TITLE XII
PUBLIC SAFETY AND WELFARE

Chapter 171-A
SERVICES FOR THE DEVELOPMENTALLY DISABLED

Section 171-A:1

    171-A:1 Purpose and Policy. –
The purpose of this chapter is to enable the department of health and human services to establish, maintain, implement and coordinate a comprehensive service delivery system for developmentally disabled persons. The policy of this state is that persons with developmental disabilities and their families be provided services that emphasize community living and programs to support individuals and families, beginning with early intervention, and that such services and programs shall be based on the following:
I. Participation of people with developmental disabilities and their families in decisions concerning necessary, desirable, and appropriate services, recognizing that they are best able to determine their own needs.
II. Services that offer comprehensive, responsive, and flexible support as individual and family needs evolve over time.
III. Individual and family services based on full participation in the community, sharing ordinary places, developing meaningful relationships, and learning things that are useful, as well as enhancing the social and economic status of persons served.
IV. Services that are relevant to the individual's age, abilities, and life goals, including support for gainful employment that maximizes the individual's potential for self-sufficiency and independence.
V. Services based on individual choice, satisfaction, safety, and positive outcomes.
VI. Services provided by competent, appropriately trained and compensated staff.

Source. 1975, 242:1. 1979, 322:2, I. 1987, 206:2. 1995, 310:181. 2006, 229:1, eff. July 31, 2006.

Section 171-A:1-a

    171-A:1-a Full Funding of Services Budget; Limits of Waiting Lists. –
I. The department of health and human services and area agencies shall provide services to eligible persons under this chapter and persons eligible for the brain injury program under RSA 137-K in a timely manner. The department and area agencies shall provide funding for services in such a manner that:
(a) For persons in school and already eligible for services from the area agencies, funds shall be allocated to them 90 days prior to their graduating or exiting the school system or earlier so that any new or modified services needed are available and provided upon such school graduation or exit.
(b) For newly found eligible adults, the period between the time of completion of an individual service agreement pursuant to RSA 171-A:12 and the allocation by the department of the funds needed to carry out the services required by the agreement shall not exceed 90 days.
(c) For persons already receiving services who experience significant life changes, such as a significant change in their medical conditions, the period of time for initiation of new services shall not exceed 90 days from the amendment of the individual service agreement except by mutual agreement between the area agency and the person specifying a time limited extension.
(d) Notwithstanding subparagraphs I(a)-(c) of this section, for fiscal years 2008 and 2009, the timelines set forth in each such subparagraph may be exceeded, provided that best efforts shall be made to meet the timelines for children graduating or exiting school and for other individuals the department determines most in need and to minimize delays with respect to others within the limits of available funding and to provide them interim services when the timelines have been exceeded by 60 days for fiscal year 2008 and 30 days for fiscal year 2009.
II. The department of health and human services shall incorporate in its appropriation requests the cost of fully funding services to eligible persons, in accordance with the requirements of paragraph I, and as otherwise required under RSA 171-A, and the legislature shall appropriate sufficient funds to meet such costs and requirements.

Source. 1997, 151:2. 2007, 363:2, eff. July 1, 2007. 2021, 122:55, 57, eff. July 9, 2021.

Section 171-A:1-b

    171-A:1-b Repealed by 1998, 248:2, eff. July 1, 2002. –

Section 171-A:1-c

    171-A:1-c Repealed by 2010, 268:5, II, eff. Sept. 4, 2010. –

Section 171-A:1-d

    171-A:1-d Repealed by 2010, 268:5, III, eff. Sept. 4, 2010. –

Section 171-A:1-e


[RSA 171-A:1-e repealed by 2023, 199:2, effective pursuant to the terms 2023, 199:3.]
    171-A:1-e Budget Flexibility. –
I. For persons with approved budgets older than 24 months who require additional funds to carry out the services required in their individual service agreement, due to additional expenditures, such as cost-of-living or other wage and compensation increases, area agencies and authorized agencies may seek additional funds from the department for such funding needs. The department shall allocate existing budget appropriations as set forth in RSA 171-A:8-b as required to meet such funding needs, provided the requested expenditures would promote efficiency, economy, and quality of care pursuant to section 1902(a)(30)(A) of the Social Security Act.
II. The department shall record and track all requests for funding under this section including, but not limited to, the amount of each request, the reason for the request, whether the request was approved and, if denied, the reason for denial. Upon approval of a funding request, area agencies and authorized agencies shall record, and provide the department with, details of the expenditure of such funds, including, but not limited to, the amount of additional funds that are paid to direct support providers, and all details of how the funding is allocated to the person's services and service providers.

Source. 2023, 199:1, eff. Aug. 4, 2023.

