New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-C - Commissioner, Department of Health and Human Services
Chapter He-C 4000 - CHILD CARE LICENSING RULES
Part He-C 4001 - NH RESIDENTIAL CHILD CARE LICENSING RULES
Section He-C 4001.01 - Definitions

Universal Citation: NH Admin Rules He-C 4001.01

Current through Register No. 40, October 3, 2024

(a) "Administer" means an act whereby a single dose of a drug is instilled into the body of, applied to the body of, or otherwise given to a resident for immediate consumption or use.

(b) "Applicant" means a person, corporation, partnership, voluntary association, or other organization, either established for profit or otherwise, who intends to operate one or more residential child care programs, and who indicates that intent to the department by submitting an application and the application attachments required by He-C 4001.02.

(c) "Authorized staff" means program staff that have completed training in medication safety and administration who are responsible for administration of medications to residents.

(d) "Child" means "child" as defined in RSA 170-E:25, I.

(e) "Child abuse" means the infliction on a child of any of the behaviors set forth in RSA 169-C:3 (a) - (d), II.

(f) "Child care institution" means "child care institution" as defined in RSA 170-E:25, III.

(g) "Child endangerment" means the negligent violation of a duty of care or protection owed to a child or negligently inducing a child to engage in conduct that endangers his or her health or safety.

(h) "Child neglect" means any of the behaviors or circumstances set forth in RSA 169-C:3 (a) or (b), XIX.

(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 that 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) "Corporal punishment" means use of aggressive physical contact or other action designed to cause the resident discomfort, used as a penalty for behavior disapproved of by the punisher.

(m) "Corrective action plan" means "corrective action plan" as defined in RSA 170-E:25, VI.

(n) "Department" means "department" as defined in RSA 170-E:25, VII.

(o) "Direct care staff" means program staff who are responsible for providing direct care to residents.

(p) "Directed corrective action plan" means a corrective action plan that is developed and issued by the department.

(q) "Evaluation" means a multi-disciplinary assessment of the resident's level of function by professionals licensed or certified in their respective fields of practice or study, which enables facility staff to plan care that allows the resident to reach his or her highest practicable level of physical, mental, and psychosocial functioning.

(r) "Field trip" means any excursion off the premises of the residential child care program with residential child care staff, other than routine or unplanned local travel such as walks in the neighborhood, travel to the local library, or other routine travel such as travel to and from school, employment, local appointments or travel to do local errands.

(s) "Full medical withdrawal management" means a protocol for a resident receiving 24-hour nursing supervision overseen by a licensed practitioner, who may be incapable of evacuating a facility on his or her own or may have medical conditions that require immediate medical intervention, such as seizures, tremors, delirium, cardiac, or are a danger to themselves or others.

(t) "Group home" means "group home" as defined in RSA 170-E:25, II(b).

(u) "Guardian" means "guardian" as defined in RSA 170-E:25, IX.

(v) "Homeless youth" means a person 16 through 20 years of age who is unaccompanied by a parent or guardian and is without shelter where appropriate care and supervision are available, whose parent or legal guardian is unable or unwilling to provide shelter and care, or who lacks a fixed, regular, and adequate residence.

(w) "Homeless youth program" means "homeless youth program" as defined in RSA 170-E:25, II(d).

(x) "Household member" means any person who resides in a child care program other than child care personnel or children admitted to the child care program.

(y) "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.

(z) "Independent living" means transition to adulthood whereby the resident negotiates living on his or her own with a set of skills and goals based on the resident's needs and interests.

(aa) "Independent living home" means "independent living home" as defined in RSA 170-E:25, X.

(ab) "License" means "license" as defined in RSA 170-E:25, XI.

(ac) "License capacity" means the maximum number of residents that can be admitted to and present in the residential child care program, as authorized by the license issued.

