Current through Register No. 40, October 3, 2024
(a)
Service planning shall be conducted in accordance with
He-M
503.09.
(b) The service coordinator shall assist the
individual and representative and other persons chosen by the individual to
develop a written service agreement in accordance with the principles outlined
in
He-M 525.05,
signed by the individual or representative and the area agency director or
designee, that includes the following:
(1) A
brief description of the individual's strengths, needs, and interests, as
applicable;
(2) The individual's
clinical and support needs as identified through current evaluations and
assessment;
(3) The specific
services to be furnished and the goal associated with each service;
(4) The amount, frequency, duration, and
desired outcome of each service;
(5) Timelines for initiation of
services;
(6) The provider to
furnish the services;
(7) The
individual's need for guardianship, if any;
(8) Service documentation requirements for
tracking outcomes and service provision, including the type of
documentation;
(9) Identification
of the person or entity responsible for monitoring the plan;
(10) The frequency of service coordinator
visits with the individual and contact with the representative pursuant to
He-M 525.08(a) and (b)
;
(11) An individualized budget pursuant to (g)
below; and
(12) If medication is
administered, provision for compliance with (k) (5) below.
(d) Requirements for documentation of service
provision shall be specified in the service agreement and include, at minimum:
(1) The dates services are provided;
and
(2) Reports on progress toward
achieving desired outcomes.
(e) Service agreements shall be renewed at
least annually and include a review of guardianship.
(f) Amendments to the service agreement may
be made at any time. Amendments shall be documented by the service coordinator
with the approval of the individual or representative and the area agency
director or designee.
(g) The
individual or representative and the area agency shall develop an
individualized budget that includes:
(1) The
specific service components;
(2)
The frequency and duration of the services required;
(3) An itemized cost of services;
and
(4) The frequency at which
budget reports will be provided by the area agency or subcontractor to the
individual or representative pursuant to (h) below.
(h) In providing services, the area agency or
subcontract agency shall establish a budget reporting mechanism, detailing
expenditures to date and the amount remaining in the budget, to assist the
individual -and representative to manage his or her budget.
(i) When PDMS are to be provided by a
subcontract agency of the area agency, one of the following shall apply:
(1) The individual or representative shall
establish an agreement with the subcontract agency; or
(2) The area agency shall establish a
contract with the subcontract agency for service provision and
oversight.
(j) Agencies
providing PDMS shall have policies regarding:
(1) Administration of medication, pursuant to
(k) (5) below; and
(2) Individual
rights in accordance with He-M 202 and He-M 310.
(k) For individuals who are 21 years of age
or older, the following shall apply:
(1)
Unless otherwise requested by the individual or representative the area agency
or a subcontract agency shall be the employer;
(2) When the individual or representative
requests to be the employer or designates an entity to perform that function
that is not a subcontractor of an area agency, the area agency shall identify
and review with the individual and representative the responsibilities
referenced in (3) below;
(3) Prior
to hiring or contracting with a staff or provider, the individual,
representative, or area agency or subcontract agency that intends to contract
with a provider, shall:
a. Submit the name of
the person and all other persons residing in the home of a non-family provider
for review against the registry of founded reports of abuse, neglect, and
exploitation to ensure that the person is not on the registry pursuant to
RSA 169-C:35 or
RSA 161-F:49;
b. Complete a criminal records check in New
Hampshire, no more than 30 days prior to contracting with the person to ensure
that he or she and all other persons residing in the home of a non-family
provider have no history of fraud, felony, or misdemeanor conviction;
c. Complete a criminal records check for the
person's state of residence if it is not New Hampshire to ensure that the
person and all other persons residing in the home of a non-family provider have
no history of fraud, felony, or misdemeanor conviction;
d. Complete a criminal records check for the
person's previous state of residence if he or she has resided in New Hampshire
for less than one year to ensure that the person and all other persons residing
in the home of a non-family provider have no history of fraud, felony, or
misdemeanor conviction;
e. Provide
information obtained pursuant to (3) a. above to the area agency;
f. Obtain at a minimum one reference on each
prospective staff or non-family provider;
g. Provide proof of insurance coverage,
including general liability and workers' compensation, to the area agency;
and
h. Comply, as applicable, with
all employer-employee legal requirements such as wage reporting and tax
withholding;
(4) An
individual, representative, area agency, or subcontract agency may hire a
person with a criminal record listed in (3) b.-d. above for a single offense
that occurred 10 or more years ago in accordance with (5) and (6) below. In
such instances, the individual, his or her guardian, if applicable, the area
agency, and the subcontract agency, if applicable, shall review the person's
history prior to approving the person's employment;
(5) Unless a waiver is granted pursuant to
(6) below, an individual, representative, area agency, or subcontract agency
shall not hire a person with a criminal record, other than as specified in (4)
above;
(6) The department may grant
a waiver of (5) above if, after reviewing the underlying circumstances, it
determines that the person does not pose a threat to the health, safety, or
well-being of individuals;
(7)
Employment of a person pursuant to (4) above shall only occur if such
employment:
a. Is approved by the individual,
his or her guardian if applicable, the area agency, and the subcontract agency
if applicable;
b. Does not
negatively impact the health or safety of the individual(s); and
c. Does not affect the quality of services to
individuals;
(8) Upon
the hiring of a person pursuant to (4) above, the area agency shall document
and retain the following information in the individual's record:
a. The dates of the approval in (4)
above;
b. The name of the person
hired;
c. The description of the
person's criminal offense;
d. The
type of service the person is hired to provide;