Section 171-A:2

    171-A:2 Definitions. –
In this chapter:
I. "Administrator" means the superintendent or chief administrative officer of any facility or of any program or service for the developmentally disabled conducted under the supervision of the commissioner or any employee he so designates as his deputy.
I-a. "Area" means a geographic region established by rules adopted by the commissioner for the purpose of providing services to developmentally disabled persons.
I-b. "Area agency" means an entity established as a nonprofit corporation in the state of New Hampshire which is established by rules adopted by the commissioner to provide or coordinate services to developmentally disabled persons in the area in accordance with 42 C.F.R. section 441.301.
I-c. "Area board" means the governing body or board of directors of an area agency.
I-d. "Assistive technology" means assistive technology as defined by 29 U.S.C. section 3002(3).
I-e. "Authorized agency" means an entity providing direct service to developmentally disabled persons, including, but not limited to, community living arrangements, employment and day services, and programs designed to enhance personal and social competence.
II. "Client" means any developmentally disabled person receiving services provided under this chapter.
III. "Commissioner" means the commissioner of health and human services.
IV. "Department" means the department of health and human services.
V. "Developmental disability" means a disability:
(a) Which is attributable to an intellectual disability, cerebral palsy, epilepsy, autism, or a specific learning disability, or any other condition of an individual found to be closely related to an intellectual disability as it refers to general intellectual functioning or impairment in adaptive behavior or requires treatment similar to that required for persons with an intellectual disability; and
(b) Which originates before such individual attains age 22, has continued or can be expected to continue indefinitely, and constitutes a severe disability to such individual's ability to function normally in society.
V-a. "Direct support staff" means any person employed by an area agency or contract provider in which at least 50 percent of the person's time is providing direct care or support to a client.
VI, VII. [Omitted.]
VIII. [Repealed.]
IX. "Habilitation" means the process by which program personnel assist clients to acquire and maintain those life skills which enable them to cope more effectively with the demands of their own persons and of their environment, to be economically self-sufficient and to raise the level of their physical, mental and social efficiency. Habilitation includes but is not limited to programs of formal, structured education and treatment.
X. "Individual service agreement" means a written document for a client's services and supports which is specifically tailored to meet the needs of each client.
XI. "Informed decision" means a choice made by a client or potential client or, where appropriate, his legal guardian that is reasonably certain to have been made subsequent to a rational consideration on his part of the advantages and disadvantages of each course of action open to him.
XI-a. "Intellectual disability" means significantly subaverage general intellectual functioning existing concurrently with deficits in adaptive behavior, and manifested during the developmental period. A person with an intellectual disability may be considered mentally ill provided that no person with an intellectual disability shall be considered mentally ill solely by virtue of his or her intellectual disability.
XII. "Least restrictive environment" means the program or service which least inhibits a client's freedom of movement, informed decisions and participation in the community, while achieving the purposes of habilitation and treatment.
XIII. "Mental illness" means mental illness as defined in RSA 135-C:2, X.
XIV. [Repealed.]
XV. [Repealed.]
XV-a. [Repealed.]
XV-aa. "Receiving facility" means any facility designated by the commissioner pursuant to RSA 171-A:20.
XV-b. [Repealed.]
XVI. "Service delivery system" means a comprehensive array of services for the diagnosis, evaluation, habilitation and rehabilitation of developmentally disabled persons, including but not limited to, service coordination, community living arrangements, employment and day services and supports to families of individuals with developmental disabilities.
XVII. "Treatment" means the prevention, amelioration and improvement of a client's disabilities and illnesses.

Source. 1975, 242:1. 1979, 322:2-5, 9, IX, 19. 1981, 492:20. 1983, 291:1, I. 1987, 206:2, 3. 1988, 107:5. 1990, 140:2, XI. 1994, 248:4; 408:3. 1995, 310:128, 172. 2001, 101:1, 2, 18, I, II. 2007, 363:4, 5. 2008, 52:14, 15, 21, eff. July 11, 2008. 2019, 287:4, 5, eff. July 1, 2019.

Section 171-A:3

    171-A:3 Rulemaking. – The commissioner of the department of health and human services shall adopt rules pursuant to RSA 541-A to implement this chapter.

Source. 1975, 242:1. 1981, 492:21. 1995, 310:172, eff. Nov. 1, 1995.

Section 171-A:4

    171-A:4 State Service Delivery System. – The department shall maintain a state service delivery system for the care, habilitation, rehabilitation, treatment and training of developmentally disabled persons. Such service delivery system shall be under the supervision of the commissioner.

Source. 1975, 242:1. 1979, 322:2, I. 1987, 206:2. 1988, 107:5. 1995, 310:172, 175. 2001, 101:3, eff. Aug. 20, 2001.

Section 171-A:5

    171-A:5 Voluntary Entry Into Service Delivery System. –
I. Applications for service shall be made by the developmentally disabled person seeking such service, and all placements shall be voluntary. If the client is under the age of 18, the application for service may be initiated by a parent or legal guardian. If the client is over the age of 18 and has been found to be incapacitated by the probate court, the application for service may be initiated by the court-appointed guardian.
II. Notwithstanding paragraph I, a person may be involuntarily admitted to the service delivery system pursuant to RSA 171-B.

Source. 1975, 242:1. 1979, 322:2, I, II. 1987, 206:2. 1994, 408:4. 1995, 310:175. 2001, 101:4, eff. Aug. 20, 2001.

Section 171-A:6

    171-A:6 Entry Into the Service Delivery System. –
I. A person seeking service shall make application in accordance with rules adopted by the commissioner to the area agency in his or her appropriate geographic region as designated by rule pursuant to RSA 171-A:2, I-b.
II. A comprehensive screening evaluation, coordinated by the staff of the area agency, shall determine the scope of the person's disability and the locus and nature of services to be provided and shall include an assistive technology evaluation both as part of the person's initial evaluation and at least on an annual basis thereafter when the person is screened for an assistive technology evaluation. The commissioner shall adopt rules pursuant to RSA 541-A relative to the evaluation. The initial evaluation shall include, but not be limited to, a physical examination and individual intellectual assessment and functional behavior scales and shall take into account the provisions of and services established under RSA 186-A.
III. A recommendation for services by the area agency shall utilize the criterion of the least restrictive environment for the client and shall be made to the service which best meets the needs of the client. Preliminary evaluations shall be completed and preliminary recommendations for services made within 21 days after application for service.
IV. In an emergency situation and in the discretion of the commissioner, temporary service arrangements may be made prior to the completion of the screening evaluation.
V. The commissioner shall adopt rules pursuant to RSA 541-A establishing hearing procedures to determine the appropriateness of a service recommendation which is challenged by the client, his or her attorney or family.

Source. 1975, 242:1. 1979, 322:2, II. 1981, 492:22, 23. 1995, 310:172. 2001, 101:5. 2007, 363:6, eff. July 1, 2007.

Section 171-A:7

    171-A:7 Withdrawal From Service Delivery System. – Except for a person admitted involuntarily pursuant to RSA 171-B, a client at any time may seek a change in services or withdraw entirely from the service delivery system. A parent or legal guardian may seek a change of services for or withdraw entirely a minor or ward in his or her custody at any time, unless such minor has reached the age of majority. The administrator shall notify the area agency of any such withdrawal and may, if appropriate, indicate in the client's record that such withdrawal was against professional advice.

Source. 1975, 242:1. 1979, 322:2, II. 1994, 408:5. 2001, 101:6, eff. Aug. 20, 2001.

