CHAPTER
He-M 700 GLENCLIFF HOME
PART He-M 701 ADMISSIONS TO GLENCLIFF HOME
Statutory
Authority: RSA 135-C:4, III
He-M 701.01 Purpose. The purpose of these rules is to establish eligibility
criteria and procedures for admission of persons to the Glencliff home.
Source. #2817, eff 8-16-84; EXPIRED: 8-16-90
New. #5224, eff 9-12-91, EXPIRED: 9-12-97
New. #7165, eff 12-18-99, EXPIRED: 12-18-08
New. #9502, eff 7-3-09, EXPIRED: 7-3-17
New.
#12406, INTERIM, eff 10-24-17, EXPIRED: 4-22-18
New.
#12519, eff 4-25-18
He-M 701.02 Definitions.
(a)
“Administrator” means the chief administrator of Glencliff home, or his
or her designee.
(b) “Area agency” means “area agency” as
defined under RSA 171-A:2, I-b, namely, “an entity established as a nonprofit
corporation in the state of New Hampshire which is established by rules adopted
by the commissioner to provide services to developmentally disabled persons in
the area.”
(c)
“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 purposes 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.
(d) “Developmental disability” means
“developmental disability” as defined under RSA 171-A:2, V, namely:
“(a) Which is attributable to 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.”
(e)
"Department" means the department of health and human
services.
(f) "Informed decision"
means a choice made voluntarily by a patient or applicant for services or,
where appropriate, such person's legal guardian, after all relevant information
necessary to making the choice has been provided, when:
(1) The person understands that he or she is free
to choose or refuse any available alternative;
(2) The person clearly indicates or expresses his
or her choice; and
(3) The choice is free from all coercion.
(g) “Licensed practitioner” means a
medical doctor, physician’s assistant, advanced practice registered nurse,
doctor of osteopathy, or doctor of naturopathic medicine licensed to practice
in New Hampshire, or his or her designee.
(h) “Least restrictive alternative”
means the program or service which least inhibits a person’s freedom of
movement and participation in the community and accommodates the person’s
informed decision-making while achieving the purposes of treatment.
(i)
"Medical assistance" means the federally financed medical assistance
program established pursuant to Title XIX and Title XXI of the Social Security
Act.
(j)
“Mental illness” means a condition of a person who is determined to have
a severe and persistent mental illness
or severe mental illness in accordance with He-M 401.05 through He-M 401.07 and
who has at least one of the following psychiatric disorders classified in the
Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition, Text Revision) (DSM-5), available as listed in Appendix A
:
(1) Schizophrenia spectrum and other psychotic
disorders, except for the following:
a. Schizotypal personality disorder;
b. Substance or medication induced psychotic
disorder; and
c. Psychotic disorder due to another medical
condition;
(2) Bipolar and related disorders, except for the
following:
a. Substance or medication induced bipolar and
related disorder; and
b. Bipolar disorder and related disorder due to
another medical condition;
(3) Depressive disorders, except for the
following:
a. Disruptive mood dysregulation disorder;
b. Premenstrual dysphoric disorder;
c. Substance or medication induced depressive
disorder; and
d. Depressive disorder due to another medical
condition;
(4) Borderline personality disorder;
(5) Panic disorder;
(6) Obsessive compulsive disorder;
(7) Post traumatic stress disorder;
(8) Bulimia nervosa;
(9) Anorexia nervosa;
(10) Other specific feeding or eating disorders;
(11) Unspecified feeding or eating disorders; and
(12) Major
neurocognitive disorders where psychiatric symptom clusters cause significant
functional impairment and one or more of the following symptom categories are
the focus of psychiatric treatment:
a. Anxiety;
b. Depression;
c. Delusions;
d. Hallucinations;
e. Paranoia; and
f. Behavioral disturbance.
(k)
"Nursing facility" means an institution, or a distinct part of
an institution, which provides one or more of the following as defined in Section
1919(a) of the Social Security Act and is not primarily for the care and
treatment of mental diseases:
(1) Skilled
nursing care or intermediate nursing care and related services for residents
who require medical or nursing care;
(2) Rehabilitation services for the
rehabilitation of injured, disabled, or sick individuals; or
(3) On a regular basis,
health-related care and services to individuals who because of their mental or
physical condition require care and services, above the level of room and
board, which can be made available to them only through an institution.
