N.H. Admin. Code § He-C 6342.05

Current through Register No. 50, December 12, 2024

Section He-C 6342.05 - Application Process For Certification For Child In Home Care Services

(a) Applicants who seek initial certification to provide child in home care services shall contact a DCYF or DJJS district office supervisor or designee and request to be referred for certification for payment.

(b) The DCYF/DJJS district office supervisor or DCYF certification specialist 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 service based on (b) above, DCYF shall forward an application packet to the applicant which includes:

(1) An "Application For Certification and Enrollment Of Child In Home Care Service Providers";

(2) An "Alternate W-9";

(3) A copy of He-C 6342;

(4) A "Medical Information Statement" form;

(5) A confidentiality form;

(6) A "Criminal Records Release Authorization" form; and

(7) A "Central Registry Name Search Authorization" form.

(d) Each applicant shall provide the following information on or with the "Application for Certification and Enrollment of Child In Home Care Service Providers":

(1) The names and addresses of 3 individuals who are familiar with the applicant's experience in caring for children;

(2) 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; and

(3) 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.

(e) The applicant shall sign and date the application.

(f) The applicant's signature shall constitute an affirmation and acceptance of the terms below:

(1) The applicant has read and understands He-C 6342; and

(2) The information contained in the application is true and correct to the best of the applicant's knowledge.

(g) Within 30 days of receipt, the applicant shall complete and return the following documents to DCYF:

(1) The "Application For Certification and Enrollment Of Child In Home Care Service Providers";

(2) The "Alternate W-9";

(3) The "Medical Information Statement" form;

(4) The confidentiality form;

(5) The "Criminal Record Release Authorization" form; and

(6) The "Central Registry Name Search Authorization" form.

N.H. Admin. Code § He-C 6342.05

(See Revision Note at part heading for He-C 6342) #9265, eff 9-20-08