N.H. Admin. Code § He-C 6339.17

Current through Register No. 50, December 12, 2024

Section He-C 6339.17 - Requirements for Home-Based Therapeutic Services

(a) The provider shall comply with sections He-C 6339.01 through He-C 6339.15 for certification compliance.

(b) Authorization for payment for home-based therapeutic services shall be pursuant to a court order, or a non-court-ordered or voluntary agreement between DCYF and the family.

(c) A provider shall not provide services that exceed 90 days per year without prior approval from the CPSW or JPPO.

(d) Service for an additional 90 days per year shall be authorized when the following conditions are met:

(1) The family's problems have not been resolved and the child remains at risk for out-of home placement;

(2) The provider has discussed a continuation of services with family members and the CPSW or JPPO; and

(3) The provider submits the following documentation to the CPSW or JPPO:

a. The therapeutic need(s) for continued services;

b. The beginning and anticipated ending dates for the continued services request;

c. The goals for the continued period of services; and

d. The anticipated child and family outcomes.

(e) Home-based therapeutic services shall be provided for:

(1) Families with a child who is at imminent risk for placement;

(2) A family with a child who has returned home or is at risk of returning to placement;

(3) Families where the parents are temporarily unable to deal with their child-rearing responsibilities because of a family member's physical or mental illness, disability, convalescence, substance use disorder, or pregnancy;

(4) Families temporarily under stress with the care of a parent, child, or another member of the family;

(5) Families for whom child placement has been determined necessary to ensure safety and the parents need assistance preparing for the placement or return of the child to a safe environment;

(6) Parents who request voluntary services, including voluntary children in need of services (CHINS) and the requested service is not available to the family through a community service agency;

(7) Families, including those who provide foster care services, needing assistance to strengthen and support the child's current placement in a foster home or a relative's home;

(8) Families who are experiencing a crisis that might require the removal of a child due to physical abuse or neglect by the parent or caregiver or unlawful behaviors by the child such as school truancy, running away, or delinquency; or

(9) Families in crisis whose child is immediately placed in emergency care for safety reasons after the initial DCYF assessment or due to legal or judicial intervention because of juvenile offenses, and the family's goal is for the child to return home with this service provided.

(f) Home-based therapeutic services shall include:

(1) On-call 24-hour availability to families;

(2) Assessment and service planning based on the DCYF case plan or pre-dispositional investigation report or treatment and ongoing assessment for each child enrolled in the program;

(3) Substance use disorder recovery support that includes ongoing risk assessment and referral for substance abuse treatment, as well as supportive counseling for those in addiction treatment programs to reduce the effects these addictions have on the child and parent;

(4) Family and individual counseling with family members and persons in their immediate support system to develop or maintain family growth and assistance necessary for independent family functioning;

(5) Assistance to parents in compliance with court orders;

(6) Crisis assistance and safety planning with families by responding immediately to a family's needs;

(7) Referrals and coordination to other services and supports made with JPPO and CPSW;

(8) A written description of services, as described in He-C 6339.14 including the cost of the service and potential reimbursement by the family to the state for services provided;

(9) For families who need crisis assistance:

a. A face-to-face meeting initiated within 24 hours of referral to complete an initial assessment and develop an immediate safety plan that includes strategies for diffusing the crisis and maintaining the safety of all family members;

b. Submit the safety plan in writing to the JPPO or CPSW within 72 hours; and

c. If safety cannot be assured at the face-to-face meeting, immediately develop and coordinate an alternative safety plan with the JPPO or CPSW, the program administrator, or DCYF field administrator or supervisor during weekends and holidays; and

(10) For families not in need of crisis assistance:

a. Contact the family within 48 hours of referral, excluding weekends and holidays; and

b. Have a face-to-face meeting with the family within 5 working days of the date of the referral to conduct an initial assessment and develop the treatment plan; and

(11) An assessment of the needs of each child and the parents that is based upon:

a. The information included from one of the following:

1. The DCYF case plan, pursuant to RSA 170-G:4 III and court reports pursuant to RSA 169-B:5-a, RSA 169-C:12-b or RSA 169-D:4-a; or

2. The investigation report, pursuant to RSA 170-G:16, I or III, RSA 169-B:16, III-IV, or RSA 169-D:14, III-IV; and

b. Identification of substance use disorders, domestic and family violence, sexual abuse, or other situations that impact the child's safety.

(g) When available, the CPSW or JPPO shall be present for the initial assessment and development of the treatment plan.

(h) Face-to-face meetings with families shall include parents or other caregivers, the child or children, and other family members as necessary to develop and implement the treatment plan.