Section 171-A:8

    171-A:8 Termination of Service. –
I. The administrator may terminate service to a client at any time that such termination is deemed in the best interest of the client or when the client can function independently without such service or when the client has received optimal benefit from such service.
II. In every instance of termination, the administrator shall refer the client to the area agency which, in turn, shall recommend an appropriate service, or be responsible for contacting the client at regular intervals after termination for as long as deemed necessary.
III. Prior to any termination of service, the administrator shall give 30 days' notice to the client, if over 18 years of age, or to the parent or guardian, if the client is a minor or has been found to be legally incapacitated. Consent of the parent or guardian is required prior to termination if the client is a minor or has been declared legally incapacitated. Service may be terminated sooner than 30 days with the consent of the client, his or her parent or guardian.
IV. The client or, where appropriate, his parent or legal guardian, may seek review of the decision to terminate from the commissioner. The decision of the commissioner shall be final.
V. Notwithstanding this section, the administrator shall not terminate service to a person involuntarily admitted pursuant to RSA 171-B without prior approval of the commissioner, except:
(a) Upon transfer of the person to another receiving facility or to the secure psychiatric unit; or
(b) Upon expiration of the order of commitment.

Source. 1975, 242:1. 1979, 322:6. 1994, 408:6. 1995, 310:172. 2001, 101:7, eff. Aug. 20, 2001.

Section 171-A:8-a

    171-A:8-a Transfer of Involuntary Admittees; Rules. –
I. A receiving facility to which a person is ordered for involuntary admission or to which such person has been transferred may transfer the person to another receiving facility if the receiving facility to which the person is to be transferred can better provide the degree of security or treatment required by the person. All transfers shall require the approval of the chief administrator of the state developmental services system. The commissioner shall adopt rules pursuant to RSA 541-A, relative to transfer criteria and procedures for the challenge of transfer decisions by the persons so transferred.
II. Transfers to the secure psychiatric unit of involuntary admittees may be made pursuant to RSA 171-B:15.

Source. 1994, 408:7. 1995, 310:129, eff. Nov. 1, 1995.

Section 171-A:8-b

    171-A:8-b Establishing Certain Dedicated Funds and Transfers of Certain Appropriations. –
I. There is hereby established the developmental services fund. The fund, from appropriations provided in accounting unit 05-95-93-930010-7100, shall be used to carry out the provisions of this chapter. The fund shall be nonlapsing and shall be continually appropriated to the commissioner for the purposes of this chapter.
II. There is hereby established the acquired brain disorder services fund. The fund, from appropriations provided in accounting unit 05-95-93-930010-7016, shall be used to carry out the provisions of this chapter. The fund shall be nonlapsing and shall be continually appropriated to the commissioner for the purposes of this chapter.
III. There is hereby established the in-home support waiver fund. The fund, from appropriations provided in accounting unit 05-95-93-930010-7110, shall be used to carry out the provisions of this chapter. The fund shall be nonlapsing and shall be continually appropriated to the commissioner for the purposes of this chapter.
IV. The funds in paragraphs I through III shall only be transferred between these funds and/or accounting units for those particular services for the purposes of this chapter.

Source. 2019, 346:70, eff. July 1, 2019.

Restraint and Seclusion

Section 171-A:9

    171-A:9 Residential Services. –
I. The commissioner shall adopt rules pursuant to RSA 541-A relative to clients in residential services, including but not limited to such matters as restraint and seclusion.
II. Restraint or seclusion may be used only in cases of emergency such as the occurrence or serious threat of extreme violence, personal injury or attempted suicide.

Source. 1975, 242:1. 1981, 492:24. 1995, 310:172. 2001, 101:8, eff. Aug. 20, 2001.

Section 171-A:10

    171-A:10 Residential Services; Legal Counsel and Guardianship. –
I. [Repealed.]
II. Whenever a client over the age of 18 years is considered incapable of managing his or her own affairs and is at risk of substantial harm to person or estate as a result, and the person does not have a legal guardian, the administrator shall take such steps as are appropriate to safeguard the person as may be consistent with RSA 464-A and 547-B, including the nomination of a guardian when no less restrictive alternative is available.
III. [Repealed.]

Source. 1975, 242:1. 1977, 587:1. 1979, 322:2, II, 20. 1983, 409:4. 1988, 107:5. 1995, 310:27. 2001, 101:9, 10, 18, III, eff. Aug. 20, 2001.

Section 171-A:11

    171-A:11 Periodic Review. –
I. The needs and services of every client in the service delivery system shall be subject to a periodic review under the supervision of the administrator, which shall include but not be limited to:
(a) A thorough clinical examination including an annual health assessment;
(b) An assessment of the client's capacity to make informed decisions; and
(c) Consideration of less restrictive alternatives for service, particularly for those clients in residential services.
II. Such periodic review shall take place at least once during the first 6 months of service and annually thereafter. The administrator shall give written notice to the client and his or her nearest relative or legal guardian at least 10 days prior to a periodic review. The results of each periodic review shall become part of the client's clinical record, and recommendations resulting from such review shall be shared with the client, and, where appropriate, with his or her guardian, parent or nearest relative.
III. Following any review or at any other time, the administrator may recommend termination of service or may refer the client to a more appropriate service pursuant to RSA 171-A:8.
IV. The commissioner shall adopt rules pursuant to RSA 541-A relative to the conduct of the review and the personnel who shall carry out the review.

Source. 1975, 242:1. 1981, 492:25. 1995, 310:172. 2001, 101:11, eff. Aug. 20, 2001.

Section 171-A:12

    171-A:12 Individual Service Agreement. –
I. There shall be an individual service agreement for every client in the service delivery system who receives services. A service coordinator chosen by the client shall develop a preliminary written individual service agreement based upon a comprehensive screening evaluation established under RSA 171-A:6 for such client within 14 days after the initial service planning meeting. The individual service agreement shall be continually reviewed by the area agency and shall be modified if necessary. The commissioner shall adopt rules pursuant to RSA 541-A relative to the development of such individual service agreements.
II. Each individual service agreement shall include but not be limited to:
(a) A statement of the nature of the specific strengths, interests, capacities, disabilities, and specific needs of the client;
(b) A description of intermediate and long-range habilitation and treatment goals chosen by the individual and his or her guardian with a projected timetable for their attainment;
(c) A statement of specific services to be provided and the amount, frequency, and duration of each service;
(d) Specification of the providers to furnish each service identified in the agreement; and
(e) Criteria for transfer to less restrictive settings for habilitation, including criteria for termination of service and a projected date for termination of service from the service.

