CHAPTER He-C 6300 GENERAL PROGRAM ADMINISTRATION

PART He-C 6339 CERTIFICATION FOR PAYMENT STANDARDS FOR COMMUNITY-BASED IN HOME SERVICE PROVIDERS: CHILD HEALTH SUPPORT, HOME BASED THERAPEUTIC, THERAPEUTIC DAY TREATMENT, ADOLESCENT COMMUNITY THERAPEUTIC SERVICES AND INDIVIDUAL SERVICE OPTIONS - IN-HOME

Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:5

REVISION NOTE:

Document #9263, effective 9-20-08, adopted Part He-C 6339 relative to certification for payment standards for community-based in-home service providers. This part incorporated provisions from the former Part He-C 6352 entitled “Certification for Payment Standards for Community-Based Service Providers” and made extensive changes to the wording, format, structure, and numbering of those provisions.

Document #9263 supersedes all prior filings in the former Part He-C 6352 relative to certification for payment standards for community-based in-home service providers. The filings affecting the former Part He-C 6352 include the following documents:

#4446, eff 7-1-88

#5096, eff 3-15-91, EXPIRED 3-15-97

#7292, eff 5-24-00

#8009, eff 1-1-04

#9112, INTERIM, eff 3-24-08, EXPIRED 9-20-08

He-C 6339.01 Purpose.

(a) The purpose of this part is to identify the qualifications and performance requirements to become a provider of community-based in-home services for the division for children, youth and families (DCYF) and describe in-home services that assist children and families in remedying abusive, neglectful, delinquent, and children in need of services (CHINS) behaviors. These services include child health support, home based therapeutic, therapeutic day treatment, adolescent community therapeutic services, and individual service options in-home.

(b) The goals of in-home community based services are to:

(1) Ensure the safety of children, families, and communities;

(2) Improve interpersonal relationships and communication within the family;

(3) Prevent the placement of a child in out-of-home care;

(4) Reduce the recurrence of juvenile delinquent or status offenses;

(5) Improve each child’s well-being in the home and community;

(6) Stabilize the child and family by providing therapeutic support prior to a court-ordered or voluntary placement; and

(7) Assist in preparing the family and the child for reunification if the child is in out-of-home placement by:

a. Supporting the permanency plan of the child; and

b. Supporting and enhancing the child’s positive community connections.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.02 Scope. This part shall apply to community-based in-home service providers who receive medicaid or financial reimbursement from the department of health and human services (DHHS) for services provided to children and families.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.03 Definitions.

(a) “Adolescent community therapeutic services” means the implementation, coordination, and maintenance of cases involving children in need of services and delinquents, which include intensive monitoring, counseling, and supervision of juveniles.

(b) “Agency” means the board of directors, executive director, and employees of an organization that is incorporated and recognized by the NH secretary of state or another state’s regulatory authority.

(d) “Certification for payment” means the process by which the division for children, youth and families approves the qualifications of and payment to providers of community-based in-home service.

(e) “Child or minor” means an individual from birth through age 20, except as otherwise stated in a specific provision.

(f) “Child health support services” means in-home support services for children and families through the provision of supportive counseling, health assessment, health education, behavioral health management, referral to resources, coordination of services, and other supports for the purpose of improving the health and well-being of children and other family members.

(g) “Child in need of services (CHINS)” means “child in need of services” as defined by RSA 169-D:2.

(h) “Child protective service worker (CPSW)” means an employee of the division for children, youth and families who has expertise in managing cases to ensure families and children achieve safety, permanency and well-being.

(i) “Commissioner” means the commissioner of the department of health and human services or his or her designee.

(j) “Community-based in-home services” means child health support, home-based therapeutic, therapeutic day treatment, individual service options in-home, and adolescent community therapeutic services.

(k) “Conflict of interest” means a situation, circumstance, or financial interest, which has the potential to cause a private interest to interfere with the proper exercise of a public duty.

(l) “Corporal punishment” means the deliberate infliction of pain intended to correct behavior or to punish.

(m) “Court-ordered” means a written decree that is issued by a district, family, superior, probate, or Supreme Court.

(n) “Department (DHHS)” means the department of health and human services.

(o) “Direct service staff” means employees, contractors, and volunteers who have access to children or access to client information.

(p) “Director” means the director of the division for children, youth and families, or the director of the division for juvenile justice services, or designee.

(q) “Division for children, youth and families (DCYF)” means the organizational unit of the department of health and human services that provides services to children and youth referred by courts pursuant to RSA 169-A, RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, RSA 170-H and RSA 463.

(r) “DCYF Case plan” means the division for children, youth and families or the division of juvenile justice services written document, pursuant to RSA 170-G:4, III, that describes the service plan for the child and family, and addresses outcomes, tasks, responsible parties, and timeframes for correcting problems that led to abuse, neglect, delinquency, or child in need of services (CHINS).

(s) “Evidence-informed practice” means the process of treatment, which takes into account client preferences and values, practitioner expertise, best scientific evidence, and clinical characteristics and circumstances.

(t) “Family” means a child(ren) and an adult(s) who reside in the same household and who have a birth, foster, step, adoptive, legal guardianship, or caretaker relative relationship.

(u) “Founded” means a report of abuse or neglect where the department has determined that there is a preponderance of the evidence to believe that a child has been abused or neglected.

(v) “Home-based therapeutic services” means the provision of intensive, short term, therapeutic interventions in the home setting in order to strengthen the family and prevent placement of the child(ren).

(w) “Indicator” means a measure, for which data is available, that helps quantify the achievement of a desired result or outcome.

(x) “Individualized education plan (IEP)” means a child-specific plan that meets educational needs, as defined in RSA 186-C:2, III.

(y) “Individual service options (ISO) In-Home” means a variety of intensive therapeutic, social, and community-based services provided or coordinated to meet the individual needs of a child and his or her family in their residence to prevent placement or to provide post-placement family support, or in a DCYF general foster care setting.

(z) “Juvenile probation and parole officer (JPPO)” means an employee of DCYF who discharges the powers and duties established by RSA 170-G:16, and supervises paroled delinquents pursuant to RSA 170-H.

(aa) “Maltreatment” means the emotional or physical abuse or neglect of a child.

(ab) “Medicaid prior authorization,” means the documentation provided by DCYF indicating the department’s responsibility for payment for medicaid eligible children.

(ac) “NH bridges” means the automated case management, information, tracking, and reimbursement system used by DCYF.

(ad) “NH medicaid mental health authority” means the office of community mental health services administration, under the division of behavioral health within DHHS.

(ae) “Non-court-ordered” means any voluntary agreement between DCYF and a family.

(af) “Outcome” means the intended result or consequence that will occur from carrying out a program or activity.

(ag) “Performance indicators” means the utilization of data measurements to gauge program or activity performance.

(ah) “Prescribing practitioner” means a provider licensed by the New Hampshire Board of Mental Health Practice, Board of Nursing, Board of Psychology or the Board of Medicine that provides services identified on 42 CFR 440:130 to reduce a physical or mental disability and aid in the restoration of a recipient to their best functional level, who demonstrates approval of a medicaid-covered in home support services by signing the child and family’s treatment plan.

(ai) “Primary Caring Adult (PCA)” means someone who:

(1) The child wants to be his or her primary caring adult with whom the child may or may not live upon case closure;

(2) Is fit to serve as the child’s primary caring adult;

(3) Makes a lifelong commitment to be the child’s primary source of guidance and encouragement;

(4) Understands the child’s current and future needs; and

(5) Is an adult other than the child’s parent.

(aj) “Program consultant” means an individual who meets the requirements of the individuals listed in He-C 6339.16(j)(1) or (j)(2).

(ak) “Progress report” means the monthly written notes, specific case reports, and outcome reporting sent by the staff of an agency that documents improvement or lack of improvement made by the child or family toward specific goals, and may also include demographic data and performance indicators, a summary of family contacts, modification to the treatment plan, educational contacts with other professionals, and the disposition of grievances.

(al) “Provider” means the agency that serves a child or family and receives financial reimbursement from DHHS.

(am) “Quality assurance” means the process that DCYF uses to monitor the quality and effectiveness of community-based in-home services.

(an) “Service authorization” means the documentation provided by DCYF indicating the division’s responsibility for payment of community-based services for non-medicaid eligible children.

(ao) “Structured decision making (SDM)” means a case management system utilizing a standardized, systematic approach to manage child protection services.

(ap) “Therapeutic day treatment services” means in-depth, short-term, outcome-oriented, therapeutic services provided to enable a child to reside in the community.

(aq) “Treatment plan” means the written, time-limited, goal-oriented, evidence based plan for the child and family developed by the provider and DCYF, which is in agreement with the DCYF case plan.

(ar) “Voluntary services” means any voluntary, non-court ordered agreement between DCYF and a family.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.04 Application for Enrollment and Certification for Payment Standards for Community-Based In-Home Service.

(a) Applicants who seek initial certification for payment standards for community-based in home service shall contact a DCYF district office supervisor or designee and request to be referred for certification.

(b) Each applicant to be a provider of child health support services shall complete, sign, and submit, a Form 2603 “Application for Certification and Enrollment of Child Health Support Services Providers” (October 2016).

(c) Each applicant shall complete, sign, and submit a “Statement of Affirmation” as part of Form 2603 “Application for Certification and Enrollment of Child Health Support Service Providers” (October 2016), that certifies the following:

“I affirm that all the information contained in this application is true, correct, and complete to the best of my knowledge and belief. I acknowledge that the provision of false information in the review document is a basis for denial of the continuation of certification. I understand that DCYF has the right to review the information contained in this review document;

I affirm that I will notify DCYF in writing within 10 days of any change in the information contained in this review of continued certification;

By my signature below, I affirm that I have read and agree to adhere to administrative rule He-C 6339, “Certification for Payment Standards for In Home Community Based Service Providers.”

(d) Part C of Form 2603 “Application for Certification and Enrollment of Child Health Support Service Providers” (October 2016) shall be completed, signed, and dated by each direct service staff and include the following:

“I declare that all the information contained above is true, correct and complete to the best of my knowledge and belief. I acknowledge that the provision of false information in the application is a basis for denial of the application.”

(e) Each submitted and signed Part C of Form 2603 “Application for Certification and Enrollment of Child Health Support Service Providers” (October 2016) shall have the following attestation signed and dated by the executive director or designee:

“I certify that a criminal record check for this individual is completed and on file at the agency.”

(f) The applicant shall provide the following information with or in addition to Form 2603 “Application for Certification and Enrollment of Child Health Support Service Providers” (October 2016):

(1) A completed, signed, and dated “State of New Hampshire Alternative W-9. (October 2016);”

(2) A current list of the board of directors including the following for each member of the board:

a. The full name;

b. The office held;

c. The professional affiliation; and

d. The address, telephone, and email address;

(3) A copy of the organizational structure of the program;

(4) Prescribing practitioner’s license;

(5) A copy of the professional and general liability insurance certificate(s) for the program;

(6) A copy of the program brochure; and

(7) A copy of a current resume or curriculum vitae of the program consultant.

(g) Each applicant for home-based therapeutic services shall complete and submit a signed and dated Form 2604 “Application for Certification and Enrollment of Home-based Therapeutic Service Providers” (October 2016).

(h) A Part C of Form 2604 “Application for Certification and Enrollment of Home-based Therapeutic Service Providers” (October 2016) shall be signed and dated by each direct service staff, and include the following:

“I declare that all the information contained above is true, correct, and complete to the best of my knowledge and belief. I acknowledge that the provision of false information in the application is a basis for denial of the application.”

(i) Each submitted and signed Part C of Form 2604 “Application for Certification and Enrollment of Home-based Therapeutic Service Providers” (October 2016) shall have the following attestation signed and dated by the executive director or designee:

“I certify that a criminal record check for this individual is completed and on file at the agency.”

(j) The applicant shall submit a signed and dated “Statement of Affirmation” as part of Form 2604 “Application for Certification and Enrollment of Home-based Therapeutic Service Providers” (October 2016), that certifies the following:

“I affirm that all the information contained in this application is true, correct, and complete to the best of my knowledge and belief. I acknowledge that the provision of false information in the application is a basis for denial of application. I understand that DCYF has the right to review the information contained in this application.

I affirm that I will notify DCYF in writing within 10 days of any change in the information contained in this application.

By my signature below, I affirm that I have read and agree to adhere to administrative rule He-C 6339, “Certification for Payment Standards in Home Community Based Service Providers.”

(k) The applicant shall provide the following information with, or in addition, to Form 2604 “Application for Certification and Enrollment of Home-based Therapeutic Service Providers” (October 2016) in (f) above:

(1) A copy of a completed, signed, and dated “State of New Hampshire Alternative W-9” (October 2016);

(2) A current list of the board of directors including the following for each member of the board:

a. The full name;

b. The office held;

c. The professional affiliation; and

d. The address, telephone, and email address;

(3) A copy of the program organizational structure;

(4) A copy of the prescribing practitioner’s license;

(5) A copy of the professional and general liability insurance certificate(s) for the program;

(6) A copy of the program brochure; and

(7) A copy of a current resume or curriculum vitae for the program coordinator and clinical supervisor.

(l) Each applicant for therapeutic day treatment services shall complete and submit a signed and dated Form 2605 “Application for Certification and Enrollment of Therapeutic Day Service Providers” (October 2016).

(m) Part C of Form 2605 “Application for Certification and Enrollment of Therapeutic Day Service Providers” (October 2016) shall be signed and dated by each direct service staff and include the following affirmation:

(n) Each submitted and signed Part C of Form 2605 “Application for Certification and Enrollment of Therapeutic Day Service Providers” (October 2016) shall have the following attestation signed and dated by the executive director or designee:

“I certify that a criminal record check for this individual is completed and on file at the agency.”

(o) The applicant shall submit a signed and dated “Statement of Affirmation” as part of Form 2605 “Application for Certification and Enrollment of Therapeutic Day Service Providers” (October 2016) that certifies the following:

“I affirm that all the information contained in this application is true, correct, and complete to the best of my knowledge and belief. I acknowledge that the provision of false information in the application is a basis for denial of the application. I understand that DCYF has the right to review the information contained in this application.

I affirm that I will notify DCYF in writing within 10 days of any change in the information contained in this application.

By my signature below, I affirm that I have read and agree to adhere to Administrative Rule He-C 6339, “Certification for Payment Standards for In Home Community Based Service Providers.”

(p) The applicant shall provide the following information with, or in addition to, Form 2605 “Application for Certification and Enrollment of Therapeutic Day Service Providers” (October 2016) in (m) above:

(1) A completed, signed, and dated “State of New Hampshire Alternative W-9” (October 2016);

(2) A current list of the board of directors including the following for each member of the board:

a. The full name;

b. The office held;

c. The professional affiliation; and

d. The address, telephone, and email address;

(3) A copy of the program organizational structure;

(4) A copy of the prescribing practitioner license;

(5) A copy of the professional and general liability insurance certificate(s) for the program;

(6) A copy of the program brochure; and

(7) A copy of a current resume or curriculum vitae for the program consultant.

(q) Each applicant for adolescent community treatment services shall complete and submit a signed and dated Form 2602 “Application for Certification and Enrollment of Adolescent Community Treatment Service Providers” (October 2016).

(r) Part C of Form 2602 “Application for Certification and Enrollment of Adolescent Community Treatment Service Providers” (October 2016) shall be signed and dated by each direct service staff and include the following affirmation:

(s) Each submitted Part C of Form 2602 “Application for Certification and Enrollment of Adolescent Community Treatment Service Providers” (October 2016) shall have the following attestation signed and dated by the executive director or designee:

“I certify that a criminal record check for this individual is completed and on file at the agency.”

(t) The applicant shall submit a signed and dated “Statement of Affirmation” as part of Form 2602 “Application for Certification and Enrollment of Adolescent Community Treatment Service Providers” (October 2016) that certifies the following:

“I affirm that all the information contained in this application is true, correct, and complete to the best of my knowledge and belief. I acknowledge that the provision of false information in the application is a basis for denial of the application. I understand that DCYF has the right to review the information contained in this application.

I affirm that I will notify DCYF in writing within 10 days of any change in the information contained in this application.

By my signature below, I affirm that I have read and agree to adhere to Administrative Rule He-C 6339, “Certification for Payment Standards for In Home Community Based Service Providers.”

(u) The applicant shall provide the following information with, or in addition to, Form 2602 “Application for Certification and Enrollment of Adolescent Community Treatment Service Providers” (October 2016) in (q) above:

(1) A completed, signed, and dated “State of New Hampshire Alternative W-9” (October 2016);

(2) A current list of the board of directors including the following for each member of the board:

a. The full name;

b. The office held;

c. The professional affiliation; and

d. The address, telephone, and email address;

(3) The organizational structure of the program;

(4) A copy of the prescribing practitioner’s license;

(5) A copy of the professional and general liability insurance certificate(s) for the program;

(6) A copy of the program brochure; and

(7) A copy of a current resume or curriculum vitae for the program supervisor.”

(v) Each applicant for individual service option in home provider shall complete and submit a signed and dated Form 2606 “Application for Certification and Enrollment of Individual Service Options (ISO) in Home Providers” (October 2016).

(w) Part C 2606 “Application for Certification and Enrollment of Individual Service Options (ISO) in Home Providers” (October 2016) shall be signed and dated by each direct service staff and affirm, the following:

(x) Each submitted and signed Part C of Form 2606 “Application for Certification and Enrollment of Individual Service Options (ISO) in Home Providers” (October 2016) shall have the following attestation signed and dated by the executive director or designee;

“I certify that a criminal record check for this individual is completed and on file at the agency.”

(y) The applicant shall submit a signed and dated “Statement of Affirmation” as part of Form 2606 “Application for Certification and Enrollment of Individual Service Options (ISO) in Home Providers” (October 2016) that certifies the following:

“I affirm that all the information contained in this application is true, correct, and complete to the best of my knowledge and belief. I acknowledge that the provision of false information in the application is a basis for denial of the application. I understand that DCYF has the right to review the information contained in this application.

I affirm that I will notify DCYF in writing within 10 days of any change in the information contained in this application.

By my signature below, I affirm that I have read and agree to adhere to Administrative Rule He-C 6339, “Certification for Payment Standards for In Home Community Based Service Providers.”

(z) The applicant shall provide the following information with or in addition to Form 2606 “Application for Certification and Enrollment of Individual Service Options (ISO) in Home Providers” (October 2016) in (v) above:

(1) A completed, signed, and dated “State of New Hampshire Alternative W-9” (October 2016);

(2) A current list of the board of directors including the following for each member of the board:

a. The full name;

b. The office held;

c. The professional affiliation; and

d. The address, telephone, and email address;

(3) A copy of the organizational structure of the program;

(4) A copy of the prescribing practitioner’s license;

(5) A copy of the professional and general liability insurance certificate(s) for the program;

(6) A copy of the program brochure; and

(7) A copy of a current resume or curriculum vitae for the program.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.05 Review of Continued Certification Compliance.

(a) Community based in-home service providers shall complete and submit a completed, signed and dated Form 2607 “Review of Continued Certification for In-Home Community-Based Service Providers” (October 2016), as provided by DCYF, within 30 days of receipt.

(b) Part C of Form 2607 “Review of Continued Certification for In-Home Community-Based Service Providers” (October 2016) shall be signed and dated by each direct service staff and include the following affirmation:

(c) Each submitted and signed Part C of Form 2607 “Review of Continued Certification for In-Home Community-Based Service Providers” (October 2016) shall have the following attestation signed and dated by the executive director or designee:

“I certify that a criminal record check for this individual is completed an on file at the agency.”

(d) The provider shall submit a signed and dated “Statement of Affirmation” as part of Form 2607 “Review of Continued Certification for In-Home Community-Based Service Providers” (October 2016) that certifies the following:

“I affirm that all the information contained in this application is true, correct, and complete to the best of my knowledge and belief. I acknowledge that the provision of false information in the application is a basis for denial of the application. I understand that DCYF has the right to review the information contained in this application.

I affirm that I will notify DCYF in writing within 10 days of any change in the information contained in this application.

By my signature below, I affirm that I have read and agree to adhere to Administrative Rule He-C 6339, “Certification for Payment Standards for In Home Community Based Service Providers.””

(e) The provider shall provide the following information with, or in addition to Form 2607 “Review of Continued Certification for In-Home Community-Based Service Providers” (October 2016) in (a) above:

(1) A copy of a resume or curriculum for the program coordinator and the executive director;

(2) The organizational structure of the program;

(3) The resume or curriculum vitae for the prescribing practitioner;

(4) A copy of the prescribing practitioner’s license;

(5) A copy of the professional and general liability insurance certificate(s) for the program;

(6) A copy of the program brochure;

(7) A current list of the board of directors including the following for each member of the board:

a. The full name;

b. The office held;

c. The professional affiliation; and

d. The address, telephone and email address;

(8) A completed, signed, and dated “State of New Hampshire Alternative W-9” (October 2016).

(f) Agencies that do not submit a signed and dated Form 2607 “Review of Continued Certification for In-Home Community-Based Service Providers” (October 2016) within 30 days of receipt shall have their certification revoked in accordance with He-C 6339.22 and denied payment.

(g) Renewal of certification shall be made by filing a signed and dated Form 2607 “Review of Continued Certification for In-Home Community-Based Service Providers” (October 2016) and shall be based on a review and verification of the provider’s compliance with He-C 6339.14 and specific requirements for the service provided.

(h) Review of continued certification compliance shall occur every 5 years from date of issue.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.06 Notification of Changes.

(a) All providers shall notify DCYF in writing within 10 days of any change in the information contained in the application and provide documentation of the change.

(b) Each agency shall send any new staff information to DCYF.

(c) All providers shall submit a copy of renewed license to DCYF within 10 days of receipt from the New Hampshire licensing authority.

(d) The provider shall notify DCYF of any changes in tax information and complete and submit to DCYF a completed, signed, and dated “State of New Hampshire Alternative W-9” (October 2016) form with its current tax information.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.07 Billing Requirements for Community-Based In-Home Services.

(a) All providers shall be certified and enrolled pursuant to He-C 6339.04 prior to being eligible for reimbursement by DHHS.

(b) The provider shall not bill DHHS for services that are to be reimbursed by another entity.

(c) Providers shall not exceed the rates established by DCYF nor will the rates exceed those charged by the provider for non-DCYF children and in no event shall DCYF be liable for any payments hereunder in excess of such available and appropriate funds.

(d) The provider shall accept reimbursement made by DHHS as payment in full for the services provided.

(e) DCYF shall determine the need for services and the determination shall be binding on the provider.

(f) The provider, if incorporated and if requested, shall submit to DCYF an audited financial statement prepared by an independent licensed public accountant.

(g) The provider shall provide services or care without discrimination as required by Title VI of the Civil Rights Act of 1964, as amended, and without discrimination on the basis of handicap as required by Section 504 of the Rehabilitation Act of 1973, as amended.

(h) The provider’s certification and enrollment shall terminate upon date of sale or transfer of ownership or close of the agency.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.08 Billing Process for Community-Based In-Home Services.

(a) Prior to service delivery, a provider shall obtain an authorization form, which consists of one of the following:

(1) For medicaid eligible recipients, a ”New Hampshire Title XIX Medicaid Program Service Authorization” from the New Hampshire Medicaid fiscal agent or

(2) For non-medicaid eligible recipients, a Form 2110 “Service Authorization”(6/30/2008).

(b) A provider shall bill the NH medicaid fiscal agent for medicaid eligible recipients either via paper claims or electronic claims submission, following the directions outlined by the NH medicaid fiscal agent, as follows:

(1) For a paper claim submission, a provider shall complete a CMS 1500 form and mail it to the NH medicaid fiscal agent; or

(2) For electronic claim submission, a provider shall submit an electronic claim to the NH medicaid fiscal agent.

(c) A provider shall bill the department through NH Bridges for non-medicaid eligible recipients either via paper claims or electronic claims submission, as specified in (d) and (e) below.

(d) For paper claim submissions for all services, a provider shall:

(1) Copy the Form 2110 “Service Authorization” 6/30/2008) for future billings, if the authorized service dates span a date range;

(2) Complete and submit a copy of the Form 2110 “Service Authorization” (6/30/2008) to the department;

(e) For electronic claim submissions, a provider shall:

(1) Request a web billing account from DHHS by completing, signing, and submitting Form 2679 “Provider Web Billing User Account Request Form” (October 2016);

(2) Be issued a log on and personal identification number (PIN) by DHHS for use in accessing the web billing account; and

(3) Neither the provider nor any authorized representative shall transfer his or her log on or PIN, or allow use of his or her log on or PIN by any other person.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.09 Billing Period.

(a) A provider shall bill within one year of the date of provision of a service.

(b) Any bill received after one year of the date of the provision of a service shall be denied pursuant to RSA 126-A:3.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.10 Billing Discrepancies. Questions regarding billing discrepancies shall be directed to the provider relations’ staff of the bureau of administrative operations in DCYF.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.11 Record-Keeping and Record Retention.

(a) A provider shall retain records for a period of no less than 7 years after the completion date of a provided service for each bill submitted to the department, any legally liable county, the medicaid fiscal agent, or a private insurance company.

(b) The provider shall keep records as are necessary to comply with RSA 170-E: 42, when applicable, and to comply with DCYF record-keeping requirements in He-C 6339.

(c) Records shall clearly document the extent of the care and services provided to children and families, including attendance records when those services are charged to the department, and information regarding any payment claimed.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.12 Quality Assurance Activities and Monitoring of Community Based In-home Service Providers.

(a) The provider shall participate in quality assurance activities conducted by DCYF using a variety of activities that may include a combination of record reviews, performance data measurements, and visits to providers.

(b) The provider shall allow an on-site visit by DCYF which may be random or scheduled, for the purposes of:

(1) Interviewing program staff;

(2) Reviewing program documents to determine continued compliance with He-C 6339; and

(3) Examining agency case records for DCYF families.

(c) Providers shall ensure that clinical records, including all progress reports, are available for inspection and review by DCYF staff during any on-site quality assurance or monitoring visit.

(d) Service providers shall be subject to monitoring and evaluation by DCYF through a variety of activities that include:

(1) Queries of data that is stored on NH Bridges case management system and the medicaid management information system (MMIS);

(2) Reviews of case record information;

(3) Data reporting from the service providers; and

(4) Satisfaction surveys from stakeholders, such as families, CPSWs, and JPPOs.

(e) Providers not demonstrating compliance with the provisions of He-C 6339 shall meet with DCYF to develop an approved corrective action plan that includes:

(1) Areas of concern or noncompliance with He-C 6339;

(2) Areas of performance needing improvement;

(3) Recommendations for corrective action or program improvements;

(4) Determinations on corrective action timeframes and any additional responses by the agency; and

(5) Any recommendation regarding continued certification or revocation of certification.

(f) A service provider shall be notified of any problems that are noted on the DCYF staff surveys that include:

(1) Negative responses concerning quality and timeliness of service provision; and

(2) Written comments about agency performance.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.13 Reporting Requirements.

(a) Each service provider shall:

(1) With the assistance of a DCYF representative, if necessary, prepare an annual report of all statistical information used to measure achievement; and

(2) Submit the annual report to DCYF no later than 30 days following the end of the calendar year.

(b) The annual report shall include the following information:

(1) Services provided and changes in strategies that resulted in effective outcomes;

(2) Issues with the service utilization and observations about shifts in the targeted service population;

(3) Barriers discovered in the system of care; and

(4) Proposed enhancements to performance indicators.

