Current through Register No. 40, October 3, 2024
(a) The service
coordinator shall be a person chosen or approved by the individual or guardian
and approved by the area agency pursuant to paragraph (d) below, provided that
the area agency shall retain ultimate responsibility for service coordination.
The area agency shall advise the individual and guardian verbally and in
writing prior to the preliminary planning stage under
He-M
522.08 and prior to the initial and yearly individual
service agreement planning process under
He-M
522.11 and
He-M
522.12 that he or she has a right to choose his or her
own service coordinator, including one who is not employed by the area
agency.
(b) For those individuals
not eligible for Medicaid home- and community-based care services pursuant to
He-M 517, the service coordinator shall:
(1)
Hold a planning session to identify service needs and goals and appropriate
community resources;
(2) Make
appropriate referrals to community agencies; and
(3) Advocate on behalf of the individual for
services to be provided in accordance with He-M 522.
(c) For those individuals eligible under
He-M
517.03, the service coordinator shall:
(1) Advocate on behalf of individuals for
services to be provided in accordance with
He-M
522.09(b) ;
(2) Coordinate the service planning process
in accordance with He-M 522.09 and
He-M
522.11;
(3) Describe to the individual or guardian
service provision options such as consolidated services;
(4) Monitor and document services provided to
the individual;
(5) Ensure the
continuity and quality of services provided;
(6) Ensure that service documentation is
maintained pursuant to
He-M
522.12(d) (1) and (g) (2) -(3)
;
(7) Determine and implement
necessary action and document resolution when goals are not being addressed,
support services are not being provided in accordance with the service
agreement, or health or safety issues have arisen;
(8) Convene service planning meetings at
least annually and whenever:
a. The
individual or guardian is not satisfied with the services received;
b. There is no progress on the goals after
follow-up interventions;
c. The
individual's needs change; or
d.
There is a need for a new provider; and
(9) Document service coordination visits and
contacts pursuant to He-M 522.11(j)
and He-M
522.12(g) (2) -(4) .
(d) A service coordinator shall
not:
(1) Be a guardian of the individual
whose services he or she is coordinating;
(2) Have a felony conviction;
(3) Have been found to have abused or
neglected an adult with a disability based on a protective investigation
performed by the bureau of elderly and adult services in accordance with He-E
700 and an administrative hearing held pursuant to He-C 200, if such a hearing
is requested;
(4) Be listed in the
state registry of abuse and neglect pursuant to
RSA
169-C:35 or
RSA
161-F:49; or
(5) Have a conflict of interest concerning
the individual, such as providing other direct services to the
individual.
(e) If the
service coordinator chosen by the individual or guardian is not employed by the
area agency or its subcontractor the following requirements shall apply:
(1) The service coordinator and area agency
shall enter into an agreement that describes:
a. The role(s) set forth in
He-M
522.10 for which the service coordinator assumes
responsibility;
b. The
reimbursement, if any, provided by the area agency to the service coordinator;
and
c. The oversight activities to
be provided by the area agency;
(2) If the area agency determines that the
service coordinator is not ensuring the implementation of the service agreement
or is not fulfilling his or her obligations as described in the letter of
agreement, the area agency shall revoke the designation of the service
coordinator with a 30-day notice and designate a new service coordinator, with
input from the individual or guardian, pursuant to
He-M
522.10(a) ; and
(3) If the area agency determines that a
service coordinator chosen by the individual or guardian is posing a serious
threat to the health or safety of the individual, the area agency shall
terminate the designation of the service coordinator immediately upon issuance
of written notice specifying the reasons for the action and designate a new
service coordinator, with input from the individual or guardian, pursuant to
He-M
522.10(a) .
(f) For individuals who receive both acquired
brain disorder services and behavioral health services, service coordination
shall be billed only by the area agency or behavioral health agency that is the
primary service provider pursuant to
He-M
426.15(b) .
(g) The role of service coordinator may, by
mutual agreement, be shared by an employee of the area agency and another
person. Such agreements shall be in writing and clearly indicate which
functions each service coordinator will perform.
(h) The individual or guardian may appeal the
area agency's decision under (e) (2) or (3) above pursuant to
He-M
522.19. At the time it provides notice under (e) (2)
or (3) above, the area agency shall advise the individual or guardian verbally
and in writing of his or her appeal rights under
He-M
522.19.
#7120, eff 10-20-99; ss by #8974, INTERIM, eff 10-6-07,
EXPIRED: 4-3-08
New. #9734, eff 6-25-10 (from
He-M
522.09)
The
amended version of this section by
New
Hampshire Register Volume 38, Number 50, eff.
11/30/2018 is not
yet available.
