N.H. Admin. Code § He-W 628.02

Current through Register No. 50, December 12, 2024

Section He-W 628.02 - Deprivation Due to Incapacity

(a) The child or children shall be considered to be deprived of support or care due to the parent's physical or mental incapacity when the incapacity is expected to last for at least 30 days, and the individual:

(1) Is eligible for or receiving supplemental security income (SSI) or social security disability income (SSDI) disability benefits;

(2) Provides currently dated documentation from a licensed physician, licensed physician assistant (PA), licensed advanced practice registered nurse (APRN), board-certified psychologist, master licensed alcohol and drug counselor (MLADC), licensed pastoral psychotherapist (LPP), licensed independent clinical social worker (LICSW), licensed clinical mental health counselor (LCMHC), or licensed marriage and family therapist (LMFT) certifying an incapacity of at least 30 continuous days;

(3) Has been determined by the office of medicaid and business policy (OMBP) as permanently disabled or blind;

(4) Reapplies for assistance within 90 days of being terminated from a case in which incapacity had been established, provided termination was not related to incapacity or earnings from employment;

(5) Is convalescing after being treated in an institution for the mentally ill, or was discharged within 90 days prior to applying for assistance; or

(6) Is needy and intellectually disabled, has resided in a state-operated intermediate care facility for individuals with intellectual disabilities (ICF/IID), and was officially discharged within 90 days of applying for assistance.

(b) The individual shall verify physical or mental incapacity:

(1) At the initial eligibility determination;

(2) At each subsequent redetermination; and

(3) Whenever a change in the incapacity occurs.

(c) To verify incapacity pursuant to (a) (2) above, the individual shall provide currently dated documentation which includes all of the following:

(1) The individual's name; and

(2) A statement by a licensed physician, licensed PA, licensed APRN, board-certified psychologist, MLADC, LPP, LICSW, LCMHC, or LMFT which indicates:

a. That the current incapacity has existed, or is expected to exist, for at least 30 days;

b. The date when the incapacity began, ended, or is expected to end;

c. The diagnosis, examination date, and current and recommended medical treatment; and

d. The name, address, phone number, profession, and dated signature of the licensed physician, licensed PA, licensed APRN, board-certified psychologist, MLADC, LPP, LICSW, LCMHC, or LMFT.

(d) When incapacity no longer exists, FANF financial assistance shall be provided for the month in which the incapacity ended and for the next full calendar month, unless the individual requests an earlier termination of assistance.

N.H. Admin. Code § He-W 628.02

(See Revision Note #1 at Chapter Heading He-W 600) #5171, eff 6-26-91; EXPIRED 6-26-97

New. #7084, eff 8-26-99; ss by #8970, eff 8-25-07; ss by #10318, eff 4-25-13

Amended by Volume XXXIX Number 06, Filed February 7, 2019, Proposed by #12718, Effective 1/26/2019, Expires 1/26/2029.