(d) Data reports shall be completed and submitted to DCYF no later than 15 days following the end of the month.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.14 Compliance Requirements.

(a) The provider shall comply with:

(1) All applicable licensing and registration requirements prior to applying for certification;

(2) The medical assistance requirements of He-W 500 and He-M 426;

(3) The statutes regarding confidentiality, including RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:19, RSA 170-C:14, and RSA 170-G:8-a; and

(4) The child abuse and neglect reporting requirements of RSA 169-C:29-30.

(b) For all direct services staff, prior to beginning their work with children, and thereafter on an annual basis, the provider shall review the sections of RSA 169 on definitions, immunity from liability, and persons required to report.

(d) The provider shall maintain both professional and general liability insurance.

(e) Whenever transportation services are provided, the agency shall:

(1) Verify that each driver possesses a valid driver’s license;

(2) Verify that each driver has automobile insurance liability coverage;

(3) Conduct a motor vehicle record check to verify that each driver has no convictions for impaired driving or multiple motor vehicle violations; and

(4) Obtain a criminal records check to verify that each driver has no convictions for crimes against persons.

(f) When domestic violence is identified as an issue for a family, each agency shall follow the “Mental Health Domestic Violence Protocols” (2009), as prepared by the NH governor’s commission on domestic violence and available via the Internet at http://doj.nh.gov/criminal/victim-assistance/protocols from the NH department of justice as listed in Appendix A.

(g) The provider shall:

(1) Be an enrolled NH medicaid provider agency;

(2) Employ or contract with a prescribing practitioner who demonstrates approval of the medicaid-covered services by signing the child and family’s treatment plan; and

(3) Accept medicaid payment as payment in full.

(h) The provider shall bill all third party sources of reimbursement, including private health insurance and medicaid, prior to billing DCYF.

(i) As part of the certification requirements, each agency shall provide to each family a written description of their services, including:

(1) Agency staff availability to families;

(2) The services as reflected in the service provision guidelines for each category of service; and

(3) The cost of the service, including the parent’s obligation to re-pay a portion of service provision, as applicable.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.15 Treatment Planning and Progress Reports.

(a) The provider shall develop a treatment plan for each child or family receiving their services, with input from individuals described in (b) below.

(b) The following individuals shall be included on the treatment team:

(1) The child, if age and developmentally appropriate;

(2) The child’s parents;

(3) The CPSW or JPPO, or both;

(4) The prescribing practitioner;

(5) Staff members from the agency;

(6) School district personnel as determined by the school districts if applicable; and

(7) Other persons significant to the family, who may include:

a. Teachers;

b. Counselors;

c. Friends;

d. Relatives; and

e. Advocates and primary caring adults assigned by the court.

(1) The findings of the assessment as required for the service being provided;

(2) An estimate by the treatment team members of the length of service to be provided to the child and family, based upon referral information and the agency’s assessment;

(3) The child’s permanency plan, identifying one of the following alternatives for the child, as identified by the CPSW or JPPO:

a. Maintain in his or her own home;

b. Reunification with the family;

c. Planned permanent living arrangements;

d. Permanent relative placement;

e. Guardianship by a relative or other person; or

f. Adoption;

(4) A concurrent plan as an alternative to the child’s permanent plan as identified by the CPSW or JPPO; and

(5) The objectives that fall within one or more of the following domains:

a. Safety and behavior of the child;

b. Family;

c. Medical;

d. Education; and

e. Independent living skills training, when applicable.

(d) Each domain identified in (c)(5) above shall address:

(1) The goals and objectives to be achieved by the child and family;

(2) The timeframes for completion of goals and objectives;

(3) An identification of the services that will be provided directly or arranged for, and any measures for ensuring their integration with the child’s activities, including identifying how the child’s family will participate in their care;

(4) The frequency of services; and

(5) An identification of the staff responsible for implementing the stated interventions in the treatment plan.

(e) For cases in which reunification is the identified goal, the treatment plan shall include:

(1) A community reintegration and transition plan that identifies the needed supports that would enable the child to return to his or her community; and

(2) The responsibilities of the participants for completing steps necessary to implement the plan.

(f) The treatment plan shall be signed and dated by the following team members, indicating they participated in the process:

(1) The provider’s executive director or treatment coordinator;

(2) The CPSW, JPPO, or both;

(3) When applicable for medicaid funding, the prescribing practitioner;

(4) When age and developmentally appropriate, the child; and

(5) The child’s parents or guardian.

(g) Revisions to the treatment plan shall be explained in writing to any individuals of the team who are unable to participate.

(h) The treatment plan shall be filed in the child’s record and copies sent to:

(1) The CPSW, JPPO, or both;

(2) The child’s parent or guardian; and

(3) The prescribing practitioner.

(i) Once the treatment plan is completed, the agency staff shall receive supervision and instruction by the program supervisors and program consultants, if any, to assure that each child’s treatment plan is consistently implemented.

(j) Each service provider shall provide progress reports and outcomes data for each child in care, in accordance with (k) below.

(k) Progress reports shall include the following:

(1) Monthly written progress reports, which shall be sent to the CPSW or JPPO no later than 15 days following the end of the month; and

(2) Outcome reports, which shall be sent electronically to the DCYF state office on a quarterly basis.

(l) Written progress reports, court reports, and termination reports prepared by the agency shall clearly and accurately reflect the family’s progress and be submitted on time pursuant to RSA 169-B:5-a, RSA 169-C:12-b and RSA 169-D:4-a; as follows:

(1) Specific court reports, which shall be sent to the court with a copy to the CPSW or JPPO no later than 5 days before the scheduled court date, pursuant to RSA 169-B:5-a, RSA 169-C:12-b and RSA 169-D:4-a; and

(2) Service termination reports, which shall be sent to the CPSW or JPPO no later than 15 days following termination.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.16 Requirements for Child Health Support Services.

(a) The provider shall comply with sections He-C 6339.01 through He-C 6339.15 for certification compliance.

(b) Authorization for payment for child health support services shall be pursuant to a court order, or a non-court ordered or voluntary agreement between DCYF and the family.

(d) Service for an additional 90 days per year shall be authorized when the following conditions are met:

(1) The family’s problems have not been resolved and the child remains at risk for out-of-home placement;

(2) The provider has discussed a continuation of services with family members and the CPSW or JPPO; and

(3) The provider submits the following information in writing to the CPSW or JPPO:

a. The reason(s) for continued services;

b. The beginning and ending dates for continued services;

c. The goals for the continued period of services; and

d. The anticipated child and family outcomes.

(e) Child health support services shall be provided for the following:

(1) Families at risk of having a child removed from the home due to maltreatment;

(2) Young parents, including teen parents and others who are inexperienced and struggling with their parental responsibilities;

(3) Socially isolated families who lack appropriate parenting role models and access to supportive services;

(4) Families in which ineffective child management techniques are being employed and children who may be withdrawn or depressed, aggressive, delinquent, anxious, or display self-destructive behaviors;

(5) Families where the parents are in the home, but temporarily are unable to effectively carry out parenting functions because of physical or mental illness, disabilities, convalescence, substance abuse, or complications of pregnancy;

(6) Families in which the parents’ ability to effectively parent their children is diminished due to a preoccupation with the care of other family members, such as a spouse, child, or a grandparent who is chronically ill, convalescing, or permanently disabled, or when a parent has a prolonged grief reaction over the death of a spouse, child, or other person;

(7) Families in need of help to learn how to care for children due to lack of knowledge, emotional immaturity, or overwhelming responsibility for many children;

(8) Families headed by grandparents or other relatives who are overwhelmed with the responsibilities of parenting, thereby placing the child at risk of placement in another home;

(9) Families in which the child has been placed out of the home on a temporary basis and the parents need therapeutic intervention to prepare for the return of the child, including help with issues such as appropriate parenting, child management techniques, discipline, communication skills, and anger management, as well as safety of the physical home environment;

(10) Families who need therapeutic intervention to avert future neglect, abuse, delinquency, status offenses, emotional disturbances, and out-of-home placement of a child;

(11) Families who provide foster care who require additional assistance in order to preserve the placement; and

(12) Adoptive families to preserve the family unit.

(f) Child health support services shall include:

(1) An initial health and behavioral health assessment, including the following;

a. The health status of each family member;

b. A behavioral health diagnosis and treatment received;

c. The prescription medications of each family member; and

d. The needs of the children and parents;

(2) Addiction recovery support that includes ongoing risk assessment and referral for substance abuse treatment, as well as supportive counseling for those in addiction treatment programs to reduce the effects these addictions have on parenting abilities;

(3) Family-based support that includes education, consultation, and follow-up activities that develop and maintain family support systems to enhance and encourage parental coping and nurturing skills, assessment of parent and child interaction, family counseling and skill building for parents and their children who are in an out-of-home placement, and parenting skills instruction, including role modeling;

(4) Behavior management that includes:

a. An initial behavioral health assessment of the family;

b. Assistance with the development and implementation of behavior strategies for the children and parents in conjunction with child development, including managing the child’s behavior through appropriate discipline;

c. Education and parenting skills to inform and prepare parents for a child’s behaviors and needs, including age appropriate socialization skills of the child;

d. Family support focused on coping skills, stress management, conflict resolution, and impulse control; and

e. Support family and modeling behavioral strategies;

(5) An assessment of the family’s home health care management and education of physical or behavioral illnesses, as well as providing assistance to parents in implementing medical regimes as they relate to their tasks of daily living as prescribed by their medical and behavioral health provider;

(6) Family support with household management that includes safety instruction to eliminate, reduce, or avoid hazards in the home;

(7) Family support with nutritional education that includes safe food handling procedures and dietary needs of children and family;

(8) Connections and facility referrals to community resources and supports that includes instruction, and assistance with accessing community agencies and services; and

(9) Parent education about age appropriate activities, discipline and behavior modification including supervised visitation between parent(s) and children, as ordered by the court.

(g) A provider for child health support services shall:

(1) Review the DCYF case plan;

(2) Complete an initial behavioral health needs assessment for the family and using information from the DCYF case plan develop a treatment plan within 30 days of the referral;

(3) Provide a completed treatment plan to the CPSW or JPPO within 30 days of referral;

(4) The agency shall document each family visit, including:

a. The type of service;

b. The date of service;

c The names of the family members and other individuals who participated;

d. The name of the agency staff who assisted the family;

e. A brief summary of the in-home session;

f. The length of time spent with the family; and

g. The provider’s signature and the signature of a family member and child, as is age appropriate;

(5) Retain a copy of the log of visits and contacts in the family’s file for review during the onsite visits;

(6) Attend case planning or treatment-planning meetings with the family as requested by the CPSW or JPPO;

(7) Discuss discharge planning needs with the family members and the CPSW or JPPO;

(8) Discuss the reason for service termination with the family and CPSW or JPPO;

(9) Immediately notify the CPSW or JPPO of any significant changes in or affecting the family, such as:

a. Changes in employment or income;

b. Housing changes including eviction notice;

c. Death or serious injury or illness of a family member;

d. Separation of the caregivers;

e. Unplanned pregnancy;

f. Changes in patterns of school attendance;

g. Arrests;

h. Police contacts; or

i. Probation or parole violations;

(10) Provide each family with a written description of services, as described in He-C 6339.14 including the cost of the service and potential reimbursement by the family to the DHHS for the services provided;

(11) Employ staff that provides evening, weekend, and holiday coverage to meet the needs of the family;

(12) Employ child health support aides in sufficient number to maintain a 1:6 average aide-to-family caseload ratio; not to exceed 1:9;

(13) Provide child health support aides with agency identification; and

(14) Have an agency policy in place regarding missed appointments by client families.

(h) The agency shall employ or contract with a prescribing practitioner.

(i) The agency shall employ or contract with a program consultant who is available for consultation with child health support aides.

(j) The program consultant referenced in (i) above shall meet one of the following:

(1) For cases when the primary issue is physical health, a physician, physician assistant, advanced registered nurse practitioner (ARNP), registered nurse (RN), or licensed practical nurse (LPN); and

(2) For cases when the primary issue is behavioral health, licensed psychologist, licensed pastoral psychotherapist, licensed clinical social worker, licensed clinical mental health counselor, or licensed marriage and family therapist.

(k) The prescribing practitioner servicing as the program consultant shall:

(1) Sign each treatment plan separately as both the prescribing practitioner and program consultant; and

(2) Meet the definition of prescribing practitioner.

(l) The program consultant shall review the treatment plan no less than quarterly and document the review by signing and dating the treatment plan.

(m) The agency shall employ child health support aides who:

(1) Are at least 22 years of age; and

(2) Possess:

a. A bachelor’s degree from an accredited college or university with a major study in nursing, health, psychology, social work, sociology, education, guidance, or a related field emphasizing human relations, physical, or behavioral health;

b. An associate’s degree from an accredited college or university with a major study in nursing, health, psychology, social work, sociology, education, guidance, or a related field emphasizing human relations, physical, or behavioral health and have 2 years’ experience working with families or other relevant human services experience; or

c. A high school diploma or general equivalency diploma and have 4 years experience working with families or other relevant human services experience.

(n) In addition to the requirements in (m) above, all child health support aides shall:

(1) Complete a minimum of 20 hours per year of in-service training, as follows:

a. At least 8 of the 20 hours shall be family systems training; and

b. 12 hours of the overall training hours may be provided in supervision and staff meetings that relate to general therapeutic topics such as:

1. Substance use disorders:

2. Child abuse and neglect;

3. Labor and sex trafficking;

4. Sexual abuse;

5. Domestic and family violence;

6. Behavioral health needs of children and families;

7. Safety planning for family members;

8. Crisis intervention techniques;

9. Early childhood screening and child development;

10. Trauma informed practice, including screening and evidence-based practices;

11. Treatment of any co-occurring disorders;

12. Restorative practices and delinquency prevention;

13. Behavioral management techniques; and

14. Infant safe sleeping practices.

(o) The agency shall maintain documentation of training that includes:

a. The dates of training;

b. The names of training sessions attended; and

c. The number of hours per training.

(p) Child health support aides shall:

(1) Be available for immediate contact so appointments may be scheduled or canceled; and

(2) Carry and present agency identification to the child’s caregiver as necessary.

(q) The program supervisor shall provide a minimum of one hour per week of individual clinical supervision for a the child health support aide working full time and pro-rated for part time staff to review the progress and barriers of each case, for which one session per month may be substituted with group supervision.

(r) The agency shall complete annual staff evaluations.

(s) Within 15 days after service termination, the agency shall forward a report to the CPSW, JPPO or his or her supervisor, that includes:

(1) A summary of visits and contacts with the family, including dates, duration, and locations;

(2) A summary of the progress or lack of progress in meeting the treatment plan, including the tasks accomplished, timeframes, and measurable outcomes achieved;

(3) New information about the family that changes or updates the DCYF case plan, pre-dispositional investigation, or court report;

(4) The community resources and supports available to the family that might be accessed in the future;

(5) Recommendation for ongoing services, including a description of additional progress by parents that is essential to address the needs of each child as specified in the treatment plan and how the provider has worked with the family to assist them in accessing recommended services; and

(6) The dated and signature of the child health support aide and prescribing practitioner;

(t) If services are terminated prior to the 15^th day of the month, no monthly progress report shall be required for the month. The information for the month in which services are terminated shall be included in a discharge report.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.17 Requirements for Home-Based Therapeutic Services.

(a) The provider shall comply with sections He-C 6339.01 through He-C 6339.15 for certification compliance.

(b) Authorization for payment for home-based therapeutic services shall be pursuant to a court order, or a non-court-ordered or voluntary agreement between DCYF and the family.

(d) Service for an additional 90 days per year shall be authorized when the following conditions are met:

(1) The family’s problems have not been resolved and the child remains at risk for out-of home placement;

(2) The provider has discussed a continuation of services with family members and the CPSW or JPPO; and

(3) The provider submits the following documentation to the CPSW or JPPO:

a. The therapeutic need(s) for continued services;

b. The beginning and anticipated ending dates for the continued services request;

c. The goals for the continued period of services; and

d. The anticipated child and family outcomes.

(e) Home-based therapeutic services shall be provided for:

(1) Families with a child who is at imminent risk for placement;

(2) A family with a child who has returned home or is at risk of returning to placement;

(3) Families where the parents are temporarily unable to deal with their child-rearing responsibilities because of a family member’s physical or mental illness, disability, convalescence, substance use disorder, or pregnancy;

(4) Families temporarily under stress with the care of a parent, child, or another member of the family;

(5) Families for whom child placement has been determined necessary to ensure safety and the parents need assistance preparing for the placement or return of the child to a safe environment;

(6) Parents who request voluntary services, including voluntary children in need of services (CHINS) and the requested service is not available to the family through a community service agency;

(7) Families, including those who provide foster care services, needing assistance to strengthen and support the child’s current placement in a foster home or a relative’s home;

(8) Families who are experiencing a crisis that might require the removal of a child due to physical abuse or neglect by the parent or caregiver or unlawful behaviors by the child such as school truancy, running away, or delinquency; or

(9) Families in crisis whose child is immediately placed in emergency care for safety reasons after the initial DCYF assessment or due to legal or judicial intervention because of juvenile offenses, and the family’s goal is for the child to return home with this service provided.

(f) Home-based therapeutic services shall include:

(1) On-call 24-hour availability to families;

(2) Assessment and service planning based on the DCYF case plan or pre-dispositional investigation report or treatment and ongoing assessment for each child enrolled in the program;

(3) Substance use disorder recovery support that includes ongoing risk assessment and referral for substance abuse treatment, as well as supportive counseling for those in addiction treatment programs to reduce the effects these addictions have on the child and parent;

(4) Family and individual counseling with family members and persons in their immediate support system to develop or maintain family growth and assistance necessary for independent family functioning;

(5) Assistance to parents in compliance with court orders;

(6) Crisis assistance and safety planning with families by responding immediately to a family’s needs;

(7) Referrals and coordination to other services and supports made with JPPO and CPSW;

(8) A written description of services, as described in He-C 6339.14 including the cost of the service and potential reimbursement by the family to the state for services provided;

(9) For families who need crisis assistance:

a. A face-to-face meeting initiated within 24 hours of referral to complete an initial assessment and develop an immediate safety plan that includes strategies for diffusing the crisis and maintaining the safety of all family members;

b. Submit the safety plan in writing to the JPPO or CPSW within 72 hours; and

c. If safety cannot be assured at the face-to-face meeting, immediately develop and coordinate an alternative safety plan with the JPPO or CPSW, the program administrator, or DCYF field administrator or supervisor during weekends and holidays; and

(10) For families not in need of crisis assistance:

a. Contact the family within 48 hours of referral, excluding weekends and holidays; and

b. Have a face-to-face meeting with the family within 5 working days of the date of the referral to conduct an initial assessment and develop the treatment plan; and

(11) An assessment of the needs of each child and the parents that is based upon:

a. The information included from one of the following:

1. The DCYF case plan, pursuant to RSA 170-G:4 III and court reports pursuant to RSA 169-B:5-a, RSA 169-C:12-b or RSA 169-D:4-a; or

2. The investigation report, pursuant to RSA 170-G:16, I or III, RSA 169-B:16, III-IV, or RSA 169-D:14, III-IV; and

b. Identification of substance use disorders, domestic and family violence, sexual abuse, or other situations that impact the child’s safety.

(g) When available, the CPSW or JPPO shall be present for the initial assessment and development of the treatment plan.

(h) Face-to-face meetings with families shall include parents or other caregivers, the child or children, and other family members as necessary to develop and implement the treatment plan.

(i) The therapist shall maintain an on-going log of contacts and visits with family members and with school, health, and other service providers including the following:

(1) The type of service;

(2) The date of service;

(3) The names of the family members and other individuals who participated;

(4) The name of the therapist who assisted the family;

(5) A brief summary of the in-home session;

(6) The length of time spent with the family; and

(7) The provider’s signature and the signature of the family member and child.

(j) The agency shall immediately notify the JPPO or CPSW of any significant changes in or affecting the family, such as:

(1) Change of employment or income;

(2) Housing changes including an eviction notice;

(3) Death or serious injury or illness of a family member;

(4) Separation of the caregivers;

(5) Unplanned pregnancy;

(6) Changes in patterns of school attendance;

(7) Arrests;

(8) Police contacts; or

(9) Violations of probation or parole.

(k) The agency shall have a policy in place regarding missed appointments by client families.

(l) The home-based therapeutic agency shall:

(1) Employ or contract with a prescribing practitioner;

(2) Employ a program coordinator who meets the following:

a. A master’s degree in social work, psychology, education, or a related field with an emphasis in human services;

b. Two years clinical experience working with families, and

c. Two years supervisory or management experience;

(3) Employ therapists who have:

a. A master’s degree with a major in social work, counseling, psychology, or a related field and at least 2 years of direct work experience in assisting children and families; or

b. A bachelor’s degree with a major in social work, counseling, psychology, or a related field and at least 5 years of direct work experience in assisting children and families; and

(4) Employ case managers who meet the following minimum qualifications:

a. A bachelor’s degree in social work, psychology, education or a related field with an emphasis in human services; and

b. Experience of 2 years with children and families.

(m) The prescribing practitioner serving as the program consultant shall:

(1) Sign each treatment plan separately as both the prescribing practitioner and program consultant; and

(2) Meet the definition of prescribing practitioner.

(n) Therapists and case managers shall participate in weekly supervision that includes a discussion of each case and a review of the progress made by each family towards the goals of the treatment plan.

(o) The agency shall have at least one full-time program coordinator for every 6 therapists.

(p) Program coordinators shall be available to the therapists and case managers 24 hours a day, 7 days a week.

(q) Each therapist and case manager shall have an annual evaluation with a copy maintained in his or her file.

(r) Each therapist and shall complete a minimum of 20 hours of training per year that includes topics related to:

(1) Family systems;

(2) Substance use disorders;

(3) Child abuse and neglect;

(4) Labor or sex trafficking;

(5) Sexual abuse;

(6) Domestic and family violence;

(7) Behavioral health;

(8) Safety planning for family members;

(9) Crisis intervention techniques;

(10) Early childhood and screening and child development;

(11) Trauma informed practice, including evidence-based practices;

(12) Treatment of any co-occurring disorders;

(13) Behavioral management techniques; and

(14) Infant safe sleeping practices.

(s) For each therapist and case manager, the agency shall maintain on file copies of training certificates, signed by the trainer, that document:

(1) The names of training sessions attended;

(2) The number of hours per training; and

(3) The dates of training.

(t) The therapist’s and case manager’s caseload shall not exceed an average of 6 families per month.

(u) The therapist and case manager shall participate in weekly supervision that includes a discussion of the progress made by each family.

(v) Within 15 days after service termination, the agency shall forward to the CPSW, JPPO, or the supervisor a report that includes:

(1) A summary of visits and contacts with the family, including dates, duration, and locations;

(2) A summary of the progress or lack of progress in meeting the treatment plan, including the tasks accomplished, timeframes, and measurable outcomes achieved;

(3) New information about the family that changes or updates the DCYF case plan, pre-dispositional investigation report, or court report;

(4) The community resources and supports available to the family that might be accessed in the future, if needed;

(5) Recommendations for ongoing services, including a description of additional progress by parents that is essential to address the needs of each child, as specified in the treatment plan, and how the provider has worked with the family to assist them in accessing recommended services; and

(6) The date and signature of the prescribing practitioner and therapist;

(w) If services are terminated prior to the 15^th day of the month, no monthly progress report shall not be required for the month. The information for the month in which services are terminated shall be included in a discharge report.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.18 Therapeutic Day Treatment Services Programs.

(a) The provider shall comply with sections He-C 6339.01 through 6339.15 for certification compliance.

(b) Authorization for payment for therapeutic day treatment services shall be pursuant to a court order, or a non-court ordered or voluntary agreement between DCYF and the family.

(d) Service for an additional 90 days per year shall be authorized when the following conditions are met:

(1) The family’s problems have not been resolved and the child remains at risk for out-of-home placement;

(2) The provider has discussed a continuation of services with family members and the CPSW or JPPO; and

(3) The provider submits the following documentation to the CPSW or JPPO;

a. The reason(s) for continued services;

b. The beginning and ending dates for continued services;

c. The goals for the continued period of services; and

d. The anticipated child and family outcomes.

(e) Therapeutic day treatment services shall be provided for children who are:

(1) Experiencing challenging conditions in one or more of the following domains:

a. Developmental;

b. Psychological;

b. Social;

c. Family;

d. Cognitive;

e. Educational;

f. Behavioral; or

g. Substance use;

(2) At imminent risk for out-of-home placement or actively engaged in reuniting with family and community; or

(3) In families who provide foster care who require additional support in order to preserve the placement.

(f) Therapeutic day treatment services shall not be a substitute for special education or other federally required educational services.

(g) A provider for therapeutic day treatment services shall offer the following:

(1) Assessment and service planning based on the DCYF case plan or pre-dispositional investigation report or treatment and ongoing assessment for each child enrolled in the program;

(2) Crisis intervention and stabilization;

(3) Evidence-based practice or best practice; and

(4) Evidence-based psychotherapies, including individual, group, and family counseling that might occur in a community or in-home setting;

(h) In addition to the requirements in (g) above, programs shall offer any combination of the following, as necessary:

(1) Vocational assessment, when specifically requested by the CPSW or JPPO;

(2) Health education, including substance use disorder prevention, sexual health, nutrition counseling, and physical fitness;

(3) Parent education, parent skills training, and parent support groups;

(4) Therapeutic recreation, such as adventure-based and experiential activities; and

(5) After school, weekend, and school vacation therapeutic programming.

(i) Interagency referral, coordination, and collaboration between DCYF, education, behavioral health, developmental disabilities, medical, and any other involved discipline shall be a component of therapeutic day treatment services.

(j) A provider for therapeutic day treatment services shall:

(1) Review each child and family referral, including pertinent documentation and previous evaluations to determine appropriateness for therapeutic day treatment;

(2) Conduct a clinical assessment within 7 working days of referral that includes an individual and family needs assessment and a mental status examination for each child, as appropriate to the program offering, unless current assessments or mental status examinations have been completed within the past year and identification of the strengths and resources of the family;

(3) Within 30 days of referral, develop and implement an individually designed treatment plan, in conjunction with the CPSW or JPPO and the child and parents;

(4) Provide each family with a written description of services as described in He C 6339.14, including the cost of the service and potential reimbursement by the family to the state for services provided;

(5) Provide 24-hour emergency coverage, 7 days per week for the child and family; and

(6) Maintain a record for each child and family that includes:

a. Child and family names, medicaid and other third party identification numbers, addresses, and birth dates;

b. Child’s medical, social, developmental, educational, and family history;

c. Child’s diagnosis and the name of attending physician, psychiatrist, or psychologist;

d. DCYF case plan;

e. Child’s individual education plan, if applicable;

f. A description of any tests ordered and performed and their results;

g. A description of treatment, including measurable goals and timeframes;

h. A list of any medications prescribed;

i. Plan for coordinating services with other providers;

j. Daily progress notes indicating the services provided to the child;

k. Monthly progress summary which identifies the services provided and progress toward achievement of treatment goals;

l. An attendance sheet or contact log that supports the dates and times that are billed; and

m. Discharge plan or summary that identifies the after care plan and summarizes the case in relationship to the treatment and plan of care.

(k) The agency shall:

(1) Employ or contract with a prescribing practitioner;

(2) Employ or contract with a program consultant who meets the following:

a. A master’s degree in social work, psychology, education, or a related field with an emphasis in human services;

b. Clinical experience of 2 years working with families; and

c. Supervisory or management experience of 2 years.

