N.H. Admin. Code § He-M 310.06

Current through Register No. 50, December 12, 2024

Section He-M 310.06 - Service Rights

(a) Individuals shall have the right to adequate and humane service and treatment, including:

(1) The right of access to services including:

a. The right to evaluation to determine the type of services needed and which provider agencies are most suited to provide those services;

b. The right to receive necessary services when those services are available, subject to the admission and eligibility policies and standards of each provider agency; and

c. The right to receive services without regard to race, color, age, religion, sex, marital status, national origin, severity of disability, sexual orientation, or inability to pay;

(2) The right to quality services including services provided in accordance with licensing requirements and rules adopted by the department in He-M 200-1300 and other applicable rules of state agencies and services provided in keeping with generally accepted clinical and professional standards applicable to the individuals' disabilities and services;

(3) The right to receive services in his or her community:

a. To the same degree of access as persons not receiving services;

b. That will promote the individual's full community participation; and

c. Except as limited by individual treatment plans for individuals involuntarily admitted in accordance with RSA 171-B;

(4) The right to a person-centered planning process that:

a. Is directed by the individual or representative, if applicable;

b. Is intended to identify the strengths, capacities, preferences, needs, and desired outcomes of the individual;

c. Includes participants freely chosen by the individual as important contributors;

d. Provides information and support to assist the individual to direct the process and to make informed choices and decisions;

e. Reflects cultural considerations of the individual and is conducted in clearly understandable language and form;

f. Occurs at times and location of convenience to the individual;

g. Includes strategies for solving conflict or disagreement within the process;

h. Offers informed choices to the individual or representative, if applicable, regarding services and supports;

i. Involves the family or other participants in enabling and assisting the individual to identify and access a personalized mix of paid and non-paid services and supports that will assist him or her to achieve personally defined outcomes in the most integrated setting appropriate to the needs of the individual;

j. Includes identification of the individual's planning goals to achieve personal outcomes in collaboration with those whom the individual has identified;

k. Results in a service agreement that identifies personally defined outcomes and training supports, therapies, treatments, and other services the individual is to receive to achieve those outcomes;

l. Includes a method for the individual to request amendments to the agreement; and

m. Records the alternative home and community based settings that were considered by the individual;

(5) The right to a service agreement developed, reviewed, and revised in accordance with He-M 503;

(6) The right to services in accordance with the time frame set in the service agreement;

(7) The right to services in a setting that is:

a. Based on the individual's needs and preferences;

b. Chosen by the individual or his or her representative from among options that are identified in the service agreement and include non-disability specific settings; and

c. Integrated in, and supportive of full access of individuals to, the greater community, including opportunities to:

1. Seek employment and work in competitive integrated settings;

2. Engage in community life;

3. Control schedules and activities;

4. Control personal resources;

5. Receive services in the community to the same degree of access as the general population; and

6. Live in a private unit in a residential setting, based on the resources available for room and board;

(8) The right to be informed of all significant risks, benefits, side effects, and alternative treatment and services and to give consent to any treatment, behavior change program, service, or referral following an informed decision, except when action is necessary to prevent harm to the individual or others or prevent substantial damage to property or where otherwise provided by law, such that:

a. Whenever it is possible, the consent shall be given in writing; and

b. In all other cases, evidence of consent shall be documented by the provider agency and shall be witnessed by at least one person;

(9) The right to refuse to participate in any form of experimental treatment or in any research or have one's representative refuse on the individual's behalf;

(10) The right to be fully informed of one's own diagnosis and prognosis;

(11) The right to voluntary participation in services, as decided by the individual or his or her representative, including the right to seek changes in services or provider agency at any time or to withdraw from any form of service or from a provider agency, unless the person is involuntarily admitted in accordance with RSA 171-B;

(12) The right to services which promote independence including services which shall be directed toward:

a. Eliminating or reducing the individual's need for continued services; and

b. Promoting the ability of the individuals to function at their highest capacity and as independently as possible;

(13) The right to receive medical care and treatment, including ensuring medications are refilled in a timely manner and avoid expiration;

(14) The right to refuse medications and treatment, except emergency treatment that is:

a. Necessary to prevent harm to the individual or others or prevent substantial damage to property; or

b. In accordance with a behavior change program that limits an individual's rights and is approved by a human rights committee;

(15) The right to consultation and second opinion, including;

a. At the individual's own expense, the consultative services of:

1. Private physicians;

2. Psychologists;

3. Dentists; and

4. Other health practitioners;

b. Granting such health practitioners reasonable access to the individual by provider agencies; and

c. Allowing such health practitioners to make recommendations to provider agencies regarding the services and treatment provided;

