be made in writing;
(2)
Be signed by a person authorized to submit the appeal; and
(3)
State the reasons for the appeal pursuant to RSA 170-G:4-a.
Source. #4442, eff 7-1-88, EXPIRED 7-1-94
New. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
He-C
6350.09 Changes of Personnel,
Policies, or Services.
(a) The residential treatment program shall
notify DCYF at least 30 days prior to making changes to the approved
certification.
(b)
The residential treatment program shall notify the department, parents, and
legally responsible parties, in writing, when it changes any of the following
from what was provided in the initial or renewal application:
(1)
Program philosophy; or
(2)
Program description.
(c) The residential treatment program shall
notify DCYF within 10 business days of the hiring of a new executive director,
assistant director, or clinical coordinator.
(d)
The notice required in (c) above shall include the individual’s credentials
documenting the education and experience requirements in He-C 6350.11, as
applicable.
Source. #4442, eff 7-1-88, EXPIRED 7-1-94
New. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
He-C
6350.10 Requirements for Written
Policies. Residential treatment
programs shall have written policies addressing the following areas, in order
to ensure quality and consistent care of children:
(a) Admission criteria and subsequent referral
process that identify the children and families the residential treatment
program is best designed to serve;
(b) Provision of a parent handbook which
identifies what family-centered services are promoted and the opportunities
families are given to be involved in all aspects of their child’s care
including, but not limited to:
(1) Activities designed to promote
permanency and support continued family involvement throughout placement;
(2)
Services that promote family involvement and partnership in a
therapeutic process from intake to discharge, which supports the identified
permanency plan;
(3)
Implementation of the reasonable and prudent parent standard by staff
including a description of how the program will identify and support normal age
and developmental experiences including social, extracurricular, enrichment,
and cultural activities in the community;
(4)
When possible, activities in the family’s home at the family’s
convenience, and other services to support the identified permanency plan;
(5)
Parental education, as needed to support the child and family’s
permanency, safety, and well-being;
(6)
Communication that includes the family in the program’s initial
orientation process and ongoing activities; and
(7)
The program’s grievance procedures, which shall ensure that children may
constructively address their concerns without fear of retaliation;
(c) Provision of a youth handbook which includes,
at a minimum:
(1)
The description of the program in which the child has been admitted;
(2)
The structure of program, such as the daily routine;
(3)
The opportunities available to the child, such as recreation or leisure,
and communication or contact with family;
(4)
The rules and expectation of the program; and
(5)
The program’s grievance procedures, which shall ensure that children may
constructively address their concerns without fear of retaliation;
(d) New staff orientation, to include a review of
the program’s policies and procedures;
(e) The responsibilities of staff in the
implementation of treatment plans and the process for how staff will
familiarize themselves with the needs of each resident;
(f) A staffing plan which describes:
(1)
Staff-to-child ratios which are consistent with the program’s category
of certification;
(2)
The utilization of staff to meet the children’s behavioral and clinical
needs;
(3)
The routine for scheduling of staff to provide for the health and safety
of children;
(4)
The process for assigning staff to errands, appointments, unplanned
local events, field trips, or recreational activities off-site while
maintaining appropriate supervision for children in the program;
(5)
How staff are accessed for emergency situations; and
(6)
The level of supervision provided by staff to children throughout the
day and night;
(g)
A prohibited item and contraband policy,
including:
(1)
A list of items that are prohibited or considered contraband;
(2)
Procedures which shall ensure that no such items are brought to the
premises; and
(3)
Procedures for the disposition of such items if they are discovered on
the premises;
(h) The daily routine available to children
including opportunities for educational, community, recreational, leisure
activities, therapeutic services, skill building including independent living
preparation, and permanency connections;
(i) The personal responsibilities of children,
which shall include expectations for:
(1)
Daily living skills and hygiene;
(2)
Chores and tasks; and
(3)
Interpersonal conduct;
(j) Provision of necessities to children,
including which items are provided by the program and which items are the
responsibility of the parent or guardian to provide;
(k) The identification of children’s possessions
that are brought to the program or acquired during placement;
(l) The protection of the children’s personal
property which shall ensure that their possessions are protected during times
when the child is off premises or is absent without leave, and that possessions
accompany the child at the time of discharge;
(m) The provision of visitation and other
communication between children and their family and friends, both on site and
off the premises of the facility;
(n) The process for determining and reporting a
runaway, including specific procedures for absconders, which shall include the
notification of the child’s parents, guardian, DCYF, and law enforcement;
(o) The safeguarding of, use, and limitations
that may be placed on children’s money;
(p) The recovery of damages to the facility
caused by a child, except:
(1)
The residential treatment program shall not charge the parents for
damages; and
(2)
Restitution paid by a child shall be based upon the child’s ability to
pay;
(q)
The residential treatment program’s religious affiliation and observances, if
any, and any restrictions on admissions resulting therefrom;
(r) The procedures a child or a parent follows to
file a grievance;
(s) The promotion of constructive work
experiences that have training and developmental components for appropriate
children;
(t) The safety and security practices used by the
program;
(u) The general behavioral and conduct
expectations of children including discipline, conduct, and management of
children’s adverse behaviors, including:
(1)
The treatment philosophy used as the basis for behavior management
techniques supporting the creation of individualized treatment;
(2)
Child management techniques identified to assist staff in making
decisions regarding children’s care;
(3)
Acceptable and unacceptable staff responses to inappropriate behavior;
(4)
The procedures and requirements for reporting events governed by RSA
126-U;
(5)
The guidelines for using time out, seclusion, and physical intervention,
including restraints, in accordance with RSA 126-U and He-C 4001; and
(6)
Documentation of inappropriate behaviors of children, which shall
include interventions that staff use in response to the children’s conduct;
(v) Emergency preparedness response for staff and
children, consistent with He-C 4001.14(r)(3);
(w)
The procedures and requirements for
reporting child abuse or neglect, including:
(1)
Who is responsible for reporting the suspected abuse or neglect;
(2)
Filing the report, including the telephone number to call;
(3)
Staff training and orientation about reporting abuse or neglect, which
includes providing staff with copies of the relevant state statutes; and
(4)
Management of staff who are being investigated for child abuse or
neglect;
(x) Acquiring and providing emergency services
for children that are demonstrating behaviors that are a threat to self or
others;
(y) Provision of aftercare services upon
discharge based upon the residential treatment program’s category of
certification;
(z) The discharge processes for both planned and
unplanned discharges; and
(aa) Record keeping, including provisions which
ensure the confidentiality of the residents and their families.
Source. #4442, eff 7-1-88, EXPIRED 7-1-94
New. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759,e ff 1-17-15;
amd by #12609, eff 8-23-18
He-C
6350.11 Requirements for Staff.
(a) The executive director of an intermediate
treatment program or shelter care program shall:
(1)
Be a full-time employee; and
(2)
Either:
a.
Possess a master’s degree in education, business, criminal justice,
administration, human services, or a field related to one of these disciplines,
or meet the definition of clinical staff in He-C 6350.02(j), and have 2 years
experience in human services; or
b.
Have a bachelor’s degree in the fields listed in a. above and 5 years
experience in human services.
(b) The clinical coordinator of an intermediate
treatment program or shelter care program shall:
(1)
Be a full time employee;
(2)
Meet the definition of clinical staff in He-C 6350.02(j); and
(3)
Have 2 years post-graduate experience in human services.
(c) The executive director of an intensive
treatment program shall:
(1)
Be a full time employee;
(2)
Possess at a minimum a master’s degree in a field identified in (a)(2)a.
above; and
(3)
Have 2 years supervisory experience in human services.
(d) The assistant director of an intensive
treatment program shall:
(1)
Be a full-time employee; and
(2)
Either:
a.
Possess a master’s degree in a field identified in (a)(2)a. above; or
b. Possess a bachelor’s degree in a
field identified in (a)(2)a. above and have 5 years experience in human
services, one year of which has included administrative responsibility.
(e) The clinical coordinator of an intensive
treatment program shall:
(1)
Be a full-time employee;
(2)
Meet the definition of clinical staff in He-C 6350.02(j); and
(3)
Have 2 years post-graduate experience in a clinical setting.
(f) The clinical staff of an intensive treatment
program shall:
(1)
Be a full-time employee or a part-time employee with a minimum of 22
hours a week; and
(2)
Meet the criteria specified in He-C 6350.02(j).
(g)
The prescribing practitioner for a residential treatment program shall meet the
following requirements:
(1)
Meet the requirements set forth in He-C 6420 for prescribing
practitioner or be licensed by the NH board of psychologists; and
(2)
Be employed by the agency or have a current contract with the agency or
like agreement.
(h) If the program employs medical staff, they
shall be licensed by the appropriate licensing board.
(i) Each residential treatment program shall
identify one staff, consistent as reported on the Form 2601 “Certification for
Payment Application – Residential Programs” (July 2018) or Form 2601R
“Certification for Payment Renewal Application – Residential Programs” (July
2018), trained to implement the reasonable and prudent parent standard for all
youth within the program. Any changes to the identified staff shall be reported
to the division within 10 days of the new assignment.
(j) Each residential treatment program with
funded family worker positions shall meet the following minimum staffing
requirements:
(1)
Family workers shall have a minimum of a bachelor’s degree in a clinical
field identified in (a)(2)a. above, education, or a related field with emphasis
in human services and family systems, and have 2 years of human services
experience;
(2)
Except in shelter care programs, all family workers shall be supervised
by clinical staff;
(3) Family workers in shelter care
programs shall be supervised by an employee who has a minimum of a bachelor’s
degree in social work, psychology, education, or a related field, with an
emphasis in human services and family systems, and 3 years experience in human
services; and
(4) Except for shelter care
programs, family workers shall maintain an aftercare caseload and availability
to provide aftercare services for families pursuant to the discharge plan for a
minimum of 30 days after the child has made the transition to home.
(k) The training requirements for family workers
shall include:
(1)
A minimum of one hour each week of individual or group clinical
supervision by clinical staff; and
(2)
A minimum of 40 hours per year of in-service training, at least 8 hours
of which shall be in working with and supporting families in communities,
including creating behavioral plans that assist with reunification efforts.
(l) All full-time direct care and clinical staff
shall annually receive 40 hours of training, of which up to 15 hours of
documented supervision may be applied towards the training.
(m) All direct care and clinical staff working
less than full-time shall annually receive at a minimum 8 hours of the required
trainings in (m) below.
(n) The training required in (j) and (k) above
shall include annual reviews of:
(1)
Emergency and safety procedures;
(2)
Principles and practices of child care including the reasonable and
prudent parent standard;
(3)
Family-centered practices including transition and permanency planning;
(4)
RSA 169-C:29, the child protection reporting law;
(5)
Administrative procedures and program goals;
(6)
Behavior management;
(7)
De-escalation techniques;
(8)
Physical intervention techniques; and
(9)
Professional boundaries, liabilities, and ethics.
(o) The in-service training component provided by
the residential treatment program shall be designed to prepare staff to care
for the children served and may include, but not be limited to, training that
corresponds to the specific needs of the population of children and families
the program serves.
(p) College courses taken for credit may be
counted towards the training requirements in a ratio of one credit equals 15
hours of training, provided the course is related to human services identified
in (k) above.
(q)
All training shall be documented in the employee’s personnel file or through an
electronic equivalent.
(r) Each employee shall have at least one
evaluation and planning conference per year.
(s) The evaluation required in (q) above shall be
documented in the employee’s personnel file and shall be signed by the employee
and the supervisor, indicating that the employee has read the evaluation or
indicating why the employee did not sign the evaluation.
(t) The executive director shall receive an
annual performance evaluation conducted and signed by the board of directors or
the executive director’s direct supervisor.
(u) The evaluation of the executive director
shall be documented in his or her personnel file.
(v) Employees of nursing homes and rehabilitation
programs shall be excluded from the training requirements above.
(w) Shelter care programs shall provide a minimum
of one hour of supervision per week by clinical staff of the program or a
half-day per week of consultation services from a licensed clinician to assist
the children and staff with treatment issues.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15;
amd by #12609, eff 8-23-18
He-C
6350.12 Admissions Criteria and
Discharge Procedures.
(a) Upon referral by the JPPO or CPSW or upon
admission of a child, the residential treatment program shall document the
child’s needs and, if known, the primary areas of treatment identified and
services to be provided based on the referral information.
(b)
Upon admission, the residential treatment program shall request a copy
of the child’s insurance cards.
(c) The residential treatment program shall make the
following available to the parent(s) or guardian during the admission process:
(1)
The program philosophy, as stated on Form 2424 or Form 2425;
(2)
The daily routines;
(3)
Behavior management and disciplinary practices of the program;
(4)
Any specific treatment strategy used by the program;
(5)
Policies on visitation and other communication with the child;
(6)
The services provided to families;
(7)
Procedures which the parent(s) or guardian may use to provide input
about the care of the child;
(8) The name and telephone number of staff at the
residential treatment program that the parent(s) or guardian may contact;
(9)
A description of any religious services;
(10) Limitations placed on personal
possessions and the policies on how children acquire necessities;
(10) How the educational needs of
children are met;
(11) How health and medical needs of children are
met;
(12) The residential treatment
program liaison identified to provide information and coordination to an insurance
carrier, if applicable; and
(13) The parent handbook referenced in He-C
6350.10 (b).
(d) If the parent(s) or guardian do not
participate in the admissions process, the same information required in (c)
above shall be mailed to them within 7 days of admission.
(e) Once admitted to the residential treatment
program, the child shall not be discharged unless one or more of the following
conditions exist:
(1)
The child is a danger to other children or staff as determined via
delinquency proceedings conducted pursuant to RSA 169-B;
(2)
The child is determined to be in need of psychiatric hospitalization
after an emergency mental health evaluation;
(3)
The child is a danger to himself, herself, or others and, after
intensive staff intervention, it is determined that a more restrictive
environment is necessary in order to maintain safety;
(4)
The child's clinical needs can be best met in another setting as
determined in the treatment planning process and the child has been accepted
into that setting; or
(5)
The child is ready to transition to the child’s identified permanency
plan or concurrent permanency plan.
(f)
If the residential treatment program determines a discharge is necessary
in accordance with (e)(1)-(4) above, DCYF shall be provided written or
electronic notice of at least 14 calendar days prior to the date that the
program is requesting the removal of the child in placement from its program
including the detailed reasons for such request, except that:
(1)
A residential treatment program may request an immediate discharge due
to a circumstance identified in (e)(1), (e)(2), or (e)(3) above; and
(2)
If a shelter care program identifies concerns that rise to a level
beyond the capabilities of the program per He-C 6350.18, the shelter care program
shall provide DCYF with 48 business hours notice to request a change in
placement to protect the well-being of the child, other children, and staff of
the program.
(g) Prior to a discharge, with the exception of a
discharge granted through (f)(1) above, the residential treatment program in
conjunction with the family and the DCYF representative, or both, shall discuss
the transitional services, and aftercare services as applicable, provided by
the residential treatment program to support family reunification or the
child’s transition to an alternative placement.
(h) When the child is discharged, the residential
treatment program shall provide details around medication management and
medical concerns to the entity the child is discharged to, in writing, on the
day of discharge.
(i) The discharge summary shall be filed in the
residential treatment program’s record and a copy shall be sent to the
representative from DCYF and the parent or guardian.
(j) Shelter care programs shall provide the discharge
summary within one business day of the child’s discharge, including a summary
of educational services provided to the child during the course of the
placement.
(k) A written discharge summary shall be sent no
later than 15 calendar days after the child’s discharge.