(3) Therapists who have:

a. A master’s degree with a major in social work, counseling, psychology, or a related field and at least 2 years of direct work experience assisting children and families; or

b. A bachelor’s degree with a major in social work, counseling, psychology or a related field and at least 5 years of direct work experience in assisting children and families; and

(4) Employ case managers who meet the following minimum qualifications:

a. A bachelor’s degree in social work, psychology, education, or a related field with an emphasis in human services; and

b. Two years of experience with children and families.

(l) The prescribing practitioner serving as the program consultant shall sign each treatment plan separately as both the prescribing practitioner and program consultant.

(m) Therapists and case managers shall participate in weekly supervision that includes a discussion of each case and a review of the progress made by each family towards the goals of the treatment plan.

(n) In addition to the requirements in (k) above, the agency shall:

(1) Provide weekly clinical supervision to staff, including a review of the treatment plan for each family;

(2) Complete annual staff evaluations;

(3) Provide 20 hours per year of mandatory in-service training for staff that includes topics related to:

a. Family systems;

b. Substance use disorders;

c. Child abuse and neglect;

d. Labor and sex trafficking:

e. Sexual abuse;

f. Domestic and family violence;

g. Safety planning for family members;

h. Crisis intervention techniques;

i. Early childhood screening and child development;

j. Trauma informed practice, including evidence-based practices;

k. Treatment of any co-occurring disorders;

l. Behavioral management techniques; and

m. Infant safe sleeping practices;

(4) For each therapist and case manager, the agency shall maintain on file copies of training certificates, signed by the trainer that document:

a. The names of training sessions attended;

b. The number of hours per training; and

c. The dates of training.

(o) The agency shall discharge the child and family from the program when:

(1) The child and family make progress in achieving the goals as identified in the treatment plan;

(2) The child’s behavior while in the program requires removal and referral to more intensive residential treatment; or

(3) The child and family are unable to utilize treatment and are referred to other services.

(p) Within 15 days after service termination, the agency shall forward to the CPSW, JPPO, or the supervisor a report that includes:

(1) A summary of visits and contacts with the family including dates, duration, and locations;

(2) A summary of the progress or lack of progress in meeting the treatment plan including the tasks accomplished, timeframes, and measurable outcomes achieved;

(3) New information about the family that changes or updates the DCYF case plan, pre-dispositional investigation report, or court report;

(4) The community resources and supports available to the family that might be accessed in the future;

(5) Recommendations for ongoing services, including a description of additional progress by parents that is essential to address the needs of each child as specified in the treatment plan and how the provider has worked with the family to assist them in accessing recommended services; and

(6) The dated signature of the prescribing practitioner and therapist.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.19 Requirements for Adolescent Community Therapeutic Services.

(a) The provider shall comply with sections He-C 6339.01 through He-C 6339.15 for certification compliance.

(b) Authority for payment for adolescent community therapeutic services shall be pursuant to a court order or any voluntary agreement between the family and DCYF.

(d) Service for an additional 90 days per year shall be authorized when the following conditions are met:

(1) The family’s problems have not been resolved and the child remains at risk for out-of-home placement;

(2) The provider has discussed a continuation of services with family members and the CPSW or JPPO; and

(3) The provider submits the following documentation to the CPSW or JPPO:

a. The reason(s) for continued services;

b. The beginning and ending dates for continued services;

c. The goals for the continued period of services; and

d. The anticipated child and family outcomes.

(e) Adolescent community therapeutic services shall be provided to:

(1) Children who are exhibiting inappropriate behaviors in the home, school, or community; and

(2) Children living in their own home, a relative’s home, a guardian’s home, or foster home.

(f) Adolescent community therapeutic services shall provide:

(1) Assessment and service planning based on the DCYF case plan, pre-dispositional investigation report or treatment, and ongoing assessment for each child enrolled in the program;

(2) Strength based counseling and support that includes multiple contacts with the child and family, school, and work sites to monitor behavior and activities and provide instruction on job search and maintaining employment, as specified by the treatment plan;

(3) Crisis intervention available to the child and family to intervene, assess the safety of the environment, and prevent out of home placement;

(4) Family intervention, including supportive based counseling with the family to improve relationships and ease tension in the household;

(5) Ongoing assessments for health and safety, including drug screenings, curfew checks, school attendance, and intensive supervision;

(6) Health and safety education, to provide counseling and information on independent living and substance use, and encourage the child to make positive choices;

(7) Behavior management skills training to assist in developing and implementing behavior modification plans for the youth and family regarding discipline, stress, and conflict issues;

(8) Information regarding community resources and support that includes advocacy and outreach to assist children and families in learning how to access community resources and to develop the skills to use these services within the community and comply with court orders by:

a. Assisting the family and CPSW or JPPO in advocating for special education services when necessary to meet the conditions of the DCYF case plan, attending school meetings, team evaluations, and IEP meetings regarding the child’s school performance, and role modeling how to effectively communicate;

b. Providing information about community resources and services, and making referrals for needed services;

c. Coordinating transportation services for child and the family to enable participation in program activities; and

d. Consulting with attorneys as requested by the CPSW or JPPO and attending court hearings with the child; and

(9) Therapeutic recreational services, including individual or group activities appropriate to the age and needs of the child and designed to:

a. Develop healthy interests;

b. Enable the program staff to assess the child in a natural environment;

c. Teach adaptive ways to spend unstructured time;

d. Develop social skills and peer interaction skills;

e. Provide a positive outlet for aggressive energy; and

f. Build self-esteem.

(g) A provider of adolescent community therapeutic services shall:

(1) Schedule an intake meeting with the child, family, CPSW or JPPO, caseworker, and program supervisor within 24 hours for emergency referrals and within 5 working days of referral for non-emergency cases;

(2) Provide each family with a written description of services, as described in He-C 6339.14 including the cost of the service and potential reimbursement by the family to the state for services provided;

(3) Complete an initial assessment within 15 calendar days of the intake meeting, in conjunction with the child, family, and CPSW or JPPO, that includes:

a. An identification of the child’s strengths;

b. The child’s responsibilities for his or her behavior;

c. The supervision to be provided by the family;

d. The adolescent community therapeutic services to be provided; and

(4) Complete a written treatment plan at the end of 30 calendar days;

(5) Reassess the treatment plan and progress toward identified goals on a monthly basis, in consultation with the child, family, agency worker, and CPSW or JPPO to determine whether to continue services, the duration of services, and the purposes and goals;

(6) Provide multiple contacts, by telephone and a minimum of a one-hour face-to-face meeting each week with the child and family as prescribed by the DCYF case plan, which may include:

a. A weekend contact with the child;

b. School attendance checks in person or by telephone;

c. Job attendance checks in person or by telephone; and

d. Curfew checks;

(7) Provide assistance to the family in locating the youth in instances of failure to meet curfew or attend school or job;

(8) Provide assistance to the family with school suspension, supervision through frequent daily telephone contacts, additional face-to-face contacts, or in-office supervision if available;

(9) Submit copies of monthly progress reports to the CPSW or JPPO, the youth, and family; and

(10) Maintain records for each child to include:

a. Name of family, address, and telephone number;

b. Reasons for referral;

c. Initial assessment, which shall be completed following the intake meeting;

d. DCYF case plan, updated at monthly progress reviews;

e. Daily log of contacts and services to the child and family;

f. Incident reports that describe behaviors by the youth, with a copy submitted to the CPSW or JPPO;

g. Progress reports that contain a summary of contacts with the youth, family and others, any mutually agreed upon changes to the treatment plan, goals and objectives achieved by the child and family, and specific plans for next month; and

h. Other information, such as behavioral health and medical records.

(h) When a child or family is visited, the child and parent, if present, shall be required to sign the contact log, and the agency staff shall retain a copy of the log in the family’s file for review during the on-site visits.

(i) The agency shall document each family visit including;

(1) The type of service;

(2) The date of service;

(3) The names of the family members and other individuals who participated;

(4) The name of the staff who assisted the family;

(5) A brief summary of the in-home session;

(6) The length of time spent with the family; and

(7) The provision of the provider’s signature and the signature of a family member and the child, if age appropriate.

(j) A provider for adolescent community therapeutic services shall:

(1) Employ or contract with a prescribing practitioner;

(2) Employ a program supervisor who:

a. Possesses a master’s degree in social work or a related field and 2 years experience in social services; or

b. A bachelor’s degree in social sciences or a related field and 5 years experience including at least 2 years of previous supervisory experience;

(3) Employ adolescent therapeutic caseworkers who possess a bachelor’s degree in social sciences or a related field;

(4) Provide 20 hours per year of mandatory in-service training for adolescent therapeutic caseworkers including topics related to:

a. Family systems;

b. Substance use disorders;

c. Child abuse and neglect;

d. Labor and sex trafficking;

e. Sexual abuse;

f. Domestic and family violence;

g. Behavioral health

h. Safety planning for family members;

i. Crisis intervention techniques;

j. Early child hood screening and child development;

k. Trauma informed practice including evidence-based practices;

l. Treatment of any co-occurring disorders;

m. Behavioral management techniques; and

n. Infant safe sleeping practices;

(5) Maintain documentation of training, which includes:

a. The dates of training;

b. The titles of training topics; and

c. The number of hours per training;

(6) Have an adolescent therapeutic caseworker to child ratio of an average of no more than 1 to 7 with a maximum caseload not exceeding 1:9;

(7) Employ staff that provide evening, weekend, and holiday coverage to meet the needs of the family;

(8) Have on-call 24-hour availability for families;

(9) Provide a minimum of one hour per week of individual clinical supervision by the program supervisor with the adolescent therapeutic caseworker to review each case progress and barriers, for which one session per month may be substituted with group supervision; and

(10) Complete annual staff evaluations, with copies maintained in staff files.

(k) The prescribing practitioner serving as the program supervisor shall sign each treatment plan separately as both the prescribing practitioner and program consultant.

(l) The agency shall:

(1) Terminate services only after consultation and a mutual decision is reached with the child, family, and CPSW or JPPO, based on previously determined criteria in the treatment plan;

(2) Forward a termination notification to the CPSW or JPPO within one working day of any unplanned terminations;

(3) Abide by the following timeframes for planned terminations:

a. Continue services for no more than 5 days to allow for transition work if the child is placed with a family who provides foster care, a residential facility, or secure placement facility;

b. Continue services for no more than 2 business days, with CPSW or JPPO approval, when the child enters an emergency foster home, respite care, relative home, or shelter care;

c. Continue services for no more than 7 days for a child who has run away if the program continues to be actively involved with the family and the plan is for the youth to continue to live at home;

d. Suspend services if the child and family are on vacation or for other reasons are to be away for more than 7 days; and

e. If services continue for 7 days or less, services shall at a minimum include daily telephone contact with the child or family;

(4) Within 15 days after service termination, the agency shall forward to the CPSW, JPPO, or his or her supervisor a report that includes:

a. A summary of visits and contacts with the family including dates, duration, and locations;

b. A summary of the progress or lack of progress in meeting the treatment plan including the tasks accomplished, time frames, and measurable outcomes achieved;

c. New information about the family that changes or updates the DCYF case plan, pre-dispositional investigation report or court report;

d. The community resources and supports available to the family that might be accessed in the future;

e. Recommendations for ongoing services, including a description of additional progress by parents that is essential to address the needs of each child as specified in the treatment plan and how the provider has worked with the family to assist them in accessing recommended services;

f. The date and signature of the prescribing practitioner and adolescent therapeutic caseworker;

(5) If services are terminated prior to the 15^th day of the month, no monthly progress report shall not be required for the month. The information for the month in which services are terminated shall be included in a discharge report.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.20 Requirements for Individual Service Options (ISO) In-Home.

(a) The provider shall comply with sections He-C 6339.01 through He-C 6339.15 for certification compliance.

(b) Authorization for payment for individual service options in-home shall be pursuant to a court order, or a non-court ordered or voluntary agreement between DCYF and the family.

(d) Services for an additional 90 days per year shall be authorized when the following conditions are met:

(1) The family’s problems have not been resolved and the child remains at risk for out-of-home placement;

(2) The provider has discussed a continuation of services with family members and the CPSW or JPPO; and

(3) The provider submits the following information in writing to the CPSW or JPPO:

a. The reason(s) for continued services;

b. The beginning and ending dates for continued services;

c. The goals for the continued period of services; and

d. The anticipated child and family outcomes.

(e) The individual service option (ISO) in-home agencies shall:

(1) Promote family self-sufficiency and to connect families to supports in the community;

(2) Promote collaboration and communication with DCYF staff and other local service providers;

(3) Serve children in their home, foster or relative care provider, or home community;

(4) Provide or coordinate all of the services needed for the treatment of the child and family;

(5) Receive approval from DCYF prior to placing a child in a residential care facility for crisis stabilization; and

(6) Provide each family with a written description of services, as described in He-C 6339.14 including the cost of the service and potential reimbursement by the family to the state for services provided.

(f) Crisis stabilization in a residential care facility shall not exceed 10 days per year per child.

(g) Requests for waivers pursuant to He-C 6339.21 to the 10-day limit for residential crisis stabilization shall be submitted to the DCYF.

(h) ISO in-home services shall be provided to families with:

(1) Abused and neglected children, CHINS, and delinquent children; and

(2) Children between the age of birth to age 21, who might be experiencing one or more of the following:

a. Chronic mental, emotional, physical, or behavioral challenges;

b. Post-traumatic stress symptoms;

c. Mental health diagnosis(e);

d. Sexually reactive behaviors;

e. A history of traumatic experiences;

f. Unable to participate in local education program;

g. Require intensive supervision and consistent structure and might benefit from remaining home; or

h. Might need short-term, intensive residential care.

(i) A provider of ISO in-home services shall provide, purchase, or connect a family to services that include:

(1) Case management, treatment planning, and service coordination;

(2) Assessment and service planning based on the DCYF case plan or pre-dispositional investigation report and ongoing assessment for each child enrolled in the program;

(3) Individual, group, family, and substance use disorder counseling;

(4) In-Home services, including:

a. Home-base therapeutic services; and

b. Child health support;

(5) Support for children who are transitioning to a family setting;

(6) Emergency on-call 24-hour response to crises;

(7) Respite care in a licensed foster home;

(8) Crisis stabilization in a residential care facility with prior DCYF approval;

(9) Transportation;

(10) Assisting older children to transition to adult living situations;

(11) Identification of relatives, mentors, and others who will support or assist the child and family;

(12) Transitional assistance from DCYF to adult services;

(13) Coordination of medical, community mental health, and dental care;

(14) Coordination of public or private school education;

(15) Coordination of recreational activities;

(16) Coordination of substance use disorder evaluations and random drug testing; and

(17) Coordination of vocational services.

(j) The ISO in-home agency shall obtain a referral for services and its attachments.

(k) The ISO in-home agency shall assess each family member’s needs in the home within 30 days of referral based on:

(1) The DCYF case plan, pursuant to RSA 170-G:4 III and court report, pursuant to RSA 169-B:5-a, RSA 169-C:12-b, or RSA 169-D:4-a; or

(2) The investigation report pursuant to RSA 170-G:16, I or III, RSA 169-B:16, III-IV, or RSA 169-D:14, III-IV.

(l) The agency’s assessment shall include:

(1) Identification of the strengths and resources of the family;

(2) Identification of alcohol or substance use disorders, domestic or family violence, sexual abuse, or other situations that might impact the child’s safety;

(3) A review of previously completed evaluations and assessments, medical records, and psychological tests;

(4) A determination of immediate services needed by the family;

(5) Identification of community or relative resources available to the family; and

(6) A summary of treatment and service needs.

(m) The ISO in-home agency shall provide DCYF with monthly progress reports that include:

(1) The family’s name;

(2) The name of the person completing the report;

(3) The date of the report;

(4) Improvements that are being made towards specific goals;

(5) Summary of family contacts and progress made towards specific goals;

(6) Changes to the treatment plan;

(7) Educational updates; and

(8) Contacts with other professionals.

(n) Progress reports shall include the following about each child’s medical, dental, and behavioral health care:

(1) Prescriptions and current dosages;

(2) Over-the-counter medication;

(3) Dates of visits during the month being reported;

(4) New health care issues and diagnosis;

(5) Next scheduled visits; and

(6) Name of health care practitioner and office address.

(o) Progress reports shall be provided to the parents or guardians, unless contraindicated by a court order, or a request from DCYF.

(p) The ISO in-home agency shall keep records that include a case record on each child and his or her family that contains:

(1) The assessment used to develop the treatment plan;

(2) The signed ISO in-home treatment plan and its revisions;

(3) Weekly child and family progress notes;

(4) Documentation of therapeutic work with the family; and

(5) Monthly progress reports.

(q) When a child or family is visited, the child and parent, if present, shall be required to sign the contact log and the agency staff shall retain a copy of the log in the family’s file for review during the onsite visits.

(r) The agency shall document each family visit including:

(1) The type of service;

(2) The date of service;

(3) The names of the family members and other individuals who participated;

(4) The name of the therapist who assisted the family;

(5) A brief summary of the in-home session;

(6) The length of time spent with the family; and

(7) The provision of the provider’s signature and the signature of a family member and child.

(s) The ISO in-home agency shall:

(1) Employ or contract with a prescribing practitioner;

(2) Employ a program coordinator who meets the following:

a. A master’s degree in social work, psychology, education, or a related field with an emphasis in human services;

b. Two years clinical experience working with families, and

c. Two years supervisory or management experience;

(3) Therapists who have:

a. A master’s degree with a major in social work, counseling, psychology, or a related field and at least 2 years of direct work experience in assisting children and families; or

b. A bachelor’s degree with a major in social work, counseling, psychology or a related field and at least 5 years of direct work experience in assisting children and families; and

(4) Employ case managers who meet the following minimum qualifications:

a. A bachelor’s degree in social work, psychology, education or a related field with an emphasis in human services; and

b. Two years of experience with children and families.

(t) The prescribing practitioner may also serve as the program consultant as long as they sign each treatment plan separately as both the prescribing practitioner and program consultant.

(u) Therapist and case managers shall participate in weekly supervision that includes a discussion of each case and a review of the progress made by each family towards the goals of the treatment plan.

(v) Therapists and case managers shall complete a minimum of 20 hours of training per year that includes topics related to:

(1) Family systems;

(2) Substance use disorders;

(3) Child abuse and neglect;

(4) Labor and sex trafficking;

(5) Sexual abuse;

(6) Domestic and family violence;

(7) Behavioral health

(8) Safety planning for family members;

(9) Crisis intervention techniques; and

(10) Early child hood screening and child development;

(11) Trauma informed practice including evidence-based practices;

(12) Treatment of any co-occurring disorders;

(13) Behavioral management techniques; and

(14) Infant safe sleeping practices.

(w) The agency shall maintain documentation of training for therapist and case managers, which includes:

(1) The dates of training;

(2) The titles of training topics; and

(3) The number of hours per training.

(x) Up to 5 hours of documented supervision by a therapist may be applied towards the 20 hours of annual training requirement for therapists and case managers.

(y) The case manager’s average caseload shall not exceed an average of 6 families per month.

(z) The therapist’s maximum caseload shall not exceed an average of 10 families per month.

(aa) Within 15 days after service termination, the agency shall forward to the CPSW, JPPO, or his or her supervisor a report that includes:

(1) A summary of visits and contacts with the family including dates, duration, and locations;

(2) A summary of the progress or lack of progress in meeting the treatment plan including the tasks accomplished, timeframes, and measurable outcomes achieved;

(3) New information about the family that changes or updates the DCYF case plan, pre-dispositional investigation, or court report;

(4) The community resources and supports available to the family that might be accessed in the future;

(6) The date and signature of the prescribing practitioner and therapist.

(ab) If the services are terminated prior to the 15^th day of the month, no monthly progress report shall not be required for the month. The information for the month in which services are terminated shall be included in the discharge report.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.21 Waivers.

(a) Applicants or providers who request a waiver of a requirement in He-C 6339 shall submit a written request to the commissioner or his or her designee that includes the following information:

(1) The anticipated length of time the requested waiver will be needed;

(2) The reason for requesting the waiver;

(3) Assurance that if the waiver is granted the quality of service and care to children and families will not be affected;

(4) A written plan to achieve compliance with the rule or explaining how the provider will satisfy the intent of the rule, if the waiver is granted;

(5) How the service will be affected if the waiver is not granted;

(6) Evidence that the agency's board of directors has approved the waiver request, such as, minutes of the board meeting documenting that the request was approved or a signature of the board's president or chairman; and

(7) A statement that the rule for which a waiver is being requested is not related to compliance with the life safety code or environmental health and safety issues, unless approved in writing by the fire inspector, local health officer, or public health services.

(b) A waiver shall be granted if:

(1) The department concludes that authorizing deviation from compliance with the rule from which waiver is sought does not contradict the intent of the rule; and

(2) The alternative proposed ensures that the object or intent of the rule will be accomplished.

(c) When a waiver is approved, the applicant’s or provider’s subsequent compliance with the alternative approved in the waiver shall be considered equivalent to complying with the rule from which waiver was sought.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.22 Denial of Application and Revocation of Provider Certification. An application shall be denied or provider certification revoked if:

(a) DCYF determines that the state does not have a need for the service;

(b) The applicant or provider, or the individual acting on the applicant’s or provider’s behalf, submits materially false information to DCYF;

(d) There has been disciplinary action taken by a licensing body or professional society, a finding of civil liability made for professional misconduct, or a finding of an ethical violation made by a state or national professional association or any other state’s regulatory board;

(e) There has been revocation of membership on any hospital, medical, or allied health provider staff;

(f) There has been revocation of provider status with any group or health maintenance organization;

(g) There has been revocation of clinical privileges;

(h) There has been termination of academic appointment by an institution;

(i) There has been cancellation of professional or general liability insurance by the insurance company;

(j) There has been abusive or neglectful treatment of a child as determined by any state statute;

(k) There has been a failure to submit a completed, signed, and dated Form 2607 “Review of Continued Certification for In-home Community based Service Providers” (October 2016) within 30 days, pursuant to He-C 6339.05; or

(l) There has been failure to comply with He-C 6339.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.23 Notification of Denial or Revocation. If DCYF denies an application or revokes certification, a letter shall be sent to the applicant or provider by registered mail, which sets forth the reasons for the determination.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.24 Request for Certification Reconsideration.

(a) A request for certification reconsideration shall:

(1) Be filed within 30 days of the date of receipt of the letter sent by DCYF;

(2) Be submitted in writing; and

(3) Be filed with the director of DCYF.

(b) The DCYF director shall uphold or overturn the request.

(d) The applicant or provider may appeal the DCYF director’s decision pursuant to He-C 6339.25.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

He-C 6339.25 Appeals.

(a) Applicants or providers who wish to appeal a decision to deny an application or revoke or suspend certification shall file an appeal with the commissioner, pursuant to RSA 170-G:4-a.

(b) In accordance with RSA 170-G:4-a, the appeal shall:

(1) Be made in writing;

(2) Be signed and dated;

(3) State the reasons for the appeal pursuant to RSA 170-G:4-a; and

(4) Be filed within 14 working days of the date of receipt of written notification.

(c) Pursuant to RSA 170-G:4-a and He-C 200, the commissioner or designee and 2 members of the DCYF advisory board shall hear the appeal.

Source. (See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08; ss by #11180, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12136, eff 3-18-17

PART He-C 6340 CERTIFICATION PAYMENT STANDARDS FOR ADOPTIVE REPORT WRITING SERVICE PROVIDERS

Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:5

REVISION NOTE:

Document #9264, effective 9-20-08, adopted Part He-C 6340 relative to certification for payment standards for adoptive report writing service providers. This part incorporated provisions from the former Part He-C 6352 entitled “Certification for Payment Standards for Community-Based Service Providers” and made extensive changes to the wording, format, structure, and numbering of those provisions.

Document #9264 supersedes all prior filings in the former Part He-C 6352 relative to certification for payment standards for adoptive report writing service providers. The filings affecting the former Part He-C 6352 include the following documents:

#4446, eff 7-1-88

#5096, eff 3-15-91, EXPIRED 3-15-97

#7292, eff 5-24-00

#8009, eff 1-1-04

#9112, INTERIM, eff 3-24-08, EXPIRED 9-20-08

He-C 6340.01 Purpose. The purpose of this part is to identify the qualifications and performance requirements to become a provider of adoptive report writing services, which includes adoptive history reports and adoptive home study reports, for the division for children, youth and families (DCYF) as required by RSA 170-G:4 XVIII and RSA 170-B:18.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16

He-C 6340.02 Scope. This part shall apply to individuals or agencies that seek certification to receive financial reimbursement from the department of health and human services (DHHS) for the provision of adoptive report writing services.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16

He-C 6340.03 Definitions.

(a) “Adoptive report writing” means adoptive history reports and adoptive home study reports.

(b) “Adoptive history report” means the completion of a written case history, which includes social, medical, psychological and educational information about a child who might be adopted and the birth family.

(c) “Adoptive home study report” means the written report of an assessment into the conditions of the adoption petitioner as described in RSA 170-B:18, I for the purpose of ascertaining whether the adoptive home is a suitable home for the minor child and whether the proposed adoption is in the best interest of the minor child.

(d) “Applicant” means the person or entity that is requesting certification for payment as an adoptive report writing service provider.

(e) “Case plan” means the division for children, youth and families’ (DCYF) written plan for the child and the family which outlines how services will be provided, pursuant to RSA 170-G: 4 III, and 42 U.S.C. 671, PART E-Federal Payments for Foster Care and Adoption Assistance Section 471(a)(16), 475(1) and (5)(A) and (D) State Plan For Foster Care and Adoption Assistance. This term includes “placement plan.”

(f) “Certification for payment” means the process by which DCYF approves the qualifications of and reimbursement to providers of adoptive report writing services.

(g) “Child” means “child” as defined in RSA 170-E:25:I or “child” as defined in RSA 169-C:3 or “child” as defined by RSA 169-D:2.

(h) “Child protective service worker (CPSW)” means an employee of DCYF who is specially trained to work with families referred to the DCYF pursuant to RSA 169-C, RSA 170-B, RSA 170-C, and RSA 463.

(i) “Commissioner” means the commissioner of the New Hampshire department of health and human services, or his or her designee.

(j) “Conflict of interest” means any circumstance, situation, or financial interest which has the potential to cause a private interest to directly or indirectly affect, influence, or interfere with the performance of the duties of a provider or his or her employee as a provider for the Division for Children, Youth and Families.

(k) “Department” means the New Hampshire department of health and human services (DHHS).

(l) “Director” means the director of the division for children, youth, and families, or his or her designee.

(m) “Division for children, youth, and families (DCYF)” means the organizational unit of the department of health and human services that provides services to children and youth referred by courts pursuant to RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, and RSA 463.

(n) “Juvenile probation and parole officer (JPPO)” means an employee of DCYF who exercises the powers and duties as provided for in RSA 170-G: 16, and supervises paroled delinquents pursuant to RSA 170-H.

(o) “NH bridges” means the automated case management, information, tracking, and reimbursement system used by DCYF.

(p) “Provider” means the individual or agency that receives financial reimbursement from the department for adoptive report writing services.

(q) “Structured analysis family evaluation (SAFE)” means the copyrighted structured home study methodology and evidence based forms obtained through the Consortium for Children by providers who have been trained and certified in their use.