Source. 1975, 242:1. 1981, 492:26. 1995, 310:172. 2001, 101:12, eff. Aug. 20, 2001. 2019, 287:6, eff. July 1, 2019.

Section 171-A:13

    171-A:13 Service Guarantees. – Every developmentally disabled client has a right to adequate and humane habilitation and treatment including such psychological, medical, vocational, social, educational or rehabilitative services as his condition requires to bring about an improvement in condition within the limits of modern knowledge.

Source. 1975, 242:1. 1979, 322:2, I. 1987, 206:2, eff. July 1, 1987.

Section 171-A:14

    171-A:14 Rights of Developmentally Disabled Persons. –
I. No person shall be deemed incompetent to manage his or her affairs, to contract, to hold professional, occupational or vehicle operator's licenses, to vote, to marry or to make a will solely by reason of his or her developmental disability or of his or her participation in the service delivery system, nor shall department rules restrict such rights. The client's right to individual dignity shall be respected at all times and upon all occasions.
II. A client in a residential service shall be provided with stationery and postage in reasonable amounts and shall have free and unrestricted mailing privileges.
III. A client shall have the right to be visited at all reasonable times unless the administrator determines that such a visit would adversely affect the client. Any denial of visiting rights and the reasons for such denial shall be entered in the client's record and may be subject to the review of the human rights committee established under RSA 171-A:17.
IV. A client in a residential service shall have the right to wear his or her own clothes, to keep and use his or her own personal possessions including toilet articles, to keep and be allowed to spend his or her own money, to have access to individual storage space for private use, to have reasonable access to telephones to make and receive confidential calls and any other rights specified by rules of the department; provided, however, that any of these rights may be denied for good cause by the administrator or designee. Any denial of these rights and the reasons for such denial shall be entered in the client's record and may be subject to the review of the human rights committee established under RSA 171-A:17.
V. The commissioner may adopt rules pursuant to RSA 541-A relative to the protection of the rights, dignity, autonomy and integrity of clients, including specific procedures to protect the rights established in this chapter.

Source. 1975, 242:1. 1979, 322:2, I. 1981, 492:27. 1987, 206:2. 1995, 310:172, 175. 2001, 101:13, eff. Aug. 20, 2001.

Section 171-A:15

    171-A:15 Rights of Clients to be Provided. – Written materials describing the rights of clients as set forth in this chapter and in the rules of the department shall be provided to each client and his or her guardian, if any. Such materials shall be presented in clearly understandable language and form.

Source. 1975, 242:1. 1995, 310:175. 2001, 101:14, eff. Aug. 20, 2001.

Section 171-A:16

    171-A:16 Repealed by 2001, 101:18, IV, eff. Aug. 20, 2001. –

Section 171-A:17

    171-A:17 Human Rights Committee. –
I. The commissioner shall establish, in each area agency, a human rights committee of 5 or more persons. The majority of the members of each human rights committee shall be persons who represent the interests of developmentally disabled clients and who are not employees of the department.
II. The duties of the human rights committee shall include, but not be limited to, the following for each program or service with which the committee is concerned:
(a) Evaluating the treatment and habilitation provided;
(b) Regularly monitoring the implementation of individual service agreements;
(c) Monitoring the use of restrictive or intrusive interventions designed to address challenging behavior;
(d) Fostering the capacity of individuals served by the area agency to exercise more choice and control in their lives; and
(e) Promoting advocacy programs on behalf of the clients.

Source. 1975, 242:1. 1979, 322:8. 1981, 492:28. 1987, 206:2. 1995, 310:172. 2001, 101:15, eff. Aug. 20, 2001.

Miscellaneous

Section 171-A:18

    171-A:18 Area Agency Responsibilities and Operations. –
I. The commissioner may designate by rules adopted pursuant to RSA 541-A for each area one area agency which shall be responsible for administering area-wide programs and services for developmentally disabled persons. Each area agency so designated shall be the primary recipient of funds that may be dispensed by the commissioner for use in establishing, operating, and/or administering such programs and services. The programs and services for which an area agency is responsible include, but are not limited to, diagnosis and evaluation, service coordination, community living arrangements, employment and day services, and programs designed to enhance personal and social competence.
II. The commissioner may enter into contracts with, make grants to, or otherwise make funds available to an area agency or authorized agency for the provision of programs and services to developmentally disabled persons. Subject to the written approval of the commissioner, an area agency or authorized agency may enter into contracts with individuals or organizations for the expenditure of portions of such funds on programs or services for developmentally disabled persons. Area agencies, authorized agencies, and other organizations under contract to provide services in accordance with this chapter shall administer programs and services in accordance with 42 C.F.R. section 441.301, and any subsequent amendments thereto.
III. Each area board shall appoint an executive director who shall be accountable to the board for administering the area-wide programs and services for developmentally disabled persons. The executive director shall serve at the pleasure of the area board and shall serve as a full-time employee of the area board.
IV. The commissioner shall, in accordance with RSA 541-A, adopt rules establishing standards for the provision of services by area agencies and authorized agencies to developmentally disabled persons. The commissioner shall further adopt rules establishing standards relating to the professional qualifications of the executive director of the area board and to the size and composition of area boards in order to assure that membership is representative of the area as a whole and reflects the concerns and interests of developmentally disabled persons and their families. The commissioner shall also adopt rules establishing a reapproval process and shall require area agencies to be subject to reapproval every 5 years.
V. With such frequency as may be determined by the commissioner, each area agency shall prepare and submit to the department for approval a plan for provision of programs and services to developmentally disabled persons who live in the area.
VI. A community mental health program established pursuant to RSA 135-C may also be designated an area agency by the commissioner, providing that the area agency is in full compliance with the requirements of this chapter and with all standards and rules adopted pursuant thereto.
VII. The department of health and human services shall assume all or any part of the responsibilities provided for in paragraphs I and II at any time during which an area agency is not designated.

