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 6300 - GENERAL PROGRAM ADMINISTRATION
Part He-C 6343 - CERTIFICATION PAYMENT STANDARDS FOR TRANSPORTATION SERVICE PROVIDERS
Section He-C 6343.09 - Application Process For Payment Standards For Accompanied Transportation Services
Current through Register No. 13, March 27, 2025
(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:
(c) If there is a need for a service based on (b) above, DCYF shall forward an application packet to the applicant which includes:
(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:
(See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09