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 522.15 - Allocation of Funds for Current and Future Individual Service Requests

(a) All services covered by He-M 522 shall be provided to the extent that funds for this purpose are available and appropriated to the bureau by the Legislature.

(b) For each applicant found eligible for Medicaid home- and community-based services, the area agency shall seek funding upon completion of the preliminary recommendation process pursuant to He-M 522.08. Unless the area agency makes a request for advanced crisis funding pursuant to (k) -(m) below, the bureau, subject to He-M 522.15(a) , shall allocate funding within 90 days of the preliminary service recommendation or within 90 days of start date requested by the individual or guardian, whichever is later.

(c) For individuals who are already receiving Medicaid home- and community-based care services, if additional services are needed, the area agency shall request such funding and, subject to He-M 522.15(a) , the bureau shall approve it within 90 days of amendment of the individual service agreement or within 90 days of the start date requested by the individual, whichever is later, unless the area agency makes a request for advanced crisis funding pursuant to (k) -(m) below.

(d) Each area agency shall maintain a projected service needs list for:

(e) Each area agency shall maintain a wait list for those individuals for whom funding is not available in accordance with (a) above and who:

(f) Each area agency shall include the following information on its wait list and projected service needs list:

(g) Each area agency shall report to the bureau quarterly:

(h) To access the wait list funds appropriated for a given fiscal year, the area agency shall submit to the bureau a single list with the names of:

(i) In submitting its list pursuant to (h) above, the area agency shall prioritize each individual's standing on the list by determining the individual's urgency of need based on the following factors:

(j) In maintaining its wait list and projected service needs list, the area agency shall exclude those circumstances where funds might be needed to cover additional expenditures, such as cost-of-living or other wage and compensation increases.

(k) For individuals eligible for Medicaid home- and community-based care services or currently receiving such services, an area agency shall request advanced crisis funding to provide services without delay when there are no generic or area agency resources available and an individual is experiencing a significant life change pursuant to (l) below.

(l) An individual shall be considered to be experiencing a significant life change if he or she is:

(m) To demonstrate the need for advanced crisis funding, the area agency shall submit to the bureau, in writing, a detailed description of the individual's circumstances and needs and a proposed budget.

(n) The bureau shall review the information submitted by the area agency and approve advanced crisis funding if it determines that one of the conditions cited in (l) above applies to the individual's situation.

(o) For each request an area agency makes for funding individual services, the bureau shall make the final determination on the cost effectiveness of proposed services.