(l) The child’s discharge summary shall include,
but not be limited to:
(1)
A summary of the child’s placement at the residential treatment program;
(2) The results of the services
provided, including the outcomes of the goals and objectives identified in the
child’s treatment plan;
(3) Documentation of interventions
utilized and the success or ineffectiveness of those interventions;
(4)
The needs of the child and family which remain to be met and the
services which will meet those needs;
(5)
An individualized aftercare plan;
(6)
Post-care packet pursuant to He-C 6350.26(h) and (i), if applicable;
(7)
If the program has been provided such a form by DCYF, one of the
following forms, updated in accordance with He-C 6350.15(g):
a.
Form 2267 “Child’s Information Sheet” (January 2015);
b.
Form 2281 “DCYF Youth Information Sheet” (January 2015);
c.
Form 2281(J) “Youth Information Sheet” (January 2015); and
(8)
A list of upcoming appointments, current medical providers with
corresponding contact information, and medications with which the child was
discharged, individually identified with the prescribing practitioner.
(m) If litigation involves a child’s record, all
information pertaining to the case shall be maintained until a settlement is
reached.
(n) Unless otherwise specified by state or
federal requirements, the child’s records shall be maintained by the
residential treatment program for a minimum of 5 years after his or her
discharge.
(o) Should the program be closed, the residential
treatment program shall notify DCYF of the location where the files will be
maintained and the entity who will oversee their storage.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15;
amd by #12609, eff 8-23-18
He-C
6350.13 Treatment Planning Process.
(a) Residential treatment programs shall conduct
a psycho-social assessment with recommendations for treatment. Based on the assessment and recommendations,
the residential treatment program shall conduct a treatment team meeting and
develop a treatment plan within 30 calendar days of placement of the child.
(b) For programs that offer short-term
programming that serves children 60 calendar days or less, the assessment and
treatment plan shall be completed within 10 calendar days of the child’s
placement.
(c) Nursing homes, rehabilitation programs, and
in-patient psychiatric services shall be exempted from the requirements in (a)
and (b) above if there are no Medicaid covered services being provided under
He-C 6420.
(d) The treatment plan shall include:
(1)
The summary of the psycho-social assessment;
(2)
A transitional section for the child and family that includes:
a.
An estimate by the treatment team members of the child’s length of stay,
based upon referral information and the residential treatment program’s
assessment; and
b.
The child’s permanency plan and concurrent plan identifying the
following alternatives for the child in care, including the identified resource
if known at the time of the treatment plan:
1.
Reunification with the family;
2.
Adoption;
3.
Guardianship by a relative or other person;
4.
Permanent placement with a fit and willing relative; or
5. Another Planned Permanent Living
Arrangement (APPLA) in accordance with RSA 169-C:24-b, II(c); and
(3)
Community reintegration and transition tasks that identify the following:
a.
Specific needed supports or services that would provide for the child to
successfully transition out of the residential treatment program and into the
community;
b.
The treatment team member who is responsible for completing the task
necessary; and
c.
The projected time frame for completion of each task.
(e) The treatment plan shall, at a minimum,
contain the following domains relating to rehabilitative and restorative
services provided by the residential treatment program:
(1)
Safety and behavior of the child;
(2)
Family;
(3)
Medical;
(4)
Education, if clinically necessary; and
(5)
Adult living preparation if the child meets the requirements of He-C
6350.26 or if determined clinically necessary.
(f) Each domain identified in (e) above shall
address:
(1)
The goals and measurable objectives to be achieved by the child and
family;
(2)
The time frames for completion of objectives; and
(3)
The individualized interventions that will be used to address the
objectives, including:
a.
Identification of the staff or individual providing or implementing the
stated intervention;
b.
The frequency of the intervention;
c.
How that intervention is documented; and
d.
Identification of the private non-medical institution services that will
be provided directly or arranged for through He-C 6420.
(g) The treatment plan shall include the date and
signatures of the following team members, indicating that they participated in
the process:
(1) The child;
(2) The child’s
parents or guardian(s);
(3) The
prescribing practitioner;
(4) A
representative of DCYF; and
(5) The clinical coordinator or the residential
treatment program’s executive director. If the prescribing practitioner is also
the clinical coordinator, he/she shall indicate dual functions.
(h) When any of the individuals in (g) above do
not participate, the residential treatment program shall document its efforts
to involve them.
(i) Revisions to the treatment plan outside the
scheduled treatment plan reviews shall include the signatures of the
prescribing practitioner, clinical coordinators, and other team members
identified in (g) above, as available, and shall be explained in writing to any
individuals of the team who are unable to participate.
(j) The treatment plan shall be implemented by
the treatment team and the residential treatment program’s staff and shall be
reflected in the child’s daily routine, logs, progress notes, and discharge
summary.
(k) The treatment team shall consist of the
individuals identified in (g) above in addition to the following invited
participants:
(1)
Clinical staff of the residential treatment program;
(2)
Attorney or guardian ad litem (GAL) for the child;
(3)
A representative of the local educational agency when clinically
appropriate;
(4)
Family assessment and inclusive reunification (FAIR) facilitator, which
is the administrative reviewer required pursuant to 42 U.S.C. 675.6; and
(5)
Other persons significant in the child’s life if clinically appropriate,
including but not limited to:
a.
Teachers;
b.
Staff members from the residential treatment program;
c.
Counselors;
d.
Friends;
e.
Relatives; and
f.
Educational surrogate.
(l) The treatment plan shall be filed in the
child’s record and copies provided to the individuals identified in (g) above.
(m) The treatment plan shall be reviewed and
updated as necessary by the treatment team at the treatment team meeting, at a
minimum as follows:
(1)
Three months from the initial treatment plan; and
(2)
Every 3 months thereafter until discharge, at no point exceeding 3
months.
(n) Changes and updates to the treatment plan
shall be made based on progress identified by the treatment team, areas of
continued treatment needs, achievement of goals or objectives, and
effectiveness of interventions, in accordance with the requirements of (d)
through (m) above.
(o) Residential treatment programs shall acquire
signatures on the treatment plans of individuals identified in (g) above within
7 calendar days of the treatment team meeting, such that:
(1)
Reasonable efforts to obtain the signature of the parent(s)/guardian(s)
and DCYF shall be documented as meeting the requirements of (o); and
(2)
Any team members participating through electronic means, other than the
prescribing practitioner or clinical coordinator, may provide verbal assent in
lieu of signature on the treatment plan but this shall not preclude efforts
identified in (1) above.
(p) Once the treatment plan is completed, all
clinical and direct care staff shall receive supervision and instruction to
assure that each child’s treatment plan is consistently implemented.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
He-C
6350.14 Logs and Progress Reports.
(a) Each residential treatment program shall
provide maintenance of logs per He-C 6420 documenting progress and summarizing
the Medicaid covered services which were provided to the child in accordance
with the written treatment plan.
(b) Unless excepted by He-C 6350.15(m), each
residential treatment program shall provide a progress report for each child in
its care, pursuant to He-C 6420, to DCYF and to parents and guardians, as
follows:
(1)
Programs which provide assessment treatment program and shelter care
program services shall provide weekly progress reports and shall comply with
(c) through (e) below; and
(2)
All other programs shall provide monthly progress reports no later than
the 15th day of each month and shall comply with (c) through (f) below. If a child has been at the residential
treatment program for fewer than 7 calendar days, the information may be
included in the most appropriate monthly progress report or discharge summary.
(c) The progress report shall include:
(1)
The child’s name;
(2)
The child’s date of birth;
(3)
The name of the person completing the report;
(4)
The date of the report;
(5)
The name of the residential treatment program; and
(6)
The date of placement.
(d) Progress reports shall address the following
areas of care and treatment within the content of the report:
(1)
General summary of the care provided to the child in that month;
(2)
Status of each domain identified in the treatment plan including notable
changes in particular goals or objectives;
(3)
A summary of contacts with family or identified connections;
(4)
Contact with other professionals;
(5) Summary of the child’s
educational progress in that month, including any challenges experienced; and
(6)
The following areas if there are updates:
a. Proposed modifications to the treatment plan;
b. Community reintegration and transition tasks;
and
c. Disposition of grievances.
(e) Progress reports shall include the following
information about each child’s medical status, behavioral health care, and
dental issues throughout the reporting period:
(1)
The prescriptions and current dosages;
(2)
List of over-the-counter medication provided by the residential
treatment program;
(3)
The dates of visits during the month being reported;
(4)
Any new health care issues and diagnoses, if applicable;
(5)
The dates of next scheduled visits; and
(6)
The name(s) of health care practitioner(s) and their office address.
(f) When children meet the requirements in He-C
6350.26(b), progress reports shall include documentation of adult living
preparation progress if progress was completed during the month, including:
(1)
Independent living training that was completed by staff and the child;
(2)
Post-care planning completed with the child; and
(3) A completed Form 1969 “Monthly
NYTD Checklist” (January 2015), completed by residential program staff, for the
purpose of collecting data for the National Youth in Transition Database (NYTD)
pursuant to 45 CFR 1356.80.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
He-C
6350.15 Basic Standards for
Residential Treatment Programs.
(a) Except as identified elsewhere in He-C 6350,
all residential treatment programs shall comply with this section.
(b) Residential treatment programs shall be
licensed in accordance with RSA 170-E or RSA 151.
(c)
Residential treatment programs shall be enrolled in NH Medicaid and shall
comply with administrative rule He-C 6420 Medicaid Covered Services.
(d) Residential treatment programs shall comply
with the following:
(e) Providers shall maintain general liability
insurance pursuant to SSA 471 (a)(10)(C) and any subsequent amendments thereto.
(1)
Any administrative rules specific to their category of service,
including all applicable sections set forth in this rule;
(2)
Juvenile Justice and Delinquency Prevention Act, 42 U.S.C. § 5601 –
5681;
(3) RSA 170-A, Interstate Compact
on Placement of Children (ICPC), and RSA 169-A, Interstate Compact of Juveniles
(ICJ); and
(4)
RSA 126-U.
(f) Residential treatment programs shall provide
the following:
(1)
Care in a structured, therapeutic environment to children who have
pending petitions for, or have been adjudicated as, abused or neglected, in
need of services, or delinquent;
(2)
Support to children and families 365 days a year including nights,
weekends, and during visits;
(3)
Monitoring and assessment of the whereabouts and safety when a child is
in the immediate care of the residential treatment program;
(4)
Age and developmentally appropriate opportunities and activities
consistent with the reasonable and prudent parent standard that positively
support the education, physical, intellectual, and social needs of children
within the residential treatment program and community;
(5)
Positive youth development techniques that emphasize providing services
and opportunities to support youth in developing a sense of competence,
usefulness, belonging, and empowerment;
(6)
Opportunities for children to maintain contact with family and
identified connections;
(7)
Daily programming to include:
a.
Supervision;
b.
Access to education per He-C 6350.27;
c.
Social and family services;
d.
Adult living preparation;
e.
Recreation;
f.
Rehabilitative services in accordance with He-C 6420; and
g.
Behavioral health services in accordance with He-C 6420; and
(8)
Coordination of services to transition the child from the residential
treatment program to the identified permanency plan or concurrent plan.
(g) For each child, DCYF shall complete and
provide to a residential treatment program one of the following completed
forms:
(1)
Form 2267 “Child’s Information Sheet” (January 2015), signed and dated
by the child’s parent or guardian and the child’s CPSW;
(2)
Form 2281 “DCYF Youth Information Sheet” (January 2015), signed and
dated by the child’s parent or guardian and the child’s CPSW;
(3)
Form 2281(J) “Youth Information Sheet” (January 2015), signed and dated
by the child’s parent or guardian and the child’s JPPO or juvenile parole and
probation supervisor (JPPS);
(h) If a residential treatment program has been
provided a completed Form 2267 “Child’s Information Sheet” (January 2015), Form
2281 “DCYF Youth Information Sheet” (January 2015), or Form 2281(J) “Youth
Information Sheet” (January 2015) from DCYF, the program shall, every 6 months,
review the information on the form, update the form as necessary, sign and date
the form, and provide to DCYF the updated form, indicating changes or no
changes. Attachments to the forms may be used to supplement the information
required.
(i) Residential treatment programs shall have
relief staff to respond to emergency situations and additional staff available
to contact for support and consultation.
(j) Residential treatment programs shall utilize
effective behavior management techniques to support the stability of the
program.
(k) Residential treatment programs shall ensure
the child’s health needs are met, and as follows:
(1)
For any initial placement of a child due to petitions filed under RSA
169-C, a comprehensive physical exam shall be arranged by the residential
treatment program in conjunction with the CPSW, to occur within the first 30
days of placement; and
(2)
Shelter care programs shall comply with He-C 6350.18(d).
(l) All residential treatment programs shall
provide and coordinate services and treatment interventions to meet the goals
identified in the treatment plan, as follows:
(1)
The treatment plan shall be consistent with the case plan provided by
DCYF;
(2) Treatment interventions shall
meet the individual needs of the children and families in therapeutic and
group-living experiences;
(3) Treatment programs shall
include individual/group problem solving and decision-making;
(4) The clinical coordinator shall
ensure therapeutic interventions and other services are implemented and
integrated into the treatment programming for the individual child and family;
(5)
Services required by the treatment plan including individual, group, and
family counseling to children shall be available within the residential
treatment program or shall be referred to community agencies depending on the
need of the child and family, and the category of service; and
(6)
Direct care staff that provides group counseling shall receive
supervision from clinical staff.
(m) Treatment programs shall support
family-centered practices and incorporate the family-centered focus in the
program’s milieu.
(n) Residential treatment programs shall make
normal daily decisions in the life of the child and grant permission for
participation in family, school, community, cultural, and social leisure time
activities based on their age, ability, development, treatment plan case plan,
or court order consistent with the reasonable and prudent parent standard.
(o) Consistent with RSA 169-B, 169-C, and 169-D,
during the course of treatment, if there is a court order that limits or
prohibits the child’s contact with the parent or guardian, or if DCYF is in the
process of securing such court order, the program shall not be required to
engage the parent or guardian in the treatment planning process or provide them
with documentation of progress reports or incident reports.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15;
amd by #12609, eff 8-23-18
He-C
6350.16 Intermediate Treatment
Program Requirements. In order for a
residential treatment program to be certified as an intermediate treatment
program, it shall comply with the following:
(a) He-C 4001, NH Residential Child Care
Licensing Rules, including staff to child ratios of one staff to 6 children
while children are awake and one staff to 12 children while children are
asleep;
(b) Services required by the treatment plan,
including counseling of children and families, shall be available within the
residential treatment program or shall be provided through the local community,
as follows:
(1)
Treatment plans shall provide and allow for increased community-based
integration and involvement, based on progress and individualized needs; and
(2)
Individual or family counseling may be provided by the clinical
coordinator, or other staff meeting the requirements of clinical staff; and
(c) Educational services to children shall
include the use of public schools per Ed 300, non-public schools per Ed 400, or
private providers of special education per Ed 1100 as approved by the NH state
board of education.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.17)
He-C 6350.17 Intensive Treatment Program Requirements. In order for a residential treatment program
to be certified as an intensive treatment program, it shall comply with the
following:
(a) He-C 4001, NH Residential Child Care
Licensing Rules, except as described in (d) below regarding staff to child
ratios;
(b) The program shall have the capacity to
provide highly structured services, both on-site and in the community, as needed
to directly affect the educational, physical, intellectual, emotional, and
social needs of the children and families;
(c) The program shall maintain a
multi-disciplinary, self-contained means of service delivery to meet the needs
identified within the treatment plan, as follows:
(1)
There shall be a clinical staff to child ratio of one clinical staff to
10 children;
(2) Clinical services shall be
provided through the residential treatment program’s on-site program unless a
special circumstance is identified through the treatment plan to support
utilizing a community provider;
(3) Clinical staff shall provide treatment
interventions to meet the individual needs of the children and families served
and shall provide a therapeutic group-living experience;
(4)
Unless otherwise specified in the child’s treatment plan, any
combination of individual, group, or family counseling services shall be
provided to each child or the family a minimum of 3 times a week;
(5)
The family-centered services component shall operate as described in
He-C 6350.10(b) and with staffing in accordance with He-C 6350.11(g) and (h);
and
(6)
The residential treatment program shall organize its clinical staff and
family workers in a flexible manner so long as families are seen face-to-face
no less than one time per week, unless otherwise specified in the child’s
treatment plan, as follows:
a.