(r) “Service authorization” means the documentation provided by DCYF indicating the division’s responsibility for payment of community based services.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16

He-C 6340.04 Compliance Requirements.

(a) Providers shall comply with:

(1) The confidentiality statutes of RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:23, RSA 170-C:14, and RSA 170-G:8-a; and

(2) The child abuse and neglect reporting requirements of RSA 169-C:29-30.

(b) Providers and his or her employees shall not have a conflict of interest as defined in He-C 6340.03(i).

(1) Denial of an applicant pursuant to He-C 6340.16;

(2) Revocation of certification for payment of a provider pursuant to He-C 6340.16; or

(3) Denial of reimbursement.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16

He-C 6340.05 Application Process For Payment Standards For Adoptive Report Writing Services.

(a) Applicants who seek initial certification for payment for adoptive report writing services shall contact DCYF and request certification.

(b) The DCYF shall assess the need for services based on the following criteria:

(1) The number of children and families who require services exceeds the available community resources;

(2) A specialized service is necessary to meet the unique needs of children and families, and there are no currently certified providers who can provide the specialized services; and

(3) Any other case circumstance which requires the provision of services pursuant to a court order.

(c) If there is a need for a service based on (b) above, DCYF shall forward an application packet to the applicant which includes:

(1) Form 2608 “Application For Enrollment Of Adoptive Report Writing Providers”(November 2016);

(2) A “State of New Hampshire Alternate W-9 FORM”;

(3) A copy of He-C 6340; and

(4) A copy of Form 1790 “Adoptive History Part I and Part II” (March 2015, PD 15-04) .

(d) Each applicant shall complete the Form 2608 “Application for Enrollment of Adoptive Report Writing Providers” (November 2016) which includes:

(1) A statement indicating whether the applicant is currently listed in any child abuse and neglect state registry as having abused or neglected a child, and if so, the dates and reasons;

(2) A statement indicating whether the applicant has been convicted of a felony or any crime against a person and if so, the name of the court, the details of the offense, the date of conviction and the sentence imposed;

(3) An up to date resume or curriculum vitae;

(4) Names and addresses of 2 individuals who have known the applicant for at least one year and who can verify professional experience and expertise.

(e) The applicant shall sign and date the application.

(f) The applicant’s signature shall constitute an acceptance of the terms below:

(1) The provider has read and understands He-C 6340 and shall adhere to the rules as an enrolled provider;

(2) The information contained in the application is true and correct to the best of the applicant's knowledge; and

(3) The applicant agrees that DCYF has the authority to verify the information contained in the application.

(g) Within 30 calendar days of receipt, the applicant shall complete and return the following documents to DCYF:

(1) Form 2608 “Application for Enrollment of Adoptive Report Writing Providers” (November 2016);

(2) An up to date resume or curriculum vitae;

(3) If applying for certification as an adoptive home study report writer, verification of SAFE certification;

(4) If applying for certification as an adoptive home study report writer, a sample of an adoptive home study report written by the applicant; and

(5) The “State of New Hampshire Alternate W-9 FORM-”.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.08)

He-C 6340.06 Requirements for Adoptive History Reports.

(a) Providers for adoptive history reports who DHHS has identified as needed shall:

(1) Possess a bachelor’s degree and have 2 years of experience in writing reports for child protection services;

(2) Submit a current resume that lists education and experience at the time of application and at review of continued certification compliance;

(3) Submit names and phone numbers of 2 individuals who can verify professional experience and expertise, unless waived pursuant to He-C 6340.15;

(4) Have experience using computer hardware and software; and

(5) Participate in adoptive history report writing training provided by DCYF, unless waived pursuant to He-C 6340.15.

(b) A Form 1790 ”Adoptive History Part I and Part II” (March 2015, PD 15-04) shall be completed with information for the birth parents and the adoptive child when identified in the case file.

(1) Be responsible for all materials and supplies needed to write the report;

(2) Within 60 days of assignment, submit a paper copy and an electronic copy of the report to the CPSW or JPPO; and

(3) Maintain all case information confidential, pursuant to RSA 169-C:25.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.05)

He-C 6340.07 Requirements for Adoptive Home Study Reports.

(a) Providers for adoptive home study reports shall:

(1) Possess a bachelor’s degree and have 2 years of experience in writing reports for child protection services;

(2) Submit a resume that lists the required education and experience to DCYF at the time of application and at review of continued certification compliance;

(3) Be employed and supervised by a child placing agency operating pursuant to He-C 6448;

(4) Have experience using computer hardware and software;

(5) Possess a SAFE certification;

(6) Provide verification of the SAFE certification;

(7) Provide a statement signed and dated by the SAFE supervisor indicating that he or she agrees to supervise the individual applicant during the SAFE home study report writing process.

(b) Providers shall write an adoptive home study report in compliance with SAFE certification evidence based methodology, including at a minimum, the following information relating to:

(1) The adoptive parent(s);

(2) Other members of the household;

(3) Members of the extended family;

(4) Health and safety checks;

(5) The adoptive parent(s)’s motivation for adoption;

(6) The adoptive home and community;

(7) The adoptive parent applicant(s)’s profile;

(8) Adoptive family life style;

(9) Adoptive family legal and financial responsibilities;

(10) The 10 items of the psychosocial inventory:

a. History of the applicant(s);

b. Personal characteristics of the applicant(s);

c. History;

d. Marital or domestic partnership relationship;

e. Sons, daughters, and others residing in the adoptive home;

f. Extended family relationships;

g. Physical and social environment of the adoptive home;

h. General parenting;

i. Specialized parenting; and

j. Adoption or foster care issues; and

(11) Conclusions;

(12) Placement considerations; and

(13) SAFE adoption home study report recommendations.

(1) Be responsible for all materials and supplies needed to write the report;

(2) Within 60 days of assignment, submit a paper copy and an electronic copy of the report to the CPSW or JPPO; and

(3) Maintain all case information confidential pursuant to RSA 169-C:25.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16

He-C 6340.08 Preliminary Information Needed for Adoptive Report Writing Services.

(a) Providers shall provide adoptive history report writing only when they have the following information:

(1) Date of request;

(2) Name of DCYF staff member requesting the report, the district office, telephone number, and email;

(3) Names of the birth parents and child(ren);

(4) Reasons or need for referral, including presenting problems and history of involvement with DCYF, as applicable;

(5) Type of services requested;

(6) Dates and duration for requested services;

(7) Dates that reports are needed for court hearings; and

(8) Any data or information from the DCYF case plan or pre-dispositional investigation that is applicable to service provision.

(b) Providers shall provide adoptive home study report writing only when they have the following information:

(1) Date of request;

(2) Name of DCYF staff member requesting the report, the district office, telephone number, and email;

(3) Type of services requested;

(4) Date the completed report is needed;

(5) Name of prospective adoptive parents, address, telephone number, and email;

(6) The “Pre-Adoptive/Foster Care Financial Statement” Form 1728 (November, 2016), and the “SAFE Questionnaire 1 - Single Applicant” (2015) or “SAFE Questionnaire 1 - Couple Applicant” (2015) received from the prospective adoptive parents; and

(7) The ”Child’s Information Sheet” Form 2267 (January 2015), and “Child/Youth Matching Profile” Form 1784 (November 2016), and any additional information the CPSW has to share about the identified prospective adoptive child that is applicable to service provision.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.07)

He-C 6340.09 Compliance During Certification.

(a) Prior to the start of service delivery, a provider shall be certified and enrolled as a provider of adoptive report writing services.

(b) Providers shall provide services without discrimination as required by Title VI of the Civil Rights Act of 1964, as amended, and without discrimination on the basis of handicap as required by Section 504 of the Rehabilitation Act of 1973, as amended.

(c) The provider shall notify DCYF in writing within 10 days of any change in the information contained in the application and provide documentation of the change as applicable.

(d) The provider shall notify DCYF of any changes in tax information and complete and submit to DCYF a signed “State of New Hampshire Alternate W-9 Form” with current tax information.

(e) Providers shall submit to DCYF an audited financial statement prepared by an independent licensed public accountant, if requested.

(f) Continuance of certification shall be based on surveys of department staff utilizing the provider.

(g) The provider’s certification and enrollment shall terminate upon date of sale or transfer of ownership or close of the agency.

(h) Providers shall be subject to a review of continued certification compliance every 3 years from the date of issue.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.04)

He-C 6340.10 Billing Process for Adoptive Report Writing Services.

(a) “Service Authorization” Form 2110 (6/30/2008) shall be requested by the DCYF case manager.

(b) The provider shall submit to the department a completed ”Service Authorization” Form 2110 (6/30/2008) signed and dated by the provider and the authorized individual.

(c) Providers shall bill the department through NH Bridges via paper claims or electronic claims submission solely for actual hours worked.

(d) Providers shall access web account at least every 90 days or the account will be deactivated.

(e) Providers shall notify DCYF when a user no longer requires access to the application;

(f) All invoices and billing submitted shall:

(1) Be completed in accordance with He-C 6340.10;

(2) Be true and accurate;

(3) Be subject to recovery by DHHS if determined to be inaccurate or fraudulent; and

(4) If submitted via web-billing, shall be submitted with the provider’s agreement that:

a. The information obtained via the provider web-billing application remains confidential and is used solely for the purposes of administering DCYF services; and

b. The provider is responsible for his or her employee’s use of the provider web-billing application.

(g) For paper claim submission, a provider shall:

(1) Copy the “Service Authorization” Form 2110 (6/30/2008) for future billings if the authorized service dates span a date range;

(2) Forward the completed and signed “Service Authorization” Form 2110 (6/30/2008) to DHHS for adoptive history report which includes a certification that the service was provided as specified and that the service claimed is an original claim; and

(3) Attach an invoice with the provider’s original signature to the “Service Authorization” Form 2110 (6/30/2008) that details dates and the number of hours spent on the report.

(h) For electronic claims submission, a provider shall:

(1) Request a web billing account from DHHS by completing, signing, and submitting Form 2679 “Provider Web Billing User Account Request Form” (November 2016);

(2) Be issued a log on and a personal identification number (PIN) by DHHS for use in accessing the web billing account; and

(3) Select the recipient(s) and timeframe(s) for which they wish to submit claims from their list of approved service authorizations.

(i) The handwritten signature in (g) above or personal identification number (PIN) if web billing pursuant to (h) above shall be submitted to DHHS and shall certify that:

(1) The billing was completed in accordance with this section;

(2) The invoice includes only those hours for which services were provided;

(3) The billing is true and accurate;

(4) Any payment made for inaccurate or fraudulent billing will be recovered by DHHS;

(5) If web-billing, that information obtained via the provider web billing application is confidential and can be used solely for the purposes of administering DCYF services;

(6) The provider shall notify DCYF when a user no longer requires access to the application;

(7) The provider is responsible for their employee’s use of the provider web billing application; and

(8) The provider understands that he or she must access web account at least every 90 days or the account will be deactivated.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.12)

He-C 6340.11 Billing Period.

(a) Providers shall bill within one year of service provision.

(b) Any bill received for payment one year or more after service date shall be denied pursuant to RSA 126-A:3.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12069, eff 12-6-16 (from He-C 6340.13)

He-C 6340.12 Billing Discrepancies. Providers who have a billing discrepancy shall contact DCYF, bureau of administrative operations, provider relations staff for assistance.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.14)

He-C 6340.13 Record Retention.

(a) Providers shall retain records in a secure location for a period of not less than 7 years after the completion date of services provided, supporting each bill submitted to the department.

(b) Records shall be subject to random and retrospective review by DHHS to determine the presence and extent of billing errors.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.15)

He-C 6340.14 Quality Assurance Activities. Providers shall be subject to review by DCYF to determine the quality of services pursuant to RSA 170-G:4 XVIII, including a random, retrospective examination of adoptive history reports and adoptive home study reports.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.16)

He-C 6340.15 Waivers.

(a) Applicants or providers who request a waiver of a requirement in He-C 6340 shall submit a written request to the Administrator of Community and Family Support, which includes the following information:

(1) The rule number for which the waiver is being requested;

(2) The anticipated length of time the requested waiver will be needed;

(3) The reason for requesting the waiver;

(4) Assurance that if the waiver is granted the quality of services will not be affected;

(5) A written plan to achieve compliance with the rule or a written plan explaining how the provider will satisfy the intent of the rule, if the waiver is granted; and

(6) How the service will be affected if the waiver is not granted.

(b) A waiver shall be granted if:

(1) The department concludes that authorizing deviation from compliance with the rule from which waiver is sought does not contradict the intent of the rule; and

(2) The alternative proposed ensures that the object or intent of the rule will be accomplished.

(d) The applicant or provider shall be notified in writing by the department of the waiver decision.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.17)

He-C 6340.16 Denial of Application and Revocation of Certification.

(a) An application shall be denied or provider certification revoked if:

(1) DCYF or determines that the state does not have a need for the service;

(2) The applicant or provider, or the individual acting on the applicant’s or provider’s behalf, submits materially false information to DCYF;

(3) The provider has been convicted of a felony or any crime against a child;

(4) There has been abusive or neglectful treatment of a child as determined by any state statute; or

(5) There has been failure to comply with He-C 6340.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.18)

He-C 6340.17 Notification of Denial or Revocation. If DCYF denies an application or revokes certification, a letter shall be sent to the applicant or provider by registered mail, which sets forth the reasons for the determination.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (from He-C 6340.19)

He-C 6340.18 Request for Certification Reconsideration.

(a) A request for certification reconsideration shall:

(1) Be filed within 30 days of the date of receipt of the letter sent by DCYF described in He-C 6340.17;

(2) Be submitted in writing; and

(3) Be filed with the director of DCYF.

(b) The DCYF director shall uphold or overturn the request pursuant to He-C 6340.18.

(d) The applicant or provider may appeal the DCYF director’s decision pursuant to He-C 6340.19.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (formerly He-C 6340.20)

He-C 6340.19 Appeals.

(a) Applicants or providers who wish to appeal DCYF’s decision to deny or revoke certification shall file an appeal with the commissioner, pursuant to RSA 170-G:4-a.

(b) The appeal shall:

(1) Be made in writing;

(2) Be signed and dated;

(3) State the reasons for the appeal pursuant to RSA 170-G:4-a; and

(4) Be filed within 14 days of the date of written notification by the director of DCYF, pursuant to RSA 170-G:4-a.

(c) Pursuant to RSA 170-G:4-a and He-C 200, the commissioner or designee and 2 members of the DCYF advisory board shall hear the appeal.

Source. (See Revision Note at part heading for He-C 6340) #9264, eff 9-20-08; ss by #12059, eff 12-6-16 (formerly He-C 6340.21)

PART He-C 6341 CERTIFICATION PAYMENT STANDARDS FOR Communication Access SERVICE PROVIDERS

Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:5

REVISION NOTE:

Document #9392, effective 3-1-09, adopted Part He-C 6341 relative to certification payment standards for interpreter service providers. This part incorporated provisions from the former Part He-C 6352 entitled “Certification for Payment Standards for Community-Based Service Providers” and made extensive changes to the wording, format, structure, and numbering of those provisions.

Document #9392 supersedes all prior filings in the former Part He-C 6352 relative to certification payment standards for community-based behavioral health service providers. The filings affecting the former Part He-C 6352 include the following documents:

#4446, eff 7-1-88

#5096, eff 3-15-91, EXPIRED 3-15-97

#7292, eff 5-24-00

#8009, eff 1-1-04

#9112, INTERIM, eff 3-24-08, EXPIRED 9-20-08

He-C 6341.01 Purpose. The purpose of this part is to identify the qualifications and compliance requirements to become a provider of communication access services for the division for children, youth and families (DCYF) to meet the communication access needs of individuals who are deaf, have hearing loss, are blind, have vision loss, are deaf-blind, have speech disabilities, or have limited English proficiency (LEP) when the criteria for the department wide contract for communication access services requiring the presence of DHHS staff are not met.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18

He-C 6341.02 Scope. This part shall apply to individuals or agencies that seek certification to receive financial reimbursement from the department of health and human services (DHHS) for the provision of communication access services for DCYF related business that involves the child(ren) or family, and any other community-based agency or provider participating in the case.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18

He-C 6341.03 Definitions.

(a) “Agency” means the board of directors, executive director, and employees of an organization that is incorporated and recognized by the NH secretary of state or another state’s regulatory authority.

(b) “Applicant” means the person or entity that is requesting certification for payment as a communication access service provider.

(c) “Certification for payment” means the process by which DCYF approves the qualifications of and payment to providers of communication access services.

(d) “Child or minor” means an individual from birth through age 20, except as otherwise stated in a specific provision.

(e) “Child protective service worker (CPSW)” means an employee of the division for children, youth and families who has expertise in managing cases to ensure families and children achieve safety, permanency, and well-being.

(f) “Commissioner” means the commissioner of the department of health and human services or his or her designee.

(g) “Communication access services” means spoken language interpretation and translation services, American sign language (ASL), communication access real time (CART), and emerging technologies, such as video remote interpretation and other assistive technology services, to meet the communication needs of individuals who are deaf, have hearing loss, are blind, have vision loss, are deaf-blind, have speech disabilities, or have limited English proficiency (LEP).

(h) “Conflict of interest” means any situation, circumstance, or financial interest which has the potential to cause a provider’s private interest to directly or indirectly affect, influence, or interfere with the performance of his or her duties as a provider for the division for children, youth and families.

(i) “Deaf person” means “deaf person” as defined in RSA 521-A:1 II.

(j) “Department (DHHS)” means the department of health and human services.

(k) “Director” means the director of the division for children, youth, and families, or his or her designee.

(l) “Division for children, youth, and families (DCYF)” means the organizational unit of the department of health and human services that provides services to children and youth referred by courts pursuant to RSA 169-A, RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, RSA-170-H, and RSA 463.

(m) “Interpreter” means “interpreter” as defined in RSA 326-I:2, VI.

(n) “Juvenile probation and parole officer (JPPO)” means an employee of DCYF who discharges the powers and duties established by RSA 170-G:16, and supervises paroled delinquents pursuant to RSA 170-H.

(o) “Limited English Proficiency (LEP)” means individuals who have a limited ability to read, speak, write, or understand English.

(p) “NH bridges” means the automated case management, information, tracking, and reimbursement system used by the division for children, youth and families.

(q) “Provider” means the individual or agency that serves a child or family and receives financial reimbursement from the department.

(r) “Quality assurance” means the process that DCYF uses to monitor the quality and effectiveness of communication access services.

(s) “Service authorization” means the documentation provided by DCYF indicating the division’s responsibility for payment of community-based services for non-medicaid eligible children.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18

He-C 6341.04 Compliance Requirements.

(a) Providers shall comply with:

(1) All applicable licensing requirements from state licensing authorities prior to applying for certification;

(2) The confidentiality statutes of RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:23, RSA 170-C:14, and RSA 170-G:8-a;

(3) The child abuse and neglect reporting requirements of RSA 169-C:29-30;

(4) The billing requirements described in He-C 6341.10; and

(5) The billing process described in He-C 6341.11.

(b) Providers and any employees shall not have a conflict of interest, as defined in He-C 6341.03(g).

(d) Failure to comply with the rules of this chapter shall result in:

(1) Denial of an applicant pursuant to He-C 6341.17;

(2) Revocation of certification for payment of a provider pursuant to He-C 6341.17; or

(3) Denial of reimbursement pursuant to He-C 6341.18 (b).

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18

He-C 6341.05 Requirements for Communication Access Services for Individuals Who Are Deaf, Have Hearing Loss, or Are Deaf-Blind. A provider of communication access services for individuals who are deaf or have hearing loss shall:

(a) Demonstrate linguistic competency and proficiency in both English and another language/modality and the demonstrated ability to accurately relay information in both languages or modalities fluently;

(b) Be 18 years of age or older;

(c) Be licensed by the NH board of licensure of interpreters for the deaf and hard of hearing and approved under the NH department of education (DOE), pursuant to RSA 326-I, or any other state’s licensing authorities and maintain a current license or certification by the Registry of Interpreters for the Deaf, Inc.;

(d) Have the ability to interpret visually or tactilely for individuals who are deaf or have hearing loss including:

(1) American sign language;

(2) Certified deaf interpretation;

(3) Oral interpretation;

(4) Tactile interpretation for the deaf/blind;

(5) Cued speech interpretation; and

(6) Communication access real time services;

(e) Contact the CPSW or JPPO prior to service delivery to discuss confidentiality, case information, court dates, and court protocols;

(f) Keep all assignment-related information confidential;

(g) Have the ability to interpret the message impartially by conveying the content and intent of the message using language most readily understood by the person(s) whom they serve;

(h) Understand and acknowledge interpreter ethics and client confidentiality needs and abide by the code of professional ethics standards contained in Int 500;

(i) Provide services through a variety of methods of communication assistance, including:

(1) Face to face in person interpretation;

(2) In person communication access real time services;

(3) Remote communication access real time services; and

(4) Emerging technologies, such as video remote interpretation, as generally accepted in practice;

(j) Be a qualified note taker; and

(k) Have the ability to provide written materials or a printed script of stock speech.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18

He-C 6341.06 Requirements for Communication Access Services for Individuals Who Are Blind or Have Vision Loss.

(a) A provider of communication access for individuals who are blind, have vision loss, or are deaf-blind shall:

(1) Demonstrate linguistic competency and proficiency in both English and another language/modality and the demonstrated ability to accurately relay information in both languages or modalities fluently;

(2) Be at least 18 years of age;

(3) Have the ability to interpret for individuals who are blind, have vision loss, or are deaf-blind including:

a. Being a qualified reader, someone who is able to read effectively, accurately, and impartially, using any necessary specialized vocabulary; and

b. Providing information in large print, braille, or electronically for use with a computer screen-reading program, or an audio recording of the printed information;

(4) Contact the CPSW or JPPO prior to service delivery to discuss confidentiality, case information, court dates, and court protocols;

(5) Keep all assignment-related information confidential;

(6) Have the ability to interpret the message impartially by conveying the content and intent of the message using language most readily understood by the person(s) whom they serve; and

(7) Understand and acknowledge interpreter ethics and client confidentiality needs and abide by the code of professional ethics standards contained in Int 500.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18

He-C 6341.07 Requirements for Communication Access Services for Individuals Who Have Speech Disabilities.

(a) A provider of communication access for individuals who have speech disabilities shall:

(2) Be at least 18 years of age;

(3) Have the ability to interpret for individuals who have speech disabilities, including:

a. Being a qualified speech to speech transliterator, a person trained to recognize unclear speech and repeat it clearly;

(4) Contact the CPSW or JPPO prior to service delivery to discuss confidentiality, case information, court dates, and court protocols;

(5) Keep all assignment-related information confidential;

(6) Have the ability to interpret the message impartially by conveying the content and intent of the message using language most readily understood by the person(s) whom they serve; and

(7) Understand and acknowledge interpreter ethics and client confidentiality needs and abide by the code of professional ethics standards contained in Int 500.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18

He-C 6341.08 Requirements for Spoken (Foreign) Language Communication Access Services.

(a) A provider of spoken foreign language communication access services shall:

(1) Demonstrate linguistic competency and proficiency in both English and another language including passing scores for languages that have national examinations or certifications, along with sensitivity to the culture of individuals needing communication assistance with the demonstrated ability to accurately relay information in both languages, fluently;

(2) Be 18 years of age or older;

(3) Have successfully completed a minimum of 60 hours of a certified interpretation training program and, where possible, completed either medical interpretation and/or legal interpreter certificate training; and submit a resume that lists education and experience at the time of application;

(4) Submit names and addresses of 2 references who can verify professional experience and expertise;

(5) Have the ability to interpret orally or in writing linguistic information for those who speak a foreign language or have limited English proficiency;

(6) Contact the CPSW or JPPO prior to service delivery to discuss confidentiality, case information, court dates, and court protocol;

(7) Keep all assignment-related information confidential;

(8) Have the ability to interpret the message impartially by conveying the content and intent of the message using language most readily understood by the person(s) whom they serve;

(9) Understand and acknowledge interpreter ethics and client confidentiality needs, and abide by the code of professional ethics standards in Int 500 of the board; and

(10) Provide services through a variety of methods of communication assistance, including:

a. Face to face in person interpretation;

b. In person communication access real time services;

c. Remote communication access real time services; and

d. Emerging technologies, such as video remote interpretation, as generally accepted in practice.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18

He-C 6341.09 Application Process for Payment Standards for Communication Access Services.

(a) Applicants who seek initial certification for payment for communication access services shall contact a DCYF district office supervisor or designee and request to be referred for certification.

(b) The DCYF district office supervisor or DCYF community based services certification specialist shall assess the need for communication access services, based on the following criteria:

(1) The number of children and families who require services exceeds the available community resources;

(2) A specialized service is necessary to meet the unique needs of children and families, and there are no currently certified providers who can provide the specialized service; or

(3) Any other case circumstance which requires the provision of services pursuant to a court order.

(c) If there is a need for a service based in (b) above, DCYF shall forward an application packet to the applicant which includes:

(1) Form 2609 “Application for Certification and Enrollment of Communication Access Service Providers” (November 2018 Edition);

(2) A “State of New Hampshire Alternate W-9” (October 2016 Edition); and

(3) A copy of He-C 6341.

(d) Each individual or agency applicant shall complete, sign, date and submit Form 2069 “Application for Certification and Enrollment of Communication Access Service Providers” (November 2018 Edition), and provide the following:

(1) A copy of the individual applicant’s licenses to practice communication access services or for agency applicants, a master list that includes the name, type of license, and the date of license expiration for each staff member providing communication access services;

(2) A resume or curriculum vitae for each individual applicant, or if agency applicant, the executive director;

(3) A program brochure, if available;

(4) A completed, signed, and dated, “State of New Hampshire Alternate W-9” (October 2016 Edition); and

(5) For an individual applicant for foreign language communication access services, the names and addresses of 2 references who can verify professional experience and expertise.

(e) In addition to the information requested in (d) above, the applicant shall complete, sign, date, and submit Part F “Statement of Affirmation” of Form 2609 “Application for Certification Enrollment of Communication Access Service Providers” (November 2018 Edition), that states:

(1) I have reviewed Administrative Rule He-C 6341 and will adhere to the rules as an enrolled provider. I understand that DCYF has the right to verify information contained in this application; and

(2) I understand and agree that any individual or agency providing services with whom I employ or subcontract will have a current and valid license for the service being provided.

(f) In addition to the information requested in (c) and (d) above, an individual applicant and agency applicant staff member, who provides communication access services, shall complete, sign, date, and submit Part E “Information” of Form 2609 “Application for Certification Enrollment of Communication Access Service Providers” (November 2018 Edition), that states:

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18

He-C 6341.10 Review of Continued Certification Compliance.

(a) Each individual or agency applicant shall complete, sign, date, and submit Form 2609R “Application for Continued Certificate and Enrollment of Communication Access Service Providers” (November 2018 Edition) as provided by DCYF, within 30 days of receipt and provide the following:

(1) A copy of the individual applicant’s licenses to practice communication access services or for agency applicants, a master list that includes the name, type or license and the date of license expiration for each staff member providing communication access services; and

(2) A completed, signed, and dated “State of New Hampshire Alternate W-9” (October 2016 Edition).