Source. #2817, eff 8-16-84; EXPIRED: 8-16-90
New. #5224, eff 9-12-91, EXPIRED: 9-12-97
New. #7165, eff 12-18-99, EXPIRED: 12-18-07
New. #9502, eff 7-3-09, EXPIRED: 7-3-17 in 701.02
intro. and paras (a)-(c), (e), (f), & (h)-(k); amd
by #9567,
eff 10-16-09, EXPIRED: 10-16-17 in paras. (d) & (g)
New.
#12406, INTERIM, eff 10-24-17, EXPIRED: 4-22-18
New.
#12519, eff 4-25-18
He-M 701.03 Eligibility Criteria. An applicant shall be eligible for admission
to Glencliff home if that applicant:
(a)
Is 60 years of age or older, or younger if the administrator determines
that the applicant:
(1) Has been referred to Glencliff home by an
area agency, a community mental health program, a licensed practitioner, or New
Hampshire hospital;
(2) Meets all of the
other criteria in (b)-(f) below; and
(3) Has been rejected by at least 2 other
facilities;
(b)
Has a mental illness or developmental disability;
(c)
Does not require physician services or psychiatric care on a daily
basis;
(d)
Has qualified for nursing facility level of care in accordance with
criteria and procedures set forth in He-E 802.04, if the applicant is a medical
assistance recipient;
(e)
Voluntarily requests admission or has a guardian of the person appointed
pursuant to RSA 464-A who requests admission and has obtained the approval of a
probate court for such admission in accordance with RSA 464-A:25; and
(f)
Has been reviewed and approved for nursing facility placement pursuant
to He-M 1302.
Source. #2817, eff 8-16-84; EXPIRED: 8-16-90
New. #5224, eff 9-12-91, EXPIRED: 9-12-97
New. #7165, eff 12-18-99, EXPIRED: 12-18-07
New. #9502, eff 7-3-09, EXPIRED: 7-3-17
New.
#12406, INTERIM, eff 10-24-17, EXPIRED: 4-22-18
New.
#12519, eff 4-25-18
He-M 701.04 Application Procedures.
(a)
Initial inquiries or referrals for admission to Glencliff home shall be
directed to the admissions coordinator at Glencliff home.
(b)
An application for admission to Glencliff home shall:
(1) Be made in writing;
(2) Be made by:
a. The applicant;
b. A person acting with the consent of the
applicant; or
c. A person legally authorized to act on behalf
of the applicant;
(3) Contain the following information regarding
the applicant:
a. Name, address, sex, and birth date;
b. Birthplace and citizenship status;
c. Diagnosis;
d. Guardianship status;
e. Name, address, and telephone number of
physician(s);
f. History of previous hospitalization(s) for
psychiatric treatment;
g. Description of self-care abilities and
physical functioning;
h. Adaptive equipment needed;
i. Medical history, including history of
tuberculosis testing;
j. Medical status, including:
1. Allergies;
2. Medications currently prescribed; and
3. Evaluation of current mental status;
k. Therapeutic and rehabilitative services
needed;
l. Social history;
m. Financial assets, including:
1. Insurance benefits;
2. Entitlements;
3. Pension benefits; and
4. Other benefits; and
n. Source of payment for care at Glencliff home;
(4) Contain written authorization permitting medical
and psychiatric facilities and personnel that are providing or have provided
care and treatment to the applicant to release clinical and medical records
concerning the applicant to Glencliff home; and
(5) Be made only
after the applicant has obtained a determination of eligibility for nursing
facility level of care from the bureau of elderly and adult services of the
department in accordance with He-E 802.04, if the applicant is a medical
assistance recipient.
(c)
An applicant or applicant’s representative shall send an application and
related material to the admissions coordinator at Glencliff home.
(d)
Within 30 days of receipt of an application, excluding weekends and
state legal holidays, the administrator or his or her designee shall review the
application and related material and shall take action as required by He-M
701.05.
(e)
If the administrator determines that application information is
insufficient to establish eligibility for admission, the administrator shall:
(1) Notify the applicant of the name, address,
official title, and telephone number of the Glencliff employee who may be
contacted regarding the application;
(2) Take steps
necessary to obtain the needed information and make a determination of
eligibility in accordance with He-M 701.03, if possible, including:
a. Notifying the applicant of any apparent
errors or omissions; and
b. Requesting any additional information
required by (b) above; and
(3) Reject the application if necessary
information is not provided pursuant to (2) above and inform the applicant in
writing of the following:
a. The fact that sufficient information to
determine eligibility has not been provided or obtained;
b. The specific, additional information which is
needed; and
c. The right of the applicant to resubmit the
application at any time.