e. The subcontract agency's name and address,
if applicable;
f. A full
explanation as to why the individual, representative, or agency is hiring the
person despite the person's criminal record;
g. The signature of the individual, guardian,
or representative indicating agreement with the employment and the date
signed;
h. The signature of the
area agency representative approving the employment; and
i. The signature and phone number of the
person being hired;
(9)
All personnel shall sign a statement annually, which shall be maintained in the
personnel file, stating that since the time of hire they:
a. Have not been convicted of a felony or
misdemeanor in this or any other state; and
b. Have not had a finding by the department
or any administrative agency in this or any other state for assault, fraud,
abuse, neglect, or exploitation of any person;
(10) Medication administration shall:
a. Comply with He-M 1201 or Nur 404 except in
situations where the individuals are living with their families and receiving
respite arranged by the family; or
b. When performed by family members paid
under He-M 525, include discussion between the area agency or subcontract
agency and the family about any concerns the family might have regarding
medication administration;
(11) Provision of nursing-related tasks
shall:
a. Comply with Nur 404 except in
situations where individuals are living with their families and receiving
respite arranged by the family; or
b. When performed by family members paid
under He-M 525, include discussion between the area agency or subcontract
agency and the family about concerns the family might have regarding the
provision of nursing-related tasks;
(12) Staff and providers who are not family
members shall:
a. Meet the educational
qualifications, or the equivalent combination of education and experience,
identified in the job description;
b. Meet the certification and licensing
requirements of the position, if any; and
c. Be 18 years of age or older;
(13) The employer, when not the
individual or representative, shall provide information to the individual and
representative regarding the staff development elements identified in
He-M
506.05 to assist him or her in making informed
decisions with respect to orientation and training of staff and providers;
and
(14) Subsequent to (13) above
and consistent with the area agency's or subcontract agency's personnel
policies, the employer shall ensure that the staff and providers receive the
orientation and training selected by the individual or
representative.
(l) In
addition to complying with (k) above, when an individual is 21 years of age or
older and lives in a staffed home:
(1) The
home shall comply with applicable local and state health, zoning, building, and
fire codes;
(2) The physical layout
and environment of the home shall meet the health and safety needs of the
individual;
(3) A signed statement
from the local fire official shall be obtained before the individual moves into
the home:
a. Verifying that the home complies
with all state and local fire codes; and
b. Specifying the number of beds that can
safely be occupied by individuals living in the home; and
(4) Quarterly fire drills in the home shall
be conducted and documented such that:
a. One
drill per year shall be conducted during sleep hours; and
b. The first drill shall be conducted no more
than 5 days after the individual has moved into the home.
(m) In addition to complying with
(k) above, when an individual is 21 years of age or older and lives with a home
provider who is not a family member, the home shall have:
(1) An integrated fire alarm system with a
functioning smoke detector in each bedroom and on each level of the home
including the basement and attic, if the attic is used as living or storage
space;
(2) A functioning septic or
other sewage disposal system;
(3) A
source of potable water for drinking and food preparation, such that, if the
water for drinking and food preparation is not from a public water supply:
a. At the time of the initial certification
there shall be well water test results less than 2 years old that indicate the
water is potable; or
b. There shall
be documentation that bottled water is used; and
(4) Two means of egress.
(n) If the home in which supports are
provided is not owned by a family member, a fire safety assessment shall be
conducted by staff in a staffed home or a home provider, when not a family
member, to address the individual's following risk factors:
(1) Response to alarm;
(2) Response to instructions;
(3) Vision and hearing
difficulties;
(4) Impaired
judgment;
(5) Mobility problems;
and
(6) Resistance to
evacuation.
(o) Based on
the findings of the fire safety assessment, the individual and other members of
his or her team shall develop a fire safety plan that addresses fire drill
frequencies, procedures to achieve evacuation within 3 minutes, and other fire
safety related strategies determined by the team to be applicable.
(p) When an individual's service agreement
specifies unsupervised time and the provider is not a family member, the staff
in a staffed home or the home provider shall conduct a personal safety
assessment that identifies the individual's ability to demonstrate the
following safety skills:
(1) Responding to a
fire, including exiting safely and seeking assistance;
(2) Caring for personal health, including
understanding health issues, taking medication, seeking assistance for health
needs and applying basic first aid;
(3) Seeking safety if victimized or sexually
exploited;
(4) Negotiating one's
community, including finding one's way, riding in vehicles safely, handling
money safely, and interacting with strangers appropriately;
(5) Responding appropriately in severe
weather and other natural disasters, including storms and extreme temperature;
and
(6) Maintaining a safe home,
including:
a. Operating heating, cooking, and
other appliances; and
b. Responding
to common household problems such as a blocked toilet, power failure or gas
odors.
(q)
Based on the findings of the personal safety assessment, the individual and
other members of his or her team shall develop a personal safety plan that:
(1) Identifies any supports necessary for an
individual to respond to each of the contingencies listed in (p)
above;
(2) Indicates who will
provide the needed supports;
(3)
Describes how the supports will be activated in an emergency;
(4) Indicates approval of the individual or
legal guardian, provider, residential coordinator, and service
coordinator;
(5) Is reviewed by the
provider or staff at the time of the individual's service agreement;
and
(6) Is revised whenever there
is a change in the individual's residence or ability to respond to the
contingencies listed in the plan.
#9391, eff 2-21-09; ss by #9890-A, eff 3-22-11; ss by
#12859, eff 8-28-19