Source. 1979, 322:7. 1981, 492:29. 1987, 206:2. 1988, 107:5. 1995, 310:130, 172, 175, 181. 1998, 168:2. 2001, 101:16, eff. Aug. 20, 2001. 2019, 287:7, eff. July 1, 2019.

Section 171-A:18-a

    171-A:18-a Family-Centered Early Supports and Services Program. – The department shall administer a family-centered early supports and services (FCESS) program designed for children birth up to age 3 who have a diagnosed, established condition that has a high probability of resulting in delay, are experiencing developmental delays, or are at risk for substantial developmental delays if supports and services are not provided. All children under the age of 3 who are born substance-exposed shall be considered at risk for substantial developmental delays and shall be referred to FCESS. In this section, a "substance-exposed newborn" means a newborn who was exposed to alcohol, or other drugs in utero, which may have adverse effects, whether or not this exposure is detected at birth through a drug screen or withdrawal symptoms. The department shall adopt rules under RSA 541-A relative to the FCESS program, including application procedures, program administration, and eligibility criteria consistent with this section.

Source. 2020, 26:43, eff. Sept. 18, 2020.

Section 171-A:19

    171-A:19 Client and Legal Services Section. –
A client and legal services section shall be established in the department. Its functions and responsibilities shall include but not be limited to:
I. Assisting the commissioner in responding to inquiries and complaints by or on behalf of mentally ill or developmentally disabled persons.
II. Assisting the commissioner in securing needed services and information for mentally ill persons, developmentally disabled persons, or their respective families.
III. Assisting the commissioner in assuring that the human rights of mentally ill persons and of developmentally disabled clients in the service delivery system are protected.

Source. 1979, 322:7. 1987, 206:2. 1995, 310:172, 181. 2001, 101:17, eff. Aug. 20, 2001.

Section 171-A:19-a

    171-A:19-a Committee for the Protection of Human Subjects. –
I. There is hereby established within the department an institutional review board which shall be known as the committee for the protection of human subjects. The committee shall oversee research conducted in department-funded programs that serve people with mental illness, developmental disabilities, and substance abuse or dependence disorders. No research shall be conducted in these programs until it has been reviewed and approved by the committee. In matters of cooperative research involving more than one institution, if the federal agency funding the research determines that a single institutional review board will provide oversight, the committee shall defer oversight to that institutional review board.
II. The committee shall have, at a minimum, 7 members with varying backgrounds to promote complete and adequate review of research activities. The commissioner shall appoint the members. The committee shall be sufficiently qualified through the experience, expertise, and diversity of its members to promote respect for its advice and counsel in protecting human subjects in research and safeguarding the privacy and confidentiality of medical records information that is used for the purposes of research. In addition to possessing the professional competence necessary to review specific research activities, the committee shall be able to ascertain the acceptability of proposed research in terms of applicable laws and regulations and standards of professional conduct and practice. The committee shall therefore include persons knowledgeable in these areas. Members of the committee shall be appointed to 3-year terms.
III. The committee shall include at least one member whose primary area of expertise is scientific and one member whose primary area of expertise is non-scientific.
IV. The committee shall include at least 2 members who are not otherwise affiliated with the department and who are not part of the immediate family of a person who is affiliated with the department.
V. The committee shall include at least 2 members who are consumers or family members of consumers.
VI. No member of the committee shall participate in initial or continuing review of any research project in which the member has a conflicting interest, except to provide information requested by the committee.
VII. The committee may, in its discretion, invite individuals with competence in special areas to assist in the review of issues that require expertise beyond or in addition to that possessed by the members of the committee. These individuals may only offer advice and guidance and shall not participate in the decision as to whether or not to approve the research.
VIII. The committee shall choose a chairperson and vice-chairperson from its membership. The commissioner may assign department staff to assist the committee as needed.
IX. The commissioner may establish fees, through rules adopted under RSA 541-A, as deemed necessary, after consultation with the committee, to offset departmental costs of providing assistance to the committee pursuant to paragraph VIII. Fee revenue shall not be deposited into the general fund, but may be used by the department to offset such costs.

Source. 2005, 183:1. 2007, 263:94, eff. July 1, 2007. 2019, 287:10, eff. July 19, 2019.

Section 171-A:19-b

    171-A:19-b Rulemaking. – The commissioner may adopt rules, pursuant to RSA 541-A, relative to the operation of the committee for the protection of human subjects, established in RSA 171-A:19-a, the procedures, conditions, and criteria for the conduct and approval of research, and fees charged by the committee.

Source. 2005, 183:1. 2007, 263:95, eff. July 1, 2007.

Involuntary Admission

Section 171-A:20

    171-A:20 Receiving Facility; Rules. –
The commissioner shall adopt rules, pursuant to RSA 541-A, relative to the criteria and procedures for designation of receiving facilities which receive persons for involuntary admissions under RSA 171-B. A receiving facility may be designated by the commissioner for one or more purposes, including, but not limited to:
I. Receiving persons for involuntary admission directly pursuant to a court order; and
II. Receiving involuntarily admitted persons by transfer with the approval of the commissioner or designee.

Source. 1994, 408:8. 1995, 310:172, eff. Nov. 1, 1995.

Section 171-A:21

    171-A:21 Discharge by Administrator. –
I. When any person has been involuntarily admitted to a receiving facility pursuant to RSA 171-B or conditionally discharged pursuant to paragraph II of this section, the administrator of the receiving facility most recently providing services to the person may grant an absolute discharge to the person with the consent of the chief administrator of the state developmental services system or designee who has reviewed the person's situation, provided that the chief administrator or designee determines that an absolute discharge shall not create a potentially serious likelihood of danger to others or a potentially serious likelihood of substantial damage to real property. The administrator shall, in writing, immediately notify the court entering the original order of commitment and the attorney general that the person has been given an absolute discharge from the receiving facility. Upon receipt of the notice, the court shall make the notice part of the person's file and shall enter the discharge and date of discharge upon the docket.
II. The administrator of the facility may, with prior approval of the chief administrator of the state developmental services system or designee, grant a person, whose condition is not considered appropriate for absolute discharge, a conditional discharge.