Technology may be used to supplement clinical services as a part of the
child’s treatment; and
b.
The utilization of a video-conferencing technology shall not replace
face-to-face contact unless documented in the child’s treatment plan with the
agreement of the treatment team as identified in He-C 6350.13(g);
(d) The program shall be staff-secure and be able
to serve those children whose needs require a high level of treatment and
supervision, as follows:
(1)
There shall be a minimum staff to child ratio of one staff to 4 children
during hours when children are awake; and
(2)
Except for residential treatment programs that have an independent
living component housed in a separate area and have the capability of moving
children that need more supervision back to the intensive care level, there
shall be an awake staff member in each building housing children;
(e) Educational services to children shall comply
with RSA 193:1 and Ed 306, as follows:
(1)
The program shall use public schools per Ed 300, non-public schools per
Ed 400, or private providers of special education per Ed 1100 as approved by
the NH state board of education; and
(2)
The agency shall operate and maintain approval as a non-public school
per Ed 400 and a private provider of special education per Ed 1100 as approved
by the NH state board of education; and
(f) When a child is discharged to a family
member, the program shall provide transitional and aftercare services for a
minimum of 30 days.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.18)
He-C
6350.18 Shelter Care Program
Requirements.
(a) In order for a residential treatment program
to be certified as a shelter care program, it shall comply with the following:
(1)
He-C 4001, NH Residential Child Care Licensing Rules, except as
described in (2)a. and b. below regarding staff to child ratios;
(2)
The program shall provide staff-secure short-term care for 60 days or
less to children in crisis who are awaiting further placement, evaluation,
completion of a service plan, or court action, as follows:
a.
Staffing during awake hours shall be at a ratio of one staff to 5
children and shall include:
1.
One clinical coordinator, and
2.
One family worker;
b.
Two awake overnight staff shall be available at the shelter care
program. Should the census drop below 4
children, 2 overnight staff shall be maintained, of which one overnight staff
shall remain awake in the building;
c.
The program shall secure the services of a registered nurse for a
minimum of 2 hours daily;
d.
The program shall provide placement for children under RSA 169-B and RSA
169-D;
e.
The shelter care program shall provide services that assist the child to
prevent the need for further placement until such time as there is a subsequent
court order; and
f.
The program shall serve children between the ages of 11 and 18 years,
who shall not be suffering from acute mental disorders or substance abuse
withdrawal;
(3)
The program shall maintain a multi-disciplinary, self-contained means of
service delivery in a highly monitored setting to meet the needs identified
within the treatment plan, as follows:
a.
The shelter care program shall respond with appropriate interventions to
stabilize the behaviors of children in placement;
b.
Clinical services shall be provided through the shelter care program’s
on-site program unless a special circumstance is identified through the
treatment plan to support utilizing a community provider;
c.
The clinical services available at the shelter care program shall
include:
1.
Group and individual counseling that is driven by each child’s treatment
plan;
2.
Substance abuse counseling to be provided for each child, as
appropriate; and
3. The ability to complete alcohol
and drug abuse evaluations, or diagnostic evaluations per He-C 6344 within the
course of placement; and
d.
The program shall establish a number of recreation and leisure
activities on site in order to monitor and supervise the children effectively. Activities in the community shall be conducted
when it is determined that the children can be provided with high levels of
structure, supervision, and support;
(4)
The program shall respond immediately to the needs of DCYF’s referring
staff and ensure that critical information pertaining to each child is obtained
as quickly as possible;
(5)
The program shall not be designed or expected to serve the following
populations, and may request removal of a child within 48 hours during business
hours and 72 hours during non-business hours if the child presents with one of
the following conditions after the admission:
a.
Actively suicidal referrals such that the child’s capacity to
participate in the shelter care program is impaired and that his or her safety
within the program may be compromised. This determination shall be made by a
qualified mental health professional, or a staff member of a mental health
facility;
b.
Intoxicated or under the influence of illegal or non-prescription drugs,
or suffering from overuse of a prescribed drug such that a potential medical
emergency exists;
c.
Psychotic or suffering from emotional disorders or chronic mental
illness such that the child’s capacity to participate in the shelter care
program is impaired;
d. Physically assaultive to a degree which would
endanger the safety of shelter care program children or staff; or
e.
Previously convicted or currently charged with the crime of arson
pursuant to RSA 634:1, or has a history of fire setting such that the safety of
the shelter care program, children, and staff may be immediately endangered;
(6)
Maintain an educational program which shall be eligible for Title I part
D funding and maintain approval as a non-public school per Ed 400 and a private
provider of special education per Ed 1100 from the NH state board of education,
to include:
a. A primary focus of working in
collaboration with the child's home school to assure continuity of education;
b. Educational programming to
children who are not determined eligible for special educational services and
shall be provided on site in a program approved by the NH state board of
education in accordance with Ed 400;
c.
Acceptance of children based on the identified approval as a private
provider of special education by the NH state board of education; and
d.
A traditional school year of 10 months with a 2-month summer
program. The need of any child whose
individual education plan calls for a summer program shall be met;
(7)
The program shall provide transportation to and from:
a.
Local medical, dental, or behavioral health related appointments;
b.
Home visits, in accordance with He-C 6350.25(a);
c.
Court appearances; and
d.
Recreation and school trips required as part of the shelter care
program; and
(8)
The residential treatment program shall not be required to provide
transportation to and from other programs.
(b) Intake information on each child shall be
obtained upon admission, to include:
(1)
Copies of court orders relating to the approval of and payment for the
placement;
(2)
Copies of authorizations for emergency medical or court-ordered
services;
(3)
DCYF’s case plan, if available; and
(4)
A photograph of the child before or upon arrival at the shelter care
program.
(c) The shelter care program shall document each
child’s medical information, to include:
(1)
A medical authorization completed within 5 calendar days of admission;
(2)
A health assessment completed by a registered nurse within 24 hours of
admission; and
(3)
A physical examination completed by a physician, physician assistant, or
advance practice registered nurse within 3 weeks of admission, if there are
known medical needs identified through the health assessment in (2) above,
warranting further examination.
(d) The shelter care program shall document each
child’s educational information, to include:
(1)
An educational assessment completed in accordance with the provisions of
Ed 1107, by a teacher within 5 calendar days of admission;
(2)
An educational status and history; and
(3)
A written weekly progress report completed by the teacher.
(e) The shelter care program shall maintain
weekly contact with DCYF staff to discuss the progress of children on a weekly
basis, and document and share with DCYF each child’s behavioral information, as
identified in He-C 6350.14(c) through (f).
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
He-C 6350.19 Nursing Homes. In order for a residential treatment program
to be certified as a nursing home, it shall:
(a) Be licensed in accordance with RSA 151 and
He-P 803 NH Nursing Home Rules;
(b) Not be required to comply with He-C
6350.15(k) unless providing services under He-C 6420; and
(c) Provide children domiciliary board, room,
laundry services, health supervision under medical and nursing direction, and
nursing care as may be individually required.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.21)
He-C
6350.20 Rehabilitation Programs. In order for a residential treatment program
to be certified as a rehabilitation program, it shall:
(a) Be licensed in accordance with RSA 151 and
He-P 807 Rules for Residential Treatment and Rehabilitation Facilities;
(b) Not be required to comply with He-C
6350.15(k) unless providing services under He-C 6420; and
(c) Assist in the rehabilitation of disabled
children through an integrated program of medical and other services, which are
provided under professional supervision.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.22)
He-C
6350.21 Substance Abuse Treatment
Programs.
(a) In order for a residential treatment program
to be certified as a substance abuse treatment program, it shall comply with the
requirements to certify for, and follow the rules of, either an intermediate
treatment program in accordance with He-C 6350.16 or an intensive treatment
program in accordance with He-C 6350.17.
(b)
Substance abuse treatment programs shall provide residential care and
rehabilitative and restorative treatment to children who also meet criteria for
substance abuse or dependence, and shall involve the families as an integral
part of the therapeutic milieu.
(c) Substance abuse treatment programs shall
maintain a NH licensed alcohol and drug counselor (LADC) on staff or contract
with an NH LADC.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.23)
He-C
6350.22 Assessment Treatment Program.
(a) In order for a residential treatment program
to be certified as an assessment treatment program, it shall comply with the
requirements to certify for, and follow the rules of, either an intermediate
treatment program in accordance with He-C 6350.16, an intensive treatment
program in accordance with He-C 6350.17, or a substance abuse treatment program
pursuant to He-C 6321, and this section.
(b) Assessment treatment programs shall provide
short-term care and treatment of children through comprehensive assessments and
initial treatment while their specific needs are being determined or
identified.
(c) Assessment treatment programs shall:
(1)
Admit children for assessment treatment program services, including
placement in the least restrictive therapeutic option with the expectation that
the child will be discharged within 60 days or less;
(2)
Focus on thorough evaluation, assessments, and screenings beyond the
standard practice for the residential treatment program for which they meet the
requirements of pursuant to (a) above;
(3)
Provide educational services parallel to the educational services
provided to children of the residential treatment program for which they meet
the requirements of pursuant to (a) above;
(4)
Provide immediate treatment and assessment to the child, as follows:
a.
Assessment tools that are completed shall be dependent on the specific
needs of the respective child or family; and
b.
The program shall develop a treatment plan in compliance with He-C
6350.13(b);
(5)
Complete weekly progress reports of the assessment and treatment
services the child is receiving, pursuant to He-C 6350.14;
(6)
Not be required to comply with the following:
a.
Submission of monthly reports in accordance with He-C 6350.14(b)(2); and
b.
Programming for adult living preparation pursuant to He-C 6350.26;
(7)
Hold a transition and discharge meeting at least 2 weeks prior to the
expected discharge, at which point the comprehensive assessments and treatment
completed by the program and the recommendations resulting from the services
provided shall be reviewed. Such a meeting may be held within 2 weeks of
discharge if circumstances or the availability of a treatment team member do
not allow the meeting to take place sooner; and
(8)
If a child is discharged from the assessment treatment program to be
admitted to another residential treatment program within the same agency,
comply with He-C 6350.12(e) and He-C 6350.13(a).
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
He-C
6350.23 Access to In-Patient Care.
(a) If a child is admitted to an in-patient
psychiatric or acute care hospital, the placement shall continue through the
date the child was admitted.
(b) If a child is admitted to an in-patient
psychiatric or acute care hospital, the residential treatment program shall
contact the appropriate JPPO or CPSW.
(c) Unless (f) below applies, the initial
psycho-social assessment, the initial treatment plan, and the discharge
summary, described in He-C 6350.12 and 6350.13, shall not be required if one of
the following criteria is met:
(1)
In the case of an unplanned admittance pursuant to (a) above, and the
child returns to the residential treatment program within 10 business days; or
(2)
In the case of planned or unplanned admittance pursuant to (a) above due
to a known pre-existing condition which was identified in the residential
treatment program’s documentation prior to the admittance, and the child
returns to the residential treatment program within 30 days.
(d) If documentation referenced (c) is not
completed, there shall be documentation in the child’s file of the treatment
team’s consent to these decisions.
(e) If a child returns to the residential
treatment program after an admittance pursuant to (a) and (c)(2) above and the
lapse in placement exceeds 30 days, it shall be considered a new placement and
the program shall comply with He-C 6350.12 and 6350.13.
(f) If extenuating circumstances, including
clinical regression or extreme behaviors such as, but not limited to,
assaultive, destructive, self-injurious, or self-destructive behaviors, have
occurred during an admittance through (a) above, updates or revisions shall be
made to the psycho-social assessment and treatment plan in accordance with He-C
6350.13.
(g) If the department determines that additional
services are required during an acute care hospital stay, the department shall
authorize 1:1 services outside the residential treatment placement,
notwithstanding He-C 6350.04(f).
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.25)
He-C
6350.24 Regulatory Compliance Requirements for Out-of-State Residential
Treatment Programs.
(a) Certification of out-of-state residential
treatment programs shall be conditioned on continued compliance with the
licensing requirements in the state in which they operate.
(b)
Out-of-state residential treatment programs shall provide to DCYF
documentation of any quality assurance records or regulatory visits upon
completion by their licensing or overseeing entity.
(c) Out-of-state residential programs shall
comply with the applicable parts of this rule that pertain to the type of care
provided to children and families.
(d) Out-of-state residential programs shall
respond accordingly to communications with DCYF.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.26)
He-C
6350.25 Visits.
(a)
All visits shall be implemented in accordance with DCYF’s case plan for the
child and the child’s treatment plan.
(b)
During a visit, the residential treatment program shall not be
responsible for the supervision of the child while the child is in the care of
the child’s family, identified connection, or a foster family care provider
licensed in accordance with RSA 170-E.
(c) The residential treatment program shall
remain available to respond to any crisis during a child’s visit, with the
exception of transitions to a foster care agency within the provisions of He-C
6355.18.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.27)
He-C 6350.26 Adult Living Preparation.
(a) Residential treatment programs shall assist
children to restore their developmentally appropriate skills and prepare for
adulthood, by complying with the adult living preparation requirements and
completing the DCYF adult living preparation documents as described below.
(b) Residential treatment programs shall identify
and meet the adult living needs of children who are age 14 or older.
(c) Information obtained through the adult living
preparation shall be included in the treatment plan, daily logs, monthly
progress reports, and discharge summary, as appropriate.
(d) Residential treatment programs providing
short-term assessment treatment programming pursuant to He-C 6350.22 or shelter
care pursuant to He-C 6350.18, not to exceed 60 days, shall not be required to
complete adult living preparation due to the brevity of stay.
(e) The process of completing adult living
preparation shall be done in collaboration with the child, and shall include
the following:
(1) Within 30 days of
admission, staff shall assist the child in completing the “Needs Assessment for
Adult Living,” Form 2290 (January 2015). The completed form shall be dated and
signed by the child and the child’s CPSW or JPPO;
(2) Within 30 days of
admission, staff shall assist the child with completing the “Adult Living
Skills Assessment,” Form 2292 (January 2015).
The completed form shall be dated and signed by the child, the person
assisting the child with the completion of the form, and the child’s CPSW or
JPPO. Every 6 months a new form shall be
completed;
(3) Within 60 days of
admission, staff shall assist the child to complete a career assessment
provided by DCYF;
(4) Within 60 days of
admission, staff shall assist the child with completing the “Adult Living
Preparation Plan,” Form 2291 (January 2015), which shall incorporate the
results of the career assessment in (3) above and any follow-up tasks to be
completed by the child or member of the treatment team. The completed form shall
be signed and dated by the child and the provider. The form shall be reviewed and updated at
least annually with more frequent updates as needed;
(5) Thirty days prior to the
child’s 18th birthday, or within 30 days of the child’s planned discharge if the
child will not discharge upon the child’s 18th birthday, staff shall assist the
child with completing the “Post-Care Plan” Form 2295 (January 2015). The
completed form shall be signed and dated by the child and the child’s CPSW or
JPPO; and
(6) If the documents outlined
in (1)-(5) above have been completed at a previous out-of-home placement within
the past 6 months, the previous documents shall be reviewed and amended as
appropriate based on any changes in circumstances.
