N.H. Admin. Code § He-M 525.06

Current through Register No. 50, December 12, 2024

Section He-M 525.06 - Administrative, Service, and Personnel Requirements

(a) Service planning shall be conducted in accordance with He-M 503.09.

(b) The service coordinator shall assist the individual and representative and other persons chosen by the individual to develop a written service agreement in accordance with the principles outlined in He-M 525.05, signed by the individual or representative and the area agency director or designee, that includes the following:

(1) A brief description of the individual's strengths, needs, and interests, as applicable;

(2) The individual's clinical and support needs as identified through current evaluations and assessment;

(3) The specific services to be furnished and the goal associated with each service;

(4) The amount, frequency, duration, and desired outcome of each service;

(5) Timelines for initiation of services;

(6) The provider to furnish the services;

(7) The individual's need for guardianship, if any;

(8) Service documentation requirements for tracking outcomes and service provision, including the type of documentation;

(9) Identification of the person or entity responsible for monitoring the plan;

(10) The frequency of service coordinator visits with the individual and contact with the representative pursuant to He-M 525.08(a) and (b) ;

(11) An individualized budget pursuant to (g) below; and

(12) If medication is administered, provision for compliance with (k) (5) below.

(d) Requirements for documentation of service provision shall be specified in the service agreement and include, at minimum:

(1) The dates services are provided; and

(2) Reports on progress toward achieving desired outcomes.

(e) Service agreements shall be renewed at least annually and include a review of guardianship.

(f) Amendments to the service agreement may be made at any time. Amendments shall be documented by the service coordinator with the approval of the individual or representative and the area agency director or designee.

(g) The individual or representative and the area agency shall develop an individualized budget that includes:

(1) The specific service components;

(2) The frequency and duration of the services required;

(3) An itemized cost of services; and

(4) The frequency at which budget reports will be provided by the area agency or subcontractor to the individual or representative pursuant to (h) below.

(h) In providing services, the area agency or subcontract agency shall establish a budget reporting mechanism, detailing expenditures to date and the amount remaining in the budget, to assist the individual -and representative to manage his or her budget.

(i) When PDMS are to be provided by a subcontract agency of the area agency, one of the following shall apply:

(1) The individual or representative shall establish an agreement with the subcontract agency; or

(2) The area agency shall establish a contract with the subcontract agency for service provision and oversight.

(j) Agencies providing PDMS shall have policies regarding:

(1) Administration of medication, pursuant to (k) (5) below; and

(2) Individual rights in accordance with He-M 202 and He-M 310.

(k) For individuals who are 21 years of age or older, the following shall apply:

(1) Unless otherwise requested by the individual or representative the area agency or a subcontract agency shall be the employer;

(2) When the individual or representative requests to be the employer or designates an entity to perform that function that is not a subcontractor of an area agency, the area agency shall identify and review with the individual and representative the responsibilities referenced in (3) below;

(3) Prior to hiring or contracting with a staff or provider, the individual, representative, or area agency or subcontract agency that intends to contract with a provider, shall:

a. Submit the name of the person and all other persons residing in the home of a non-family provider for review against the registry of founded reports of abuse, neglect, and exploitation to ensure that the person is not on the registry pursuant to RSA 169-C:35 or RSA 161-F:49;

b. Complete a criminal records check in New Hampshire, no more than 30 days prior to contracting with the person to ensure that he or she and all other persons residing in the home of a non-family provider have no history of fraud, felony, or misdemeanor conviction;

c. Complete a criminal records check for the person's state of residence if it is not New Hampshire to ensure that the person and all other persons residing in the home of a non-family provider have no history of fraud, felony, or misdemeanor conviction;

d. Complete a criminal records check for the person's previous state of residence if he or she has resided in New Hampshire for less than one year to ensure that the person and all other persons residing in the home of a non-family provider have no history of fraud, felony, or misdemeanor conviction;

e. Provide information obtained pursuant to (3) a. above to the area agency;

f. Obtain at a minimum one reference on each prospective staff or non-family provider;

g. Provide proof of insurance coverage, including general liability and workers' compensation, to the area agency; and

h. Comply, as applicable, with all employer-employee legal requirements such as wage reporting and tax withholding;

(4) An individual, representative, area agency, or subcontract agency may hire a person with a criminal record listed in (3) b.-d. above for a single offense that occurred 10 or more years ago in accordance with (5) and (6) below. In such instances, the individual, his or her guardian, if applicable, the area agency, and the subcontract agency, if applicable, shall review the person's history prior to approving the person's employment;

(5) Unless a waiver is granted pursuant to (6) below, an individual, representative, area agency, or subcontract agency shall not hire a person with a criminal record, other than as specified in (4) above;

(6) The department may grant a waiver of (5) above if, after reviewing the underlying circumstances, it determines that the person does not pose a threat to the health, safety, or well-being of individuals;

(7) Employment of a person pursuant to (4) above shall only occur if such employment:

a. Is approved by the individual, his or her guardian if applicable, the area agency, and the subcontract agency if applicable;

b. Does not negatively impact the health or safety of the individual(s); and

c. Does not affect the quality of services to individuals;