Source. 1994, 408:8. 1995, 310:131, eff. Nov. 1, 1995.

Section 171-A:22

    171-A:22 Conditions of Conditional Discharge. –
I. The administrator of a receiving facility may, with prior approval of the chief administrator of the state developmental services system or designee, grant a conditional discharge to any person who consents, by an informed decision, to participate in continuing services from an area agency, who agrees to be subject to any rules adopted by the chief administrator relative to conditional discharge, and who agrees to comply with the conditions of the discharge. The administrator of the facility or designee shall prepare, deliver a copy of, and read and explain to the person being conditionally discharged a written statement in clear and understandable language of the conditions of conditional discharge and a warning that violation of those conditions may result in revocation of the conditional discharge pursuant to RSA 171-A:23.
II. A conditional discharge shall not exceed the period of time remaining on the order of involuntary admission and shall become absolute at the end of its term, unless extended by the court.

Source. 1994, 408:8. 1995, 310:132, eff. Nov. 1, 1995.

Section 171-A:23

    171-A:23 Revocation of Conditional Discharge. –
I. If an administrator at an area agency providing continuing services to a person conditionally discharged pursuant to RSA 171-A:22 or the administrator's designee reasonably believes that:
(a) The person has violated a condition of the discharge; or
(b) A condition or behavior exists as a result of which the person may pose a potentially serious likelihood of danger to others or a potentially serious threat of substantial damage to real property, the administrator or designee may conduct a review of the acts, behavior or condition of the person to determine if the conditional discharge shall be revoked. The review may be conducted only after the person has been given written and verbal notice of the belief, and the reasons for such belief, that a violation of the conditional discharge has occurred or other circumstance or condition exists which may result in a potentially serious likelihood of danger to others or a potentially serious threat of substantial damage to real property, and the person has been given an opportunity to provide information to the administrator or designee as to why the revocation should not occur.
II. If the person refuses or is otherwise unavailable for the review under paragraph I, the administrator or other representative of the area agency may sign a complaint for delivery of the person for the review. The complaint and the written notice required by paragraph I shall be provided to a law enforcement officer who shall take custody of the person and immediately deliver such person to the place specified in the complaint.
III. If the administrator or designee, following the review, finds that either the person has violated a condition of the discharge or a condition or behavior exists as a result of which the person may pose a potentially serious likelihood of danger to others or a potentially serious threat of substantial damage to real property, he or she may temporarily revoke the conditional discharge. If the conditional discharge is temporarily revoked, the administrator or designee shall inform the person affected verbally and in writing, giving the reasons for the revocation and shall identify the receiving facility to which the person is to be delivered.
IV. A law enforcement officer shall take custody of the person whose conditional discharge was temporarily revoked under paragraph II and deliver the person, together with a copy of the notice and the reasons for the temporary revocation, to the receiving facility identified by the administrator or designee where the reasons for temporary revocation of the discharge shall be reviewed. Following such review, if the administrator of the receiving facility or designee finds that either the person conditionally discharged has violated a condition of the discharge or a condition or behavior exists as a result of which the person may pose a potentially serious likelihood of danger to others or a potentially serious threat of substantial damage to real property, the administrator or designee may revoke absolutely the conditional discharge and shall provide to the person written and verbal notice of the reasons for the absolute revocation. Following such revocation the person shall be subject to the terms and conditions of the order of involuntary admission from which conditional discharge was granted as if the conditional discharge had not been granted.
V. If the administrator or designee performing a review under paragraph III or paragraph IV finds no basis for temporary or absolute revocation of the discharge, the person shall be returned by the program or facility which has custody of the person to the location where the person was initially taken into custody or to another location agreed to by the person.

Source. 1994, 408:8, eff. Jan. 1, 1995.

Section 171-A:24

    171-A:24 Review by Chief Administrator; Appeal; Rules. – A person whose conditional discharge is revoked pursuant to RSA 171-A:23 may appeal the decision to the chief administrator of the state developmental services system. The person shall be entitled to a hearing on the appeal, before the chief administrator of the state developmental services system or designee, within 5 days, excluding weekends and holidays, of the receipt of request for the hearing in accordance with rules adopted by the chief administrator pursuant to RSA 541-A. Such rules shall include provision for legal counsel and for waiver of the hearing.

Source. 1994, 408:8. 1995, 310:133, eff. Nov. 1, 1995.

Section 171-A:25

    171-A:25 Action for Discharge. – Any person subject to an order for involuntary admission pursuant to RSA 171-B:12 may file in probate court a petition setting forth such person's name, the underlying circumstances and date of the prior order of the court ordering such person's involuntary admission, a request for discharge from involuntary admission, and the reasons for such request. The petition shall be accompanied by the certificate of a physician, psychiatrist, or psychologist with experience and training in developmental and intellectual disabilities stating that the person is no longer in need of involuntary admission and setting forth the facts upon which such opinion is based. Upon receipt of the petition and the certificate, the court shall conduct a hearing pursuant to RSA 171-B.

Source. 1994, 408:8. 2008, 52:16, eff. July 11, 2008.

Section 171-A:26

    171-A:26 Habeas Corpus. – RSA 171-A:25 shall not be construed to deprive any person of the benefits of the writ of habeas corpus. If the court issuing the writ of habeas corpus grants relief, the court shall enter an order discharging the person and shall transmit a certified copy of it to the probate court entering the original order of involuntary admission. Upon receipt of the certified copy, the probate court shall enter an order finding that such person has been discharged by order of the court.

Source. 1994, 408:8, eff. Jan. 1, 1995.