(f)
If the administrator finds that sufficient information is available to
determine eligibility for admission, the administrator shall either:
(1) Approve eligibility for admission and inform
the applicant in writing of the approval if the applicant meets all of the
criteria for admission; or
(2) Deny eligibility for admission if the applicant
does not meet one or more of the eligibility criteria in He-M 701.03 and,
within 10 days of the determination, issue written notification to the
applicant and, if applicable, his or her guardian of the denial and the
specific criteria not met.
Source. #2817, eff 8-16-84; EXPIRED: 8-16-90
New. #5224, eff 9-12-91, EXPIRED: 9-12-97
New. #7165, eff 12-18-99, EXPIRED: 12-18-07
New.
#12406, INTERIM, eff 10-24-17, EXPIRED: 4-22-18
New.
#12519, eff 4-25-18
He-M 701.05 Admission Procedures.
(a)
An eligible applicant shall be admitted to Glencliff home if a vacancy
exists which is suitable for the applicant pursuant to He-M 701.05(c).
(b)
An eligible applicant shall be suitable for a vacancy unless one or more
of the following conditions apply:
(1) The applicant is assaultive and other
residents would be at risk if the admission were made; or
(2) The available services and physical
accommodations do not satisfy the applicant's need for care and supervision.
(c)
If there are more eligible applicants for admission to Glencliff home
than there are current vacancies, the administrator shall establish a waiting
list.
(d)
The administrator shall admit eligible applicants as follows:
(1) Applicants who are suitable for admission and
are determined to have priority pursuant to (e) below shall be placed before
other applicants; and
(2) Except as provided in (e) below, applicants who
are suitable for admission shall be placed in the order in which the
applications were received.
(e)
An eligible applicant shall be determined to have priority for
admission, regardless of date of application, if one of the following criteria
applies:
(1) The applicant is a patient at New Hampshire
hospital;
(2) Within his or her current living environment,
the applicant presents a serious risk of physical or psychological harm to self
or others; or
(3) The applicant is homeless.
Source. #2817, eff 8-16-84; EXPIRED: 8-16-90
New. #5224, eff 9-12-91, EXPIRED: 9-12-97
New. #7165, eff 12-18-99, EXPIRED: 12-18-08
New. #9502, eff 7-3-09,
EXPIRED: 12-18-08
New. #9502, eff 7-3-09, EXPIRED: 7-3-17
New.
#12406, INTERIM, eff 10-24-17, EXPIRED: 4-22-18
New.
#12519, eff 4-25-18
He-M 701.06 Appeals. An applicant or anyone authorized to act on
behalf of an applicant may appeal any decision rendered under these rules in
accordance with He-M 202 and He-M 204, rights protection procedures, and He-C
200, rules of practice and procedure.
Source. #2817, eff 8-16-84; EXPIRED: 8-16-90
New. #5224, eff 9-12-91, EXPIRED: 9-12-97
New. #7165, eff 12-18-99, EXPIRED: 12-18-08
New. #9502, eff 7-3-09,
EXPIRED: 12-18-08
New. #9502, eff 7-3-09, EXPIRED: 7-3-17
New.
#12406, INTERIM, eff 10-24-17, EXPIRED: 4-22-18
New.
#12519, eff 4-25-18
APPENDIX
A: INCORPORATION BY REFERENCE INFORMATION
Rule |
Title |
Publisher, How to Obtain; and
Cost |
|
|
|
He-M 701.02(j) |
Diagnostic
and Statistical Manual of Mental Disorders, (Fifth Edition, Text Revision)
(DSM-5) |
Available from the publisher, American
Psychiatric Publishing (http://www.appi.org/Home),
a division of the American Psychiatric Association (APA) (www.psychiatry.org). Cost is $155.00. |
APPENDIX B
Rule |
Specific
State Statutes which the Rule Implements |
|
|
He-M
701.01- 701.05 |
RSA
135-C:4, III, RSA 135-C:12 |
He-M
701.06 |
RSA
135-C:5, I (b) |