(8) Upon the hiring of a person pursuant to (4) above, the area agency shall document and retain the following information in the individual's record:

a. The dates of the approval in (4) above;

b. The name of the person hired;

c. The description of the person's criminal offense;

d. The type of service the person is hired to provide;

e. The subcontract agency's name and address, if applicable;

f. A full explanation as to why the individual, representative, or agency is hiring the person despite the person's criminal record;

g. The signature of the individual, guardian, or representative indicating agreement with the employment and the date signed;

h. The signature of the area agency representative approving the employment; and

i. The signature and phone number of the person being hired;

(9) All personnel shall sign a statement annually, which shall be maintained in the personnel file, stating that since the time of hire they:

a. Have not been convicted of a felony or misdemeanor in this or any other state; and

b. Have not had a finding by the department or any administrative agency in this or any other state for assault, fraud, abuse, neglect, or exploitation of any person;

(10) Medication administration shall:

a. Comply with He-M 1201 or Nur 404 except in situations where the individuals are living with their families and receiving respite arranged by the family; or

b. When performed by family members paid under He-M 525, include discussion between the area agency or subcontract agency and the family about any concerns the family might have regarding medication administration;

(11) Provision of nursing-related tasks shall:

a. Comply with Nur 404 except in situations where individuals are living with their families and receiving respite arranged by the family; or

b. When performed by family members paid under He-M 525, include discussion between the area agency or subcontract agency and the family about concerns the family might have regarding the provision of nursing-related tasks;

(12) Staff and providers who are not family members shall:

a. Meet the educational qualifications, or the equivalent combination of education and experience, identified in the job description;

b. Meet the certification and licensing requirements of the position, if any; and

c. Be 18 years of age or older;

(13) The employer, when not the individual or representative, shall provide information to the individual and representative regarding the staff development elements identified in He-M 506.05 to assist him or her in making informed decisions with respect to orientation and training of staff and providers; and

(14) Subsequent to (13) above and consistent with the area agency's or subcontract agency's personnel policies, the employer shall ensure that the staff and providers receive the orientation and training selected by the individual or representative.

(l) In addition to complying with (k) above, when an individual is 21 years of age or older and lives in a staffed home:

(1) The home shall comply with applicable local and state health, zoning, building, and fire codes;

(2) The physical layout and environment of the home shall meet the health and safety needs of the individual;

(3) A signed statement from the local fire official shall be obtained before the individual moves into the home:

a. Verifying that the home complies with all state and local fire codes; and

b. Specifying the number of beds that can safely be occupied by individuals living in the home; and

(4) Quarterly fire drills in the home shall be conducted and documented such that:

a. One drill per year shall be conducted during sleep hours; and

b. The first drill shall be conducted no more than 5 days after the individual has moved into the home.

(m) In addition to complying with (k) above, when an individual is 21 years of age or older and lives with a home provider who is not a family member, the home shall have:

(1) An integrated fire alarm system with a functioning smoke detector in each bedroom and on each level of the home including the basement and attic, if the attic is used as living or storage space;

(2) A functioning septic or other sewage disposal system;

(3) A source of potable water for drinking and food preparation, such that, if the water for drinking and food preparation is not from a public water supply:

a. At the time of the initial certification there shall be well water test results less than 2 years old that indicate the water is potable; or

b. There shall be documentation that bottled water is used; and

(4) Two means of egress.

(n) If the home in which supports are provided is not owned by a family member, a fire safety assessment shall be conducted by staff in a staffed home or a home provider, when not a family member, to address the individual's following risk factors:

(1) Response to alarm;

(2) Response to instructions;

(3) Vision and hearing difficulties;

(4) Impaired judgment;

(5) Mobility problems; and

(6) Resistance to evacuation.

(o) Based on the findings of the fire safety assessment, the individual and other members of his or her team shall develop a fire safety plan that addresses fire drill frequencies, procedures to achieve evacuation within 3 minutes, and other fire safety related strategies determined by the team to be applicable.

(p) When an individual's service agreement specifies unsupervised time and the provider is not a family member, the staff in a staffed home or the home provider shall conduct a personal safety assessment that identifies the individual's ability to demonstrate the following safety skills:

(1) Responding to a fire, including exiting safely and seeking assistance;

(2) Caring for personal health, including understanding health issues, taking medication, seeking assistance for health needs and applying basic first aid;

(3) Seeking safety if victimized or sexually exploited;

(4) Negotiating one's community, including finding one's way, riding in vehicles safely, handling money safely, and interacting with strangers appropriately;

(5) Responding appropriately in severe weather and other natural disasters, including storms and extreme temperature; and

(6) Maintaining a safe home, including:

a. Operating heating, cooking, and other appliances; and

b. Responding to common household problems such as a blocked toilet, power failure or gas odors.

(q) Based on the findings of the personal safety assessment, the individual and other members of his or her team shall develop a personal safety plan that:

(1) Identifies any supports necessary for an individual to respond to each of the contingencies listed in (p) above;

(2) Indicates who will provide the needed supports;

(3) Describes how the supports will be activated in an emergency;

(4) Indicates approval of the individual or legal guardian, provider, residential coordinator, and service coordinator;

(5) Is reviewed by the provider or staff at the time of the individual's service agreement; and

(6) Is revised whenever there is a change in the individual's residence or ability to respond to the contingencies listed in the plan.

N.H. Admin. Code § He-M 525.06

#9391, eff 2-21-09; ss by #9890-A, eff 3-22-11; ss by #12859, eff 8-28-19

Amended by Volume XXXIX Number 37, Filed September 12, 2019, Proposed by #12859, Effective 8/28/2019, Expires 8/28/2029.