N.H. Admin. Code § He-E 801.24

Current through Register No. 50, December 12, 2024

Section He-E 801.24 - Personal Care Services

(a) PCS shall be documented in the provider care plan and covered when provided for non-acute needs by employees of:

(1) Home health care providers licensed in accordance with RSA 151:2 and He-P 809;

(2) Home care service providers licensed in accordance with RSA 151:2 and He-P 822; or

(3) Other qualified agencies certified in accordance with RSA 161-I and He-P 601.

(b) Covered personal care services shall include the following services:

(1) Hands-on assistance with the ADLs or IADLs or cuing a participant to perform a task;

(2) Assisting the participant with eating;

(3) Under the direction of the participant, assistance with self-administration of oral or topical medication as prescribed, including:

a. Reminding the participant regarding the timing and dosage of the medication, and to take his or her medication as written on the medication container;

b. Placing the medication container within reach of the participant;

c. Assisting the participant with opening the medication container;

d. Assisting the participant by steadying shaking hands; and

e. Observing the participant take the medication and recording the same in the participant's record;

(4) Accompanying the participant in the community when:

a. The assistance of the personal care worker is required by the participant; and

b. The need for re-direction or direct assistance, or both, is required;

(5) When non-medical transportation services are authorized, hands-on assistance at the authorized destination when the provider care plan documents that this assistance is required at the destination;

(6) General household tasks, limited to the following:

a. Laundering the participant's personal clothing items, towels, and bedding;

b. Light cleaning limited to the participant's bedroom, bathroom, mobility and medical devices, and common living spaces;

c. Light cleaning of the kitchen, entry way areas, and common living spaces, to maintain a safe environment for the participant;

d. Errands for necessary tasks identified in the provider care plan;

e. Preparing meals and snacks for CFI participants including cleaning the food preparation area after the food is served; and

(7) Care, grooming, or feeding of service animals as defined in 28 CFR 35.104, or assistance animals as defined by the U.S Department of Housing & Urban Development's "Office of Fair Housing & Equal Opportunity Notice: FHEO-2020-01" (January 2020), available as noted in Appendix A.

(c) Personal care services shall not be covered:

(1) For the purpose of transportation only, when no other assistance is required;

(2) When provided in any of the following settings:

a. A residential care facility;

b. A hospital;

c. A nursing facility;

d. A rehabilitation facility;

e. An adult family care home; and

f. An adult day care; and

(3) When provided by any of the following individuals:

a. The participant's personal care services representative, designated in accordance with (d) and (e) below;

b. The participant's agent acting under a designated power of attorney pursuant to RSA 564-E; or

c. The participant's legal guardian.

(d) The participant, his or her legal guardian, or a person granted authority under a power of attorney of the participant may designate a PCS representative to act on the participant's behalf:

(1) To direct the PCS being provided; and

(2) Under the following conditions:

a. The following persons shall not serve as a PCS representative for purposes of directing personal care services:

1. The personal care worker providing services;

2. The participant's case manager; and

3. Anyone having a financial relationship with any agency providing personal care services or intermediary services, as defined in RSA 161-:2, VI, to the participant;

b. The PCS representative shall be designated through a written document, stating that:

1. The PCS representative's role applies only to decisions made regarding the personal care services described in this section;

2. The appointment of a PCS representative may be revoked by the participant at any time; and

3. The responsibilities of the PCS representative shall be to:

(i) At a minimum, have weekly face-to-face contact with the participant and the personal care worker;

(ii) At a minimum, have monthly contact with the participant's case manager concerning PCS;

(iii) Ensure that the personal care worker is taking the participant's care preferences into consideration; and

(iv) Communicate concerns or satisfaction to the provider agency that employs that personal care worker; and

c. The written document designating the PCS representative shall be signed by the participant or his or her legal guardian or by the person granted authority under a power of attorney and a witness and be maintained by the provider agency.

(e) When a PCS representative is designated, the participant, his or her guardian, or the person granted authority under a power of attorney shall:

(1) Notify the provider agency in writing of the PCS representative's name and scope of authority; and

(2) Notify the provider agency in writing of any changes in representation within 30 days of the date that the change occurs.

N.H. Admin. Code § He-E 801.24

(See Revision Note at part heading for He-E 801) #9969, eff 8-8-11

Amended by Volume XXXIX Number 32, Filed August 8, 2019, Proposed by #12830, Effective 8/7/2019, Expires 2/3/2020.

Amended by Volume XLII Number 6, Filed February 10, 2022, Proposed by #13340, Effective 1/29/2022, Expires 1/29/2032 (formerly He-E 801.22).