(b) In addition to the information requested in (a) above, an individual applicant or agency applicant staff member who provides communication access services shall complete, sign, date, and submit Parts B, C, and D that includes the following declaration:

(c) In addition to the information requested in (a) and (b) above, the individual applicant or agency applicant shall complete, sign, date, and submit Part E “Statement of Affirmation” of Form 2609R “Application for Continued Certification Enrollment of Communication Access Service Providers” (November 2018 Edition), that states:

(d) Providers who fail to submit Form 2609R “Application for Continued Certification and Enrollment of Communication Access Service Providers” (November 2018 Edition) within 30 days of receipt shall have their certification revoked in accordance with He-C 6341.17 and be denied payment.

(e) Continuance of certification shall be based on a review and verification of the provider’s compliance with He-C 6341.

(f) Review of continued certification compliance shall occur every 3 years from the date of issue.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18 (formerly He-C 6341.08)

He-C 6341.11 Notification of Changes.

(a) Providers shall notify DCYF in writing within 10 days of any change in the information contained in the application or recertification and provide documentation of the change.

(b) At the time of expiration of mandatory state licenses, the provider shall submit a copy of the renewed license to DCYF within 10 days of receipt from the licensing authority.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18 (formerly He-C 6341.09)

He-C 6341.12 Billing and Rate Requirements for Communication Access Services.

(a) Providers shall be certified prior to the start of service delivery, as a provider of services to children and families.

(b) Providers shall not bill DCYF for services that are to be reimbursed by any other entity.

(c) Providers shall be reimbursed at a rate equivalent to the department’s current communication access contract or any subsequent contract that might be entered into by the department.

(d) The rates established pursuant to He-C 6341 are contingent upon the availability and continued appropriation of sufficient funds for this purpose, and in no event shall DCYF be liable for any payments hereunder in excess of such available and appropriated funds.

(e) Providers shall accept agreed upon payments made by DCYF as payments in full for the services it provides.

(f) DCYF shall determine the necessity of care and services and the determination shall be binding on the provider.

(g) Providers shall notify DCYF of any changes in tax information by submitting to DCYF a completed, signed, and dated “State of New Hampshire Alternate W-9” (October 2016 Edition)with current tax information.

(h) Providers shall provide services or care without discrimination as required by 42 U.S.C 2000d et. seq., as amended, and without discrimination on the basis of handicap as required by 29 U.S.C. 794, as amended.

(i) The agency provider’s certification shall terminate upon date of sale or transfer of ownership or close of the agency.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18 (formerly He-C 6341.10)

He-C 6341.13 Billing Process for Communication Access Services.

(a) Providers shall request Form 2110 “Service Authorization” (June 2008 Edition) from DCYF prior to service delivery.

(b) Services provided without Form 2110 “Service Authorization” (June 2008 Edition), shall not be paid.

(d) For paper claim submission, a provider shall:

(1) Copy Form 2110 “Service Authorization” (June 2008 Edition), for future billings if the authorized service dates span a date range;

(2) Forward the completed and signed Form 2110 “Service Authorization” (June 2008 Edition) to the department; and

(3) Attach an invoice to the Form 2110 “Service Authorization” (June 2008 Edition) that details dates and number of hours interpreting services were provided.

(e) For electronic claims submission, a provider shall:

(1) Request a web billing account from DHHS by submitting a completed, signed, and dated Form 2679 “Provider Web Billing User Account Request Form” (February 2017 Edition) that includes the following certification statements:

“I understand that provider billing requirements are governed by administrative rules (He-C 6339, He-C 6340, He-C 6348, He-C 6350, He-C 6914) which is incorporated herein by reference and I agree to abide by these requirements.”;

“I understand and agree that as a provider, I am responsible for any and all billing invoices submitted by me or on my behalf by my authorized representative, whether user is an employee authorized as a billing representative or authorized billing representative of a management service company.”;

“I understand and agree that any payments made which are based on inaccurate or fraudulent billing, whether submitted by me or by my authorized user will be recovered from me by DHHS.”;

“I understand and agree that it is my responsibility to notify the Division for Children, Youth, and Families by contacting Provider Relations when a user no longer required access to the web billing application.”;

“I understand that by submitting an invoice via the Provider Web Billing Application I am certifying that the invoice is true and accurate.”;

“I understand and agree that information obtained via the Provider Web Billing Application is confidential and can be used solely for the purposes of administering Division for Children, Youth, and Families (DCYF) Services.”;

“I understand and agree that I am responsible for my authorized representative, employee, and/or any management service company’s use of the Provider Web Billing Application.”; and

“I understand and agree that I must access my web account at least every ninety (90) days or my account will be de-activated.”; and

(2) Be issued a log in and personal identification number (PIN) by DHHS for use in accessing the web billing account.

(f) Neither the provider of any authorized representative shall transfer his or her log in or PIN or allow use of his or her log in or PIN by any other person.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18 (formerly He-C 6341.11)

He-C 6341.14 Billing Period.

(a) Providers shall bill within one year of service provision.

(b) Bills received for payment one year or more after the service date shall be denied pursuant to RSA 126-A:3.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18 (formerly He-C 6341.12)

He-C 6341.15 Billing Discrepancies. Questions regarding billing discrepancies shall be directed to the provider relations’ staff of the bureau of administrative operations in DCYF.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18 (formerly He-C 6341.13)

He-C 6341.16 Billing Record Retention. Providers shall retain records for a period of not less than 7 years after the completion date of services provided, supporting each bill submitted to the department.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18 (formerly He-C 6341.14)

He-C 6341.17 Quality Assurance Activities.

(a) Providers shall be subject to quality assurance reviews conducted by DCYF.

(b) Providers shall allow:

(1) Scheduled or unscheduled on-site visits by DCYF;

(2) Interviews with program staff; and

(3) A review of program documents to determine continued compliance with He-C 6341.

(c) Providers shall ensure records, including all billing records, are available for inspection and review by DCYF staff during any on-site quality assurance visit.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18 (formerly He-C 6341.15)

He-C 6341.18 Waivers.

(a) Applicants who request a waiver of a requirement in He-C 6341 shall submit a written request to the commissioner or his or her designee, which includes the following information:

(1) The reason for requesting the waiver;

(2) The anticipated length of time the requested waiver will be needed;

(3) Assurance that if the waiver is granted the quality of services to children youth and families will not be affected;

(4) A written plan to achieve compliance with the rule or explaining how the provider will satisfy the intent of the rule, if the waiver is granted;

(5) How the service will be affected if the waiver is not granted; and

(6) The signature of the person requesting the waiver.

(b) A waiver shall be granted if:

(1) The department concludes that authorizing deviation from compliance with the rule from which waiver is sought does not contradict the intent of the rule or conflict with statute; and

(2) The alternative proposed ensures that the object or intent of the rule will be accomplished.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18 (formerly He-C 6341.16)

He-C 6341.19 Denial of Application and Revocation of Certification; Denial of Reimbursement.

(a) An application shall be denied or provider certification revoked if:

(1) DCYF determines that the state does not have a need for the service;

(2) The applicant or the individual acting on the applicant’s or provider’s behalf, submits materially false information to DCYF;

(3) There has been a conviction for a felony or any crime by the applicant or provider against a child that has not been annulled or overturned;

(4) The applicant or provider knowingly retained an employee for whom there has been a conviction for a felony or any crime against a person;

(5) There has been abusive or neglectful treatment of a child by the applicant or provider as determined by any state statute;

(6) There has been disciplinary action taken by a licensing body or professional society, a finding of civil liability made for professional misconduct, or a finding of an ethical violation made by a state or national professional association or any other state’s regulatory board on the applicant or provider that has not been annulled or overturned;

(7) The applicant or provider has failed to submit a review form within 30 days; or

(8) The applicant or provider has failed to comply with He-C 6341.

(b) Reimbursement shall be denied to a provider if DCYF determines any of the conditions of He-C 6341.18 (a) (2) through (8) have occurred.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18 (formerly He-C 6341.17)

He-C 6341.20 Notification of Denial or Revocation.

(a) If DCYF denies an application for certification or revokes an existing certification, DCYF shall send notice of the denial or revocation to the applicant or provider by certified mail.

(b) The notice shall:

(1) Inform the applicant or provider of the facts or conduct upon which DCYF bases its action;

(2) Advise the applicant or provider of their right to request reconsideration of DCYF’s decision pursuant to He-C 6341.20; and

(3) In the case of an existing certification, inform the provider that the revocation shall not take effect until the provider has had an opportunity through an appeal, pursuant to RSA 170-G:4-a and He-C 6341.21, to show compliance with all lawful requirements for retention of the certification.

Source. (See Revision Note at part heading for He-C 6341) #9392, eff 3-1-09, EXPIRED: 3-1-17

New. #12535, INTERIM, eff 5-24-18, EXPIRED: 11-20-18

New. #12684, eff 11-30-18 (formerly He-C 6341.18)

He-C 6341.21 Request for Certification Reconsideration.

(a) A request for certification reconsideration shall:

(1) Be filed within 30 days of the date of receipt of the letter sent by DCYF;

(2) Be submitted in writing; and

(3) Be filed with the director of DCYF.

(b) The DCYF director shall grant or deny the request, pursuant to He-C 6341.18.

(d) The applicant or provider may appeal the DCYF director’s decision pursuant to He-C 6341.21.

Source. #12684, eff 11-30-18 (formerly He-C 6341.19)

He-C 6341.22 Appeals.

(a) Applicants or providers who wish to appeal DCYF’s decision shall file an appeal pursuant to RSA 170-G: 4-a with the commissioner.

(b) The appeal shall be:

(1) Made in writing and state the reasons for the appeal pursuant to RSA 170-G:4-a;

(2) Filed within 14 working days of the date of receipt of written notification; and

(3) Signed and dated.

(c) Pursuant to RSA 170-G:4-a and He-C 200, the commissioner or designee and 2 members of the DCYF advisory board shall hear the appeal.

Source. #12684, eff 11-30-18 (formerly He-C 6341.20)

PART He-C 6342 CERTIFICATION PAYMENT STANDARDS FOR CHILD IN HOME CARE SERVICE PROVIDERS - EXPIRED

Statutory Authority: RSA 170-G:4, XVIII; RSA 170-G:5

REVISION NOTE:

Document #9265, effective 9-20-08, adopted Part He-C 6342 relative to certification for payment standards for child in-home service providers. This part incorporated provisions from the former Part He-C 6352 entitled “Certification for Payment Standards for Community-Based Service Providers” and made extensive changes to the wording, format, structure, and numbering of those provisions.

Document #9265 supersedes all prior filings in the former Part He-C 6352 relative to certification for payment standards for child in-home service providers. The filings affecting the former Part He-C 6352 include the following documents:

#4446, eff 7-1-88

#5096, eff 3-15-91, EXPIRED 3-15-97

#7292, eff 5-24-00

#8009, eff 1-1-04

#9112, INTERIM, eff 3-24-08, EXPIRED 9-20-08

He-C 6342.01 – He-C 6342.17

Source. (See Revision Note at part heading for He-C 6342) #9265, eff 9-20-08, EXPIRED: 9-20-16

PART He-C 6343 CERTIFICATION PAYMENT STANDARDS FOR TRANSPORTATION SERVICE PROVIDERS

Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:5

REVISION NOTE:

Document #9390, effective 3-1-09, adopted Part He-C 6343 relative to certification payment standards for transportation service providers. This part incorporated provisions from the former Part He-C 6352 entitled “Certification for Payment Standards for Community-Based Service Providers” and made extensive changes to the wording, format, structure, and numbering of those provisions.

Document #9390 supersedes all prior filings in the former Part He-C 6352 relative to certification payment standards for community-based behavioral health service providers. The filings affecting the former Part He-C 6352 include the following documents:

#4446, eff 7-1-88

#5096, eff 3-15-91, EXPIRED 3-15-97

#7292, eff 5-24-00

#8009, eff 1-1-04

#9112, INTERIM, eff 3-24-08, EXPIRED 9-20-08

He-C 6343.01 Purpose. The purpose of this part is to identify the qualifications and performance requirements to become a provider of community based transportation services for the division for children, youth and families (DCYF) and describe transportation services that assist children and families in remedying abusive, neglectful, delinquent, and child in need of services (CHINS) behaviors.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19

He-C 6343.02 Scope. This part shall apply to community based transportation service providers who receive financial reimbursement from the DCYF for services provided to children and families.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19

He-C 6343.03 Definitions.

(a) “Accompanied transportation services” means transportation of children and approved adults to and from appointments or educational programs as approved by the child’s local education agency.

(b) “Agency” means the board of directors, executive director, and employees of an organization that is incorporated and recognized by the NH secretary of state or by another state.

(c) “Applicant” means the person or entity that is requesting certification for payment as a transportation service provider.

(d) “Caregiver” means an individual who is providing care for the child(ren).

(e) “Certification for payment” means the process by which DCYF approves the qualifications of, and payment to providers of transportation services.

(f) “Child or minor” means an individual from birth through age 20, except as otherwise stated in a specific provision.

(g) “Child protective service worker (CPSW)” means an employee of DCYF who has expertise in managing child protection cases to ensure families and children achieve safety, permanency and well-being.

(h) “Child in need of services (CHINS)” means “child in need of services” as defined by RSA 169-D:2, II.

(i) “Commissioner” means the commissioner of the department of health and human services or his or her designee.

(j) “Conflict of interest” means any situation, circumstance, or financial interest, which has the potential to cause a provider’s private interest to directly or indirectly affect, influence, or interfere with the performance of his or her duties as a provider for DCYF.

(k) “Department” means the department of health and human services.

(l) “Destination provider” means the individual, social service agency, or other family support service provider that a child is being transported to or returning from.

(m) “Director” means the director of DCYF or his or her designee.

(n) “Division for children, youth, and families (DCYF)” means the organizational unit of the department of health and human services that provides services to children and youth referred by courts pursuant to RSA 169-A, RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, RSA 170-H and RSA 463.

(o) “Educational transportation service” means the transportation of children from their residence or other setting to their school placement and back to their residence or other setting as approved by DCYF.

(p) “Foster Care” means the supervised 24-hour substitute care of a child placed away from their parent or legal guardian for whom the State has placement and care responsibility. This includes family foster homes, relative homes, pre-adoptive homes, shelters, and residential facilities.

(q) “Juvenile probation and parole officer (JPPO)” means an employee of DCYF who discharges the powers and duties established by RSA 170-G:16, and supervises paroled delinquents pursuant to RSA 170-H.

(r) “Medically necessary” means reasonably calculated to prevent, diagnose, correct, cure, alleviate, or prevent the worsening of conditions that endanger life, cause pain, result in illness or infirmity, threaten to cause or aggravate a handicap, or cause physical deformity or malfunction, and no other equally effective course of treatment is available or suitable.

(s) “NH bridges” means the automated case management, information, tracking, and reimbursement system used by DCYF.

(t) “Outcome” means the intended result or consequence that occurs from carrying out a program or activity.

(u) “Performance indicators” means the utilization of data measurements to gauge program or activity performance.

(v) “Private vehicle transportation services” means transportation of children and families to and from non-medicaid support services via a provider’s own vehicle.

(w) “Provider” means the individual or agency that serves a child or family and receives financial reimbursement from the department.

(x) “Public transportation services” means transportation services arranged through a travel agency to children and families to and from support services.

(y) “Quality assurance” means the process that DCYF use to monitor the quality and effectiveness of community-based transportation services.

(z) “Relative care” means the placement of a child, who has a legal relationship with DCYF, in a home in which one of the responsible caregivers is a person related to the child.

(aa) “Secure transportation services” means transportation of children in law enforcement vehicles, who are considered to be at risk of flight from custody, present significant behavior management issues, or exhibit harmful behaviors toward themselves or others, and who require physical restraint while being transported.

(ab) “Service authorization” means the documentation provided by DCYF indicating the division’s responsibility for payment of community-based services.

(ac) “Service reports” means a written report that includes demographic and performance indicators.

(ad) “Support services” means services that assist families in remedying the circumstances attributed to abuse and neglect, delinquency, and CHINS behaviors.

(ae) “Transport aide” means an individual age 21 or older, employed by an accompanied transportation service provider who accompanies a child, and approved adult(s), to and from appointments and remains on-site with child during the appointment.

(af) “Travel Agency” means an agency engaged in selling and arranging transportation, accommodations, tours, and trips for travelers.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19

He-C 6343.04 Requirements for Accompanied Transportation Services.

(a) Accompanied transportation service providers shall:

(1) Be an enrolled NH medicaid provider;

(2) Be an agency, not an individual;

(3) Employ a program coordinator who shall:

a. Have a bachelor’s degree in a social services discipline or related field or 5 years’ experience in providing direct service to families;

b. Have one year of experience in a supervisory capacity, as confirmed by a copy of a resume;

c. Recruit, hire, train, and supervise the transport aides;

d. Receive referrals from DCYF;

e. Assign transport aides to provide transportation services;

f. Communicate service changes to staff, as needed;

g. Conduct program staff meetings at least monthly with each aide to review the status of referrals and transportation activities, and to address any problems or barriers;

h. Report any concerns or difficulties immediately to CPSW and JPPO;

i. Be available 5 days a week during DCYF business hours; and

j. Have a pool of available transport aides who are available 7 days a week to provide services at times that best serve children and families;

(4) Have a written plan for providing services when a transport aide cannot provide the scheduled service;

(5) Employ transport aides who shall:

a. Be at least 21 years of age;

b. Have at minimum, a high school diploma or equivalency;

c. Possess a valid driver’s license;

d. Provide proof that their vehicle is registered in accordance with RSA 261:40 and inspected in accordance with RSA 266:1;

e. Provide proof of current automobile liability insurance that includes coverage for accidental injury and death, and coverage for the transporting of another;

f. Have no convictions for impaired driving or multiple motor vehicle violations;

g. Have no conviction for a felony or crime against persons;

h. Have no founded cases of child abuse or neglect;

i. Not drive under the influence of alcohol or drugs pursuant to RSA 265-A;

j. Submit to yearly drug and alcohol testing as determined by the program coordinator except for newly hired transport aides who shall be tested within 6 months from date of hire then yearly thereafter;

k. Not provide service in excess of 12 hours in a 24 hour period; and

l. Not be related to any service recipient or any member of the service recipients family for whom they provide the service;

(6) The provider shall maintain a copy of the following for each transportation aide in the aide’s personnel file:

a. Current driver’s license;

b. Automobile liability insurance;

b. Motor vehicle record;

c. Criminal record report; and

d. Central registry check.

(7) Have written personnel policies which are available for inspection at the time of a quality assurance review as described in He-C 6343.21;

(8) Conduct and document annual staff performance evaluations and training logs making them available for inspection at the time of a quality assurance review;

(9) Have a written policy in place regarding missed appointments by client families which includes notifying the CPSW or JPPO immediately, followed by a written report within 24 hours, when a parent or child fails to show up for a scheduled transport;

(10) Maintain records available for inspection during quality assurance reviews, as described in He-C 6343.20;

(11) Provide transport aides with a written itinerary for each trip that includes but is not limited to:

a. The name of the child and the caregiver;

b. The name of the driver who is picking up the child;

c. The name of the driver who is returning the child, if different from the pick-up driver;

d. The date, time, and pick up location;

e. The destination;

f. The destination provider;

g. The time of the scheduled appointment or visit;

h. The estimated time of return to the child’s caregiver; and

i. A field for the signature of the caregiver upon pick up;

(12) Review with the transport aide, prior to beginning work with children and annually thereafter, RSA 169-C, specifically sections on definitions, immunity from liability, and persons required to report, for all employees and volunteers, who have access to children, prior to beginning their work with children;

(13) Provide transport aides with:

a. Ten hours of training during their first 6 months of employment which includes training relating to accepted transportation practices, personal safety, child safety, and behavior management; and

b. Fifteen hours of training annually that includes topics relating to accepted transportation practices, personal safety, child safety, cultural sensitivity, behavior management, safe driving education, and indicators of child abuse and neglect;

(14) Maintain training records that include trainer signed certificates or letters of attendance that specify dates, hours, and training topics that are available at the time of quality assurance reviews or monitoring; and

(15) Notify DCYF within 24 hours of any transportation aide’s motor vehicle infraction or arrest that would result in the inability to lawfully operate a vehicle in NH.

(b) The transport aide, referenced in (a)(5) above, shall:

(1) Have a means of communication so appointments can be scheduled or canceled;

(2) Carry and present identification to the child’s caregiver and to destination providers;

(3) Not be responsible for transferring information between a child’s parent or caregiver and the service provider, CPSW, JPPO, or parent being visited;

(4) Maintain professional behavior while transporting children;

(5) During vehicle operation:

a. Comply with RSA 263 regarding drivers and licenses;

b. Comply with RSA 265:107-a regarding child passenger restraints required during vehicle operation; and

c. Ensure that all vehicle occupants use safety restraints pursuant to RSA 265:107-a and that passengers under the age of 12 are secured in the back seat of the vehicle;

(6) Notify the CPSW or JPPO immediately, followed by a written report within 24 hours, of any injury that occurs during a trip or visit, such as a traffic accident or if the youth was assaultive or attempted to run away; and

(7) Maintain a file on each child served which includes:

a. Referral information about the child;

b. Transport logs with the name of the transport aide and driver;

c. Log of service provision including service dates, pick up and return locations, the signature of the caregiver, or destination provider, mileage, highway tolls, and parking fees, for billing substantiation;

d. Copies of required reports to be submitted to DCYF;

e. Billing records; and

f. Family related information and correspondence for other providers.

(1) Be registered with the secretary of state prior to applying for certification;

(2) Comply with the medical assistance requirements of He-W 500 and He-M 426;

(3) Comply with the confidentiality statutes of RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:23, RSA 170-C:14, and RSA 170-G:8-a; and

(4) Comply with the child abuse and neglect reporting requirements of RSA 169-C:29-30.

(d) The provider and his or her employees shall not have a conflict of interest as defined in He-C 6343.03(j).

(e) The provider shall maintain liability insurance.

(f) Failure to comply with the rules of this chapter shall result in:

(1) Denial of an applicant pursuant to He-C 6343.24;

(2) Revocation of certification for payment of a provider pursuant to He-C 6343.24; or

(3) Denial of reimbursement.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19

He-C 6343.05 Requirements for Educational Transportation Services.

(a) Educational transportation service providers shall:

(1) Be approved by the child’s local education agency;

(2) Have an exemption as a licensed foster parent pursuant to He-C 6347;

(3) For agencies, be certified as an accompanied transportation service provider according to He-C 6343.04; or

(4) Be certified for private vehicle transportation services according to He-C 6343.06.

(b) Individual applicants for educational transportation services approved by a child’s local education agency shall;

(1) Complete and submit to the department Form 2615 “Application for Certification and Enrollment of Private Vehicle or Educational Transportation Service Providers” (January 2019) and include documentation of approval by a local education agency to DCYF; and

(2) Include an updated approval from the local education agency annually after the original application; and

(3) Comply with the provisions of He-C 6343.06 and He-C 6343.11.

(1) Provide notification of foster care licensing to the DCYF community-based services specialist;

(2) Maintain foster care licensing according to He-C 6347 to maintain certification for educational transportation services; and

(3) Comply with the provisions of He-C 6343.06 and He-C 6343.11.

(d) Agency applicants for educational transportation services certified as accompanied transportation providers shall comply with the provisions of He-C 6343.04 and He-C 6343.09.

(e) Applicants for educational transportation services certified as private vehicle transportation providers shall comply with the provisions of He-C 6343.06 and He-C 6343.11.

(f) Failure to comply with the rules of this chapter shall result in:

(1) Denial of an applicant pursuant to He-C 6343.24; or

(2) Revocation of certification for payment for an existing provider pursuant to He-C 6343.24.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19

He-C 6343.06 Requirements for Private Vehicle Transportation Services.

(a) An individual who provides transportation services, including individuals who provide foster and relative care, via his or her own vehicle shall:

(1) Possess a valid driver’s license;

(2) Maintain automobile insurance liability coverage for the transportation of others;

(3) Have no conviction for impaired driving or multiple motor vehicle violations;

(4) Not drive under the influence of alcohol or drugs pursuant to RSA 265-A;

(5) During vehicle operation, ensure that all vehicle occupants use safety restraints pursuant to RSA 265:107-a and that passengers under the age of 12 are secured in the back seat of the vehicle;

(6) Submit documentation to DCYF for He-C 6343.06 (a)(1) through (3) above, which shall include copies of driver’s licenses, automobile liability insurance policies, and motor vehicle records as well as a completed NH department of safety, division of state police Form DSSP 256 “Criminal History Record Information Release Authorization Form”, and a completed and notarized Form 2503, “DCYF Central Registry Name Search Authorization” at the time of application and re-certification;

(7) Comply with:

a. Licensing requirements pursuant to RSA 263, and registration requirements pursuant to RSA 261, prior to applying for certification;

b. The medical assistance requirements of He-W 500 and He-M 426;

c. The confidentiality statutes of RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:23, RSA 170-C:14, and RSA 170-G:8-a;

d. The child abuse and neglect reporting requirements of RSA 169-C:29-30; and

e. RSA 265:107-a, child passenger restraints required;

(8) Review RSA169-C, specifically sections on definitions, immunity from liability, and persons required to report for all employees and volunteers, who have access to children prior to beginning their work with children and annually thereafter;

(9) Not have a conflict of interest as defined in He-C 6343.03(j);

(10) Maintain a log of service provision including service dates, pick up and return locations, the signature of the provider, or destination provider, mileage, highway tolls, and parking fees for billing substantiation; and

(11) Be at least 18 years old.

(b) Private vehicle transportation service providers shall not be reimbursed for transporting his or her own children or other household family members not associated with the DCYF case.

(c) Private vehicle transportation service providers shall notify DCYF within 24 hours of any motor vehicle infraction or arrest that would result in the inability to lawfully operate a vehicle in NH.

(d) Failure to comply with the rules of this chapter shall result in:

(1) Denial of an applicant pursuant to He-C 6343.24;

(2) Revocation of certification for payment of a provider pursuant to He-C 6343.24; or

(3) Denial of reimbursement.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.07)

He-C 6343.07 Requirements for Public Transportation Services.

(a) Travel agencies who arrange public transportation services shall:

(1) Be registered with the NH secretary of state and submit proof of such to DCYF; and

(2) Comply with licensing and registration requirements prior to applying for certification if applicable.

(b) Failure to comply with the rules of this chapter shall result in:

(1) Denial of an applicant pursuant to He-C 6343.24;

(2) Revocation of certification for payment of a provider pursuant to He-C 6343.24; or

(3) Denial of reimbursement.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.08)

He-C 6343.08 Requirements for Secure Transportation Services.

(a) Secure transportation services shall be provided for children who:

(1) Are before the court as runaways, escapees, or absconders pursuant to the interstate compact on juveniles, RSA 169-A;

(2) Are before the court adjudicated as delinquent children pursuant to RSA 169-B;

(3) Are before the court adjudicated as children in need of services pursuant to RSA 169-D;

(4) Are considered to be at risk of flight from custody;

(5) Exhibit safety concerns regarding themselves or others; or

(6) Require physical restraint while being transported, as applicable.

(b) Providers of secure transportation services shall:

(1) Use law enforcement personnel to transport children;

(2) Maintain custody of court-transported children until the court releases custody of the child from law enforcement or are otherwise relieved by court security or other authorized personnel;

(3) Use only trained officers who are certified by the NH police standards and training council;

(4) Maintain a copy of certification by the NH police standards and training council in the provider’s personnel file, which shall be available for review at the time of an on-site quality assurance monitoring visit;

(5) Use only county or municipal law enforcement department secure vehicles assigned by that department for the secure transportation of juveniles; and

(6) Maintain records to substantiate billing which shall be available for inspection and include:

a. A log of transports;

b. Pick up location, destination, time, and date;

c. Name of officer transporting;

d. Name of JPPO;

e. Name of child transported;

f. Mileage; and

g. Any incidents that occurred such as, traffic accidents, if the youth was assaultive or attempted to run away.

