N.H. Admin. Code § He-C 6339.20

Current through Register No. 50, December 12, 2024

Section He-C 6339.20 - Requirements for Individual Service Options (ISO) In-Home

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

(b) Authorization for payment for individual service options in-home shall be pursuant to a court order, or a non-court ordered or voluntary agreement between DCYF and the family.

(c) Services shall be limited to a period of time not to exceed 180 days, without DCYF approval.

(d) Services 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 information in writing to the CPSW or JPPO:

a. The reason(s) for continued services;

b. The beginning and ending dates for continued services;

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

d. The anticipated child and family outcomes.

(e) The individual service option (ISO) in-home agencies shall:

(1) Promote family self-sufficiency and to connect families to supports in the community;

(2) Promote collaboration and communication with DCYF staff and other local service providers;

(3) Serve children in their home, foster or relative care provider, or home community;

(4) Provide or coordinate all of the services needed for the treatment of the child and family;

(5) Receive approval from DCYF prior to placing a child in a residential care facility for crisis stabilization; and

(6) Provide each family with 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.

(f) Crisis stabilization in a residential care facility shall not exceed 10 days per year per child.

(g) Requests for waivers pursuant to He-C 6339.21 to the 10-day limit for residential crisis stabilization shall be submitted to the DCYF.

(h) ISO in-home services shall be provided to families with:

(1) Abused and neglected children, CHINS, and delinquent children; and

(2) Children between the age of birth to age 21, who might be experiencing one or more of the following:

a. Chronic mental, emotional, physical, or behavioral challenges;

b. Post-traumatic stress symptoms;

c. Mental health diagnosis(e);

d. Sexually reactive behaviors;

e. A history of traumatic experiences;

f. Unable to participate in local education program;

g. Require intensive supervision and consistent structure and might benefit from remaining home; or

h. Might need short-term, intensive residential care.

(i) A provider of ISO in-home services shall provide, purchase, or connect a family to services that include:

(1) Case management, treatment planning, and service coordination;

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

(3) Individual, group, family, and substance use disorder counseling;

(4) In-Home services, including:

a. Home-base therapeutic services; and

b. Child health support;

(5) Support for children who are transitioning to a family setting;

(6) Emergency on-call 24-hour response to crises;

(7) Respite care in a licensed foster home;

(8) Crisis stabilization in a residential care facility with prior DCYF approval;

(9) Transportation;

(10) Assisting older children to transition to adult living situations;

(11) Identification of relatives, mentors, and others who will support or assist the child and family;

(12) Transitional assistance from DCYF to adult services;

(13) Coordination of medical, community mental health, and dental care;

(14) Coordination of public or private school education;

(15) Coordination of recreational activities;

(16) Coordination of substance use disorder evaluations and random drug testing; and

(17) Coordination of vocational services.

(j) The ISO in-home agency shall obtain a referral for services and its attachments.

(k) The ISO in-home agency shall assess each family member's needs in the home within 30 days of referral based on:

(1) The DCYF case plan, pursuant to RSA 170-G:4 III and court report, 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.

(l) The agency's assessment shall include:

(1) Identification of the strengths and resources of the family;

(2) Identification of alcohol or substance use disorders, domestic or family violence, sexual abuse, or other situations that might impact the child's safety;

(3) A review of previously completed evaluations and assessments, medical records, and psychological tests;

(4) A determination of immediate services needed by the family;

(5) Identification of community or relative resources available to the family; and

(6) A summary of treatment and service needs.

(m) The ISO in-home agency shall provide DCYF with monthly progress reports that include:

(1) The family's name;

(2) The name of the person completing the report;

(3) The date of the report;

(4) Improvements that are being made towards specific goals;

(5) Summary of family contacts and progress made towards specific goals;

(6) Changes to the treatment plan;

(7) Educational updates; and

(8) Contacts with other professionals.

(n) Progress reports shall include the following about each child's medical, dental, and behavioral health care:

(1) Prescriptions and current dosages;

(2) Over-the-counter medication;

(3) Dates of visits during the month being reported;

(4) New health care issues and diagnosis;

(5) Next scheduled visits; and

(6) Name of health care practitioner and office address.

(o) Progress reports shall be provided to the parents or guardians, unless contraindicated by a court order, or a request from DCYF.

(p) The ISO in-home agency shall keep records that include a case record on each child and his or her family that contains:

(1) The assessment used to develop the treatment plan;

(2) The signed ISO in-home treatment plan and its revisions;

(3) Weekly child and family progress notes;

(4) Documentation of therapeutic work with the family; and

(5) Monthly progress reports.

(q) When a child or family is visited, the child and parent, if present, shall be required to sign the contact log and the agency staff shall retain a copy of the log in the family's file for review during the onsite visits.

(r) The agency shall document each family visit including:

(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 provision of the provider's signature and the signature of a family member and child.

(s) The ISO in-home 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) 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. Two years of experience with children and families.

(t) The prescribing practitioner may also serve as the program consultant as long as they sign each treatment plan separately as both the prescribing practitioner and program consultant.

(u) Therapist 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.

(v) Therapists and case managers 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 and sex trafficking;

(5) Sexual abuse;

(6) Domestic and family violence;

(7) Behavioral health

(8) Safety planning for family members;

(9) Crisis intervention techniques; and

(10) Early child hood 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.

(w) The agency shall maintain documentation of training for therapist and case managers, which includes:

(1) The dates of training;

(2) The titles of training topics; and

(3) The number of hours per training.

(x) Up to 5 hours of documented supervision by a therapist may be applied towards the 20 hours of annual training requirement for therapists and case managers.

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

(z) The therapist's maximum caseload shall not exceed an average of 10 families per month.

(aa) Within 15 days after service termination, the agency shall forward to the CPSW, JPPO, or his or her 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, or court report;

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

(5) Recommendation 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.

(ab) If the 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 the discharge report.

N.H. Admin. Code § He-C 6339.20

(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.