(i) The therapist shall maintain an on-going log of contacts and visits with family members and with school, health, and other service providers including the following:

(1) The type of service;

(2) The date of service;

(3) The names of the family members and other individuals who participated;

(4) The name of the therapist who assisted the family;

(5) A brief summary of the in-home session;

(6) The length of time spent with the family; and

(7) The provider's signature and the signature of the family member and child.

(j) The agency shall immediately notify the JPPO or CPSW of any significant changes in or affecting the family, such as:

(1) Change of employment or income;

(2) Housing changes including an eviction notice;

(3) Death or serious injury or illness of a family member;

(4) Separation of the caregivers;

(5) Unplanned pregnancy;

(6) Changes in patterns of school attendance;

(7) Arrests;

(8) Police contacts; or

(9) Violations of probation or parole.

(k) The agency shall have a policy in place regarding missed appointments by client families.

(l) The home-based therapeutic agency shall:

(1) Employ or contract with a prescribing practitioner;

(2) Employ a program coordinator who meets the following:

a. A master's degree in social work, psychology, education, or a related field with an emphasis in human services;

b. Two years clinical experience working with families, and

c. Two years supervisory or management experience;

(3) Employ therapists who have:

a. A master's degree with a major in social work, counseling, psychology, or a related field and at least 2 years of direct work experience in assisting children and families; or

b. A bachelor's degree with a major in social work, counseling, psychology, or a related field and at least 5 years of direct work experience in assisting children and families; and

(4) Employ case managers who meet the following minimum qualifications:

a. A bachelor's degree in social work, psychology, education or a related field with an emphasis in human services; and

b. Experience of 2 years with children and families.

(m) The prescribing practitioner serving as the program consultant shall:

(1) Sign each treatment plan separately as both the prescribing practitioner and program consultant; and

(2) Meet the definition of prescribing practitioner.

(n) Therapists and case managers shall participate in weekly supervision that includes a discussion of each case and a review of the progress made by each family towards the goals of the treatment plan.

(o) The agency shall have at least one full-time program coordinator for every 6 therapists.

(p) Program coordinators shall be available to the therapists and case managers 24 hours a day, 7 days a week.

(q) Each therapist and case manager shall have an annual evaluation with a copy maintained in his or her file.

(r) Each therapist and shall complete a minimum of 20 hours of training per year that includes topics related to:

(1) Family systems;

(2) Substance use disorders;

(3) Child abuse and neglect;

(4) Labor or sex trafficking;

(5) Sexual abuse;

(6) Domestic and family violence;

(7) Behavioral health;

(8) Safety planning for family members;

(9) Crisis intervention techniques;

(10) Early childhood and screening and child development;

(11) Trauma informed practice, including evidence-based practices;

(12) Treatment of any co-occurring disorders;

(13) Behavioral management techniques; and

(14) Infant safe sleeping practices.

(s) For each therapist and case manager, the agency shall maintain on file copies of training certificates, signed by the trainer, that document:

(1) The names of training sessions attended;

(2) The number of hours per training; and

(3) The dates of training.

(t) The therapist's and case manager's caseload shall not exceed an average of 6 families per month.

(u) The therapist and case manager shall participate in weekly supervision that includes a discussion of the progress made by each family.

(v) Within 15 days after service termination, the agency shall forward to the CPSW, JPPO, or the supervisor a report that includes:

(1) A summary of visits and contacts with the family, including dates, duration, and locations;

(2) A summary of the progress or lack of progress in meeting the treatment plan, including the tasks accomplished, timeframes, and measurable outcomes achieved;

(3) New information about the family that changes or updates the DCYF case plan, pre-dispositional investigation report, or court report;

(4) The community resources and supports available to the family that might be accessed in the future, if needed;

(5) Recommendations for ongoing services, including a description of additional progress by parents that is essential to address the needs of each child, as specified in the treatment plan, and how the provider has worked with the family to assist them in accessing recommended services; and

(6) The date and signature of the prescribing practitioner and therapist;

(w) If services are terminated prior to the 15^th day of the month, no monthly progress report shall not be required for the month. The information for the month in which services are terminated shall be included in a discharge report.

N.H. Admin. Code § He-C 6339.17

(See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08

Amended by Volume XXXVI Number 41, Filed October 13, 2016, Proposed by #11180, Effective 9/19/2016, Expires 3/18/2017.

Amended by Volume XXXVII Number 15, Filed April 13, 2017, Proposed by #12136, Effective 3/18/2017, Expires 3/18/2027.