(1) Denial of an applicant pursuant to He-C 6343.24; or

(2) Revocation of certification for payment for an existing provider pursuant to He-C 6343.24.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.09)

He-C 6343.09 Application Process For Payment Standards For Accompanied Transportation Services.

(a) Applicants who seek initial certification for payment standards for accompanied transportation services shall contact a DCYF district office supervisor or designee and request to be referred for certification.

(b) The DCYF district office supervisor or DCYF community, family, and program support certification specialist shall assess the need for services, based on the following criteria:

(1) The number of children and families who require services exceeds the available community resources;

(2) A specialized service is necessary to meet the unique needs of children and families, and there are no currently certified providers who can provide the specialized service; or

(3) Any other case circumstance which requires the provision of services pursuant to a court order.

(c) If there is a need for a service based on (b) above, DCYF shall forward an application packet to the applicant which includes:

(1) Form 2614 “Application for Certification and Enrollment of Accompanied or Agency Educational Transportation Service Providers” (March2019)”;

(2) A “State of New Hampshire Alternate W-9” (October 2016); and

(3) A copy of He-C 6343.

(d) Each applicant shall complete and submit Form 2614“Application for Certification and Enrollment of Accompanied or Agency Educational Transportation Service Providers” (March 2019) to DCYF within 30 days of receipt, together with all the attachments in He-C 6343.09(c).

(e) Each agency staff member listed in Part C: “Agency Staff” shall sign and date Part D: “Staff Information” of Form 2614 “Application for Certification and Enrollment of Accompanied or Agency Educational Transportation Service Providers” (March 2019) certifying the following:

(f) Each Part D: “Agency Staff” of Form 2614 “Application for Certification and Enrollment of Accompanied or Agency Educational Transportation Service Providers” (March 2019) shall be signed and dated by the executive director or designee, certifying the following:

“I certify that a:

Current criminal records check for this individual is completed and on file at the agency;

Current copy of the individual’s Department of Motor Vehicle Report is on file at the agency;

Current copy of the individual’s driver’s insurance is on file at the agency.”

(g) Each applicant shall sign and date Part F: “Authorization/Statement of Understanding” as part of Form 2614 “Application for Certification and Enrollment of Accompanied or Agency Educational Transportation Service Providers” (March 2019) certifying the following:

“I have reviewed the Administrative Rules He-C 6343 and will adhere to the rules as a certified provider. I authorize the NH Division for Children, Youth and Families (DCYF) to conduct a certification for payment review to determine the program’s compliance with Administrative Rules He-C 6343. I further understand that DCYF has the right to verify information contained in this application. The information contained in this application is correct to the best of my knowledge. I acknowledge that the provision of false information in the application is a basis for denial of the application.”

(h) In addition to the requirements in (c)-(g) above, applicants shall submit the following:

(1) A resume or curriculum vitae for the program coordinator;

(2) A copy of the agency’s organizational structure;

(3) A copy of their budget;

(4) A program brochure, if available;

(5) A statement indicating whether the applicant or any direct service staff:

a. Has ever had their automobile or general liability insurance canceled;

b. Has ever been convicted of a felony or any crime against a person and if so, the name of the court, the details of the offense, the date of conviction and the sentence imposed;

c. Has ever been subject to disciplinary action by a licensing body or professional society, been found civilly liable for professional misconduct, or found to have committed an ethical violation by a state or national professional association or any other state’s regulatory board, and if so, the name of the licensing body or professional society, the reasons, dates, and results; and

d. Is currently listed in any child abuse and neglect state registry as having abused or neglected a child, and if so, the dates and reasons;

(6) A written description of the agency’s no show and cancellation policy;

(7) A written description of the agency’s quality assurance plan including the method of handling client complaints;

(8) The agency’s record keeping and confidentiality policies;

(9) Description of what is provided to the transportation aides for agency identification; and

(10) A written description of services that includes the cost of the service and the parent’s obligation to repay a portion of the service provision.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.10)

He-C 6343.10 Application Process For Payment Standards For Educational Transportation Services.

(a) Applicants who seek initial certification for the provision of educational transportation services shall contact a DCYF district office supervisor or designee and request to be referred for certification.

(b) The DCYF district office supervisor or DCYF community, family, and program support certification specialist shall assess the need for services, based on the following criteria:

(1) The number of children and families who require services exceeds the available community resources;

(2) A specialized service is necessary to meet the unique needs of children and families, and there are no currently certified providers who can provide the specialized service; or

(3) Any other case circumstance which requires the provision of services pursuant to a court order.

(1) Verify existing documentation and certification(s) for applicants asserting they meet one of the requirements of He-C 6343.05(a);

(2) Follow the provisions of He-C 6343.11 for applicants meeting the requirements of 6343.05(a)(1), (2) or (4); or

(3) Follow the provisions of He-C 6343.09 for applicants meeting the requirements of 6343.05(a)(3).

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.11)

He-C 6343.11 Application Process For Payment Standards For Private Vehicle Transportation Services.

(a) Individual applicants who seek initial certification for the provision of private transportation services shall contact a DCYF district office supervisor or designee and request to be referred for certification.

(b) The DCYF district office supervisor or DCYF community, family, and program support certification specialist shall assess the need for services, based on the following criteria:

(1) The number of children and families who require services exceeds the available community resources;

(2) A specialized service is necessary to meet the unique needs of children and families, and there are no currently certified providers who can provide the specialized service; or

(3) Any other case circumstance which requires the provision of services pursuant to a court order.

(c) If there is a need for a service based on (b) above, DCYF shall forward an application packet to the applicant which includes:

(1) Form 2615 “Application for Certification and Enrollment of Private Vehicle or Educational Transportation Service Providers”;

(2) A “State of New Hampshire Alternate W-9”;

(3) A NH department of safety, division of state police Form DSSP 256 “Criminal History Record Information Release Authorization Form” for the provider unless the provider is a licensed foster care provider;

(4) A Form 2503 “DCYF Central Registry Name Search Authorization” for the provider unless the provider is a licensed foster care provider; and

(5) A copy of He-C 6343.

(d) Each applicant shall complete and submit Form 2615 “Application for Certification and Enrollment of Private Vehicle or Educational Transportation Service Providers” (March 2019) to DCYF within 30 days of receipt, together with all the attachments in He-C 6343.11(g).

(e) Each applicant shall sign and date Part C: “Applicant Information” of Form 2615 “Application for Certification and Enrollment of Private Vehicle or Educational Transportation Service Providers” (March 2019) certifying the following:

(f) Each applicant shall sign and date Part D: “Authorization/Statement of Understanding” of Form 2615 “Application for Certification and Enrollment of Private Vehicle or Educational Transportation Service Providers” (March 2019) certifying the following:

“I have reviewed the Administrative Rule He-C 6343, Certification for Payment Standards for Transportation Service Providers and will adhere to the rules as a certified provider. I authorize the NH Division for Children, Youth and Families (DCYF) to conduct a certification for payment review to determine the program’s compliance with Administrative Rule He-C 6343, Certification for Payment Standards for Transportation Service Providers. I further understand that DCYF has the right to verify information contained in this application.

The information contained in this application is correct to the best of my knowledge. I acknowledge that the provision of false information in the application is a basis for denial of the application.”

(g) Each applicant shall submit the following with Form 2615 “Application for Certification and Enrollment of Private Vehicle or Educational Transportation Service Providers” (March 2019):

(1) A completed “State of New Hampshire Alternate W-9” (October 2016);

(2) A completed and notarized Form 2503 “DCYF Central Registry Name Search Authorization”, (February 2017) or Authorization for DCYF to obtain. This will not be required if the applicant is currently licensed as a foster care provider under He-C 6347;

(3) A completed NH department of safety, division of state police DSSP 256 “Criminal History Record Information Release Authorization Form” This will not be required if the applicant is currently licensed as a foster care provider under He-C 6347; and

(4) A copy of the provider’s motor vehicle record from the NH department of safety, division of motor vehicles.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.13)

He-C 6343.12 Application Process For Payment Standards For Public Transportation Services.

(a) Applicants who seek initial certification for payment standards for public transportation services shall contact a DCYF district office supervisor or designee and request to be referred for certification.

(b) The DCYF district office supervisor or DCYF community, family, and program support certification specialist shall assess the need for services, based on the following criteria:

(1) The number of children and families who require services exceeds the available community resources;

(2) A specialized service is necessary to meet the unique needs of children and families, and there are no currently certified providers who can provide the specialized service; or

(3) Any other case circumstance which requires the provision of services pursuant to a court order.

(c) If there is a need for a service based on (b) above, DCYF shall forward an application packet to the applicant which shall include:

(1) Form 2616 “Application for Certification and Enrollment of Public Transportation Service Providers” (March 2019);

(2) A “State of New Hampshire Alternate W-9” (October 2016); and

(3) A copy of He-C 6343.

(d) Each applicant shall complete and submit Form 2616 “Application for Certification and Enrollment of Public Transportation Service Providers” (March 2019) to DCYF within 30 days of receipt, together with proof of registration with the New Hampshire secretary of state.

(e) Each applicant shall sign and date Part C: “Authorization/Statement of Understanding” of Form 2616 “Application for Certification and Enrollment of Public Transportation Service Providers” (March 2019) certifying following:

The information contained in this application is correct to the best of my knowledge, I acknowledge that the provision of false information in the application id s basis for denial of the application.”

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.14)

He-C 6343.13 Application Process For Payment Standards For Secure Transportation Services.

(a) Applicants who seek initial certification for payment standards for secure transportation services shall contact a DCYF district office supervisor or designee and request to be referred for certification.

(b) The DCYF district office supervisor or the DCYF community, family, and program support certification specialist shall assess the need for services based on the following criteria:

(1) The number of children and families who require services exceeds the available community resources;

(2) A specialized service is necessary to meet the unique needs of children and families, and there are no current certified providers who can provide the specialized service; and

(3) Any other case circumstance which requires the provision of services pursuant to a court order.

(c) If there is a need for services based on the criteria in (b) above, DCYF shall forward an application packet to the applicant, which shall include:

(1) Form 2613 “Application for Certification and Enrollment of Secure Transportation Service Providers” (March 2019);

(2) A “State of New Hampshire Alternate W-9” (October 2016); and

(3) A copy of He-C 6343.

(d) Each applicant shall submit a completed Form 2613 “Application for Certification and Enrollment of Secure Transportation Service Providers” (March 2019) to DCYF within 30 days of receipt, together with a completed “State of New Hampshire Alternate W-9” (October 2016).

(e) Each applicant shall sign and date Part B: “Authorization/Statement of Understanding” of Form 2613 “Application for Certification and Enrollment of Secure Transportation Service Providers” (XXXXX 2019) certifying the following:

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.15)

He-C 6343.14 Review of Continued Certification Compliance.

(a) Transportation service providers shall complete and submit Form 2616R “Review of Continued Certification for Transportation Service Providers” (March 2019) as provided by DCYF within 30 days of the receipt.

(b) Part C of Form 2616R “Review of Continued Certification for Transportation Service Providers” (March 2019) shall be signed and dated by each direct service staff of accompanied transportation services providers certifying the following affirmation:

(c) Each Part C of Form 2616R “Review of Continued Certification for Transportation Service Providers” (March 2019) submitted by an accompanied transportation service provider agency shall have the following attestation signed and dated by the program coordinator or executive director:

“I certify that a criminal record check for this individual is completed an on file at the agency.”

(d) The provider shall sign and date Part D “Statement of Affirmation” of Form 2616R “Review of Continued Certification for Transportation Service Providers” (March 2019) certifying the following:

“I have reviewed the Administrative Rule He-C 6343 Certification for Payment Standards for Transportation Service Providers and will adhere to the rules as a certified provider. I authorize the NH Division for Children, Youth and Families (DCYF) to conduct a certification for payment review to determine the program’s compliance with Administrative Rule He-C 6343, Certification for Payment Standards for Transportation Service Providers. I further understand that DCYF has the right to verify information contained in this application.

(e) Each applicant shall submit the following with Form 2616R “Review of Continued Certification for Transportation Service Providers” (March 2019):

(1) A “State of New Hampshire Alternate W-9” (October 2016);

(2) A Current list of the Board of Directors that shall include the following information of each person:

a. Full Name;

b. Office held;

c. Professional affiliation;

d. Address; and

e. Telephone number;

(3) Automobile and general liability insurance certificates; and

(4) Resume or curriculum vitae for the program coordinator or executive director.

(f) Renewal of certification shall be made by filing a signed and dated Form 2616 “Review of Continued Certification for Transportation Service Providers” (March 2019) and shall be based on a review and verification of the provider’s compliance with He-C 6343 and the specific requirements for the certification of Transportation Service provided.

(g) Providers who fail to submit a review form within 30 days of receipt shall have their certification revoked in accordance with He-C 6343.24 and be denied payment.

(h) Continuance of certification shall be based on a review and verification of the provider’s compliance with service requirements.

(i) Review of continued certification compliance shall:

(1) Occur every 5 years from the date of issue for:

a. Accompanied transportation service providers;

b. Public transportation service providers; and

c. Secure transportation service providers; and

(2) Occur every year for private vehicle transportation service providers with the exception of a foster parent licensed through He-C 6347 who is also certified as a private vehicle transportation service provider. Continued certification review shall coincide with renewal of their foster care license.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.16)

He-C 6343.15 Notification of Changes.

(a) For the period of certification, the provider shall notify DCYF in writing within 10 days of any change in the information contained in the application or recertification application and provide documentation of the change.

(b) At the time of expiration of mandatory state driver’s licenses, private vehicle transportation providers shall submit a copy of the renewed license to DCYF.

(c) Failure to notify DCYF of any change shall result in revocation of certification in accordance with He-C 6343.24 and denied payment.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.17)

He-C 6343.16 Billing Requirements for Transportation Services.

(a) Providers shall be certified as a provider of transportation services and authorized to provide the services by a CPSW or JPPO.

(b) The provider shall not bill DCYF for services that are to be reimbursed by any other entity.

(d) Providers shall accept payments in full for non-medicaid services it provides and in no event shall DCYF be liable for any payments in excess of available and appropriated funds.

(e) DCYF shall determine the need for services and the determination shall be binding on the provider.

(f) Providers shall notify DCYF within 10 business days of any changes in tax information by completing and submitting an updated “State of New Hampshire Alternate W-9” (October 2016) with current tax information.

(g) Providers shall provide services or care without discrimination as required by 42 U.S.C 2000d, et seq., as amended, and without discrimination on the basis of handicap as required by 29 U.S.C 794, as amended.

(h) The provider’s certification shall terminate upon date of sale or transfer of ownership or close of the agency.

(i) Billing for private vehicle service providers shall be for mileage, highway tolls, and parking fees for authorized transportation at rates determined by the DHHS rate setting unit.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.18)

He-C 6343.17 Billing Process for Transportation Services.

(a) Providers shall request a service authorization form prior to service delivery.

(b) Services provided without service authorization shall not be paid.

(c) Accompanied and educational transportation service providers shall bill DHHS for non-medicaid eligible recipients and services via paper claims.

(d) All other transportation service providers shall bill DHHS for non-medicaid eligible recipients and services via paper claims or electronic claims submission.

(e) For paper claims submission, a provider shall complete and submit to the department a copy of Form 2110 “Service Authorization” (October 2016) for future billings if authorized service dates span a date range.

(f) For electronic claims submission, a provider shall request a web billing account from DHHS by completing and submitting Form 2679 “Provider Web Billing User Account Request Form” (October 2016).

(g) Both the user and the user’s supervisor, if the user is an employee, shall sign the form described in (f) certifying the following:

“I understand and agree that any payments made which are based on inaccurate or fraudulent billing, whether submitted by me or by my authorized user will be recovered from me by DHHS.”;

“I understand that by submitting an invoice via the Provider Web Billing Application I am certifying that the invoice is true and accurate.”;

“I understand and agree that I am responsible for my authorized representative, employee, and/or any management service company’s use of the Provider Web Billing Application.”; and

“I understand and agree that I must access my web account at least every ninety (90) days or my account will be de-activated.”;

(h) After the provider complies with (f) above, the DHHS shall issue to the provider a log on and personal identification number (PIN) for use in accessing the provider web billing user account.

(i) The provider or any authorized representative, shall not transfer his or her log on or PIN, or allow use of his or her log on or PIN by any other person.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.19)

He-C 6343.18 Billing Period.

(a) A provider shall bill within one year of service provision.

(b) Any bill received for payment one year after service date shall be denied pursuant to RSA 126-A:3.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.20)

He-C 6343.19 Billing Discrepancies. Questions regarding billing discrepancies shall be directed to the provider relations’ staff of the bureau of administration operations in DCYF.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.21)

He-C 6343.20 Record-Keeping and Record Retention.

(a) Providers shall retain records for a period of no less than 7 years after the completion date of a provided service for each bill submitted to the department, the medicaid fiscal agent or a private insurance company.

(b) Records shall clearly document the extent of the care and services provided to children and families, when those services are charged to the department, and information regarding any payment claimed.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.22)

He-C 6343.21 Quality Assurance Activities of Transportation Service Providers.

(a) Providers shall be subject to quality assurance reviews conducted by DCYF to determine the quality of services pursuant to RSA 170-G:4, XVIII, using a variety of activities that may include a combination of record reviews, performance data measurements, and visits to providers.

(b) For the purposes of assessing compliance and for quality assurance reviews, providers shall allow:

(1) Scheduled or unscheduled on-site visits by DCYF;

(2) Interviews with providers and program staff; and

(3) A review of program documents to determine continued compliance with He-C 6343 including all service reports.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.23)

He-C 6343.22 Monitoring of Accompanied Transportation Service Providers.

(a) Providers shall submit an annual report to DCYF no later than 30 days following the end of the calendar year.

(b) The annual report shall include the following information:

(1) Service provided and changes in strategies that resulted in effective outcomes;

(2) Issues with the service utilization and observations about shifts in the targeted service population;

(3) Barriers discovered in the system of care;

(4) Proposed enhancements to performance indicators,

(5) Training topics presented over the past year for transportation aides; and

(6) Annual statistics for:

a. The number of referrals received;

b. The number of referrals serviced; and

c. The number of referrals not serviced and the reason for not servicing.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.24)

He-C 6343.23 Waivers.

(a) Applicants or providers who request a waiver of a requirement in He-C 6343 shall submit a written request to the commissioner or his or her designee that includes the following information:

(1) The reason for requesting the waiver;

(2) The anticipated length of time the requested waiver will be needed including permanent waivers;

(3) Assurance that if the waiver is granted the quality of service and care to children, youth and families will not be affected;

(4) A written plan to achieve compliance with the rule or explaining how the provider will satisfy the intent of the rule, if the waiver is granted;

(5) How the service will be affected if the waiver is not granted;

(8) The signature of the person requesting the waiver.

(b) A waiver shall be granted if:

(1) The department concludes that authorizing deviation from compliance with the rule from which waiver is sought does not contradict the intent of the rule and the rule does not conflict with statute; and

(2) The alternative proposed ensures that the object or intent of the rule will be accomplished.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.25)

He-C 6343.24 Denial of Application and Revocation of Certification.

(a) An application shall be denied or provider certification revoked if:

(1) DCYF determines that the state does not have a need for the service;

(2) The applicant or provider, or the individual acting on the applicant’s or provider’s behalf, submits materially false information to DCYF;

(3) The provider knowingly retained an employee for whom there has been a conviction for a felony or any crime against a person;

(4) The provider has been convicted of a felony or any crime against a person, which has not been annulled or overturned;

(5) There has been disciplinary action taken against a provider by a licensing body or professional society, a finding of civil liability made for professional misconduct, or a finding of an ethical violation made by a state or national professional association or any other state’s regulatory board, which has not been annulled or overturned;

(6) There has been a cancellation of insurance by the provider’s insurance company;

(7) There has been abusive or neglectful treatment of a child by a provider as determined by any state statute;

(8) The foster care provider has had their foster care license revoked;

(9) A local education agency has revoked authorization for an educational transportation service provider;

(10) The provider fails to submit a copy of renewed driver’s license at the time of expiration; or

(11) The provider fails to comply with He-C 6343.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.26)

He-C 6343.25 Notification of Denial or Revocation.

(a) If DCYF denies an application for certification or revokes an existing certification, DCYF shall send notice of the denial or revocation to the applicant or provider by certified mail.

(b) The notice shall:

(1) Inform the applicant or provider of the facts or conduct upon which DCYF bases its action;

(2) Advise the applicant or provider of their right to request reconsideration of DCYF’s decision pursuant to He-C 6343.26; and

(3) In the case of an existing certification, inform the provider that the revocation shall not take effect until the provider has had an opportunity through an appeal, pursuant to RSA 170-G:4-a and He-C 6343.27, to show compliance with all lawful requirements for retention of the certification.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.27)

He-C 6343.26 Request for Certification Reconsideration.

(a) A request for certification reconsideration shall:

(1) Be filed within 30 days of the date of receipt of the letter sent by DCYF;

(2) Be submitted in writing; and

(3) Be filed with the director of DCYF.

(b) The DCYF director shall grant or deny the request pursuant to He-C 6343.27.

(d) The applicant or provider may appeal the DCYF director’s decision pursuant to He-C 6343.27.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.28)

He-C 6343.27 Appeals.

(a) Applicants or providers who wish to appeal DCYF’s decision shall file an appeal pursuant to RSA 170-G:4-a with the commissioner.

(b) The appeal shall be:

(1) Made in writing and state the reasons for the appeal pursuant to RSA 170-G:4-a;

(2) Filed within 14 working days of the date of receipt of written notification; and

(3) Signed and dated;

(c) Pursuant to RSA 170-G:4-a and He-C 200, the commissioner or designee and 2 members of the DCYF advisory board shall hear the appeal.

Source. (See Revision Note at part heading for He-C 6343) #9390, eff 3-1-09, EXPIRED: 3-1-17

New. #12592, INTERIM, eff 7-26-18, EXPIRED: 1-22-19

New. #12750, eff 3-26-19 (formerly He-C 6343.29)

PART He-C 6344 CERTIFICATION PAYMENT STANDARDS FOR COMMUNITY-BASED BEHAVIORAL HEALTH SERVICE PROVIDERS

Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:5

REVISION NOTE:

Document #9311, effective 11-5-08, adopted Part He-C 6344 relative to certification payment standards for community-based behavioral health service providers. This part incorporated provisions from the former Part He-C 6352 entitled “Certification for Payment Standards for Community-Based Service Providers” and made extensive changes to the wording, format, structure, and numbering of those provisions.

Document #9311 supersedes all prior filings in the former Part He-C 6352 relative to certification payment standards for community-based behavioral health service providers. The filings affecting the former Part He-C 6352 include the following documents:

#4446, eff 7-1-88

#5096, eff 3-15-91, EXPIRED 3-15-97

#7292, eff 5-24-00

#8009, eff 1-1-04

#9112, INTERIM, eff 3-24-08, EXPIRED 9-20-08

He-C 6344.01 Purpose. The purpose of this part is to identify the qualifications and performance requirements to become a provider of community-based behavioral health services for the division for children, youth and families (DCYF) and describe the array of behavioral health services related to improving child and family functioning regarding situations involving abuse, neglect, delinquency, and Children in Need of Services (CHINS).

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08, ss by #12206, eff 6-10-17

He-C 6344.02 Scope. This part shall apply to community-based behavioral health service providers for DCYF who receive financial reimbursement from the department of health and human services (DHHS) for services provided to children and families.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08, ss by #12206, eff 6-10-17

He-C 6344.03 Definitions.

(a) “Applicant” means the entity that is requesting certification for payment as a behavioral health service provider.

(b) “Division of behavioral health (DBH)” means the organizational unit of the department health and human services established pursuant to RSA 135-C:6.

(c) “Case plan” means the division for children, youth and families written document, pursuant to RSA 170-G:4, III, that describes the service plan for the child and family, and addresses outcomes, tasks, responsible parties, and timeframes for correcting problems that led to abuse, neglect, delinquency, or child in need of services (CHINS).

(d) “Certification for payment” means the process by which DCYF approves the qualifications of and payment to providers of community-based behavioral health services.

(e) “Child” means an individual from birth through age 20, except as otherwise stated in a specific provision. The term includes “minor”.

(f) “Child in need of services (CHINS)” means “child in need of services” as defined by RSA 169-D:2.

(g) “Child protective service worker (CPSW)” means an employee of the division for children, youth and families who has expertise in managing cases to ensure families and children achieve safety, permanency and well-being.

(h) “Cognitive Behavioral Therapy (CBT)” means a psychotherapy based on modifying everyday thoughts and behaviors, with the aim of positively influencing emotions. The cognitive model of managing emotional responses encourages the development of specific goals that are measurable and quantifiable.

(i) “Commissioner” means the commissioner of the department of health and human services or his or her designee.

(j) “Community mental health program (CMHP)” means a program operated by the state, city, town, or county, or a community-based New Hampshire nonprofit corporation for the purpose of planning, establishing, and administering an array of community-based, mental health services pursuant to He-M 403 and as defined in RSA 135-C:2, IV.

(k) “Community-based behavioral health services” means behavioral health services certified by DCYF pursuant to RSA 170-G:4 XVIII.

(l) “Conflict of interest” means a situation, circumstance, or financial interest, which has the potential to cause a private interest to interfere with the proper exercise of a public duty.

(m) “Crisis intervention services” means short term in or out of home services designed to stabilize children and families in emergent situations.

(n) “Department (DHHS)” means the department of health and human services.

(o) "Diagnostic evaluation" means psychological testing or psychosocial assessment to determine the nature and cause of a child or family’s dysfunction including mental status, child development, family history, and recommendations for treatment.

(p) “Director” means the director of the division for children, youth, and families or designee.

(q) “Division for children, youth, and families (DCYF)” means the organizational unit of the department of health and human services that provides services to children and youth referred by courts pursuant to RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, and RSA 463.

(r) “Educationally identified child” means “child with a disability'' as defined in RSA 186-C:2 namely, “any person 3 years of age or older but less than 21 years of age who has been identified and evaluated by a school district according to rules adopted by the state board of education and determined to have an intellectual disability, a hearing impairment including deafness, a speech or language impairment, a visual impairment including blindness, an emotional disturbance, an orthopedic impairment, autism, traumatic brain injury, acquired brain injury, another health impairment, a specific learning disability, deaf-blindness, multiple disabilities, or a child at least 3 years of age but less than 10 years of age, experiencing developmental delays, who because of such impairment, needs special education or special education and related services. The term "child with a disability'' shall include a child ages 18 to 21, who was identified as a child with a disability and received services in accordance with an individualized education program but who left school prior to his or her incarceration, or was identified as a child with a disability but did not have an individualized education program in his or her last educational institution.”

(s) “Evidence-informed practice” means the process of treatment, which takes into account client preferences and values, practitioner expertise, best scientific evidence and clinical characteristics and circumstance.

(t) “Family therapy” means evidence-informed treatment involving family members and a therapist when treatment is focused on ameliorating conditions that impair family functioning.

(u) “Group outpatient counseling” means the use of evidenced-informed psychotherapeutic or counseling techniques in the treatment of a group, most of whom are not related by blood, marriage, or legal guardianship in a community setting.