(ad) "Licensed clinical supervisor" means a registered nurse (RN) licensed under the state of New Hampshire pursuant to RSA 326-B, or an individual licensed by the board of licensing for alcohol and other drug use professionals or board of mental health practice to practice and supervise substance use counseling who meets the initial licensing qualifications set forth in RSA 330-C:18.

(ae) "Licensed counselor" means a master licensed alcohol and drug counselor (MLADC), a licensed alcohol and drug counselor (LADC), or a licensed mental health professional who has demonstrated competency in the treatment of substance use disorders (SUD).

(af) "Licensed health care practitioner" means a:
(1) Medical doctor;

(2) Physician's assistant;

(3) Advanced practice registered nurse (APRN);

(4) Doctor of osteopathy;

(5) Doctor of naturopathic medicine; or

(6) Any other practitioner with diagnostic and prescriptive powers licensed by the appropriate state licensing board.

(ag) "Limited medical withdrawal management" means a resident is capable of evacuating the facility without assistance, is medically cleared to participate in limited medical withdrawal management by a licensed practitioner prior to or at the time of admission, and is not a danger to themselves or others.

(ah) "Mechanical restraint" means "mechanical restraint" as defined in RSA 126-U:1, IV.

(ai) Medical director" means a practitioner licensed in accordance with RSA 329 or RSA 326-B, who is responsible for overseeing the quality of medical care and services in a specialized care program.

(aj) "Medical technology dependent" means a resident with limitations so severe as to require both an assistive medical technology device to compensate for the loss of a vital body function and significant and sustained care to avert death or further disability. Assistive medical technology devices include, but are not limited to tracheostomy tube, feeding tube, c-pap or bi-pap machines, and wheelchairs.

(ak) "Medication" means a drug prescribed for a resident by a licensed health care practitioner and over-the-counter medications.

(al) "Medication log" means a written record of medications administered to a resident.

(am) "Medication occurrence" means any error in the administration of a medication as prescribed or in the documentation of such administration, with the exception of a resident's refusal.

(an) "Medication restraint" means "medication restraint" as defined in RSA 126-U:1, IV(a).

(ao) "Mental illness" means a substantial impairment of emotional processes, or of the ability to exercise conscious control of one's actions, or of the ability to perceive reality or to reason, when the impairment is manifested by instances of extremely abnormal behavior or extremely faulty perceptions. It does not include impairment primarily caused by:
(1) Epilepsy;

(2) Intellectual disability;

(3) Continuous or non-continuous periods of intoxication caused by substances such as alcohol or drugs; or

(4) Dependence upon or addiction to any substance such as alcohol or drugs.

(ap) "Monitoring visit" means an announced or unannounced visit made to a residential child care program by department personnel for the purpose of assessing compliance with the standards set by rule adopted by the commissioner pursuant to RSA 541-A.

(aq) "Nursing care" means the provision or oversight of a resident's physical, mental, or emotional condition by diagnosis as confirmed by a licensed practitioner.

(ar) "Orders" means instructions by a licensed practitioner, produced verbally, electronically, or in writing for medication, treatments, recommendations, and referrals, and signed by the licensed practitioner using terms such as authorized by, authenticated by, approved by, reviewed by, or any other term that denotes approval by the licensed practitioner.

(as) "Parent" means a father, mother, legal guardian, or other person or agency responsible for the placement of a resident.

(at) "Permanency" means a permanent connection with at least one adult committed to helping the homeless youth meet his or her needs throughout his or her life.

(au) "Physical intervention" means a behavior management technique in which staff use the minimum amount of physical contact on a resident, which is necessary for the circumstances, in accordance with RSA 627:6, II(b) and RSA 126-U, to protect the resident, other residents present, the staff, and the general public.

(av) "Pre-service training" means training or education required to meet the minimum qualifications for the position of program director, as specified in He-C 4001.19(e), or direct care staff, as specified in He-C 4001.19(f).

(aw) "Procedure" means a licensee's written, standardized method of performing duties and providing services.