Section 171-A:27

    171-A:27 Custody and Transportation. –
I. Any law enforcement officer shall take custody of persons who are subject to proceedings for involuntary admission under the following circumstances:
(a) Upon issuance by an administrator or designee of a complaint for delivery for review pursuant to RSA 171-A:23, II;
(b) Upon a determination to revoke a conditional discharge temporarily pursuant to RSA 171-A:23, III; or
(c) As necessary to ensure the presence of the person at hearings or examinations conducted under RSA 171-A or 171-B, to effect a transfer between receiving facilities, or to carry out any other lawful order of a court.
II. A law enforcement officer shall also transport any person taken into custody to the appropriate receiving facility, court, place of examination, or other location.

Source. 1994, 408:8, eff. Jan. 1, 1995.

Section 171-A:28

    171-A:28 Duty to Transport. – Upon request, the office of the sheriff of the county in which any person is located who is to be taken into custody in accordance with RSA 171-A:27 shall take such person into custody and transport that person to the appropriate destination.

Source. 1994, 408:8, eff. Jan. 1, 1995.

Section 171-A:29

    171-A:29 Rights Guaranteed. – All rights guaranteed by RSA 171-A to persons with developmental disabilities shall be retained by persons involuntarily admitted under RSA 171-B except where safety or security mandates restriction of such rights. Any restriction of rights under this section may be appealed to the commissioner pursuant to rules adopted by the commissioner under RSA 171-A:3.

Source. 1994, 408:8. 1995, 310:172, eff. Nov. 1, 1995.

Autism Registry

Section 171-A:30

    171-A:30 Autism Registry. –
I. There shall be established a state registry in the department which shall include a record of all reported cases of autism spectrum disorder (ASD) that occur in New Hampshire and other information relevant and appropriate to conduct thorough and complete epidemiologic surveys of ASD, to enable analysis of this problem, and to facilitate planning for services to children with ASD and their families. The department may enter into an agreement with an appropriate entity for the management of the registry; provided, that any records and data submitted to the department pursuant to this subdivision shall be the property of the department.
II. Physicians, psychologists, and any other licensed or certified health care provider who is qualified by training to make the diagnosis and who then makes the diagnosis that a child is affected with ASD shall report all new cases of this diagnosis to the department in a form and manner prescribed by the commissioner. The report shall be in writing and shall include the name and address of the person submitting the report and the child's date of birth, gender, and zip code at birth residence, and the specific diagnosis of the child diagnosed as having ASD. The department shall assign a unique identification code to identify the child diagnosed as having ASD. The code shall not include the name or address of the child.
III. All information required to be reported under this subdivision shall be confidential. A physician, psychologist, or health care provider providing information to the department in accordance with this section shall not be deemed to be, or held liable for, divulging confidential information.
IV. Nothing in this section shall be construed to compel a child who has been reported as affected with ASD to submit to medical or health examination or supervision by the department.

Source. 2006, 106:2, eff. Aug. 7, 2006.

Section 171-A:31

    171-A:31 Rulemaking. –
The commissioner shall adopt rules, pursuant to RSA 541-A, relative to:
I. Procedures for reporting cases of ASD under RSA 171-A:30.
II. Content of all forms required under this subdivision.
III. Confidentiality of records and information reported pursuant to this subdivision.

Source. 2006, 106:2, eff. Aug. 7, 2006.

New Hampshire Council on Autism Spectrum Disorders

Section 171-A:32

    171-A:32 New Hampshire Council on Autism Spectrum Disorders Established; Duties. –
I. There is established a council on autism spectrum disorders to provide leadership in promoting comprehensive and quality education, health care, and services for individuals with autism spectrum disorders and their families. The members of the council shall be as follows:
(a) The governor, or designee.
(b) The commissioner of the department of education, or designee.
(c) The commissioner of the department of health and human services, or designee.
(d) The director of the division of public health services, department of health and human services, or designee.
(e) The bureau chief of the bureau of developmental services, department of health and human services, or designee.
(f) The bureau chief of the bureau of behavioral health, department of health and human services, or designee.
(g) The director of the Institute on Disability, University of New Hampshire, or designee.
(h) A special education director, appointed by the New Hampshire Association of Special Education Administrators, Inc.
(i) The president of the New Hampshire Medical Society, or designee.
(j) A representative of the New Hampshire Developmental Disabilities Council, appointed by the council.
(k) An individual who has an autism spectrum disorder, appointed by the governor.
(l) A family member of a person who has an autism spectrum disorder, appointed by the governor.
(m) A representative of the Community Support Network, Inc., appointed by such organization.
(n) A representative of the New Hampshire Psychological Association, appointed by the association.
(o) The director of the office of Medicaid business and policy, department of health and human services, or designee.
(p) Up to 5 additional members, nominated by the council and appointed by the governor.
(q) A person who has an autism spectrum disorder, appointed by the council.
(r) A representative of the New Hampshire Nurses' Association, appointed by the association.
(s) A licensed speech-language pathologist, appointed by the New Hampshire Speech-Language-Hearing Association, Inc.
I-a. A quorum of the council shall be a majority plus one member of the appointed members of the council.
II. The council shall:
(a) Provide leadership on training, policy, research, and coordination of supports and services for individuals and their families.
(b) Provide information to families and individuals with autism spectrum disorder about evidenced-based and promising practices for community-based education, support, and treatment.
(c) Collaborate with schools and other service systems to identify exemplary supports and services and promote successful practices throughout New Hampshire.
(d) Increase resources for individuals with autism spectrum disorders and their families by accessing federal and state grants and pursuing development opportunities through foundations, corporations, and planned giving.
(e) Serve as an information clearinghouse for individuals, families, and providers seeking diagnosticians, behavioral specialists, speech pathologists, occupational therapists, psychologists, and others who have expertise in working with individuals with autism spectrum disorders.
(f) Encourage the establishment of regional collaboratives with representation from educational, health care, and community service providers to ensure that individuals with autism spectrum disorders and their families receive necessary services.
(g) Make an annual report beginning on April 1, 2009 to the governor, the speaker of the house of representatives, the president of the senate, the commissioners of the department of health and human services and department of education, the members of the house committees on education, health, human services and elderly affairs, and finance, and the members of the senate committees on education, health and human services, and finance.
III. The department of health and human services shall provide administrative support to the council.

