Section He-C 6340.05 - Application Process For Payment Standards For Adoptive Report Writing Services(a) Applicants who seek initial certification for payment for adoptive report writing services shall contact DCYF and request certification.(b) The DCYF shall assess the need for services based on the following criteria: (1) The number of children and families who require services exceeds the available community resources;(2) A specialized service is necessary to meet the unique needs of children and families, and there are no currently certified providers who can provide the specialized services; and(3) Any other case circumstance which requires the provision of services pursuant to a court order.(c) If there is a need for a service based on (b) above, DCYF shall forward an application packet to the applicant which includes: (1) Form 2608 "Application For Enrollment Of Adoptive Report Writing Providers"(November 2016);(2) A "State of New Hampshire Alternate W-9 FORM";(3) A copy of He-C 6340; and(4) A copy of Form 1790 "Adoptive History Part I and Part II" (March 2015, PD 15-04) .(d) Each applicant shall complete the Form 2608 "Application for Enrollment of Adoptive Report Writing Providers" (November 2016) which includes: (1) A statement indicating whether the applicant is currently listed in any child abuse and neglect state registry as having abused or neglected a child, and if so, the dates and reasons;(2) A statement indicating whether the applicant has been convicted of a felony or any crime against a person and if so, the name of the court, the details of the offense, the date of conviction and the sentence imposed;(3) An up to date resume or curriculum vitae;(4) Names and addresses of 2 individuals who have known the applicant for at least one year and who can verify professional experience and expertise.(e) The applicant shall sign and date the application.(f) The applicant's signature shall constitute an acceptance of the terms below: (1) The provider has read and understands He-C 6340 and shall adhere to the rules as an enrolled provider;(2) The information contained in the application is true and correct to the best of the applicant's knowledge; and(3) The applicant agrees that DCYF has the authority to verify the information contained in the application.(g) Within 30 calendar days of receipt, the applicant shall complete and return the following documents to DCYF:(1) Form 2608 "Application for Enrollment of Adoptive Report Writing Providers" (November 2016);(2) An up to date resume or curriculum vitae;(3) If applying for certification as an adoptive home study report writer, verification of SAFE certification;(4) If applying for certification as an adoptive home study report writer, a sample of an adoptive home study report written by the applicant; and(5) The "State of New Hampshire Alternate W-9 FORM-".N.H. Admin. Code § He-C 6340.05
(See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08
Amended by Volume XXXVII Number 2, Filed January 12, 2017, Proposed by #12059, Effective 12/6/2016, Expires 12/6/2026.