New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-M - Former Division of Mental Health and Developmental Services
Chapter He-M 500 - DEVELOPMENTAL SERVICES
Part He-M 522 - ELIGIBILITY DETERMINATION AND SERVICE PLANNING FOR INDIVIDUALS WITH AN ACQUIRED BRAIN DISORDER
Section He-M 522.04 - Application for Services

Universal Citation: NH Admin Rules He-M 522.04

Current through Register No. 40, October 3, 2024

(a) Application for services shall be made by an applicant or an applicant's guardian.

(b) An application for services shall be made in writing to the area agency in the applicant's region of residence.

(c) An area agency shall explain the eligibility process and offer assistance to the applicant or guardian in making application for services.

(d) The area agency shall inform the applicant or guardian of its roles and responsibilities and provide information about:

(1) Evaluation;

(2) Eligibility determination;

(3) Service coordination;

(4) Service agreement development and review;

(5) Services provided by the area agency and how service needs are identified;

(6) Service provision; and

(7) Service monitoring.

(e) An area agency shall request each applicant to authorize release of information to permit the area agency to access relevant records and information regarding the applicant's:

(1) Acquired brain disorder;

(2) Personal, family, social, educational, neuropsychological, medical and rehabilitation history; and

(3) Functional abilities, interests, and aptitudes.

(f) Authorization to release information shall specify:

(1) The name of the applicant and the information to be released;

(2) The name of the person or organization being authorized to release the information;

(3) The name of the person or organization to whom the information is to be released; and

(4) The time period for which the authorization is given, which shall not exceed one year.

(g) To provide comprehensive, efficient, and coordinated services, the area agency shall undertake an assessment of the public and private benefits and resources that are available to the applicant.

#7120, eff 10-20-99; ss by #8974, INTERIM, eff 10-6-07, EXPIRED: 4-3-08

New. #9734, eff 6-25-10

The amended version of this section by New Hampshire Register Volume 38, Number 50, eff. 11/30/2018 is not yet available.

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