(f) Staff shall submit the “Monthly NYTD
Checklist,” Form 1969 (January 2015), each month pursuant to He-C 6350.14(f).
(g) The residential treatment program shall
provide children with weekly skills training using the DCYF adult living
preparation curriculum.
(h) To assist children
in their transition out of placement, staff shall prepare a post-care packet
for each child 30 days prior to the child’s 18th birthday or within 30 days of
the child’s planned discharge if the child will not discharge upon the child’s
18th birthday, which includes:
(1) The “Post-Care Plan” in
(e)(5) above;
(2) Resources pertaining to
post-secondary education and adult education programs or vocational programs in
the community to which the child will be returning;
(3) Copies of school
transcripts and individual educational plan, if the child’s education was
provided by the intensive treatment program; and
(4) Career assessment results,
completed by the residential treatment program.
(i) The staff shall prepare a transition packet
for each child prior to his or her leaving placement to be utilized by the
child, including:
(1) The names and telephone
numbers of people identified as supports for the child in aftercare, including:
a. The CPSW or JPPO;
b. The residential treatment
program counselors and foster parents;
c. The counselors and mental
health therapist;
d. Adult advocates, teachers,
or coaches; or
e. Other individuals who will
assist the child;
(2) The date of the child’s last medical physical or visit to the
doctor, and any upcoming appointments;
(3) The child’s medical
history, immunizations updates, and family medical history, if available;
(4) The physical and mental
health status of the child;
(5) A list of medications
currently prescribed for the child; and
(6) The identification of any specific long-term medical conditions
and any health concerns pertaining to the child.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.28)
He-C
6350.27 Education.
(a) The residential treatment program shall make
time and space available for studying and shall ensure that children have access
to reference materials.
(b) Based on the residential treatment program’s
category of service, the school-aged child shall be enrolled in a NH state board
of education approved program or a general equivalency diploma program for
children over 16 when the program complies with RSA 186-C:9.
(c)
The residential treatment program shall not prevent children from going
to school as a consequence for misbehavior.
The program shall provide the school with any information regarding
circumstances which might present a concern for the safety of the child and/or
community in order for the school to determine if the school is able to support
the safety of the child and/or community.
(d) Children attending school outside the
residential treatment program shall be encouraged to take part in the school's
extracurricular activities, unless contraindicated by the treatment team.
(e) Using the reasonable and prudent parent
standard, the residential treatment program shall allow and encourage the child
in care to participate in school-related activities and events based on their
age, ability, treatment, and development if there are no existing safety
concerns for their inclusion and the activity is otherwise not prohibited by
the treatment plan, case plan, or court order.
(f) The residential treatment program shall
ensure that life-skills training is available and appropriate to the age and
abilities of the child.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.29); amd by #12609, eff 8-23-18
He-C 6350.28 Communication with Family and Identified
Connections.
(a) The residential treatment program shall
encourage visits and other forms of communication between the child and family
members and identified connections.
(b) The residential treatment program shall make
available space and times that are convenient for visiting.
(c) The staff shall coordinate opportunities for
a child in care to visit outside the residential treatment program.
(d) Staff shall facilitate, support, supervise,
or enforce the limit of visits with others in accordance with the court orders,
case plan, and treatment plan.
(e) Staff shall provide privacy for visits and
telephone contacts between children and their families or identified
connections if appropriate.
(f) Staff shall allow a child in care to receive
and send mail.
(g) Staff shall not read children’s mail unless
the reason is documented in the treatment plan or approved by DCYF.
(h) The residential treatment program shall be
equipped with either pay or free telephones for the children’s use and shall
have procedures about their use.
(i) The residential
treatment program shall provide privacy for and not prevent a child from
communicating verbally, written, or directly with an identified attorney,
guardian ad litem, ordained representative of the child’s faith, or DCYF staff
member.
(j) In accordance with He-C 4001, each
residential treatment program shall maintain incident reports on all accidents
and personal injuries.
(k) The residential treatment program shall make
efforts to communicate with the birth parent or legal guardian about the
implementation of the reasonable and prudent parent standard in structuring
activities for the child within the operation of the program.
(l) The residential treatment program shall share
information regarding incident reports as follows:
(1) Parents, guardians, and
DCYF shall be notified on the next business day and provided with the details
of the incident;
(2) If requested by any of the
people in (1) above, a copy of the written incident report shall be provided
electronically or mailed;
(3) Should any of the required
contacts in (1) above have no phone, a written copy of the incident report
shall be mailed to the last known address; and
(4) Reportable incidents under
RSA 126-U shall be documented in accordance with RSA 126-U.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.30); amd by #12609, eff 8-23-18
He-C
6350.29 Requirements for Staff
Communications.
(a) The residential treatment program shall
maintain a daily log for staff communication which may include those
circumstances requiring continued attention by staff, in addition to logs
specific to Medicaid covered services in accordance with He-C 6420.07(a)(4).
(b) Direct care staff shall have access to
children's records at the residential treatment program in order to provide
care and supervision of the child and facilitate treatment plan goals.
(c) Direct care staff shall have input into
program policy development and planning when appropriate.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.31)
He-C
6350.30 Children’s Money.
(a) Children may have access to their own money
by receiving an allowance from the residential treatment program, by having
opportunities for paid work within the residential treatment program, or
through outside employment, unless otherwise indicated by the treatment plan,
or consistent with the program’s written policy.
(b) Money owned, earned, or received as a gift or
as an allowance shall be the child's personal property and shall not be taken
or borrowed by any staff member.
(c) Children shall not be required to pay for
daily hygiene items, grooming supplies, and haircuts.
(d) The residential treatment program shall have
a separate accounting system for each child's money from any Source.
(e) For purchases and payments to restitution
made by the residential treatment program using the children's money, the child
shall sign a receipt, which shall identify the item, the date received, and the
amount of the exchange.
(f)
The receipt referenced in (e) above shall be filed in the child’s record and in
the residential accounting system in (d) above.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.32)
He-C
6350.31 Religion.
(a) During the admission process, the staff shall
determine if the family has wishes regarding the child’s religion or faith and
discuss any religious affiliation of the residential treatment program with the
child and the parent or guardian.
(b)
A residential treatment program shall not require any child to participate in
any religious observance or practice except with the written permission of the
parent or guardian.
(c) The residential treatment program shall
obtain written permission of the child's parent or guardian before any child
changes his or her religious affiliation.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(from He-C 6350.33)
He-C 6350.32 Absconders/Runaways.
(a) Pursuant to the definitions in He-C
6350.02(a) and (al), some runaways shall also be deemed to be absconders.
(b) Providers shall be
reimbursed by DCYF, pursuant to He-C 6350.04, at their authorized board and
care and treatment rate through the day the child runs away and shall resume on
the date the child returns to the residential treatment program, if applicable.
(c) If a child runs
away, the residential treatment program shall immediately notify the local law
enforcement agency, the parent(s), and DCYF. When reporting to law enforcement,
the report shall include information that the child is court ordered in
placement at the residential treatment program.
(d) In the event a child runs away, if the court
order for placement at the residential treatment program is still in effect
during the time that the child is absent a runaway, it shall be at the
discretion of the program to remain involved with the child’s case if approved
by DCYF.
(e) If a child returns to the residential
treatment program within 10 business days of running away, updates to the
psycho-social assessment and treatment plan and the discharge summary,
described in He-C 6350.12 and 6350.13, shall not be required, unless (f) below
is applicable.
(f) If extenuating
circumstances, including significant changes, clinical regression, or extreme
behaviors such as, but not limited to, assaultive, destructive, self-injurious,
or self-destructive behaviors, have occurred during the time a child is absent
as a runaway, updates or revisions shall be made to the psycho-social
assessment and treatment plan in accordance with He-C 6350.13.
(g) Any child who runs away shall be screened for
indications that the child might be a victim of human trafficking. The residential treatment program shall
notify DCYF and cooperate with DCYF to meet any needs identified.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(formerly He-C 6350.34)
He-C
6350.33 Grievance Procedures.
(a) A grievance procedure shall be established
and provided in the parent and youth handbooks, so children may constructively
address their concerns without fear of retaliation.
(b) For any grievance filed, its disposition
shall be recorded in the child’s record and in the monthly progress report.
Source. #6617, eff 10-25-97; ss by #8453, INTERIM,
eff
10-25-05, EXPIRED: 4-23-06
New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15
(formerly He-C 6350.35)
PART He-C 6351 - RESERVED
PART He-C 6352 CERTIFICATION FOR PAYMENT STANDARDS FOR
COMMUNITY-BASED SERVICE PROVIDERS
Statutory Authority: RSA 170-G:4, XVIII, RSA 170-G:5
He-C 6352.01 - 6352.10 - EXPIRED
Source. #4446, eff 7-1-88, EXPIRED: 7-1-94
New. #7292, eff 5-24-00; ss by #9112, INTERIM, eff
3-24-08, EXPIRED: 9-20-08
He-C 6352.11 - 6352.31 - EXPIRED
Source. #7292, eff 5-24-00; ss by #9112, INTERIM, eff
3-24-08, EXPIRED: 9-20-08
PART
He-C 6353 ALLOCATION AND DISTRIBUTION OF
INCENTIVE FUND GRANTS - REPEALED
He-C 6353.01 - 6353.08
Source. #4714, eff 11-30-89, EXPIRED 11-30-95
New. #7363, eff 9-19-00, EXPIRED: 9-19-08
New. #9640, eff 1-23-10; rpld by #12332, eff
7-21-17
PART He-C 6354 MONITORING HOME-BASED THERAPEUTIC SERVICES
PROVIDERS
Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:4 VI, RSA
170-G:5.
He-C 6354.01 - 6354.03
Source. #8009, eff 1-1-04, EXPIRED: 1-1-12
PART He-C 6355 CERTIFICATION
FOR PAYMENT OF FOSTER CARE PROGRAMS
He-C
6355.01 Definitions.
(a) “Agency”
means the board of directors, executive director, employees, foster parents and volunteers of an organization that is incorporated
and recognized by the secretary of state and licensed
by the department as a child placing agency in accordance with RSA 170-E:24.
(b) “Applicant” means the person or entity that
is requesting certification of a foster care program.
(c) “Case manager” means a staff member employed
by the foster care program with a minimum of:
(1) A bachelor’s degree in social work, psychology, education
or a related field with an emphasis in human services; and
(2) At least 2 years of experience
working with children and families.
(d) “Case plan” means the division for children,
youth and families (DCYF) written plan for the child and the family which
outlines how services will be provided, pursuant to RSA 170-G:4, III and 42
U.S.C. 671, PART E-Federal Payments for Foster Care and Adoption Assistance
SEC.471(a)(16), 475(1) and (5)(A and D) State Plan For Foster Care and Adoption
Assistance.
(e) “Certification for payment” means the process
by which DCYF approves the operation of and payment to foster care programs.
(f) “Child” means:
(1) “Child” as defined in RSA
170-E:25, I. The term includes “youth;”
or
(2) For the purposes of
compliance with RSA 126-U, “child” as defined in RSA 126-U:1, I, namely “a
person who has not reached the age of 18 years and who is not under adult
criminal prosecution or sentence of actual incarceration resulting therefrom,
either due to having reached the age of 17 years or due to the completion of
proceedings for transfer to the adult criminal justice under RSA 169-B:24, RSA
169-B:25, or RSA 169-B:26. ‘Child’ also includes a person in actual attendance
at a school who is less than 22 years of age and who has not received a high
school diploma.”
(g) “Child placing agency” means “child placing
agency” as defined in RSA 170-E:25, IV.
(h) “Child protective services worker (CPSW)”
means an employee of DCYF who has expertise in managing cases to ensure
families and children achieve safety, permanency and well-being referred to the
department pursuant to RSA 169-C, RSA 170-B, RSA 170-C and RSA 463.
(i) “Clinician” means an individual who has a
master’s degree in a clinical field such as social work, marriage and family
therapy, psychology, education, counseling, human services, or a degree which
would make one eligible for a
(j) “Clinical coordinator” means a staff member
employed by the foster care program responsible for administrative oversight of
the clinical services provided at the program. This term includes treatment
coordinator.
(k) “Commissioner” means “commissioner” as
defined in RSA 170-E:25, V.
(l) “Contact” means any communications including
face-to-face, via telephone, postal mail, electronic mail, or internet
networking.
(m) “Corrective action plan” means “corrective
action plan” as defined in RSA 170-E:25, VI.
(n) “Department” means the
(o)
“Division for children, youth, and families (DCYF)” means the organizational
unit of the department of health and human services that provides services to
children and youth referred by courts pursuant to RSA 169-B, RSA 169-C, RSA
169-D, RSA 170-B, RSA 170-C and RSA 463.
(p) “Eligible” means that a provider demonstrates
the ability to meet required quality and performance standards of certification
for payment.
(q) “Eligible youth for adult living preparation”
means youth in out-of-home care who are age 14 years or older.
(r) “Family” means the individuals to whom the
child is related legally or biologically, such as, but not limited to parents,
siblings, grandparents, aunts, and uncles.
(s) “Foster family home” means child care in a
family setting as defined in RSA 170-E:25.
(t) “Foster care program” means a licensed child
placing agency which recruits, trains and licenses and supervises foster family
homes and provides parental care in a licensed foster family home on a regular,
24 hour a day, residential basis.
(u) “Human services” means helping people in
areas, which include:
(1) Education;
(2) Mental health;
(3) Recreation;
(4) Child care;
(5) Medical services;
(6) Law enforcement;
(7) Corrections; and
(8) Social services.
(v) “Incident” means:
(1) A child’s behavior that is
extreme, including, but not limited, to behavior that is assaultive,
destructive, self-injurious, or self-destructive;
(2) Any behavior leading to
physical intervention or seclusion of a child; or
(3) An occurrence involving an
accident or injury, or requiring involvement of outside agencies.
(w) “Juvenile probation and parole officer
(JPPO)” means the DCYF representative who has an expertise in managing cases
resulting from concerns of delinquency pursuant to RSA 169-B or CHINS pursuant
to RSA 169-D, to ensure families and children achieve safety, permanency, and
well-being.
(x) “License” means “license” as defined in RSA
170-E:25, XI.
(y) “NH bridges” means the case management,
tracking, and automated billing system used by DCYF for children who are in
out-of-home placement and/or for whom the department has a legal
responsibility.
(z) “Permanency plan” means the set of
goal-directed activities designed by DCYF, the parents, and the child that will
achieve legal, emotional and physical permanency for children in foster care.
(aa) “Physical intervention” means a behavior
management technique through which staff or foster parent(s) use the minimum
amount of physical contact on a child, which is necessary for the
circumstances. This term includes “physical management.” Physical intervention
might be reportable under RSA 126-U.
(ab) “Policies” mean written guidelines, practices
and procedures specifying the current and future actions to be taken that
direct the operation of the foster care program.
(ac) “Prescribing practitioner” means any of the
following state licensed healthcare providers, that provide services identified
in 42 CFR 440.130 to reduce a physical or mental disability, and aid in the
restoration of a recipient to his or her
best functioning level:
(1) Health care providers
licensed in accordance with RSA 326-B;
(2) Physicians;
(3) Physician’s assistants;
(4) Any practitioner licensed
by the
(5) Any practitioner licensed
by the
(ad) “Program” means an identifiable system of
social service interventions designed for an individual child or groups of
children.
