Section He-M 522.09 - Service Guarantees on Services for Which Funds Are Available(a) All services shall: (1) Be voluntary on the part of the individual;(2) Be provided only after the informed consent of the individual or guardian;(3) Comply with the rights of the individual established under He-M 310; and(4) Facilitate as much as possible the individual's ability to determine and direct the services he or she will receive.(b) All services shall be designed to: (1) Promote the individual's personal development and quality of life in a manner that is determined by the individual;(2) Meet the individual's needs in personal care, employment, adult education, and leisure activities;(3) Promote the individual's health and safety;(4) Protect the individual's right to freedom from abuse, neglect, and exploitation;(5) Increase the individual's participation in a variety of integrated activities and settings;(6) Provide opportunities for the individual to exercise personal choice, independence, and autonomy within the bounds of reasonable risks;(7) Enhance the individual's ability to perform personally meaningful or functional activities;(8) Assist the individual to acquire and maintain life skills such as managing a personal budget, participating in meal preparation, or traveling safely in the community; and(9) Be provided in such a way that the individual is seen as a valued, contributing member of his or her community.(c) The environment in which an individual receives services shall promote the person's freedom of movement, ability to make informed decisions, self-determination, and participation in the community.(d) An individual or guardian may select any person, any agency, or another area agency as a provider to deliver one or more of the services identified in the individual's service agreement. The area agency shall advise the individual and guardian verbally and in writing prior to the initial and yearly individual service agreement planning process under He-M 522.11 and He-M 522.12 that he or she has a right to choose his or her own provider(s) . The area agency shall provide a state-wide list of service providers to individuals and guardians who wish to choose providers.(e) All providers shall comply with the rules pertaining to the service(s) offered and meet the provisions specified within the individual's service agreement. Providers shall also enter into a contractual agreement with the area agency and operate within the limits of funding authorized by it.(f) After discussions with the individual, guardian, and proposed or current provider, if the area agency determines that a provider chosen by the individual or guardian is a provider that proposes a service arrangement that is not in accordance with department rules, or is a provider that has not been in compliance with department rules in the past, the area agency shall: (1) Provide a written rationale to the individual or guardian stating the reasons why the area agency will not enter into a service contract with the provider; and(2) With input from the individual or guardian, identify another provider.(g) After discussions with the individual, guardian, and proposed or current provider, if the area agency determines that a provider chosen by the individual or guardian is not implementing the service agreement, providing for the health and safety of the individual, or in complying with applicable rules while providing services, the area agency shall: (1) Terminate the service contract with the provider with a 30-day notice; and(2) With input from the individual or guardian, establish another service arrangement and amend the service agreement.(h) If the area agency determines that a provider chosen by the individual or guardian is posing a serious threat to the health or safety of the individual, the area agency shall, with input from the individual or guardian, secure another provider and issue a notice to immediately terminate the service contract of the current provider, specifying the reasons for the action.(i) The individual or guardian may appeal the area agency's decision under (f) -(h) , above. At the time it provides notice, the area agency shall advise the individual or guardian in writing and verbally of his or her appeal rights under He-M 522.19.(j) An area agency shall create service agreements for all individuals for whom funding for Medicaid home- and community-based care services is available pursuant to He-M 517.N.H. Admin. Code § He-M 522.09
#7120, eff 10-20-99; ss by #8974, INTERIM, eff 10-6-07, EXPIRED: 4-3-08
New. #9734, eff 6-25-10 (from He-M 522.08 )
The amended version of this section by New Hampshire Register Volume 38, Number 50, eff. 11/30/2018 is not yet available.