Source. 2008, 190:1. 2013, 11:1-3, eff. July 6, 2013. 2018, 315:11, eff. Aug. 24, 2018. 2022, 158:1, 2, eff. Aug. 6, 2022.

Developmental Services Quality Council

Section 171-A:33

    171-A:33 Developmental Services Quality Council Established; Membership; Duties. –
I. There is established the developmental services quality council to provide leadership for consistent, systemic review and improvement of the quality of the developmental disability and acquired brain disorder services provided within New Hampshire's developmental services system. At least 51 percent of the members of the council shall be individuals with disabilities served by the system or parents of individuals served by the system. The members of the council shall be as follows:
(a) The commissioner of the department of health and human services, or designee.
(b) A representative of People First of New Hampshire, appointed by such organization.
(c) A representative of Advocates Building Lasting Equality in New Hampshire (ABLE NH), appointed by such organization.
(d) A representative of the New Hampshire council on autism spectrum disorders who shall be either the individual who has an autism spectrum disorder or the family member of a person who has an autism spectrum disorder, appointed by the council.
(e) A representative of the Brain Injury Association of New Hampshire, appointed by the association.
(f) Two representatives of the New Hampshire Developmental Disabilities Council, at least one of whom shall be a person with a developmental disability, appointed by the council.
(g) Three representatives of local Family Support Councils, appointed by the state Family Support Council.
(h) One direct support professional and one enhanced family care provider, appointed by the New Hampshire Developmental Disabilities Council.
(i) Three representatives of area agency boards of directors including at least 2 persons with a developmental disability or family members of such persons, appointed by the Community Support Network Incorporated.
(j) A representative of the Community Support Network Incorporated, appointed by such organization.
(k) A representative of the Private Provider Network, appointed by such organization.
(l) The director of the Institute on Disability, University of New Hampshire, or designee.
(m) A representative of the Disability Rights Center - NH, appointed by the center.
(n) Up to 5 additional members, nominated by the council and appointed by the governor.
II. The groups represented under paragraph I are encouraged to provide, according to their ability, the in-kind and other resources necessary for the council to succeed. The council may request information and analysis on quality from the department of health and human services, area agencies, and providers. The council shall have access to all non-confidential information on quality for services funded all or in part by public funds.
III. The council shall regularly review information on the quality of developmental services in New Hampshire and make recommendations for improving service quality and the quality assurance and continuous improvement systems, including, but not limited to:
(a) Standards of quality and performance expected of area agencies and provider agencies.
(b) Types of data to be collected, analyzed, and disseminated to determine whether standards are being met.
(c) Quality assurance and oversight mechanisms to be used to gather data and information.
(d) Content, frequency, and recipients of quality evaluation and improvement reports.
(e) Expectations and procedures for following up on identified areas where improvements are needed.
(f) Structures, policies, rules, and practices, including staffing or organizational changes, to ensure that the developmental services system works as intended in RSA 171-A:1, including:
(1) Ways of supporting values-based and person-centered service planning and provision, as well as problem solving, innovation, and learning;
(2) Recognizing and disseminating what is working well (best/model practices);
(3) Significant changes proposed by the department relating to, or which may impact any of, the practices, policies, standards, rates, budgets, funding formulae, or rights pertaining to eligibility or provision of supports and services under RSA 171-A; and
(4) Reviewing, clarifying, and disseminating data and information on a regular basis to bring about transparency for all stakeholders and the public.
IV. The council shall provide the department with recommendations for improving service quality and the quality assurance and continuous improvement systems, no more frequently than quarterly. The department shall respond in writing within 30 business days of receipt of the council's recommendations with a statement indicating whether it agrees or disagrees with each of the council's recommendations. Following receipt of the department's response, the council shall place the response on the next council meeting agenda for discussion by the commissioner's designee on the council. Within 60 business days of the council meeting, discussion, and record of the discussion in the minutes, the department shall provide:
(a) For each recommendation it agrees with, a detailed plan for how the department will address the areas identified as needing improvement including the specific steps the department plans to take, along with a timeline for each step;
(b) For any recommendation it does not agree with, an explanation of the basis for its disagreement and rationale for its decision not to take action on any specific recommendation; and
(c) If the department is unable to respond to the council's recommendations within the time frames above, the department shall inform the council in writing and include the reasons for not being able respond within the time frames.
V. The quarterly limit as described in paragraph IV is not intended restrict the council's ability to comment on rules, regulations, proposals, or other initiatives impacting the quality of services for people with developmental disabilities and acquired brain disorders as needed throughout the year.
VI. The council shall make an annual report beginning on November 1, 2010 that includes its recommendations and an assessment of the actions taken in response to previous recommendations to the governor, the speaker of the house of representatives, the president of the senate, the members of the house committee on health, human services and elderly affairs and the members of the senate committee on health and human services.
VII. The meetings shall be convened by the chair or vice chair of the council or commissioner of the department of health and human services, or designee, and shall meet regularly as determined by the council. The meetings shall be open to the public and subject to the provisions of RSA 91-A, the right-to-know law. The council may establish bylaws for governing its meetings, decisions, and other operations. For the purpose of convening council meetings in compliance with RSA 91-A, a quorum of the council shall be a majority plus one member of the appointed members of the council. Members who are not able to be physically present at council meetings due to their disabilities or the disability of a family member shall be counted as attending "in person" for the purpose of the establishment of a quorum provided that each member participating electronically or otherwise is able to simultaneously hear and speak to each of the other council members during the meeting, and shall be audible or otherwise discernable to public in attendance at the meeting's location. Any member participating in such fashion shall identify the persons present in the location from which the member is participating.

Source. 2009, 104:1, eff. Aug. 14, 2009. 2014, 102:1, eff. Aug. 10, 2014. 2022, 158:3, 4, eff. Aug. 6, 2022. 2023, 183:1, eff. Oct. 3, 2023.

Commission To Study the Needs of Certain Individuals in New Hampshire's Developmental Services System

Section 171-A:34

    171-A:34 Repealed by 2019, 269:2, effective Nov. 30, 2019. –