(ae) “Program coordinator” means the individual responsible
for the daily administration of a foster care program.
(af) “Progress reports” means the monthly written
notes sent to DCYF and the parent(s) or guardian(s) by the staff of a foster
care program which document the services being provided to the child.
(ag) “Psycho-social assessment” means a type of
professional assessment, which provides a clinical summary derived from a
multidimensional evaluation of psychological, sociocultural, and environmental
factors that are components of a presenting issue. It includes results of tests
and evaluations, brief expressive descriptions of the problem, and an inventory
of actual and potential assets and resources, the prognosis, and analysis of
what is needed or planned to achieve the desired outcomes. The term psycho-social assessment includes a
psychosocial diagnosis.
(ah) “Quality assurance” means the process that
DCYF staff use to monitor, support, and provide technical assistance to foster
care programs to assist in their ability to comply with He-C 6335.
(ai) “Residential treatment program” means the
model and implementation of services to meet the treatment and supervision
needs of the children pursuant to RSA 170-G:4, XVIII, and provide 24 hour care
of children 365 days a year including all of the employees therein.
(aj) “Respite care” means “respite care” as
defined in RSA 170-E:25, XV.
(ak) “Restraint” means “restraint” as defined in
RSA 126-U:1, IV.
(al) “Runaway” means a child who has failed to
return to his or her placement, has hid, or concealed him or herself without
permission of his or her legal custodian, foster care provider, or supervising
authority.
(am) “Seclusion means “seclusion” as defined in
RSA 126-U:1, V-a.
(an) “Supervision” means an administrative, supportive,
and educational process used extensively in foster care programs to help case
managers and clinical staff develop and refine their skills, so they are able
to provide quality care and treatment to the child and his or her family.
(ao) “Transitional plan” means an agreement made
between a foster care program and the residential treatment team to set
responsibilities, roles, and timeframes for the completion of tasks to complete
the transition of a child from a residential treatment program to a foster care
program.
(ap) “Transitional visit” means a visit which is
part of the child’s community re-integration and transition process approved in
the transitional plan that will support the matching and temporary overnight
visitation of a child into a licensed foster family home towards the goal of
achieving a successful permanent placement.
(aq) “Treatment plan” means the written,
time-limited, goal-oriented, therapeutic plan developed by the treatment team
for the child and family, which includes the strategies to address the issues
that brought the child into placement, and which is consistent with
rehabilitative and restorative services.
(ar) “Treatment team”
means the individuals including, at a minimum, the child, if developmentally
appropriate, his or her parent(s) and guardian(s), foster parent, foster care
program clinical staff, prescribing practitioner, and DCYF staff.
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He-C
6355.02 Application Process.
(a) A licensed foster family home shall be
considered compliant with certification standards when it is determined to be
in compliance with He-C 6446.
(b) A staffed foster family home shall be
considered compliant with certification standards when it is determined to be
in compliance with He-C 6355.11 and He-C 6446.
(c) Each foster care program shall be determined
eligible for certification by demonstrating in its application that it meets
the quality and performance certification standards in He-C 6355.
(d) Each foster care program applicant shall
demonstrate compliance with RSA 170-G:4, XVII, He-C 6380, enrollment and
payment requirements, and He-C 6420, Medicaid covered services in residential
facilities.
(e) Any foster care program as defined in He-C
6355.01(t) above, licensed in accordance with RSA 170-E, He-C 6446 or from
another state, that seeks certification in accordance with He-C 6355 shall
request application Form 2612 “Certification For Payment Application - Foster
Care Program,” (January 2015) from DCYF and be supported by a need identified
by DCYF in accordance with RSA 170-G:4.
(f) The application in (e) above shall be
completed, signed and dated by the foster care program’s executive director, or
designee, affirming or agreeing with all of the following:
(1) “I have reviewed the
Administrative Rules He-C 6355 and He-C 6446 and will adhere to the rules as a
certified provider. I authorize the NH
Division for Children, Youth and Families (DCYF) to conduct a certification for
payment review to determine the program’s compliance with Administrative Rules
He-C 6355 and He-C 6446. I further
understand that DCYF has the right to verify information contained in this
application.”
(2) “I attest that the program
is in compliance with He-C 6355, He-C 6446 and the applicable Medicaid rules,
and that all information provided as part of the application and in the required
attachments is true and complete to the best of my knowledge.”
(3) “I certify that the following pre-employment checks were completed
for all staff, and reviewed as required in He-C 6355.04, a criminal record
check, a BEAS state registry check, a DCYF central registry check and a NH
motor vehicle record check.”
(4) “I understand and agree to
cooperate with a site visit as part of the application process.”
(5) “The information contained
in this application is correct to the best of my knowledge.”
(g) The completed application in (e) above shall
be returned to DCYF within 90 days of receipt.
(h) The applicant shall provide the following
information with the application in (e) above:
(1) A narrative, which shall include:
a. A description of
the foster care program being proposed, to include any specialized services and
the population the program desires to serve;
b. The documented
need for the program as required by RSA 170-G:4, XVIII;
c. A description of
how individual needs of children and families will be met, including but not
limited to clinical provisions, educational, recreational, independent living,
transitional services and case management, as applicable;
d. A description of
how the program promotes the safety, permanency and well-being of children and
families;
e. A description of
medical services provided or arranged in order to meet the individual needs of
children; and
f. The quality
assurance process that the applicant intends to use for the program, including
all supporting documentation.
(2) Attachments, which shall include:
a. The name, office
held, professional affiliation, address and telephone number of each person on
the program’s board of directors;
b. A copy of the
program’s license issued in accordance with the following:
1. For programs in
2. For programs outside of
c. A completed Form
2426 “Residential Resource Guide Provider Form,” (January 2015);
d. A detailed budget
describing the costs associated with the delivery of the foster care program;
and
e. An organizational
chart, to include names, titles, and job descriptions of personnel, and the
corresponding credentials which document the education and experience
requirements in He-C 6355.16, as applicable; and
(3) A copy of the program’s
policies required by He-C 6355.09 and any other policies maintained by the
program.
(i) If the type of certification being sought in
(e) above is for staffed foster family home care, the following additional
information shall be included:
(1) The name and address of 3
non-family members as references for the director, including the most recent
employer, if applicable;
(2) The names, addresses, and
telephone numbers of the members of the board of directors and advisory board;
and
(3) Documentation that the
residence and staff have met the requirements of He-C 6446.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
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New. #10783, eff 2-13-15
He C
6355.03 Renewal of Applications.
(a) A licensed foster care program seeking to
renew the certification as a foster care program shall file for renewal of
certification no later than 3 months prior to the expiration date of the
current certification.
(b) The
executive director or designee shall complete and sign Form 2612R
“Certification for Payment Renewal Application – Foster Care Programs” (January
2015), affirming or agreeing to the following:
(1) “I have reviewed the
Administrative Rules He-C 6355 and He-C 6446 and will adhere to the rules as a
certified provider. I authorize the NH
Division for Children, Youth and Families (DCYF) to conduct a certification for
payment review to determine the program’s compliance with administrative rules
He-C 6355 and He-C 6446. I further
understand that DCYF has the right to verify information contained in this
application.”
(2) “I attest that the program
is in compliance with He-C 6355, He-C 6446 and the applicable Medicaid rules,
and that all information provided as part of the application, and in the
required attachments is true and complete to the best of my knowledge.”
(3) “I certify that the following pre-employment checks were completed
for all staff, and reviewed as required in He-C 6355.04, a criminal record
check, a BEAS state registry check, a DCYF central registry check and a NH
motor vehicle record check.”
(4) “I understand and agree to
cooperate with a site visit as part of the application process.”
(5) “The information contained
in this application is correct to the best of my knowledge.”
(c) The foster care program shall provide the
following information on the renewal application:
(1) A narrative
which shall include:
a. A description of
any changes made to the program during the last certification period; and
b. The results of
the most recent self-evaluation reviewing the program’s performance in meeting
identified goals and outcomes; and
(2) Attachments
documenting the following:
a. A description of
the foster care program being proposed, the documented need for the program, and
how individual needs of children and families will be met, including but not
limited to, clinical provisions, medical, educational, recreational,
independent living, transitional and permanency services, as applicable and how
the program promotes the safety, permanency and well-being of children and
families, including specialized services that are supported by certifications
and/or accreditations;
b. Any changes made
to the program’s board of directors and the names, addresses, and telephone
numbers of the new board members;
c. The names and job
functions of any personnel hired since the last certification; and
d. A copy of the
program’s license and/or operational approval, in accordance with the
following:
1. For programs in
2. For programs outside of
e. A completed Form
2426 “Residential Resource Guide Provider Form,” (January 2015).
(d) The foster care program
shall cooperate with the department during all site visits conducted in
accordance with He-C 6355.27(b)(2).
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
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He-C 6355.04 Requirements
for Background Checks.
(a) The foster care program shall, within 30 days
of employment, submit the following for each new staff member who will work
directly with children in foster care:
(1) The full name;
(2) The date of birth;
(3) The position for which he
or she was hired; and
(4) A notarized statement to
confirm that the following pre-employment checks were completed and reviewed:
a. A criminal
record;
b.
c. DCYF central
registry; and
d. A NH motor
vehicle record.
(b) The foster care program shall not make a
final offer of employment to an individual until:
(1) It has reviewed the
criminal record,
(2) Has determined if any
finding, arrest, criminal conviction and motor vehicle violation or offense of
the employee affects the care and safety of children.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
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New. #10783, eff 2-13-15
He-C 6355.05 Length
of Certification. Certification shall
be valid for 2 years from the date issued, unless certification is voluntarily
surrendered by the foster care program, the program closes, or the program’s
certification is revoked by the department pursuant to He-C 6355.29.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
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New. #10783, eff 2-13-15
He-C
6355.06 Reimbursement.
(a) Billing shall begin on the day of admission and
continue through the day of discharge.
(b) The department shall only reimburse a
certified provider as long as there is no concurrent payment for placement
being made to another paid placement.
The certified provider shall be reimbursed for the day of admission and
the day of discharge, or both if applicable, pursuant to (a) above.
(c) The foster care program may sub-contract with
other providers for the range of services required by He-C 6355.12(e)(1)-(11)
and He-C 6355.13(n)(1)-(14) as long as the DCYF staff member responsible for
the child’s case has approved the arrangement.
(d) Any sub-contractor used on a temporary or
long-term basis, as authorized in (c) above, shall operate with a current
license in accordance with RSA 170-E or within the scope of their professional
license, if required.
(e) DCYF shall not be responsible for payments
made by a foster care program to a sub-contractor for services provided in
accordance with (d) above.
(f) Any foster care program that readmits a child
who has run away or had an acute hospitalization shall be reimbursed pursuant
to sections He-C 6355.20 and He-C 6355.21.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
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New. #10783, eff 2-13-15
He-C 6355.07 Referrals
and Admissions to a Foster Care Program.
(a) The foster care program shall make the
following information available to the parent(s) or guardian(s) during the
admission process:
(1) The philosophy of the
program;
(2) Typical routines of the
foster family;
(3) The behavior management and
disciplinary practices of the program;
(4) Any specific treatment
strategy used by the program;
(5) Policies on visitation and
other communication with the child;
(6) The services provided to
families and the associated costs;
(7) Procedures that the
parent(s) or guardian(s) may use to provide input about the care of the child;
(8) The name and telephone
number of staff at the foster care program that the parent(s) or guardian(s)
may contact;
(9) A description of any
religious practices or services available to children;
(10) How the educational needs
of children are met; and
(11) How health and medical
needs of children are met.
(b) Should the parent(s) or guardian(s) not
participate in the admissions process, the same information required in (a)
above shall be mailed to them within 7 days of intake. If the parent’s location
is unknown, the information shall be provided to DCYF for service to the parent
when located.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
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7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C 6355.08 Discharge
Conditions.
(a) Once admitted to the foster
care program, the child shall not be discharged unless one or more of the
following conditions exist:
(1) The child has successfully
completed the program and is ready to transition to his/her identified
permanency plan or concurrent permanency plan;
(2) The treatment team has
determined that a less restrictive environment is in the child’s best interest;
(3) The child is a danger to
himself, herself, or others and, after intensive staff intervention or crisis
stabilization, it is determined that a more restrictive placement is necessary
in order to maintain safety;
(4) The child is determined to
be in need of psychiatric hospitalization after an emergency mental health
evaluation;
(5) The child is a danger to
others as determined via delinquency proceedings conducted pursuant to RSA
169-B; or
(6) The child's clinical needs
can be best met in another setting as determined in the treatment planning
process and the child has been accepted into that setting.
(b) If DCYF or the foster care program determines
an unplanned discharge is necessary, all treatment team members shall be
provided written, or electronic, notice at least 14 calendar days prior to the
requested date that the child in placement is to be removed from their program
including the detailed reasons for such request, except if a request for an
immediate unplanned discharge is granted due to a circumstance identified in
(a)(3), (a)(4), or (a)(5) above.
(c) Prior to a discharge, with the exception of a
discharge relative to (a)(3), (a)(4), or (a)(5) above, the foster care program
in conjunction with the family and the DCYF representative, or both, shall
discuss the transitional services to support family reunification, or the
child’s transition to an alternative placement.
(d) When the child is discharged, the foster care
program shall provide details around medication management and medical concerns
to the entity the child is discharged to, in writing, on the day of discharge.
(e) A written discharge summary shall be
completed no later than 15 days after the child's discharge.
(f) The discharge summary shall be filed in the
foster care program’s record and a copy shall be sent to the representative
from DCYF and the parent(s) or guardian(s).
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
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New. #10783, eff 2-13-15
He-C 6355.09 Requirements for Written Policies of a
Foster Care Program. The program
shall have written policies and procedures on:
(a) The referral, admission and discharge
process;
(b) Recruiting and screening of foster parents;
(c) Matching of youth with foster parents;
(d) The services provided to both the foster
family and the child’s family to promote permanency and support continued
family involvement through placement;
(e) Respite care options;
(f) The array of social and clinical services
provided and limitations or conditions for use;
(g) The foster care program’s processes for:
(1) Filing a grievance,
(2) Discharging a child; and
(3) Emergency planning.
(h) The foster care program’s general behavioral
and conduct expectations of children including discipline, conduct and
management of children’s adverse behaviors, including:
(1) The methods and tools used for the creation
of the individualized treatment plan;
(2)
The child management techniques identified to assist foster parents and
or staff in making decisions regarding children’s behavior;
(3)
Acceptable and unacceptable foster parents and or staff responses to
inappropriate behavior;
(4)
The procedures and requirements for reporting and documenting events
governed by RSA 126-U;
(5) The guidelines for using timeout,
seclusion and physical intervention in accordance with RSA 126-U and He-C 4001;
and
(6) Documentation, by foster parents and
staff, of inappropriate behaviors of children and interventions used in
response to the child’s conduct;
(7)
Obtaining emergency services by foster parents and staff, for children
who are demonstrating behaviors that are a threat to self or others;
(8)
Documentation and reporting of incidents;
(9)
Documentation and reporting of inappropriate conduct of foster parents
and staff; and
(10)
Use of seclusion and restraint in accordance with RSA 126-U.
(i) The foster care program’s record keeping
policies regarding confidentiality; and
(j) The foster care program’s administrative
procedures.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
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New. #10783, eff 2-13-15
He-C 6355.10 Compliance
Requirements for Foster Family Homes.
(a) Foster family homes shall provide substitute
family life experiences for a child in a home for a planned, temporary time, in
accordance with He-C 6446.