(v) “Individual outpatient therapy” means the use of evidenced-informed psychotherapeutic or counseling techniques in the treatment of an individual on a one-to-one basis in a community setting.

(w) “Juvenile probation and parole officer (JPPO)” means an employee of DCYF who discharges the powers and duties established by RSA 170-G: 16, and supervises paroled delinquents pursuant to RSA 170-H.

(x) “Licensed alcohol and drug counselor (LADC)” means a person licensed by the state of New Hampshire board of licensing for alcohol and other drug use professionals according to RSA 330-C to practice substance use counseling as a LADC.

(y) “Licensed practitioner” means a psychiatrist, advanced registered nurse practitioner, psychiatric nurse, psychologist, pastoral psychotherapist, independent clinical social worker, clinical mental health counselor, substance use counselor, or marriage and family therapist holding a state license to practice in their respective field.

(z) “Managed care organization (MCO)” means an organization, contracted with the Department, that combines the functions of health insurance, delivery of care, and administration.

(aa) “Master licensed alcohol and drug counselor (MLDAC)” means a person licensed by the state of New Hampshire board of licensing for alcohol and other drug use professionals according to RSA 330-C to practice substance use counseling as a MLDAC.

(ab) “NH bridges” means the automated case management, information, tracking, and reimbursement system used by DCYF.

(ac) “NH mental health authority” means the bureau of mental health services administration, under the division of behavioral health within DHHS.

(ad) “Outcome” means the intended result or consequence that will occur from carrying out a program or activity.

(ae) “Prescribing practitioner” means a provider licensed by the New Hampshire board of mental health practice, board of nursing, board of medicine, or the board of phycologists that provides services identified in 42 CFR 440:130 to reduce a physical or mental disability and aid in the restoration of a recipient to their best functional level.

(af) “Private provider” means an individual behavioral health practitioner who is a sole practitioner or who is employed by an agency, excluding CMHP’s, and provides services to a child or family and receives financial reimbursement from DHHS.

(ag) “Program” means the community mental health program.

(ah) “Provider” means the individual, agency or program that serves a child or family and receives financial reimbursement from DHHS.

(ai) “Progress report” means the written document, submitted on a regular basis to DCYF by the behavioral health provider, which includes a summary of contacts and data documenting outcomes of the child and family specific treatment goals, dates of service, awareness of the permanency goal and congruence with case plan.

(aj) "Psychotherapy” means face-to-face clinical intervention or assessment and monitoring necessary to determine the course and progress of therapy for individuals or families that:

(1) Is based on evidence-informed psychological treatment principles;

(2) Has as its purpose the improvement of interpersonal and self-care skills, psychological understanding, or a change in behavior(s), or any combination of these;

(3) Is provided by a professional qualified pursuant to He-M 426.08(h)-(l);

(4) Is monitored through the clinical record; and

(5) Is based on an individual service plan.

(ak) “Quality assurance” means the process that DCYF use to monitor the quality and effectiveness of community-based behavioral health services.

(al) “Re-approval” means the division of behavioral health’s process of conducting a comprehensive quality assurance and compliance evaluation for all community mental health programs that generates a re-approval report.

(am) “Service authorization” means the form provided by DCYF indicating the division’s responsibility for payment of community-based services for non-medicaid eligible children.

(an) “Trauma-informed service system” means a system in which all parties involved recognize and respond to the impact of traumatic stress on those who have contact with the system including children, caregivers, and service providers. A trauma-informed service system reinforces trauma awareness, knowledge, and skills in the organizational cultures, practices, and policies of all those who are involved with the child, using the best available science, to facilitate and support the recovery and resiliency of the child and family.

(ao) “Treatment plan” means the written, time-limited, goal-oriented, evidence-informed plan for the child and family developed by the provider and DCYF, which is in agreement with the case plan.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17

He-C 6344.04 Categories and Descriptions of Community-Based Behavioral Health Services:

(a) Behavioral health providers shall include:

(1) Private providers of behavioral health services; and

(2) CMHP.

(b) All behavioral health services shall include clinical assessments, diagnostic evaluations, and treatments which derive from attachment and trauma theory and which are evidence- informed practices.

(c) The evaluator shall determine a child and family’s level of functioning and recommend the appropriate clinical interventions.

(d) Diagnostic evaluations and assessments shall include:

(1) Mental status exam;

(2) Current developmental status;

(3) Impact of trauma on current level of functioning;

(4) Identifying strengths and risk factors;

(5) Assessment of capacity for healthy attachment;

(6) Any appropriate standardized psychological or neuropsychological tests; and

(7) A detailed report submitted to the CPSW or JPPO.

(e) Therapeutic intervention services shall include:

(1) Individual intervention based on evidence-informed treatments.

(2) Family intervention based on evidence-informed treatment models of family therapy; or

(3) Group interventions based on evidence-informed treatment interventions involving 2 to 10 individuals and a therapist when the focus of the group is ameliorating conditions that impair functioning; especially as a result of trauma and attachment issues or exposure to family or domestic violence.

(f) Certification of providers shall be determined by reviewing the documentation provided in He-C 6344.07 through He-C 6344.10 and a review of training and experience in the following services:

(1) Diagnostic evaluations which shall include:

a. Behavioral consultation;

b. Child psychiatry evaluation;

c. Competency evaluation;

d. Developmental evaluation;

e. Domestic or family violence evaluation;

f. Dual diagnosis of:

1. Mental health and substance use; or

2. Behavioral health and developmental challenges;

g. Fire-setting evaluation;

h. Neuropsychiatry evaluation;

i. Neuropsychological evaluation;

j. Psychological evaluation;

k. Psycho-sexual risk evaluation;

l. Sexual abuse victim or perpetrator evaluation; and

m. Forensic evaluation;

(2) Family therapy;

(3) Group outpatient therapy; and

(4) Individual outpatient therapy.

(g) Comprehensive assessments or evaluations for substance use disorders and treatment shall include:

(1) Individual interventions based on evidence-informed treatment models of age-appropriate treatment for substance use disorders;

(2) Family interventions based on evidence-informed models of family interventions for substance use disorders;

(3) Group interventions based on evidence-informed interventions involving 2 or more individuals and a therapist when the focus of the group is treating substance use disorders or enhancing recovery; and

(4) Crisis intervention services.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17

He-C 6344.05 Compliance Requirements for Private Providers.

(a) Private providers shall comply with:

(1) All applicable licensing and registration requirements prior to applying for certification;

(2) The medical assistance requirements of He-W 500 and He-M 426;

(3) The statutes regarding confidentiality, including RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:19, RSA 170-C:14, and RSA 170-G:8-a; and

(4) The child abuse and neglect reporting requirements of RSA 169-C:29-30.

(b) All providers, prior to beginning their work with children, and thereafter on an annual basis, shall review the sections of RSA 169 on definitions, immunity from liability and persons required to report.

(d) Private providers shall maintain professional and general liability insurance.

(e) When domestic or family violence is identified as an issue for a family, each private provider shall follow the “Mental Health Domestic Violence Protocols,” 1996, prepared by the NH governor’s commission on domestic violence and available directly from the NH department of justice or on-line as listed in Appendix A.

(f) The provider shall provide services or care without discrimination as required by 42 U.S.C 2000d et seq., as amended, and without discrimination on the basis of handicap as required by 29 U.S.C 794, as amended.

(g) Private providers shall:

(1) Be an enrolled NH medicaid provider;

(2) Accept medicaid payment as payment in full;

(3) Submit their medicaid number to DCYF; and

(4) Participate with one or more of the NH managed care organizations (MCO).

(h) The requirement in (g)(1) above shall be waived if the provider holds only a LADC license.

(i) Private providers shall verify recipient eligibility for and bill all third party sources of reimbursement, including private health insurance, and medicaid, or MCO, prior to billing DCYF.

(j) Private providers shall request prior authorization for services in advance for recipients covered by third party insurance.

(k) Private providers shall request prior authorization for psychotherapy services for medicaid or MCO eligible recipients requiring more than 12 visits per fiscal year as outlined in He-W 530.

(l) Private providers shall submit a monthly progress report to CPSW or JPPO.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17

He-C 6344.06 Compliance Requirements for CMHP.

(a) CMHP providers shall comply with:

(1) All applicable licensing and registration requirements prior to applying for certification;

(2) The medical assistance requirements of He-W 500 and He-M 426;

(3) The statutes regarding confidentiality, including RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:19, RSA 170-C:14, and RSA 170-G:8-a;

(4) The child abuse and neglect reporting requirements of RSA 169-C:29-30; and

(5) DCYF requirement for a master’s degree and 2 years post graduate experience to be assigned to all cases.

(b) For all employees and volunteers who have access to children, prior to beginning their work with children, and thereafter on an annual basis, the provider shall review the sections of RSA 169 on definitions, immunity from liability and persons required to report.

(d) CMHP shall maintain professional and general liability insurance.

(e) When domestic violence is identified as an issue for a family, each agency shall follow the “Mental Health Domestic Violence Protocols,” 1996, as prepared by the NH governor’s commission on domestic violence and available directly from the NH department of justice or online as listed in Appendix A.

(f) The provider shall provide services or care without discrimination as required by 42 U.S.C 2000d, et. seq, as amended, and without discrimination on the basis of handicap as required by 29 U.S.C 794, as amended.

(g) The CMHP shall:

(1) Be an enrolled NH Medicaid and MCO provider that meets the following requirements:

a. A prescribing practitioner shall demonstrate approval of the Medicaid-covered services by signing the child and family’s treatment plan; and

b. Medicaid-covered services shall be authorized for children who are:

1. Medicaid eligible, either as categorically or medically needy; and

2. Under the age of 21 years;

(2) Private providers shall verify recipient eligibility for and bill all third-party sources of reimbursement, including private health insurance and medicaid or MCO, prior to billing DCYF.

(3) Accept Medicaid payment as payment in full for services provided; and

(4) Have a current contract with the DBH and shall not be an individual provider.

(h) All CMHP shall comply with the service provisions outlined in He-M 426.

(i) Each CMHP shall submit a quarterly progress reports for each client to the CPSW or JPPO.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17

He-C 6344.07 Application Process For Payment Standards For Private Providers of Community-Based Behavioral Health Services.

(a) Applicants who seek initial certification for payment standards for community-based behavioral health services shall only be referred by a DCYF district office supervisor or designee.

(b) If the request is approved, DCYF shall forward an application packet to the applicant, which includes:

(1) A Form 2617 “Application For Certification And Enrollment Of Private Behavioral Health Service Providers” (October 2016);

(2) “State of New Hampshire Alternate W-9 Form”; and

(3) A copy of He-C 6344.

(c) Each applicant shall complete, sign, date, and submit a Form 2617 “Application For Certification And Enrollment Of Private Behavioral Health Service Providers”(October 2016); and the following information:

(1) A signed and dated “Statement of Affirmation” as part of Form 2617 “Application For Certification And Enrollment Of Private Behavioral Health Service Providers” (October 2016) that states the following:

“I have reviewed Administrative Rule He-C 6344 and will adhere to the rules as an enrolled provider. I understand that DCYF has the right to verify information contained in this application”;

“I will notify DCYF in writing within ten business days of any change to the information contained in this application”;

“I understand and agree that any individual whom provides services or agency that I subcontract with will have a current and valid license for the service being provided”; and

“The information contained in this application is correct to the best of my knowledge”.

(2) The applicant shall provide the following information with, or in addition to, Form 2617 “Application For Certification And Enrollment Of Private Behavioral Health Service Providers”(October 2016) in (1) above:

a. A copy of the applicant’s state license to practice or operate;

b. A completed, signed, and dated “State of New Hampshire Alternate W-9 Form”;

c. A resume or curriculum vitae; and

d. A sample of a treatment plan.

(d) In addition to the information requested in (c) above, the applicant shall complete, sign, date, and submit the attestation in Part E of Form 2617 “Application For Certification And Enrollment Of Private Behavioral Health Service Providers” (October 2016) that states:

(e) Each applicant shall complete, sign, date, and submit a “Statement of Affirmation” as part of Form 2617 “Application For Certification And Enrollment Of Private Behavioral Health Service Providers” (October 2016) that states the following:

“I have reviewed Administrative Rule He-C 6344 and will adhere to the rules as an enrolled provider. I understand that DCYF has the right to verify information contained in this application”;

“I will notify DCYF in writing within ten business days of any change to the information contained in this application”;

“I understand and agree that any individual whom provides services or agency that I subcontract with will have a current and valid license for the service being provided”; and

“The information contained in this application is correct to the best of my knowledge”.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.08)

He-C 6344.08 Application Process For Payment Standards For CMHP Providers.

(a) CMHP’s shall be contracted for services through the DBH.

(b) CMHP’s shall provide a copy of a “State of New Hampshire Alternate W-9 Form” to the DCYF certification specialist within 30 days of receipt.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from he-C 6344.09)

He-C 6344.09 Review of Continued Certification Compliance for Private Providers.

(a) Private providers shall complete, sign, date, and submit a Form 2617R “Certification Renewal - Private Behavioral Health Providers” (October 2016), as provided by DCYF, within 30 days of receipt and include the following information:

(1) A completed, signed, and dated “Statement of Affirmation” as part of Form 2617R “Certification Renewal - Private Behavioral Health Providers” (October 2016) that states the following:

“I have reviewed Administrative Rule He-C 6344 and will adhere to the rules as an enrolled provider. I understand that DCYF has the right to verify information contained in this application”;

“I will notify DCYF in writing within 10 business days of any change to the information contained in this application”;

“I understand and agree that any individual whom provides services or agency that I subcontract with will have a current and valid license for the service being provided”; and

“The information contained in this application is correct to the best of my knowledge.”

(2) The applicant shall provide the following information with, or in addition to, Form 2617R “Certification Renewal - Private Behavioral Health Providers” (October 2016):

a. License to practice or operate; and

b. “State of New Hampshire Alternate W-9 Form”.

(3) In addition to the information requested in (a) and (b) above the applicant shall complete, sign, date, and submit the attestation in Part C of Form 2617R “Certification Renewal - Private Behavioral Health Providers” (October 2016) that states:

(b) Private providers who fail to complete and submit a Form 2617R “Certification Renewal - Private Behavioral Health Providers” (October 2016) within 30 days of receipt shall have their certification revoked in accordance with He-C 6344.23 and be denied payment.

(c) Continuance of certification shall be based on a review and verification of the provider’s compliance with He-C 6344.

(d) Private provider applicants shall submit a copy of the documentation required by the appropriate state licensing board or boards to DCYF at the time of license renewal to DCYF.

(e) Private provider applicants shall submit a copy of their renewed license to DCYF.

(f) Review of continued certification shall coincide with the date of expiration of the private provider’s applicable state licensing board(s).

(g) In the event of dual licensing the date of the earliest license expiration will be used.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.11)

He-C 6344.10 Review of Continued Certification Compliance for CMHP Providers.

Renewals for CMHP providers shall occur every 5 years and coincide with the date of the re-approval report completed by the DBH.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.12)

He-C 6344.11 Notification of Changes for Private Providers. The private provider shall:

(a) Notify DCYF in writing within 10 business days of any change in the information contained in the application and changes to the items required by He-C 6344.07 (c)(1) - (3) above, and provide documentation of the change; and

(b) Submit a copy of the renewed license, at the time of expiration of mandatory state licenses to DCYF within 10 days of receipt from the licensing authority.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.14)

He-C 6344.12 Notification of Changes for CMHP Providers. All providers shall comply with the requirements of He-M 403 with regard to any changes.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.15)

He-C 6344.13 Billing Requirements for Community-Based Behavioral Health Services.

(a) All providers of community-based behavioral health services shall:

(1) Be certified prior to the start of service delivery;

(2) Not exceed the rates established by DCYF nor shall the rates exceed those charged by the provider for non-DCYF children and families;

(3) Not bill DCYF for services that are to be reimbursed by any other entity including third party insurance or Medicaid; and

(4) Accept payments made by DCYF as payments in full for the services it provides.

(b) DCYF shall determine the need for services and the determination shall be binding on the provider.

(c) The provider shall notify DCYF of any changes in tax information and complete and submit to DCYF a signed “State of New Hampshire Alternate W-9 Form” with current tax information.

(e) The provider shall provide services or care without discrimination as required by 42 U.S.C 2000d et. seq., as amended, and without discrimination on the basis of handicap as required by 29 U.S.C 794, as amended.

(f) The provider’s certification terminates upon date of sale or transfer of ownership or close of the provider agency.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.17)

He-C 6344.14 Billing Process for Community-Based Behavioral Health Services.

(a) All providers shall bill all third party sources of reimbursement, including private health insurance and Medicaid and Medicaid MCO, prior to billing DCYF.

(b) All providers shall bill the NH Medicaid fiscal agent or Medicaid MCO for Medicaid eligible recipients following the processes outlined by the NH Medicaid fiscal agent.

(c) The provider shall request and obtain from DCYF a service authorization form for services not billable to Medicaid, Medicaid MCO or private insurance prior to service delivery.

(d) A provider shall bill the DCYF through NH Bridges for non-Medicaid eligible recipients either via paper claims or electronic claims submission.

(e) For paper claim submissions, a provider shall copy the service authorization form for future billings, if the authorized service dates span a date range.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.18)

He-C 6344.15 Billing Period.

(a) A provider shall bill within one year of the date of provision of a service.

(b) Bills received after one year from the date of service shall be denied pursuant to RSA 126-A:3.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.19)

He-C 6344.16 Billing Discrepancies. Questions regarding billing discrepancies billed via NH Bridges shall be directed to the provider relations’ staff of the bureau of administrative operations in DCYF. All other questions shall be directed to either Medicaid or the private insurance company.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.20)

He-C 6344.17 Record-Keeping and Record Retention.

(a) Records shall be retained for a period of no less than 7 years after the completion date of a provided service for each bill submitted to the department, the Medicaid fiscal agent or a private insurance company.

(b) The provider shall keep records as are necessary to comply with RSA 170-E: 42, when applicable, and to comply with DCYF record-keeping requirements in He-C 6344.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.21)

He-C 6344.18 Monitoring and Quality Assurance Activities for Private Behavioral Health Providers.

(a) Private providers shall participate in quality assurance activities conducted by DCYF using a variety of activities that may include a combination of record reviews, performance data measurements and visits to the provider.

(b) Private providers shall allow DCYF, to conduct quality assurance reviews which shall include:

(1) Interviewing the private provider;

(2) Interviewing children and families served;

(3) Reviewing provider documents, to include:

a. The evidence-informed treatment modalities used;

b. The treatment outcomes achieved and the length of time in treatment; and

c. The providers treatment plan to assure that it agrees with the DCYF case plan; and

(4) Examining case records to determine continued compliance with He-C 6344.

(c) Private providers shall ensure that clinical records, including all progress reports, are available for inspection and review by DCYF.

(d) Private providers shall be monitored and evaluated by DCYF through a variety of activities including:

(1) Monthly queries of data that is stored on NH Bridges case management system and the Medicaid management information system;

(2) Reviews of case record information; and

(3) Satisfaction surveys from stakeholders, such as families, CPSW and JPPOs.

(e) Private providers shall be notified of any problems that are noted on the DCYF staff surveys that include:

(1) Negative responses concerning quality and timeliness of service provision; and

(2) Written comments about private provider performance.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.22)

He-C 6344.19 Service Limitations.

(a) Medicaid recipients shall be subject to the service limits described in He-W 530.

(b) Non-Medicaid recipients shall be limited to 12 visits per year.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.25)

He-C 6344.20 Treatment Planning and Progress Reports.

(a) The treatment plan for each child or family receiving services shall include input from the individuals described in (b) below.

(b) The following individuals shall be included on the treatment team:

(1) The child, if age and developmentally appropriate;

(2) The child’s parents;

(3) The CPSW or JPPO, or both;

(4) The prescribing practitioner;

(5) School district personnel; and

(6) Unless otherwise ordered by the court, other persons as requested by the child and family, including:

a. Teachers;

b. Counselors;

c. Friends;

d. Relatives; and

e. Advocates assigned by the court.

(c) The initial clinical treatment plan shall be written within 30 days of intake approval for extension and reviewed quarterly thereafter and shall include:

(1) The findings of the provider’s assessment;

(2) An estimate by the treatment team members of the length of service to be provided to the child and family, based upon referral information and the provider’s assessment;

(3) The child’s permanency plan, as identified by the CPSW or JPPO:

(4) A concurrent plan as an alternative to the child’s permanent plan as identified by the CPSW or JPPO; and

(5) The goals and objectives for the child and family that shall address one or more of the following domains identified in the plan:

a. Safety and behavior;

b. Emotional well-being;

c. Interpersonal relationships;

d. Family community connections;

e. Physical health;

f. Mental health;

g. Education; and

h. Independent living skills training, if applicable.

(d) Each domain identified in (c)(5) above shall address:

(1) The specific goals and objectives to be achieved by the child and family;

(2) The timeframes for completion of goals and objectives;

(3) An identification of:

a. The behavioral health services to be provided directly to the child and family,

b. The frequency and duration of services, and

c. Any measures for ensuring their integration with the child’s activities, including identifying how the child’s family, relative family or foster family will participate in their treatment; and

(4) An identification of the person responsible for implementing the stated interventions in the treatment plan.

(e) For cases in which reunification is the identified permanency goal, the treatment plan shall include:

(1) A community reintegration and transition plan identifying the behavioral health supports for the child to return to his or her community; and

(2) The transfer of behavioral health services to the appropriate certified providers in the child’s community of origin, if necessary.

(f) The provider’s treatment plan shall be signed and dated by the provider and the following team members, indicating they participated in the process:

(1) The CPSW, JPPO, or both;

(2) The prescribing practitioner;

(3) The child, when age and developmentally appropriate; and

(4) The child’s parent(s) or guardian.

(g) Treatment plan revisions shall be explained in writing to all team members.

(h) The treatment plan and any revisions shall be filed in the child’s DCYF case file and copies sent to:

(1) The CPSW, JPPO, or both;

(2) The child’s parent(s) or guardian;

(3) The prescribing practitioner; and

(4) The foster or placement provider, if participating.

(i) Once the treatment plan is completed, the provider shall receive supervision by the prescribing practitioner.

(j) Each provider shall provide reports to DCYF, as follows:

(1) Progress reports every month;

(2) Any reports required by the court pursuant to RSA 169-B:5-a, RSA 169-C:12-b and 169-D:4-a; and

(3) Service termination reports, which shall be sent the CPSW or JPPO no later than 10 days following termination.

(k) The progress reports shall clearly and accurately reflect the child and family’s progress regarding measurable treatment plan goals and objectives.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.26)

He-C 6344.21 Service Limitations Extensions.

(a) Medicaid recipients shall be subject to the service limits described in He-W 530.

(b) Non-Medicaid recipients shall be limited to 12 visits per year.

(c) The provider’s requests to extend the service limit shall be made in writing 30 days prior to the expiration of benefits.

(d) Written request made pursuant to (c) above shall be submitted to the CPSW and JPPO and include the following:

(1) Provider name, address, telephone number, and medicaid provider number;

(2) Recipient name, address, telephone number;

(3) The type of service being requested;

(4) Initial assessment as described in He-C 6344.20 (c);

(5) A copy of the providers treatment plan as described in He-C 6344.20 (c);

(6) Identification of:

a. The progress and measurable outcomes of treatment to date;

b. The prognosis including the likelihood of achieving anticipated outcomes in the future; and

c. The need for any availability of other services; and

(7) The duration of the requested extension.

(e) Extensions shall be time-limited and based on the needs of the child and family.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17

He-C 6344.22 Waivers.

(a) Applicants or providers who request a waiver of a requirement in He-C 6344 shall submit a written request to the commissioner or his or her designee that includes the following information:

(1) The anticipated length of time the requested waiver will be needed;

(2) The reason for requesting the waiver;

(3) Assurance that if the waiver is granted the quality of service and care to children and families will not be affected;

(4) A written plan to achieve compliance with the rule or explaining how the provider will satisfy the intent of the rule, if the waiver is granted; and

(5) How the service will be affected if the waiver is not granted.

(b) A waiver shall be granted if:

(1) The department concludes that authorizing deviation from compliance with the rule from which waiver is sought does not contradict the intent of the rule; and

(2) The alternative proposed ensures that the object or intent of the rule will be accomplished.

(c) When a waiver is approved, the applicant’s or providers subsequent compliance with the alternative approved in the waiver shall be considered equivalent to complying with the rule from which waiver was sought.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.27)

He-C 6344.23 Denial of Application and Revocation of Private Provider Certification. An application for private provider certification shall be denied or certification revoked if:

(a) DCYF determines that the state does not have a need for the service;

(b) The applicant or provider, or the individual acting on the applicant’s or provider’s behalf, submits materially false information to DCYF;

(e) There has been revocation of membership on any hospital, medical, or allied health provider staff;

(f) There has been revocation of provider status with any group or health maintenance organization;

(g) There has been revocation of clinical privileges;

(h) There has been termination of academic appointment by an institution;

(i) There has been cancellation of professional or general liability insurance by the insurance company;

(j) There has been abusive or neglectful treatment of a child as determined by any state statute;

(k) There has been a failure to submit a review form within 30 days; or

(l) There has been failure to comply with He-C 6344.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.28)

He-C 6344.24 Denial of Application and Revocation of a CMHP Provider Certification. An application for CMHP provider certification shall be denied or certification revoked if:

(a) There has been failure to comply with He-C 6344;

(b) There has been failure to comply with He-M 426; and

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.29)

He-C 6344.25 Notification of Denial or Revocation.

(a) If DCYF denies an application for certification or revokes an existing certification, DCYF shall send notice of the denial or revocation to the applicant or provider by certified mail.

(b) The notice shall:

(1) Inform the applicant or provider of the facts or conduct upon which DCYF bases its action;

(2) Advise the applicant or provider of their right to request reconsideration of DYCF’s decision pursuant to He-C 6344.26; and

(3) Inform an existing provider that the revocation shall not take effect until the provider has had an opportunity through an appeal, pursuant to RSA 170-G:4-a and He-C 6344.27, to show compliance with all lawful requirements for retention of the certification.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.31)

He-C 6344.26 Request for Certification Reconsideration.

(a) A request for certification reconsideration shall:

(1) Be filed within 30 days of the date of receipt of the letter sent by DCYF;

(2) Be submitted in writing; and

(3) Be filed with the director of DCYF.

(b) The DCYF director shall uphold or overturn the request pursuant to He-C 6344.07.

(d) The applicant or provider may appeal the DCYF director’s decision pursuant to He-C 6344.27.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.32)

He-C 6344.27 Appeals.

(a) Applicants or providers who wish to appeal DCYF’s decision to deny an application or revoke a certification shall file an appeal pursuant to RSA 170-G:4-a with the commissioner.

(b) The appeal shall:

(1) Be made in writing;

(2) Be signed and dated;

(3) State the reasons for the appeal pursuant to RSA 170-G:4-a; and

(4) Be filed within 14 working days of the date of receipt of written notification pursuant to RSA 170-G:4-a.

(c) The appeal shall be heard pursuant to RSA 170-G:4-a and He-C 200 by the commissioner or designee and 2 members of the DCYF advisory board.

Source. (See Revision Note at part heading for He-C 6344) #9311, eff 11-5-08; ss by #12206, eff 6-10-17 (from He-C 6344.33)

PART He-C 6346 CERTIFICATION FOR PAYMENT STANDARDS FOR RECREATION SERVICE PROVIDERS

Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:5

REVISION NOTE:

Document #9312, effective 11-5-08, adopted Part He-C 6346 relative to certification for payment standards for recreation service providers. This part incorporated provisions from the former Part He-C 6352 entitled “Certification for Payment Standards for Community-Based Service Providers” and made extensive changes to the wording, format, structure, and numbering of those provisions.