(16) The right to choose, or have one's representative choose, one or more of the following persons to be present at any person-centered planning meeting or other service planning meeting requiring the individual's participation and informed decision-making:

a. Guardian;

b. Representative;

c. Attorney;

d. Family member;

e. Friend;

f. Direct support staff;

g. Advocate;

h. Consultant; or

i. Other person the individual requests;

(17) The right to freedom from restraint including:

a. For individuals under the age of 18, the right to limitations on the use of restraint and seclusion pursuant to RSA 126-U; and

b. The right to be free from seclusion and physical, mechanical, or pharmacological restraint except that in cases of emergency such as the occurrence or serious threat of extreme violence, personal injury, or attempted suicide where no less restrictive alternative would be effective:

1. Such means of restraint as are authorized by a prescribing practitioner and approved by a human rights committee pursuant to RSA 171-A:17, II(c), may be used as part of a treatment plan to which the individual or individual's guardian or representative, if any, has consented, having made an informed decision to do so; and

2. The minimum necessary degree of restraint may also be used:

(i) In an emergency to prevent harm to the individual or others or prevent substantial damage to property;

(ii) As part of a behavior change program that limits an individual's rights and is approved by a human rights committee pursuant to RSA 171-A:17, II, (c); or

(iii) When the person is involuntarily admitted in accordance with RSA 171-B; and

(18) The right to choose with whom to interact.

(b) Applicants shall have the right to evaluation to determine an applicant's eligibility for services and the type of services needed and to determine which provider agencies are most suited to provide the services needed.

(c) Provider agencies shall maximize the decision-making authority of the individual.

(d) Whenever possible, individuals shall be served in generic, integrated settings rather than specialized programs for persons with developmental disabilities or acquired brain disorders.

(e) Provider agencies may restrict access by individuals to various locations to:

(1) Ensure the privacy or safety of the individuals;

(2) Achieve other necessary objectives contained in the service agreement; or

(3) Comply with provisions of law and orders of court.

(f) These rules shall not require any licensed professional to administer treatment contrary to such professional's clinical judgment.

(g) The service rights of a person involuntarily admitted in accordance with RSA 171-B may be restricted where safety or security requires such limitation.

(h) For individuals who have a guardian or representative, the following provisions shall apply:

(1) The provider agency shall ensure that the guardian or representative and all persons involved in the provision of services are made aware of the individual's needs, views, preferences, and aspirations;

(2) The provider agency shall comply with decisions made by the guardian or representative within the legitimate scope of his or her authority;

(3) A guardian or representative is only allowed to make decisions that are within the scope of his or her powers pursuant to RSA 464-A:25, RSA 463:12, or RSA 137-J:5 and as modified by the court, or as otherwise allowed by law;

(4) The area agency and provider agencies shall obtain a copy of the guardianship order or power of attorney from the guardian or representative and keep the order in the individual's record;

(5) If any issues arise relative to the provision of services and supports which are outside the scope of the guardian's or representative's decision-making authority as set forth in the guardianship order or power of attorney, the individual's choice and preference relative to those issues shall prevail unless the guardian's or representative's authority is expanded by the court to include those issues;

(6) A provider agency shall take such steps as are necessary to prevent a guardian or representative from exceeding the decision-making authority granted by the court or acting in a manner that does not further the best interests of the individual, including:

a. Reviewing with the guardian or representative the limits on his or her decision-making authority; and

b. If necessary, bringing the matter to the attention of the court that appointed the guardian; and

(7) In the event that there is a dispute between the provider agency and the guardian or representative, the provider agency shall inform the guardian or representative of his or her right to take either or both of the following actions:

a. Appeal the matter pursuant to He-M 202 and He-C 200; or

b. Bring the dispute to the attention of the probate court that appointed the guardian.

N.H. Admin. Code § He-M 310.06

#4413, eff 4-27-88; ss by #5094, eff 3-15-91; ss by 6212, INTERIM, eff 3-30-96, EXPIRES: 12-31-98; ss by #6758, eff 5-27-98; ss by #8640, INTERIM, eff 5-27-06, EXPIRES: 11-23-06; ss by #8701, eff 8-4-06

Amended byVolume XXXV Number 18, Filed May 7, 2015 , Proposed by #10821, Effective 4/25/2015, Expires4/25/2025.

Amended by Number 28, Filed July 13, 2023, Proposed by #13676, Effective 6/24/2023, Expires 6/24/2033.