Current through Register No. 40, October 3, 2024
(a) The service
coordinator shall create service agreements for all individuals in accordance
with (b)-(f) below.
(b) All service
agreements shall:
(1) Be understandable to the
individual, guardian, or representative and all provider agencies and providers
responsible for service provision;
(2) At a minimum, be written in plain
language and in a manner accessible to individuals with disabilities and
persons who have limited proficiency in English;
(3) Be finalized and agreed to in writing by
the individual, guardian, or representative and signed by all provider agencies
responsible for the implementation of the service agreement;
(4) Be entered into the electronic platform,
Intellect Ability at, and then NH Easy at, when Intellect Ability sunsets;
and
(5) Be distributed to the
individual, guardian or representative, area agency, and all provider agencies
and providers who are responsible for the implementation or monitoring of the
service agreement.
(c)
Within 14 days of the initial person-centered service planning meeting pursuant
to He-M
503.09(e), the service coordinator
shall develop a service agreement that includes, but is not limited to, the
following:
(1) A statement of the nature of
the specific strengths, interests, capacities, disabilities, and specific needs
of the individual;
(2) A
description of intermediate and long-range habilitation and treatment goals
chosen by the individual and their guardian with a projected timetable for
their attainment;
(3) A statement
of specific services to be provided and the amount, scope, frequency, and
duration of each service;
(4)
Specification of the provider agencies to furnish each service identified in
the service agreement;
(5) Criteria
for transfer to less restrictive settings for habilitation, including criteria
for termination of service, and a projected date for termination of
service;
(6) Demographic
information;
(7) A personal
profile;
(8) The specific services
to be furnished based on the support needs identified in (1) above and how the
services selected will support the individual's goals;
(9) Guardianship, supported decision-making,
and representative payee information;
(10) Service documentation requirements
sufficient to track outcomes;
(11)
Identification of the persons and entities responsible for monitoring the
services in the service agreement;
(12) Documentation that all settings where
the individual receives services meet the criteria of
42 CFR
441.301, are chosen by the individual or
representative, and support full access to the greater community, including
opportunities to seek employment and work in competitive integrated settings,
engage in community life, control personal resources, and receive services in
the community to the same degree of access as people not receiving
services;
(13) Documentation that
the setting is selected by the individual from among setting options, including
non-disability specific settings and an option for a private unit in a
residential setting, and that the settings options are identified and based on
the individual's needs, and preferences;
(14) Documentation that any restriction on
the right of an individual is justified by:
a.
An identified specific and individualized need that the modification is based
on;
b. The positive interventions
and supports used prior to any modifications to the individual's
rights;
c. The less intrusive
methods of meeting the need that were tried but did not work;
d. A clear description of the condition that
is directly proportionate to the specific assessed need;
e. The regular collection and review of data
to measure the ongoing effectiveness of the modification;
f. Established time limits for periodic
reviews of the necessity of the modification;
g. The informed consent of the individual,
guardian, or representative; and
h.
An assurance that the modification will not cause harm to the
individual;
(15) Services
needed but not currently available; and
(16) If applicable, risk factors and the
measures required to be in place to minimize them, including backup plans and
strategies.
(d) For
individuals receiving waiver services, the information provided below shall be
added to the service agreement:
(1) The
specific waiver services to be provided including the amount, scope, frequency,
and duration;
(2) The results of
the SIS-A ® and the HRST;
(3)
Service documentation requirements sufficient to describe progress on goals and
the services received; and
(4) If
applicable, reporting mechanisms under self-directed services regarding budget
updates and individual and guardian satisfaction with
services.
(e) For
individuals who reside in a provider owned or controlled residential setting,
the service agreement shall document any modifications of the individual's
rights in said setting to:
(1) Privacy in
their sleeping or living unit, including doors lockable by the individual with
only appropriate providers having keys to doors as needed;
(2) Freedom and support to control their own
schedule and activities;
(3) Access
to food at any time;
(4) Having
visitors of their choosing at any time; and
(5) Freedom to furnish and decorate sleeping
or living units.
(f) A
provider agency shall only make modifications pursuant to (e) above by
documenting in the service agreement the following:
(1) An identified specific and individualized
assessed need that the modifications are based on;
(2) The positive interventions and supports
used prior to any modifications to the service agreement;
(3) The less intrusive methods of meeting the
need that have been tried but did not work;
(4) A clear description of the condition that
is directly proportionate to the specific assessed need;
(5) The regular collection and review of data
to measure the ongoing effectiveness of the modification;
(6) Established time limits for periodic
reviews to determine if the modification is still necessary or can be
terminated;
(7) The informed
consent of the individual or representative; and
(8) An assurance that the interventions and
support will not cause harm to the individual.
(g) Within 5 business days of completion of a
service agreement, or service agreement amendment, the service coordinator
shall provide the individual and guardian, or representative the following:
(1) The service agreement, signed by the
service coordinator, and all provider agencies identified in the service
agreement;
(2) The name, address,
email, and phone number of all provider agencies; and
(3) A description of the procedures for
challenging the proposed service agreement pursuant to
He-M
503.16 for those situations where the individual,
guardian, or representative disapproves of the service
agreement.
(h) The
individual, guardian, or representative shall have 10 business days from the
date of receipt of the service agreement, or the service agreement amendment,
to respond in writing, indicating approval or disapproval of the service
agreement or amendment. Unless otherwise arranged between the individual,
guardian, or representative and the service coordinator, failure to respond
within the time allowed shall constitute approval of the service agreement or
amendment.
(i) When a service
agreement has been approved by the individual, guardian, or representative and
service coordinator, the services shall be implemented and monitored as
follows:
(1) A person responsible for
implementing any part of a service agreement, shall collect and record
information about services provided and how they have impacted progress on the
individual's goals, in a timeframe outlined in the service agreement or, at a
minimum, monthly;
(2) On at least a
monthly basis, the service coordinator shall visit or have verbal or written
contact, as determined by the individual or persons responsible for
implementing a service agreement, and document these contacts;
(3) The service coordinator shall visit the
individual and contact the guardian, if any, at least quarterly, or more
frequently if so specified in the individual's service agreement, to determine
and document:
a. Whether services match the
interests and needs of the individual;
b. Individual and guardian satisfaction with
services; and
c. Progress on the
goals in the expanded service agreement; and
(4) If the individual receives services under
He-M 1001, or residential services under He-M 521, He-M 524, or He-M 525, all
of the service coordinator's quarterly visits with the individual shall be in
the home where the individual resides.
#1969, eff 2-25-82; ss by #2615, eff 2-6-84; ss by
#2962, eff 1-22-85; ss by #5211, eff 8-28-91; EXPIRED: 8-28-97
New. #6581, INTERIM, eff
9-19-97, EXPIRED: 1-17-98
New. #6932, eff 1-27-99; ss by
#8805, eff 1-27-07