(ax) "Program director" means the individual who has responsibility for the daily operation of the residential child care program.

(ay) "Program staff" means all staff, both professional and non-professional, including direct care staff, who are responsible for the supervision, care, or treatment of residents.

(az) "Pro re nata (PRN)" means medication administered as circumstances may require in accordance with licensed practitioner's orders.

(ba) "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 his or her best functional level.

(bb) "Repeat violation" means a violation of a specific licensing rule or law for which the program has been previously cited during the past 5 years, which has not been removed as a result of an informal dispute resolution or overturned as a result of an adjudicatory procedure and that posed a health or safety risk to residents.

(bc) "Reportable incident" means an occurrence of any of the following while the resident is either in the program or in the care of program personnel:

(1) The death of the resident;

(2) Suspected abuse or neglect of the resident; or

(3) The unexplained absence of a resident from the program.

(bd) "Resident" means a child who has been admitted to a residential child care program.

(be) "Residential child care program (program)" means "child care agency" as defined in RSA 170-E:25, II. The term also means "child-care institution" as defined in 42 CFR § 672(c)(2)(a).

(bf) "Restraint" means "restraint" as defined by RSA 126-U:1, IV.

(bg) "Runaway" means a child who is absent without leave or permission from the program that is responsible for the supervision of that child.

(bh) "Sanitize" means to clean by removing all organic material then wiping down or washing with a disinfecting or germicidal solution consisting of one tablespoon of regular strength chlorine bleach to one gallon of water which is mixed fresh daily, or a commercial product which is designed to kill germs and which, when used in accordance with manufacturer's directions, does not pose a health or safety risk to residents.

(bi) "Seclusion" means "seclusion" as defined in RSA 126-U:1, V-a.

(bj) "Short term" means a placement which is intended to last for 60 days or less, unless the residential child care program has written documentation on file that the 60 day period has been extended by the department's division for children, youth and families (DCYF), juvenile justice services (JJS), or by the referring agency.

(bk) "Social or non-medical withdrawal management" means a treatment service provided by appropriately trained staff who provide 24-hour supervision, observation, and support for residents who are intoxicated or experiencing withdrawal with no staff-administered medication.

(bl) "Specialized care" means "specialized care" as defined in RSA 170-E:25, II(c). Such care includes substance use disorder and behavioral health. The term also includes "specialized care program (SCP)".

(bm) "Substance use disorder (SUD)" means a disease that affects a person's brain and behavior and may lead to an inability to control the use of a legal or illegal substance. Substances can include alcohol and other drugs.

(bn) "SUD program" means a residential program, excluding hospitals as defined in RSA 151:2,I(a), which provides residential SUD treatment relating to the youth's medical, physical, psychosocial, vocational, and educational needs.

(bo) "Time out" means the restriction of a resident for a period of time to a designated area from which the resident is not physically prevented from leaving, for the purpose of providing the resident the opportunity to regain self-control or as a consequence to a specific behavior.

(bp) "Treatment plan" means the program's written, time-limited, goal-oriented therapeutic plan for the child and family, which includes strategies to address the issues that brought the child into placement, and which is developed by the family, program staff, and the agency responsible for the placement of the child. This includes, but is not limited to, a child specific planning document prepared in cooperation with DCYF, JJS, a school district, or other placing or sending organization. A treatment planning document that complies with certification requirements satisfies licensing requirements.

(bq) "Unit" means the department's child care licensing unit.

(br) "Volunteer" means an unpaid person who assists with the provision of food services or activities, and who does not provide direct care or assist with direct care.

(bs) "Withdrawal management" means a residential treatment service provided by appropriately trained staff who provide 24-hour supervision, observation, and support for youth who are intoxicated or experiencing withdrawal with prescription medication administered based on the results of an appropriate evaluation tool.

#2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06; amd by #10319, eff 7-1-13; amd by #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14

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