(b) These experiences shall include but not be
limited to:
(1) Care in a family
environment for children who have pending petitions for, or have been
adjudicated as, abused or neglected, in need of services, or delinquent;
(2) Access to age
and developmentally appropriate opportunities and activities that positively
support his or her education, physical, intellectual, and social needs; and
(3) Opportunities to maintain contact with family and
identified connections, as deemed appropriate.
(c) Foster family homes shall demonstrate
compliance with this section and:
(1) He-C 6446,
Foster Family Care Licensing Requirements;
(2) RSA 170-E; and
(3) RSA 126-U.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
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New. #10783, eff 2-13-15
He-C
6355.11 Compliance Requirements for
Staffed Foster Family Homes.
(a) Staffed
foster family homes shall provide substitute family life experiences for a
child in a home staffed by program personnel, for a planned, temporary time, in
accordance with He-C 6446, including but not limited to:
(1) Care in a family
environment for children who have pending petitions for, or have been
adjudicated as, abused or neglected, in need of services, or delinquent;
(2) Access to age
and developmentally appropriate opportunities and activities that positively
support his or her education, physical, intellectual, and social needs;
(3) Opportunities to maintain contact with family and
identified connections, as deemed appropriate; and
(4) Staffed foster
family homes shall not allow the possession or storage of weapons or firearms
on the premises.
(b) Staffed foster family homes shall serve a
maximum of 4 children in the foster family home.
(c) Staffed foster family homes shall demonstrate
compliance with this section and:
(1) He-C 6446,
Foster Family Care Licensing Requirements;
(2) RSA 170-E; and
(3) RSA 126-U.
(d) Staffed foster family homes shall be licensed
and supervised by the child-placing agency that owns, rents, or leases the
property, applied for the certification, and employs the staff assigned to the
home.
(e) Staffed foster family homes s shall not be
required to have full-time resident staff, but shall comply with 24-hour staff
coverage for the foster family home, as follows:
(1) Employs direct
care staff who meet the education, background, and experience requirements to
be a foster parent pursuant to He-C 6446;
(2) Employ a minimum
of 2 staff or caregivers during waking hours to provide care and supervision;
and
(3) Provide
overnight coverage with a minimum of one available staff on the premises.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
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New. #10783, eff 2-13-15
He-C
6355.12 Compliance Requirements for
Therapeutic Foster Care.
(a) Foster care programs certified to provide
therapeutic foster care shall demonstrate compliance with this section and:
(1) He-C 6446,
Foster Family Care Licensing Requirements;
(2) He-C 6448,
Standards for Child Placing Agencies;
(3) He-C 6420,
Medicaid Covered Services;
(4) RSA 170-E:25,
IV; and
(5) RSA 126-U.
(b) Foster care programs certified to provide
therapeutic foster care shall be a licensed child placing agency in
(c) Foster
care programs certified to provide therapeutic foster care shall be provided in
an experienced foster family home that is licensed in accordance with He-C
6446.
(d) Foster care programs certified to provide
therapeutic foster care shall provide services to children who have chronic
mental, emotional, physical, or behavioral problems that require individual
supervision and consistent programmatic structure, in a treatment intensive
family environment.
(e) The foster care programs certified to provide
therapeutic foster care shall provide, at a minimum, the following services:
(1) Placements in a
licensed foster family home in the region where the child has resided unless
otherwise requested by DCYF;
(2) Case management
services for parents and children;
(3) Counseling and
therapeutic interventions;
(4) Coordination of
treatment teams, case conferences, and services;
(5) A system for
24-hour, 7-days-per-week crisis response that includes at a minimum, on-call
services;
(6) Transportation
for the children in the therapeutic foster family home;
(7) Child health
support assistance;
(8) Parent education
and training;
(9) Behavior and clinical
consultation for foster parents, staff and parents;
(10) Assistance with
social development of the child, including but not limited to, child care,
developmental pre-school, camp, community and recreational activities for
children; and
(11) A treatment
planning process in accordance with this section.
(f) Therapeutic foster family homes shall be
supervised by a child placing agency that has a family-centered focus in which
foster parents and clinical support staff provide intensive services to children
and their families and implement a structured treatment plan.
(g) The foster care program shall be established
and designed so that the service delivery system is responsive to the needs of
the foster children, families and therapeutic foster families.
(h) The foster
care programs certified to provide therapeutic foster
care shall employ at a minimum:
(1) A program
coordinator;
(2) A recruitment
and licensing specialist;
(3) Clinicians who
provide assistance and clinical support to therapeutic foster families; and
(4) A prescribing
practitioner.
(i) Unless otherwise determined in the case plan,
supportive and clinical services needed to implement the treatment plan shall
be provided to the child, family, and the foster parents by the therapeutic
foster care program.
(j) The program shall maintain daily
documentation of supportive services to the child and foster family to assess
and monitor the child's progress. This shall include daily notes completed by
the therapeutic foster care parent.
(k) At all treatment team meetings, the program
shall outline in the treatment plan the level of support provided to the
therapeutic foster care parents to meet the needs of the child and foster
family.
(l) The clinician from the foster care program certified to provide therapeutic foster care shall:
(1) Meet the
qualifications to be clinical staff in accordance He-C 6355.01(i);
(2) Be supervised by
a prescribing practitioner or licensed clinician for a minimum of one hour
every 2 weeks;
(3) Deliver the
level of support foster parents need to implement the child’s treatment plan in
the foster family home and the community;
(4) Coordinate and
facilitate the meetings of the treatment team and the services to the child,
family, and foster family; and
(5) Provide
supportive individual and family counseling and clinical services as determined
in the treatment plan for the child, family and foster family, unless otherwise
determined in the case plan.
(m) Therapeutic foster families shall:
(1) Participate in
weekly face-to-face supervisory visits in the foster family home provided by
the program;
(2) Provide daily
written notes each week to the therapeutic foster care program that reflect
progress towards the goals and objectives established in the child’s treatment
plan;
(3) Care for not
more than one foster child, unless assisting DCYF in coordinating care for a
sibling group or an approved respite situation; and
(4) Provide no other
certified or licensed child care services in the home.
(n) The primary therapeutic foster parent shall:
(1) Be a licensed
foster parent who is at least 25 years of age and who has not experienced any
major life changes within the past year, including but not limited to: a
divorce, death of a spouse or child, or loss of employment;
(2) Have at least 4
years experience providing foster care, and an interest and demonstrated skill
in working with children with significant clinical needs;
(3) Demonstrate 24
hour per day availability to meet the child’s needs and provide case management
responsibilities;
(4) Complete 24
hours of foster parent training per year, including ongoing and
situation-specific topics including but not limited to:
a. Trauma-informed
care which incorporates in the treatment an awareness of the impact of
traumatic stress on the abused or neglected children and their families;
b. Parenting a child
with attachment difficulties;
c. Siblings and
family relationships;
d. Educational
advocacy;
e. Crisis management
and positive behavioral interventions;
f. Understanding and
facilitating transitions to permanency; and
g. Self-care of the
foster parent; and
(5) Access foster
parent support, which shall include, at a minimum, respite care, support
groups, social events and activities.
(o) If the primary therapeutic foster parent is
unable to meet the requirements in He-C 6355.12 (n)(3) above, the treatment
team or program shall implement a
pre-approved plan to support the therapeutic foster parent in meeting the needs
of the child.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
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7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C
6355.13 Compliance Requirements for
Individual Service Options Programs.
(a) Individual Service Options (ISOs) programs
shall demonstrate compliance with this section and:
(1) He-C 6446,
Foster Family Care Licensing Requirements;
(2) He-C 6420,
Medicaid Covered Services;
(3) RSA 126-U;
(4) RSA 170-E; and
(5) One of the
following:
a. He-C 6448,
Standards for Child Placing Agencies; or
b. He-C 4001, New
Hampshire Residential Child Care Licensing rules.
(b) An ISO program shall have a current license
to operate a residential facility or child placing agency in
(c) ISO foster care services shall be provided in
an experienced foster family home that is licensed in accordance with He-C
6446.
(d) The ISO program applying for certification
may either be a child placing agency, or a licensed residential child care
facility that has foster family homes licensed by another child placing agency,
provided that the requirements in (a) above are met.
(e) An ISO program shall have an array of
professional, social, and community services that may be accessed to meet the
individual needs of a child and his or her family.
(f) An ISO program shall develop and implement a
service delivery system that shall be designed primarily to wrap around individualized
programming for children who have chronic mental, emotional, physical, or
behavioral problems.
(g) An ISO program shall place only one foster
child with a family unless:
(1) A sibling group
is being placed together; or
(2) The department and the ISO program determine, following
an assessment of the foster parents ability, experience and skill, that a
second unrelated child may be cared for and the safety and well-being of both
children can be maintained.
(h) The ISO program shall be designed in such a
way that the service delivery system is able to respond immediately and
directly to the needs of the child.
(i) ISO programs shall provide services to
children who meet the following criteria:
(1) Abused and
neglected children, children in need of services (CHINS), and delinquents who
have a court order, or children using voluntary services for an ISO foster care
placement; and
(2) Children from birth to under 21 years of age, who
display or have symptoms of any combination of the following:
a. Chronic mental,
emotional, physical or behavioral problems;
b. Present
post-traumatic stress symptoms;
c. Challenging and
provocative behaviors;
d. A mental health
diagnosis; and
e. Are sexually
reactive;
(3) Can participate
in a local education program;
(4) Will benefit
from out-of-home placement in a foster family home care setting; and
(5) Require
intensive supervision and consistent structure.
(j) The ISO program
shall determine a child’s acceptance within 10 days of the date of receipt of
the referral form, Form 1906 “Referral to Individual Service Options Provider,”
(January 2015) completed by the CPSW or JPPO, including:
(1) Copies of court
orders relating to the approval of and payment for the foster care;
(2) The family’s
social history, if completed or as soon as available;
(3) The child’s and
family’s available medical history;
(4) The current case
plan in its entirety, if completed or as soon as available;
(5) The child’s
predispositional investigation, if completed or as soon as available; and
(6) The ISO’s
release of information form signed by the parent or guardian.
(k) The ISO program shall provide or coordinate
services that meet the clinical needs of the child, child and parent, and the
foster family either through services within the program or accessing community
services. The program shall coordinate community-based services for the birth
family, when requested.
(l) The service delivery system shall be based on
the individual needs of the child as identified in the treatment plan.
(m) The ISO
program shall conduct and document a psycho-social assessment and develop a
treatment plan for each child in accordance with He-C 6355.15.
(n) ISO programs shall provide or coordinate the
following services for the child identified for ISO foster care services, as
applicable:
(1) Placements in a
licensed foster family home in the region where the child has resided, unless
otherwise requested by DCYF;
(2) Planned
visitation, both supervised and unsupervised, among the parents and the child
and siblings or extended family;
(3) Case management,
treatment planning, and service coordination, to include assistance in the
coordination of:
a. Medical,
community mental health, and dental care;
b. Public or private
school education;
c. Recreation;
d. Vocational
services; and
e. Substance abuse
evaluations and random drug testing, if applicable;
(4) Individual
counseling and family counseling for the child;
(5) Emergency
on-call 24-hour response to crises;
(6) Crisis
stabilization;
(7) Respite care in
a licensed foster family home or program;
(8) Licensed child
care;
(9) Transportation;
(10) Adult living
preparation for adolescents;
(11) Administration
of medications;
(12) Identification
of relatives, mentors, and others who will support or assist the child and
family;
(13) Transitional
assistance to adult care, if applicable; and
(14) Transitional
assistance to reach the permanency goal for the child;
(o) If the program is unable to comply with He-C
6355.13 (n)(1) above, it shall document justification for a placement outside
of the region, in accordance with the child’s treatment or service needs.
(p) If the child identified for ISO services is
placed with a sibling or sibling group, the foster care program shall only be
financially responsible for the child identified for ISO services, and shall
assist DCYF in coordinating services for the siblings in the same home.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C
6355.14 Crisis Stabilization for a
Foster Care Program.
(a) The foster program shall contact the DCYF
administrator or designee to request approval of residential crisis
stabilization for a child, prior to service delivery.
(b) Crisis stabilization in residential care
provided by a foster care program shall not exceed 10 days within each 12-month
period that the child is in placement.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C
6355.15 Treatment Planning Process
for a Foster Care Program.
(a) The treatment planning process shall only
apply to therapeutic foster care programs (TFCs) and ISOs.
(b) All foster care programs shall conduct and
document a psycho-social assessment of the child with recommendations for
treatment. Based on the assessment and recommendations, the program shall
conduct a treatment team meeting and develop a treatment plan within 30
calendar days of admitting the child.
(c) The treatment plan shall include:
(1) The summary of
the psycho-social assessment;
(2) Treatment
recommendations based on the psycho-social assessment; and
(3) A transition
plan for the child and family that includes:
a. An estimate by
the treatment team members of the child’s length of stay, based upon referral
information and the foster care program’s assessment;
b. The child’s permanency plan and concurrent plan
identifying one of the following alternatives for the child in care:
1. Reunification;
2. Adoption;
3. Guardianship by a relative or other person;
4. Permanent relative placement; or
5. Another planned permanent living arrangement;
and
c. Community
reintegration and transition tasks that identify:
1. Specific necessary supports or services that
would enable the child to successfully return to his or her community;
2. The treatment team member who is responsible
for completing the necessary task; and
3. The projected time frame for completion of
each task.
(d) The treatment plan shall, at a minimum,
contain the following domains relating to rehabilitative and restorative
services:
(1) Safety and
behavior of the child;
(2) Family;
(3) Medical,
including community mental health and dental care;
(4) Education; and
(5) Children 14
years of age or older, shall have adult living preparation in addition to
general independent living skills.
(e) Each domain identified in (d) above shall
address:
(1) The goals and
measurable objectives to be achieved by the child and family;
(2) The time frames
for completion of goals and objectives;
(3) The method to be
used for evaluating the child’s and family’s progress; and
(4) The
individualized interventions that shall be used to address the objectives,
including:
a. An identification
of the services that will be provided directly or arranged for, and any
measures for ensuring their integration with the child’s activities including
identifying how the child’s family and foster family will participate in
his/her care;
b. An identification
of the individuals responsible for implementing the stated interventions in the
treatment plan;
c. The frequency of
the intervention; and
d. How the
intervention is documented.
(f) The treatment team shall consist of the
following participants:
(1) The child, if he
or she is of an age, or developmentally appropriate to participate;
(2) The child's
parents or guardian;
(3) The child’s
foster parent(s);
(4) A representative
of DCYF;
(5) The prescribing
practitioner;
(6) The sending
school district personnel for an identified child, as determined by the school
district;
(7) The case manager
or clinician from the foster care program; and
(8) Other persons
significant in the child's life or case, including but not limited to:
a. Teachers;
b. Counselors;
c. Friends;
d. Relatives;
e. CASA or GAL;
f. Family Assessment and Inclusive Reunification (FAIR)
facilitator, which is the administrative reviewer required pursuant to 42 USC
675;
g. Educational
surrogate; and
h. Other advocates
assigned by the court.
(g) The treatment
plan shall include the date and signatures of the following team members,
indicating they participated in the process:
(1) The foster care
program’s program director or clinical coordinator;
(2) A representative
of DCYF;
(3) For Medicaid
funding, the name of the prescribing practitioner. If the prescribing
practitioner is also the clinical coordinator, he or she shall indicate these
dual functions;
(4) The clinician or
the case manager of the foster care program;
(5) The child, if
appropriate for the age or developmental level;
(6) The child’s
parents or guardian. If DCYF is the guardian, the worker shall sign to indicate
the dual functions; and
(7) The child’s
foster parent(s).
(h) When any of the individuals in (g) above do
not participate, the foster care program shall document its efforts to involve
them.
