N.H. Admin. Code § He-M 524.20

Current through Register No. 50, December 12, 2024

Section He-M 524.20 - In-Home Supports Service Agreement

(a) The service agreement describing services provided pursuant to He-M 524 shall:

(1) Be developed in accordance with He-M 524.19(b), He-M 503.10, excluding He-M 503.10(c)-(e), and unless otherwise listed below;

(2) Be developed jointly by the individual, family, representative, providers, service coordinator, and consultants in accordance with the individual's interests, preferences, and needs and the family's and individual's or representative's priorities;

(3) Include the following:

a. A list of specific activities to be carried out, including those regarding safety;

b. The specific schedule for the provision of services;

c. Name(s) of the person(s) responsible for providing the services;

d. Specific documentation requirements;

e. Specific contingency plans for assuring provision of service when the usual providers are not available;

f. Emergency contact information; and

g. An individualized budget which specifies:

1. Service components;

2. Duration and frequency of services required; and

3. Itemized cost of services;

(4) Be amended at any time by the individual, family, representative, service providers, service coordinator, and others involved in the care of the individual through joint discussion, written revision, and with indication of consent as shown by the signature of the individual or representative; and

(5) Be reviewed, and if necessary, amended, as required under (4) above, but at least annually, with:

a. Formal discussion of the individual's progress in developing greater independence and life skills;

b. Documentation of the family's, representative's, and individual's satisfaction with the service provision; and

c. Provision and review of information regarding personal rights and the complaint process.

(b) Within 5 business days of completion of the service agreement, the area agency shall send the individual, guardian, or representative the following:

(1) A copy of the expanded service agreement signed by the area agency executive director or designee;

(2) The name, address, and phone number of the service coordinator or service provider(s) who may be contacted to respond to questions or concerns; and

(3) A description of the procedures for challenging the proposed expanded service agreement pursuant to He-M 524.25 for those situations where the individual, guardian, or representative disapproves of the expanded service agreement.

(c) The individual, guardian, or representative shall have 10 business days from the date of receipt of the expanded service agreement to respond in writing, indicating approval or disapproval of the service agreement. Unless otherwise arranged between the individual, guardian, or representative and the area agency, failure to respond within the time allowed shall constitute approval of the service agreement.

(d) The signature page of the service agreement shall document the individual's or representative's informed consent and that the individual or representative has been fully informed of community and institutional service alternatives and of the right to a hearing, as defined in He-C 201.02(i), to dispute any component of the service agreement.

(e) If either the individual or representative, or area agency executive director, or designee, disapproves of the service agreement or an amendment proposed pursuant to (a)(4) above, the dispute shall be resolved:

(1) Through informal discussions among the individual, family, representative, service coordinator, and area agency executive director;

(2) By reconvening a service planning meeting;

(3) By the individual or representative filing a complaint pursuant to He-M 202; or

(4) By filing a formal appeal pursuant to He-M 524.25.

(f) When the service agreement has been approved by the individual, guardian, or representative and area agency director, the services shall be implemented and monitored as follows:

(1) A person responsible for implementing any part of an expanded service agreement, including goals and support services, shall collect and record information about services provided and summarize progress as required by the service agreement or, at a minimum, monthly;

(2) On at least a monthly basis, the service coordinator shall visit or have verbal or video call contact with the individual or persons responsible for implementing an expanded service agreement and document these contacts;

(3) The service coordinator shall visit the individual and contact the guardian, if any, in person or through a video call at least quarterly, or more frequently if so specified in the individual's expanded service agreement, to determine and document:

a. Whether services match the interests and needs of the individual;

b. Individual and guardian satisfaction with services;

c. Progress on the goals in the expanded service agreement; and

d. The utilization of allocated funds.

(4) At least 2 of the service coordinator's quarterly visits with the individual shall be conducted in person in the home where the individual resides.

N.H. Admin. Code § He-M 524.20

Derived from Volume XLII Number 28, Filed July 14, 2022, Proposed by #13397, Effective 6/18/2022, Expires 6/18/2032 (formerly He-M 524.08)