(i) Revisions to the treatment plan shall be
explained in writing to any individuals of the team who are unable to
participate and documented in the child’s file.
(j) The treatment team shall implement the
treatment plan, which shall be reflected in the child’s daily routine, logs,
progress notes, and discharge summary.
(k) The treatment plan shall be filed in the
child’s record and copies sent to the individuals identified in (g) above and
the legally liable school district.
(l) An internal treatment plan review meeting
shall be held by the foster care program’s staff 3 months from the date of the
initial treatment plan meeting, to evaluate progress made towards the
established goals and objectives.
(m) The treatment team shall meet 6 months from
the date of the initial plan to:
(1) Update the
treatment plan;
(2) Document
progress towards objectives; and
(3) Review the
requirements in (d) through (e) above.
(n) For children whose care is extended beyond
the 6-month treatment plan meeting, the treatment team shall meet every 3
months thereafter, as in (m) above, or more frequently if necessary until the
community reintegration and transition plan is implemented or an alternative
discharge plan has occurred.
(o) The foster care program shall be allowed a 7
calendar day extension to acquire signatures on the treatment plans. Reasonable
efforts to obtain the signature of the parent(s)/guardian(s) and DCYF shall be
documented as meeting this requirement.
(p) Once the treatment plan is completed, foster
parents, case managers, and clinicians shall receive direct supervision and
instruction from the foster care program with oversight by the prescribing
practitioner to assure that each child’s treatment plan is consistently
implemented.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C
6355.16 Staffing and Training
Requirements for a Foster Care Program.
(a) Foster care programs shall provide the
following staff:
(1) A program
coordinator who has the following minimum qualifications:
a. A master’s degree
in social work, psychology, education or a related field, with an emphasis in
human services;
b. Two years of
clinical experience working with families; and
c. Two years of
supervisory or management experience;
(2) At least one clinician
pursuant to He-C 6355.01(i), who has 2 years clinically supervised experience
working with children and families.
(3) Case managers
pursuant to He-C 6355.01(c);
(4) A prescribing
practitioner who is employed by the program or has a current contract or like
agreement with the program;
(5) A recruitment
and licensing specialist who shall:
a. Recruit and
screen applicants to be licensed as a foster family care provider;
b. Perform or
coordinate a home study and recommend foster parents for licensure;
c. Coordinate
pre-service training for prospective foster parents;
d. Coordinate
ongoing training opportunities and monthly support groups for foster parents in
accordance with the requirements of He-C 6446;
e. Participate in
the matching of children with licensed foster family homes; and
f. Monitor foster
family homes for compliance with He-C 6446; and
(6) Trained foster
parents available to meet the needs of the children accepted into the program.
(b) Clinicians who provide services to the
children, foster care programs, and families shall:
(1) Participate in
weekly supervision with the prescribing practitioner or clinical coordinator,
which shall include a discussion of each case and a review of the progress made
by the child and family towards the goals of the treatment plan;
(2) Receive 40 hours
of specialized training during each year of employment, which shall be in
individual and family issues and include:
a. Current family
systems theory;
b. Current
psychology of family systems;
c. Ethics;
d. Trauma-informed
care;
e. Any
evidence-based programs pertinent to the service population; and
f. Up to 15 hours of
weekly supervision; and
(3) Clinicians shall
not exceed a maximum of 10 concurrent cases.
(c) Case managers who provide services to the
children, foster care programs, and families shall:
(1) Receive weekly
supervision by a licensed clinician, or clinical coordinator, for a minimum of
one hour every week, including a discussion of each case and a review of the
progress made by the child and family towards the goals of the treatment plan;
(2) Receive 30 hours of specialized training
during each year of employment which shall include:
a. Ethics;
b. Current practice;
c. Needs of the
service population; and
d. Up to 8 hours of
weekly supervision; and
(3) Case managers
shall not exceed a maximum of 6 concurrent cases.
(d) Recruitment and licensing specialists shall
receive 20 hours of training during each year of employment on topics related
to foster care, which shall include recruitment techniques, and retention and
training of foster parents.
(e) Foster parents shall receive a minimum of 24
hours of training each year on the provision of care based on the direction of
the foster care program.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C
6355.17 Record Keeping and Reporting
Requirements for a Foster Care Program.
(a) Each foster care program shall provide DCYF
with a monthly progress report for each child in its care.
(b) Progress reports on the child’s involvement
in services shall be provided to the child’s parent(s) or guardian(s) unless
contraindicated by a court order, or if DCYF has applied for or is in the
process of applying for a court order.
(c) Progress reports shall be mailed to DCYF, and
parent(s) or guardian(s) no later than the 15th day of the month following the
date of the progress report. If the child has been in care for fewer than 14
calendar days the information may be included in the most appropriate monthly
progress note or discharge summary.
(d) The progress report shall include:
(1) The child’s name
and date of birth;
(2) The name of the
person completing the report and the date of the report;
(3) The name of the
foster care program; and
(4) The date of
placement.
(e) Progress reports shall address the following
areas of care:
(1) Status of each
domain identified in the treatment plan including notable changes in specific
goals or objectives;
(2) Summary of
contacts with the child’s family and identified connections;
(3) Modifications to
the treatment plan;
(4) Educational
data;
(5) Contact with
other professionals;
(6) Information about the child’s medical status,
behavioral health care and dental issues, including but not limited to:
a. Prescriptions and
current dosages;
b. List of over the
counter medication;
c. Dates of visits
during the month being reported;
d. New health care
issues and diagnosis;
e. Next scheduled
visits; and
f. Name of health
care practitioner and office address;
(7) Summary of any
incidents or incident reports including reports of the use of seclusion and
restraint as required by RSA 126-U during the period being reported on; and
(8) Disposition of
grievances.
(f) For youth who are age 14 or older, progress
reports shall include documentation of adult living preparation progress, including:
(1) Independent
living training that was completed by staff or foster parents and the child;
(2) Post-care
planning completed with the child; and
(3) A Form 1969
“Monthly NYTD Checklist” (January 2015) completed by the foster care program, for
the purpose of collecting data for the National Youth in Transition Database
(NYTD) pursuant to 45 CFR 1356.80.
(g) The program shall keep records including a
case record on each child and his or her family that contains:
(1) The assessment
used for the development of the treatment plan;
(2) The signed
treatment plan and revisions thereto;
(3) Weekly contact
logs completed by the case manager or clinician documenting at least one
Medicaid covered service;
(4) Daily child and
family progress notes documented by the foster parent, including at least one
Medicaid covered service provided every 7 days;
(5) Documentation of
therapeutic work with the child(ren) and all identified members of the family
system, in support of the case plan and treatment goals;
(6) Copies of the
completed Form 2266 “Medical Authorization and Release,” (August 2006);
(7) Copies of the
completed Form 2267 “Child’s Information Sheet,” (January 2015), Form 2281 “DCYF
Youth Information Sheet,” (January 2015), or Form 2281(J) “Youth Information
Sheet,” (January 2015), as provided by DCYF;
(8) A record of
health care visits including the date, the reason for the visit, provider name
and address;
(9) Any protocol for
the handling and transferring of psychotropic meds;
(10) Monthly
progress reports;
(11) Any incident
reports including reports of the use of seclusion and restraint as required by
RSA 126-U; and
(12) A discharge
summary, if applicable, sent within 15 days of discharge including the
following information:
a. The results of
the services provided, including the outcomes of the goals and objectives
identified in the child’s treatment plan;
b. The needs of the
child and family which remain to be met and the services which will meet those
needs;
c. For planned
discharges, an individualized aftercare plan for each child being reunified
with his or her family;
d. Form 2267 “Child’s
Information Sheet” (January 2015), Form 2281 “DCYF Youth Information Sheet”
(January 2015), or Form 2281(J) “Youth Information Sheet” (January 2015), as
provided by the department and updated by the foster care program; and
e. Documentation of
interventions utilized and the success or ineffectiveness of those
interventions.
(h) Upon discharge from the foster care program, the
program shall transfer the child’s health care information to the new provider
or to the parents or guardian.
(i) Incident reports, including reports of
seclusion and restraint required by RSA 126-U:7-a, shall include, at a minimum:
(1) The date;
(2) Where the
incident occurred, if applicable;
(3) A detailed
description of what occurred prior to, during and after the incident;
(4) The names of all
parties involved;
(5) A description of
any injuries sustained by, and any medical care administered to, the child,
employees or others before, during or after the incident; and
(6) How the incident
was resolved and any outstanding need for follow-up.
(j) Unless prohibited by court order, the foster
care program shall provide notification and documentation of the incident, as
follows:
(1) The foster care
program shall provide verbal notification of the incident to the parent(s),
guardian(s), and DCYF as soon as practicable or within 24 hours whichever is
earlier;
(2) For any incident
where a child is missing or runs away, or the child suffers an injury, which
requires emergency care, the foster care program shall provide immediate verbal
notice to the parent(s), guardian(s) and DCYF;
(3) The foster care
program shall provide a copy of the written incident report described in (i)
above to the child’s parent(s), guardian(s) and DCYF within 5 business days of
the incident; and
(4) Pursuant to RSA
126-U:7-a, for an incident involving serious injury or death during the use of
seclusion or restraint:
a.
The foster care program shall provide verbal notice of the incident
immediately to DCYF;
b. The foster care
program shall provide a copy of the incident report shall be delivered to DCYF
within 48 hours of the incident;
c. DCYF shall provide
verbal notice to the commissioner, the attorney general and the state’s
federally-designated protection and advocacy agency for individuals with
disabilities as soon as practicable or within 24 hours of the incident,
whichever is earlier; and
d. DCYF shall send a
copy of the incident report to the commissioner, the attorney general and the
state’s federally-designated protection and advocacy agency for individuals
with disabilities within 5 business days of receipt of the report of the
incident.
(k) Child-specific reports written by the program
shall be available for review by the child’s parent(s) or guardian(s) unless
contraindicated by the court order or if DCYF has applied for or is in the
process of applying for a court order.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C
6355.18 Transitions to a Foster Care
Program from a Residential Treatment Program.
(a) All transitional visits shall be implemented
in accordance with DCYF’s case plan and the residential program’s treatment
plan for the child.
(b) The identified
foster care program shall become a member of the child’s treatment team.
(c) The treatment team shall develop a written
transitional plan and agreement in accordance with the case plan, which shall
address the length of the transition not to exceed 3 months, the transportation
needs, and other services required to make the transition successful.
(d) The foster care program shall be responsible
for:
(1) Coordinating
transitional visits with DCYF and the residential program;
(2) Preparing foster
parents for the child’s visits;
(3) Providing
support and services to the foster parents as identified in the transition
plan;
(4) Responding to
the foster parents’ needs during the visit; and
(5) Providing
information to the residential program and DCYF concerning the outcome of the
visit.
(e) Pursuant to He-C 6350.25(c), the residential
program shall remain available to respond to any crisis during a transitional
visit including returning the child to the program.
(f) The foster care program shall be responsible
for the supervision of the child during a transitional visit.
(g) The
foster family shall receive a stipend for the DCYF identified respite rate for
overnight transitional visits. The foster care program shall provide any
additional support requested by the foster family, as identified in the
transitional plan.
(h) The
process for transitional visits shall not exceed a total of 10 overnights as
specified in the child’s transitional plan.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C 6355.19 Respite
Care.
(a) Foster care
programs shall provide an array of respite options, including at a minimum:
(1) Hourly staff
support;
(2) In-home and
out-of-home care;
(3) Alternative
child care arrangements as described in the treatment plan; and
(4) Emergency
respite care.
(b) Overnight respite care providers shall be licensed
providers, relatives of the child who are approved, or anyone who has another connection
with the child and who has been approved by the treatment team.
(c) Foster care programs may provide respite
services for another foster child in care, unless contraindicated by either
child’s treatment plan, and as approved by DCYF.
(d) If a sibling group is placed together, the
foster care programs shall assist DCYF in coordinating respite care for the
sibling group, and shall be financially responsible only for the child
identified for ISO services.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C
6355.20 Access to In-Patient Care.
(a) A foster care program shall notify DCYF
immediately upon learning of a child’s need for inpatient or acute care.
(b) Should a child be admitted to an in-patient
psychiatric or acute care hospital, the sending foster care program shall be
reimbursed by the department at the authorized board, care, and treatment rate
for up to 10 consecutive days, if the following criteria are met:
(1) The foster care
program remains available to expedite the return of the child to the foster
family home; and
(2) The foster care
program and the placement provider remain in contact with the child during his
or her hospitalization through attendance at treatment team meetings, phone
contact, and visitation.
(c) While the child is admitted or hospitalized
in accordance with (a) above, the sending foster care program shall not bill
medicaid.
(d) If it is known at the time of the admission
or hospitalization that the child will not be returning to the foster care
program then the child’s payment authorization to the program shall be closed
out immediately.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C
6355.21 Runaways.
(a) Foster care programs shall notify DCYF
immediately upon learning that the child has run away.
(b) Foster care programs shall continue to be
reimbursed by DCYF at their authorized board and care and treatment rate for up
to 10 consecutive days if the following conditions are met:
(1) The foster care
program remains available to expedite the return of the child to the program;
and
(2) The child has
not been placed into another DCYF funded residential treatment program during
that time period.
(c) If a child runs away, the foster care program
shall not bill medicaid during the time that the child is absent without leave.
(d) If it is known at the time a child runs away
that the child will not be returning to the foster care program then the
child’s payment authorization to the program shall be closed out immediately.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C
6355.22 Education.
(a) Foster care programs shall work cooperatively
with the licensing agency, DCYF, the parent(s)
or guardian(s) of the child in care, and the school
in providing for the education of the child in care.
(b) The child shall be enrolled in the local
public school unless his or her needs require an alternative approved
educational program.
(c) The foster care program shall assist in
implementing the individual education plan for a child in care who has been
identified as educationally disabled.
(d) The foster care program shall make time and
space available for studying and shall ensure that children have access to
reference materials.
(e) The foster care program shall support the
on-going education and career planning for youth over the age of 14.
(f) The foster care program shall ensure that
life skills training is available and appropriate to the age and abilities of
the child, including life skills training in:
(1) Family roles;
(2) Sex education;
(3) Hygiene;
(4) Social development;
and
(5) Self-care.
(g) Foster care programs shall assist a child who
is eligible, to participate in the DCYF adult living program, and receive
education in the following:
(1) Consumer
education;
(2) Money
management;
(3) Housing needs;
(4) Higher
education; and
(5) Career planning.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C 6355.23 Adult Living Preparation.
(a) Foster care programs shall assist children to
restore their developmentally appropriate skills and prepare for adulthood, by
complying with the adult living preparation requirements and assisting in the
completion of the DCYF adult living preparation documents.
(b) Foster care programs shall identify and meet
the adult living needs of children who are age 14 or older.
(c) Information obtained through the adult living
preparation shall be shared with the program through DCYF and included in the
treatment plan, daily logs, monthly progress reports, and discharge summary, as
appropriate.
(d) The process of completing or updating adult
living preparation plans shall be done in collaboration with the DCYF worker
and the child.
(e) Foster parents or program staff shall
complete and submit Form 1969 “Monthly NYTD Checklist,” (January 2015) each
month pursuant to He-C 6355.17(f).
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15
He-C
6355.24 Health Care.
(a) Pursuant to He-C 6355.15(d)(3), foster care
programs shall comply with the child’s treatment plan for health care by:
(1)
Arranging for health care services as set forth in the child’s treatment
plan;
(2)
Consulting with the DCYF health care coordinator at the state office
when planning for the psychotropic needs of a child in care.
(3)
Ensuring that the prescribed program of immunizations is followed.
(b) Arranging for other routine and emergency
health care visits and services as appropriate and as needed.
(c)
Foster care programs
shall maintain a record of the health care visits of a child in care, in
accordance with He-C 6355.17(e)(6).
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15 (from He-C 6355.23)
He-C
6355.25 Out-of-State Travel.
(a)
The foster care program’s staff shall obtain written permission from a
child’s parent(s) or legal guardian(s) before transporting a child outside the
state of
(b) The foster care program’s staff shall obtain
written permission from a child’s parent(s), legal guardian(s) and DCYF before
allowing out-of-state travel for overnight visits.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15 (from He-C 6355.24)
He-C
6355.26 Visitation and Interactions
with Family and Friends.
(a) The foster care program shall encourage
positive social relationships and life-long permanent connections with
nurturing adults.
(b) The foster care program shall create and
implement a plan with DCYF and the child’s parent(s) or guardian(s) to maintain
a strong and consistent relationship between the child and his or her family in
accordance with the court order, if family interactions are supported by the
permanency plan required in He-C 6355.15(c)(3)(b).
(c) The plan in (b) above shall:
(1)
Include the location where visits will take place and outline the plan
for transportation arrangements;
(2)
Ensure visitation environments and locations present optimal
opportunities for positive interactions between the child and the visiting
individual(s);
(3)
Specify the length of time and frequency of visits;
(4)
Address privacy and safety issues, including the need for supervised
visitation if required;
(5)
Identify a variety of ways by which family, guardian(s) and friends may
interact with the child including, but not limited to, phone contact and postal
and electronic communication; and
(6)
Provide feedback to the team regarding how the visits have been and the
needs and expectations of future visitation.
(d) The foster
care program shall further support the child in maintaining connections through
receiving and sending mail, use of electronic web-based communications, and
phone, unless contraindicated in the treatment plan.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15 (from He-C 6355.25)
He-C
6355.27 Quality Assurance.
(a) The foster care program shall cooperate with
DCYF in gathering data relative to outcome measures, as follows:
(1) Provide
quarterly data as requested by DCYF;
(2) Provide an
annual data report to DCYF, 30 days after the end of the calendar year; and
(3) Provide an annual narrative report on the number of
children served, work that was accomplished, and any system barriers to the
DCYF foster care specialist.
(b) DCYF shall conduct quality assurance reviews with
each foster care program, consisting of the following:
(1) A review of all
case records, including all foster family home and child treatment records;
(2) A review of the
renewal application as described in He-C 6355.03;
(3) An annual
analysis of the referral data and statistics;
(4) An initial
on-site visit conducted within the first year of a new foster care agency
program’s operation;
(5) For currently
certified programs, an on-site visit once every 2 years; and
(6) An exit
interview held with the executive director to review issues of noncompliance,
areas of concern, observations, and commendations.
(c) Should it
be determined during any departmental visit or quality assurance review that
there are areas of non-compliance with this section, DCYF will require the
foster care program to submit a plan of correction within 30 calendar days of
the date of receipt of the notice of non-compliance.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15 (from He-C 6355.26)
He-C 6355.28 Waiver
Process for a Foster Care Program.
(a) Waivers of requirements for a specific foster
family home shall comply with He-C 6446.26.
(b) Applicants or programs seeking a waiver of a
requirement set forth in He-C 6355.02 – He-C 6355.13 shall submit a written
request to the department, including the following information:
(1) The rule number
for which the waiver is being requested;
(2) The anticipated
length of time for which the requested waiver will be needed;
(3) The reason for
requesting the waiver;
(4) If the waiver is
granted, how the foster care program shall continue to provide for quality care
of the children in light of the waiver;
(5) A plan
specifying how the foster care program shall meet the intent of He-C 6355.02 –
He-C 6355.13 if the waiver is granted;
(6) The impact on
the child and family if the waiver is not granted;
(7) The potential
impact on all children affected by the waiver request; and
(8) A statement
attesting that the request is not out of compliance with the program’s
licensing requirements in RSA 170-E:31.
(c) When a waiver request involves prospective
staff who do not meet the certification
qualifications, the program shall not hire the individual until the department
has made a decision to grant or deny the waiver request.
(d) A request for a waiver shall be approved if
the department determines it meets the following criteria:
(1) The requested
waiver will not jeopardize the quality of care and service provided to
children;
(2) The requested
waiver will not be a violation of a state law; and
(3) The foster care
program has an alternative plan for complying with the intent of the rule.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15 (from He-C 6355.27)
He-C
6355.29 Denial and Revocation of
Certification for Payment.
(a) The department shall deny an initial
application when the applicant has not met the requirements set forth in He-C
6355.02.
(b) The department shall revoke certification for
payment when it determines that the applicant is non-compliant with He-C 6355,
or has had its license denied, revoked or suspended in accordance with RSA
170-E:35.
(c) The department shall not renew the request
for certification for payment if a foster care program notifies the department
that it will no longer accept children from NH into its program when the
program is not at full capacity.
(d)
Revocation of certification for payment shall include removal of the program
from the NH bridges payment system, and initiate the department’s recoupment of
unused funds, if applicable.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15 (from He-C 6355.28)
He-C
6355.30 Notification of Denial or
Revocation.
(a) If the
department denies or revokes certification for payment to an applicant or a
foster care program, a letter shall be sent to the applicant or foster care
program by certified mail that sets forth the reasons for the denial or
revocation.
(b) The
denial or revocation shall become final 10 business days after receipt of the
letter referenced in (a) above, unless the applicant or certified program
requests a hearing pursuant to RSA 170-G:4-a.
Source. #8696, eff 7-29-06; ss by #10640, INTERIM,
eff
7-29-14, EXPIRED: 1-26-15
New. #10783, eff 2-13-15 (from He-C 6355.29)
He-C 6355.31 Administrative Appeals and Hearings.
(a) Applicants or certified programs that plan to
appeal a decision made by the department relative to the denial of an
application or revocation of certification, shall file an appeal with the
commissioner, within 10 business days of the date of the letter or other
written notification of the action, pursuant to RSA 170-G:4-a, RSA 541-A and
He-C 200.
(b) The appeal shall be:
(1)
Made in writing;
(2)
Signed by a person authorized to submit the appeal; and
(3)
State the reasons for the appeal pursuant to RSA 170-G:4-a.
Source. #10783, eff 2-13-15 (from He-C 6355.30)
Appendix A
Documents Incorporated by Reference
Location in the Rule of the Document to be Incorporated by Reference |
Title of the Document to be Incorporated by Reference |
How to Obtain the Document and the Cost of Document to be
Incorporated by Reference |
He-C 6344.05(e) and He-C 6344.06(e) |
“Mental Health Domestic Violence Protocols” (1996) NH Governor’s
Commission on Domestic Violence” |
The document is available free of charge on line at: http://doj.nh.gov/criminal/victim-assistance/protocols.htm |
APPENDIX B
RULE |
SPECIFIC
STATE OR FEDERAL STATUTE THE RULE IMPLEMENTS |
He-C 6339.01 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6339.02 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6339.03 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6339.04 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6339.05 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6339.06 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6339.07 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6339.08 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6339.09 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6339.10 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6339.11 |
RSA 170-G:4, XVII; RSA
170-G:5; RSA 170-E:42 |
He-C 6339.12 |
RSA 170-G:4, XVIII; RSA
170-G:5;RSA 170-E:42 |
He-C 6339.13 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:42 |
He-C 6339.14 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:42 |
He-C 6339.15 |
RSA 170-G:4, XVIII;RSA
170-G:5; RSA 170-E:42 |
He-C 6339.16 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:42 |
He-C 6339.17 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:42 |
He-C 6339.18 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:42 |
He-C 6339.19 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:42 |
He-C 6339.20 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:42 |
He-C 6339.21 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:42 |
He-C 6339.22 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:42 |
He-C 6339.23 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:42 |
He-C 6339.24 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:42 |
He-C 6339.25 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-G:4-a |
|
|
He-C 6340.01- 6340.10 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6340.11 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 126-A:3 |
He-C 6340.12-6340.19 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
|
|
He-C 6341.01 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.02 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.03 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.04 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.05 |
RSA 170-G:4, XVIII; RSA 170-G:5; RSA 326-I |
He-C 6341.06 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.07 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.08 |
RSA 170-G:4, XVIII; RSA 170-G:5 and RSA 161:2, VI |
He-C 6341.09 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.10 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.11 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.12 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.13 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.14 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.15 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.16 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.17 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.18 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.19 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.20 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.21 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6341.22 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
|
|
He-C 6342.01 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.02 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.03 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.04 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.05 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.06 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.07 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.08 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.09 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.10 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.11 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.12 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.13 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.14 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.15 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.16 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6342.17 |
RSA 170-G:4, XVIII; RSA 170-G:4-a; RSA 170-G:5 |
|
|
He-C 6343.01 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.02 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.03 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.04 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.05 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.06 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.07 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.08 |
RSA 170-G:4, XVIII; RSA 170-G:5 and RSA 161:2, VI |
He-C 6343.09 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.10 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.11 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.12 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.13 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.14 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.15 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.16 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.17 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.18 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.19 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.20 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.21 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.22 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.23 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.24 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.25 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.26 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6343.27 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
|
|
He-C 6344.01 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.02 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.03 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.04 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.05 |
RSA 170-G:4, XVIII; RSA 170-G:5; RSA 330-A |
He-C 6344.06 |
RSA 170-G:4, XVIII; RSA 170-G:5; RSA 135-C:10 |
He-C 6344.07 |
RSA 170-G:4, XVIII; RSA 170-G:5; RSA 330-A:10, XII |
He-C 6344.08 |
RSA 170-G:4, XVIII; RSA 170-G:5; RSA 135-C:7 |
He-C 6344.09 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.10 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.11 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.12 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.13 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.14 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.15 |
RSA 170-G:4, XVIII; RSA 170-G:5; RSA 126-A:3, II |
He-C 6344.16 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.17 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.18 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.19 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.20 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.21 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.22 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.23 |
RSA 170-G:4, XVIII; RSA 170-G:5; and RSA 330-A:23 |
He-C 6344.24 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.25 |
RSA 170-G:4, XVIII; RSA 170-G:5; RSA 330-A:10, VI-X |
He-C 6344.26 |
RSA 170-G:4, XVIII; RSA 170-G:5 |
He-C 6344.27 |
RSA 170-G:4, XVIII; RSA 170-G:5 RSA 170-G:4-a. I |
|
|
He-C 6346.01 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.02 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.03 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.04 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.05 |
RSA 170-G:4, XVIII, RSA
170-G:5 |
He-C 6346.06 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.07 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.08 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.09 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.10 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.11 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 126-A:3 |
He-C 6346.12 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.13 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.14 |
RSA 170-G:4, VIII; RSA
170-G:4, XVIII; RSA 170-G:5 |
He-C 6346.15 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.16 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.17 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.18 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6346.19 |
RSA 170-G:4-a,I; RSA
170-G:4, XVIII; RSA 170-G:5 |
|
|
He-C 6347.01 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6347.02 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6347.03 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6347.04 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:27; RSA 169-C:29-30 |
He-C 6347.05 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:25 |
He-C 6347.06 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6347.07 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:34 |
He-C 6347.08 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:34 |
He-C 6347.09 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:34 |
He-C 6347.10 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:34 |
He-C 6347.11 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:34; RSA 170-E:53 |
He-C 6347.12 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:34 |
He-C 6347.13 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:34 |
He-C 6347.14 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:31 |
He-C 6347.15 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:32 |
He-C 6347.16 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:34 |
He-C 6347.17 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6347.18 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6347.19 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 126-A:3 |
He-C 6347.20 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6347.21 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:42 |
He-C 6347.22 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 541-A:22,IV |
He-C 6347.23 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:35 |
He-C 6347.24 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:36 |
He-C 6347.25 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E: 36; |
He-C 6347.26 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:34,I(e); RSA 170-E:35-37 |
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He-C 6348.01-He-C 6348.04 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6348.05 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 126-A:3,II |
He-C 6348.06-He-C 6348.08 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6348.09 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 161:2, VI |
He-C 6348.10-He-C 6348.14 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6348.15 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-G:4a,I |
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He-C 6349.01 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6349.02 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6349.03 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6349.04 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:3, I (c); RSA 170-E:4 |
He-C 6349.05 |
RSA 170-G:4, XVIII; RSA 170-G:5;
RSA 170-E:3 (a); RSA 170-E:4 |
He-C 6349.06 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:3(a); RSA 170-E:4 |
He-C 6349.07 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:4; RSA 170-E:6; |
He-C 6349.08 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:3(a) |
He-C 6349.09 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6349.10 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E 7 |
He-C 6349.11 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6349.12 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6349.13 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6349.14 |
RSA 170-G:4, XVIII; RSA
170-G:5 |
He-C 6349.15 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:19 |
He-C 6349.16 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-G:4, VIII |
He-C 6349.17 |
RSA 170-G:4, XVIII ;RSA
170-G:5; RSA 170-E:11, I(m) |
He-C 6349.18 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E:12 |
He-C 6349.19 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-E: 13 |
He-C 6349.20 |
RSA 170-G:4,XVIII; RSA
169-GL4-a; RSA 170-E:13 |
He-C 6349.21 |
RSA 170-G:4, XVIII; RSA
170-G:5; RSA 170-G:4a,I |
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He-C 6350.01 – 6350.04 |
RSA 170-E:25; RSA 170-G:5 |
He-C 6350.05 – 6350.07 |
RSA 170-G:4, XVIII |
He-C 6350.08 |
RSA 170-G:4, XVIII; RSA 170-G:4-a |
He-C 6350.09 |
RSA 170-G:4, XVIII; RSA 170-G:4, VII |
He-C 6350.10 |
RSA 170-G:4, XVIII |
He-C 6350.11 |
RSA 170-G:4, VII; RSA 170-G:4, XVIII |
He-C 6350.12 – 6350.14 |
RSA 170-G:4, XVIII |
He-C 6350.14(f)(3) |
45 CFR 1356.80 |
He-C 6350.15 |
RSA 126-U; RSA 170-E:25; RSA 170-G:4, III; RSA
170-G:4, XVIII |
He-C 6350.16 – 6350.17 |
RSA 170-E:25, II(b); RSA 170-G:4, III; RSA 170-G:4,
XVIII; RSA 193:28 |
He-C 6350.18 |
RSA 170-G:4, III; RSA 170-G:4, XVIII |
He-C 6350.19 – 6350.22 |
RSA 170-E:25, II(c); RSA 170-G:4, III; RSA 170-G:4,
XVIII |
He-C 6350.23 – 6350.33 |
RSA 170-G:4, III; RSA 170-G:4, XVIII; RSA 193:27 |
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He-C 6354.01 |
RSA 170-G:4, VI |
He-C 6354.02 |
RSA 170-G:4, VI |
He-C 6354.03 |
RSA 170-G:4, VI |
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He-C 6355.01 |
RSA 170-G:5; Title IV-E 45 CFR 1355.20 |
He-C 6355.02 – 6355.08 |
RSA 170-G:5 |
He-C 6355.09 |
RSA 170-G:5; RSA 126-U:7-a |
He-C 6355. 10 – 6355.16 |
RSA 170-G:5; 42 USC 675 |
He-C 6355.17 |
RSA 170-G:5; RSA 126-U:7-a; 45 CFR 1356.80 |
He-C 6355.18 – 6355.27 |
RSA 170-G:5 |
He-C 6355.28 – 6355.30 |
RSA 170-G:5; RSA 170-G:4, XVIII |