Document #9312 supersedes all prior filings in the former Part He-C 6352 relative to certification for payment standards for recreation service providers. The filings affecting the former Part He-C 6352 include the following documents:

#4446, eff 7-1-88

#5096, eff 3-15-91, EXPIRED 3-15-97

#7292, eff 5-24-00

#8009, eff 1-1-04

#9112, INTERIM, eff 3-24-08, EXPIRED 9-20-08

He-C 6346.01 – He-C 6346.19

Source. (See Revision Note at part heading for He-C 6346) #9312, eff 11-5-08, EXPIRED: 11-5-16

PART He-C 6347 CERTIFICATION FOR PAYMENT STANDARDS FOR FOSTER CARE SERVICE CREDENTIALS

Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:5

REVISION NOTE:

Document #9266, effective 9-20-08, adopted Part He-C 6347 relative to certification for payment standards for foster care services. This part incorporated provisions from the former Part He-C 6352 entitled “Certification for Payment Standards for Community-Based Service Providers” and made extensive changes to the wording, format, structure, and numbering of those provisions.

Document #9266 supersedes all prior filings in the former Part He-C 6352 relative to certification for payment standards for foster care services. The filings affecting the former Part He-C 6352 include the following documents:

#4446, eff 7-1-88

#5096, eff 3-15-91, EXPIRED 3-15-97

#7292, eff 5-24-00

#8009, eff 1-1-04

#9112, INTERIM, eff 3-24-08, EXPIRED 9-20-08

He-C 6347.01 Purpose. The purpose of this part is to identify the qualifications and procedures to become credentialed to provide specific foster family care services for the division for children, youth and families (DCYF).

Source. (See Revision Note at part heading for He-C 6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20

He-C 6347.02 Scope. This part shall apply to foster parents who receive stipends twice per month based on a daily rate per age of the child from the department of health and human services (DHHS) based on credentials for foster family care services provided to children.

Source. (See Revision Note at part heading for He-C 6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20

He-C 6347.03 Definitions.

(a) “Adolescent care ” means a category of foster family care where the care of adolescents, age 14-21 years with specialized needs, provided by foster parents that have been recruited, selected, and trained to serve this specialized population.

(b) “Agency” means a child-placing agency or a child care institution, pursuant to RSA 170-E.

(c) “Assessment Care” means a category of foster family care where during the initial placement of a child in care, the foster parent will support an evaluation of the child and birth family’s placement and treatment needs for a period of 60 days.

(d) “Case plan” means the DCYF written plan for the child and the family which outlines how services will be provided, pursuant to RSA 170-G: 4 III, 42 U.S.C. 671,), and 42 U.S.C. 675.

(e) “Certification” means the approval of payment by DCYF to a foster parent for the category of care for which the foster parent has a credential.

(f) “Child” means:

(1) “Child” as defined in RSA 170-E:25, I, namely “any person under 21 years of age.” The term includes “youth”; or

(2) For the purposes of compliance with RSA 126-U, “child” as defined in RSA 126-U:1, I, namely, “a person who has not reached the age of 18 years and who is not under adult criminal prosecution or sentence of actual incarceration resulting therefrom, either due to having reached the age of 17 years or due to the completion of proceedings for transfer to the adult criminal justice system under RSA 169-B:24, RSA 169-B:25, or RSA 169-B:26. ‘Child’ also includes a person in actual attendance at a school who is less than 22 years of age and who has not received a high school diploma.” The term includes “youth.”

(g) “Child protective service worker (CPSW)” means an employee of DCYF who has expertise in managing cases to ensure families and children achieve safety, permanency, and well-being referred to the department pursuant to RSA 169-C, RSA 170-B, RSA 170-C, and RSA 463.

(h) “Commissioner” means the commissioner of the department of health and human services or his or her designee.

(i) “Credential” means the approval to provide a category of foster family care including general care, emergency care, crisis care, assessment care, adolescent care, respite care, specialized care, or supplemental care.

(j) “Crisis care” means a category of foster family care accessible for court-ordered placement outside of DCYF’s normal operating hours for a period not to exceed 5 calendar days.

(k) “Department (DHHS)” means the New Hampshire department of health and human services.

(l) “Division for children, youth and families (DCYF)” means the organizational unit of DHHS that provides services to children and youth referred by courts pursuant to RSA 169-A, RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, RSA 170-H, and RSA 463.

(m) “Emergency care” means a category of foster family care where an unplanned placement is made in a foster family home and services are provided to a child in care for a period not to exceed 10 calendar days.

(n) “Foster parent” means an individual who has a license or permit for foster family care. This includes the term “provider”.

(o) “General care” means a credential for foster family care where shelter, supervision, and support services are provided.

(p) “Juvenile probation and parole officer (JPPO)” means an employee of DCYF who exercises the powers and duties established by RSA 170-G:16, and supervises paroled delinquents pursuant to RSA 170-H.

(q) “Parent” means “parent” as defined in RSA 169-C:3, XXI, namely, “‘mother’, ‘father’, ‘adoptive parent”, but such term shall not include a parent as to whom the parent-child relationship has been terminated by judicial decree or voluntary relinquishment”.

(r) “Primary caring adult” means an adult other than a child’s parent who the child chooses and the court appoints to make a lifelong commitment to be the child’s primary source of guidance and encouragement, and understands the child’s current and future needs.

(s) “Quality assurance” means the process that DCYF uses to monitor the quality and effectiveness of foster family care services.

(t) “Respite care” means a category of foster family care where substitute care is provided by a licensed foster parent who provides temporary overnight relief of child care responsibilities for the parent or for the substitute care provider for children in foster family care programs.

(u) “Specialized care” means a category of foster family care where shelter, supervision, and support services are provided to children identified as needing specialized care, by foster parents who have met the additional training and care requirements.

(v) “Supplemental care” means a category of foster family care where daily stipends are made, based on the intensity of care and services provided by foster parents for a specific child residing in foster family care who requires more than general care or specialized care.

Source. (See Revision Note at part heading for He-C 6347) #9266, eff 9-20-08; amd by #9514, eff 7-18-09; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20

He-C 6347.04 Compliance Requirements.

(a) The foster parent shall comply with:

(1) All licensing requirements per He-C 6446; and

(2) The requirements of He-C 6347 as applicable to the type of foster family care credential the foster parent has obtained or is seeking.

(b) Failure to comply with He-C 6347 shall result in:

(1) Denial of a credential pursuant to He-C 6347.23;

(2) Termination of certified credential pursuant to He-C 6347.23; or

(3) Denial of reimbursement.

Source. (See Revision Note at part heading for He-C 6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20

He-C 6347.05 Categories of Foster Family Care Requiring a Credential.

(a) A separate foster family credential shall be required for the following categories of foster family care:

(1) General care;

(2) Respite care;

(3) Specialized care;

(4) Emergency care;

(5) Crisis care;

(6) Assessment care;

(7) Adolescent care; and

(8) Supplemental care.

(b) Foster family care providers may provide additional foster care services through a child-placing agency as identified in He-C 6355, including individual service option, therapeutic, and staffed foster care.

(c) All individuals licensed pursuant to He-C 6446 shall have the credential to provide general foster family care and respite care in order to be reimbursed for the established rate in He-C 6423 for that care.

(d) Any individual licensed pursuant to He-C 6446 shall request certification for reimbursement at the established rate in He-C 6423 for emergency care provided that the individual has a credential and is in compliance with He-C 6347.08.

(e) Any individual licensed pursuant to He-C 6446 shall request certification for reimbursement at the established rate in He-C 6423 for crisis care provided that the individual has a credential and is in compliance with He-C 6347.09.

(f) Any individual licensed pursuant to He-C 6446 shall request certification for reimbursement at the established rate in He-C 6423 for assessment care provided that the individual has a credential and is in compliance with He-C 6347.10.

(g) Any individual licensed pursuant to He-C 6446 shall request certification for reimbursement at the established rate in He-C 6423 for adolescent care provided that the individual has a credential and is in compliance with He-C 6347.11.

(h) Any individual licensed pursuant to He-C 6446 shall request certification for reimbursement at the established rate in He-C 6423 for specialized care provided that the individual has a credential and is in compliance with He-C 6347.07.

(i) Foster parents shall be certified for supplemental care based on the actual costs for a specific child in compliance with He-C 6347.12.

Source. (See Revision Note at part heading for He-C 6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20

He-C 6347.06 Utilizing Respite Care Credentials.

(a) A foster parent shall provide respite care to children who are:

(1) Living with parents or other relatives; or

(2) In out-of-home care settings.

(b) Respite care shall be provided in order to:

(1) Provide temporary overnight relief to parents, relatives, or foster parents;

(2) Allow other foster parents to attend an overnight training or conference;

(3) Allow other foster parents to take a vacation, if the child is unable to accompany the family;

(4) Prevent placement disruption of a child; or

(5) Provide a temporary foster family care setting to a child who is placed in a residential treatment program, in accordance with the child’s case plan.

(c) A foster parent providing respite care shall not be eligible for reimbursement for respite care unless prior approval was granted or supported in the child’s case plan by a DCYF administrator when:

(1) A child has already received the maximum of 14 days of respite care service per state fiscal year; or

(2) Respite care has been provided for more than 3 consecutive days.

(d) A foster parent providing respite care shall involve the caregiver and the child, if age and developmentally appropriate, in planning and making arrangements for the care of the child during respite care, including:

(1) Visits and contacts;

(2) Medical information and authorization;

(3) Work and emergency telephone numbers; and

(4) Beginning and ending dates and times of respite care.

(e) When a child is in an out-of-home setting, both the out-of-home provider and the foster parent providing respite care shall be eligible to receive reimbursement for the care of the child for the days in which the child receives respite care, with the exception of foster care programs under He-C 6355 which include respite care as a part of the foster care service requirements.

Source. (See Revision Note at part heading for He-C 6347) #9266, eff 9-20-08; rpld by #9514, eff 7-18-09

New. #12134, eff 3-18-17; ss by #13055, eff 6-16-20

He-C 6347.07 Requirements for Specialized Care Credential.

(a) In addition to being in compliance with He-C 6446, a foster parent seeking a specialized care credential shall:

(1) Have at least one year of experience as a foster parent;

(2) Provide one written reference from a professional, such as a currently licensed foster parent, physician, therapist, or teacher who has personal knowledge of the foster parent’s ability to observe and assess children’s behavior;

(3) Provide one written reference from a CPSW or a JPPO who is familiar with the foster parent’s experience with children in foster care;

(4) Attend 21 hours of DCYF-approved training for specialized care, which includes topics relating to:

a. Introduction to specialized care that includes the following topics:

1. Foster care as a family support service;

2. The role of the foster parent in case assessment and planning;

3. How to clearly describe the behaviors of children; and

4. The importance of establishing case objectives and action steps to achieve those objectives;

b. Behavior management;

c. Handling sexualized behaviors;

d. Caring for children with developmental disabilities;

e. Caring for children with emotional disabilities; and

f. Working with the primary families to encourage the family members to remain active participants in the life of the child; and

(5) Have sufficient experience and education, as demonstrated through compliance with He-C 6446.16 through He-C 6446.19 to care for a child with special needs.

(b) A foster parent providing specialized care shall complete a minimum of 24 hours of in-service training during the 2 year licensing period pursuant to He-C 6446.14(k), 12 hours of which shall be related to the special needs of the child in care or as approved by the DCYF to enable the foster parent to strengthen or develop competencies to meet the needs of child(ren) in care.

(1) Keep and maintain detailed records on each child in care, including:

a. A detailed description of the placement:

b. A description of the visits between the family with the child in care and the CPSW or JPPO; and

c. A description of other appointments kept by the child in care; and

(2) By the 15th of each month, complete and submit to the CPSW or JPPO a monthly report including the following about the child in care:

a. The name and birth date of the child:

b. The date of placement of the child in the foster home;

c. The name of the child’s CPSW or JPPO;

d. Observations of the child’s behavior and attitudes, any incidents requiring restraint or seclusion reportable under RSA 126-U:7-a, and relationship with members of the foster family;

e. Health care information;

f. Involvement with psychotherapy or counseling;

g. School attendance and performance;

h. Court action during the month; and

i. Any other information related to the health, safety, or educational progress of the child, including indications of improvement and areas of concern.

Source. (See Revision Note at part heading for He-C 6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20 (formerly He-C 6347.07)

He-C 6347.08 Requirements for Emergency Care Credential.

(a) In addition to being in compliance with He-C 6446, a foster parent seeking an emergency care credential shall attend in its entirety 6 hours of DCYF-approved training associated with emergency care that includes information on how to assist children through traumatic separation from their family while learning how to manage anger and transition.

(b) A foster parent providing emergency care shall complete and submit to the CPSW or JPPO a written report within 15 days of the departure of the child in emergency care from the foster home that includes but is not limited to the following:

(1) A detailed description of the placement;

(2) A description of the visits between the family with the child in care and the CPSW or JPPO;

(3) A description of other appointments attended by the child in care;

(4) Observations of the behavior and attitude of the child in care including any incidents requiring restraint or seclusion reportable under RSA 126-U:7-a; and

(5) Other information about the child that would be helpful to the case manager for the purposes of case planning.

Source. (See Revision Note at part heading for He-C 6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20

He-C 6347.09 Requirements for Crisis Care Credential. A foster parent providing emergency care pursuant to He-C 6347.08 shall be invited to provide crisis care via a recommendation from a DCYF staff member or a child-placing agency staff member responsible for licensing foster care providers.

Source. (See Revision Note at part heading for He-C 6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20

He-C 6347.10 Requirements for Assessment Care Credential.

(a) In addition to being in compliance with He-C 6446, a foster parent seeking an assessment care credential shall:

(1) Have at least one year of experience as a foster parent;

(3) Provide one written reference from a CPSW or a JPPO who is familiar with the foster parent’s experience with providing foster care, to include a description of the foster parent’s knowledge of the NH foster care system, other substitute care options, and services and resources available in the foster parent’s community; and

(4) Complete 6 hours of DCYF approved training related to assessment care, including information on:

a. Observing and assessing children’s behavior;

b. Record keeping; and

c. The foster parent’s role in case planning.

(b) A foster parent providing assessment care shall complete a minimum of 24 hours of in-service training during the 2-year licensing period, pursuant to He-C 6446.14(k), 16 hours of which shall be related to the development of skill and competency to assess the behavior of children in care or as approved by the licensing agency to enable the foster parent to strengthen or develop competencies to meet the needs of child(ren) in care.

(c) A foster parent providing assessment care shall provide enhanced support for the evaluation of a child placed in their home by:

(1) Providing transportation for the child to appointments and visits to meet his or her case plan goals for permanency and well-being; and

(2) Attending:

a. Scheduled monthly meetings with DCYF staff and the child in the home; and

b. Treatment team meetings, school meetings, including Individualized Education Program (IEP) meetings, family assessment and inclusive reunification review meetings, and court reviews.

(d) A foster parent providing assessment care shall keep and maintain detailed records on each child in care, which includes documentation of the following:

(1) All work with the family of the child in care to maintain communication and to gather data for court reports and the case plan;

(2) All appointments and collateral contacts of the child in care;

(3) Daily observation of the behavior patterns and episodes of the child in care, including any incidents requiring restraint or seclusion reportable under RSA 126-U:7-a;

(4) At least one foster parent providing full-time, 24 hours per day of supervision of the child; and

(5) The foster parent’s attendance of the licensing agency’s case planning meetings concerning the child.

Source. (See Revision Note at part heading for He-C 6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17; ss by #13055, eff 6-16-20

He-C 6347.11 Requirements for Adolescent Care Credential.

(a) In addition to being in compliance with He-C 6446, a foster parent seeking an adolescent care credential shall:

(1) Have at least one year of experience as a foster parent;

(3) Provide one written reference from a CPSW or a JPPO who is familiar with the foster parent’s experience and knowledge of working with adolescent children in foster care; and

(4) Complete 22 hours of DCYF-approved pre-service training related to adolescent care, including information on:

a. Introduction to being an adolescent foster home;

b. Caring for adolescents;

c . Understanding adolescent development and attachment; and

d. The foster parent’s role in future planning and preparing youth for adulthood.

(b) A foster parent providing adolescent care shall complete a minimum of 24 hours of in-service training during the 2year licensing period, 12 hours of which shall focus on enabling the foster parent to strengthen or develop competencies to meet the needs of the youth in their care.

(1) Providing modeling and instruction to the youth on adult living preparation including:

a. The development of life skills;

b. The process to identify and access resources;

c. Assisting the youth in gaining employment and volunteer opportunities;

d. Assisting the youth in applying to college or a career training program and with other aftercare planning as needed;

e. Supporting the youth participating in extracurricular activities and opportunities for the DCYF’s adolescent program sponsored activities; and

f. Assisting the youth with transition and post care planning at least 6 months before the youth will leave foster care;

(2) Implementing the adult living preparation process in consultation with the CPSW or JPPO and the youth by:

a. Completing the DHHS curriculum for preparing youth for adulthood with the youth; and

b. Developing an adult living preparation plan with the youth by completing and submitting the “Adult Living Preparation Plan” Form 1695 (January 2015 edition), signed by both the provider and the youth;

(3) Ensuring that the youth has opportunities and supports to meet his or her case plan goals for permanency, including but not limited to:

a. The opportunity to make positive connections with family, friends, and community members including a commitment to a long-term relationship and connection to the youth beyond the DCYF closure of the youth’s case or when the youth attains the age of 18 years or 21 years if jurisdiction is extended pursuant to RSA 170-E:53; and

b. Collaborating with the CPSW or JPPO and the court in identifying a primary caring adult for the youth, if the court-ordered permanency goal is another planned permanency living arrangement, in compliance with the New Hampshire circuit court’s “Protocols Relative to RSA 169-C Post- Permanency Hearings for Older Youth with a Permanency Plan of Another Planned Permanent Living Arrangement (APPLA)” available at https://www.courts.state.nh.us/fdpp/Protocols-Relative-to-RSA-169-C.pdf;

(4) Supporting the foster children’s bill of rights as set forth in RSA 170-G:21 by signing and submitting to DCYF Form 1960 “Bill of Rights for New Hampshire Youth in Care” (August 2015 edition);

(5) Providing care and supervision for no more than 2 youths who require adolescent foster care services at any one time; and

(6) Participating in planning for the youth in care by attending:

a. Scheduled monthly meetings with DCYF staff and the youth in the home;

b. Treatment team meetings, school meetings, including individualized education program meetings, family assessment and inclusive reunification review meetings, and court reviews; and

c. The youth’s 90 day transition meeting as requested by the youth.

(d) DCYF with the assistance of the youth and the foster parent providing adolescent care shall complete the documentation for the adult living preparation plan as follows:

(1) The “Needs Assessment for Adult Living,” Form 1690 (January 2015) within 30 days of placement. The completed, dated, and signed form shall be dated and signed by the youth and the youth’s CPSW or JPPO;

(2) A life skills assessment provided by DCYF within 30 days of placement;

(3) A career assessment provided by DCYF, within 60 days of placement;

(4) The “Adult Living Preparation Plan,” Form 1695 (January 2015), submitted within 60 days of placement and updated annually thereafter, which shall incorporate the results of the career assessment in (3) above and any follow-up tasks to be completed by the youth or member of the treatment team. The completed form shall be signed and dated by the youth and the foster parent; and

(5) The “Post Care Plan” Form 1984 (June 2020), 30 days prior to the youth’s 18th birthday, or within 30 days of the youth’s planned discharge if the youth will not discharge upon the youth’s 18th birthday. The completed form shall be signed and dated by the youth, the youth’s CPSW or JPPO, and any other individual who has reviewed the form such as the parent and placement provider.

(e) If acting as the current placement provider, a foster parent providing adolescent care shall complete necessary documentation as follows:

(1) Track daily living skill acquisition, and school and employment attendance;

(2) By the 10th of each month, complete and submit to the CPSW or JPPO a written monthly report on the progress of the youth towards the goals established in the “Adult Living Preparation Plan,” Form 1695 (January 2015); and

(3) For each calendar month, complete a Form 1969 “Monthly National Youth in Transition Database (NYTD) Checklist” (June 2020) and submit to the CPSW or JPPO, documenting support provided for the NYTD categories as follows:

a. Academic support;

b. Budget and financial management;

c. Career preparation;

d. Employment programs and vocational training;

e. Family support and healthy marriage education;

f. Health education and risk prevention;

g. Housing education and home management;

h. Mentoring; and

i. Post-secondary educational support.

He-C 6347.12 Requirements for Supplemental Foster Care Credential.

(a) A foster parent who is in compliance with He-C 6446 shall be provided the supplemental care credential for a child already in his or her care, when it is demonstrated that the child’s behaviors, conditions, and needs require a level of care that exceeds general care or specialized care.

(b) The areas shall be related to the child’s assessed behaviors, conditions, and needs, and to the resources that the foster parent shall be required to bring to the care of the child in placement, in accordance with his or her case plan.

(c) In order to qualify for supplemental care reimbursement, the assessed child behaviors, conditions, and needs shall include a gap in at least one of the following criteria:

(1) Behavior towards self, others, and animals, and role performance which includes but is not limited to an assessment of:

a. The child’s overt, daily actions toward self and others;

b. The child’s age and developmental stage; and

c. The type and degree of trauma experienced by the child;

(2) Medical, psychological, and developmental complicating condition which includes an assessment of the child’s physical, emotional, and psychological well-being;

(3) Caregiver resources, including an assessment of the knowledge, skills, and abilities of the foster parent to meet the needs of the child;

(4) The extent of required visitation between the child, parent, or others to achieve reunification or another permanency goal; or

(5) Accessible community resources.

(d) The daily stipend to a foster parent certified for reimbursement for supplemental care shall be directly related to the estimated out-of-pocket costs to the foster parent in order to meet the needs of the child or expectations of the case.

He-C 6347.13 Certification Process For Foster Family Care Credentials.

(a) All foster parents shall be licensed pursuant to He-C 6446 prior to seeking certification for reimbursement to provide a category of foster family care.

(b) Foster parents shall contact a DCYF resource worker or designee and request to be certified after completing the prerequisite training requirements.

(c) If a foster parent’s license is managed by a child-placing agency other than DCYF, the agency shall contact the foster care manager with the request to be certified on behalf of the foster parent who has completed the prerequisite training requirements.

He-C 6347.14 Length of Certification. Certification for reimbursement to provide a category of care shall expire at the same time as the existing foster care license expiration, unless the license and credential are renewed pursuant to He-C 6446.15 and He-C 6347.15 respectively.

He-C 6347.15 Renewal of Certification.

(a) Pursuant to RSA 170-E:32, a foster parent shall file for renewal of the foster care license 3 months prior to the expiration date of the foster family care license.

(b) The foster parent shall renew his or her foster family care license pursuant to He-C 6446.15 and verify ongoing training requirements for continued certification for reimbursement to provide a category of foster family care.

(c) Based on qualifications and performance that conforms to He-C 6347 and He-C 6446, the foster parent’s license and foster family care credential shall be renewed.

He-C 6347.16 Notification of Changes. For the period of certification, the foster parent shall notify DCYF in writing of any changes, pursuant to He-C 6446.

He-C 6347.17 Billing Requirements for Foster Care Services.

(a) Foster parents shall be certified with the foster family care credential prior to billing for the provision of a credentialed service.

(b) The foster parent shall not bill DCYF for services that are to be reimbursed by any other entity.

(d) DCYF shall determine the necessity of care and services and the determination shall be binding on the foster parent.

(e) The foster parent shall notify DCYF of any changes in tax information and complete and submit to DCYF a signed “State of New Hampshire Alternate W-9” Form (October 2016) with current tax information. When completing this form the foster parent shall be considered a service provider or other provider when choosing his or her principle activity.

(f) The foster parent shall provide services or care without discrimination as required by Title VI of the Civil Rights Act of 1964, as amended, and without discrimination on the basis of handicap as required by Section 504 of the Rehabilitation Act of 1973, as amended.

He-C 6347.18 Billing Process for Foster Care Services.

(a) DHHS shall issue reimbursements to foster parents for general care, specialized care, assessment care, or adolescent care services provided to a child at the rate established in He-C 6423.

(b) DCYF shall issue board and care invoices to foster parents to submit to DHHS for reimbursement of emergency care and crisis care services provided to a child.

(c) Prior to service delivery for respite care or supplemental care, a foster parent shall obtain a “Service Authorization” Form 2110 (June 2008 edition) from the CPSW or JPPO.

(d) Respite care and supplemental care services shall not be paid unless DHHS receives a signed and dated “Service Authorization” Form 2110 (June 2008 edition) from the foster parent.

(e) When requesting a stipend for respite care or supplemental care services, a foster parent shall:

(1) Copy the “Service Authorization” Form 2110 (June 2008 edition) for future billing, if the authorized service dates span a date range; and

(2) Forward the completed and signed “Service Authorization” Form 2110 (June 2008 edition) to DHHS.

(f) The handwritten signature in (e)(2) above shall be submitted to DHHS and shall certify that the foster parent agrees:

(1) The billing was completed in accordance with this section;

(2) The invoice includes only the days and overnights for which services were provided;

(3) The billing is true and accurate; and

(4) Any payment made for inaccurate or fraudulent billing will be recovered by DHHS.

He-C 6347.19 Billing Period.

(a) A foster parent shall bill within one year of service provision.

(b) Any bill received for payment one year after service date shall be denied pursuant to RSA 126-A:3.

He-C 6347.20 Billing Discrepancies. Foster parents who have a billing discrepancy shall contact the provider relations’ staff of DHHS’s office of finance for assistance by:

(a) Email at provider.relations@dhhs.state.nh.us;

(b) Telephone at (800) 852-3345, ext. 4954 or (603) 271-4954; or

DCYF-Provider Relations

The Department of Health and Human Services

129 Pleasant Street

Concord, NH 03301.

He-C 6347.21 Quality Assurance Activities.

(a) The foster parent shall submit to a biennial review to determine the quality of services pursuant to RSA 170-G:4 XVIII which includes, but is not limited to:

(1) The foster parents continued compliance with He-C 6446 and He-C 6347;

(2) Services provided to the child;

(3) The outcomes achieved for the child in care;

(4) Progress towards the child’s permanency goals;

(5) An interview with foster parents; and

(6) An interview with the child in care, if age appropriate.

(b) The biennial review described in (a) above shall coincide with the renewal date of the foster parent’s foster family care license.

He-C 6347.22 Waivers.

(a) Foster parents who request a waiver of the requirement in He-C 6347 shall submit a written request to the commissioner of the department of health and human services or his or her designee, which includes the following:

(1) The reason for requesting the waiver of the requirement in a specific credential;

(2) The anticipated length of time the requested waiver will be needed;

(3) Assurance that if the waiver is granted the quality of service and care to children, youth, and families will not be affected;

(4) A written plan to achieve compliance with the rule or explaining how the foster parent will satisfy the intent of the rule if the waiver is granted;

(5) The number and ages of children who will be affected by the requested waiver; and

(6) The signature of the person requesting the waiver.

(b) A CPSW or JPPO shall request a waiver on behalf of a foster family if a specific credential is needed to adequately provide for the needs and circumstances of a specific child or sibling group.

(c) Request for a waiver of any of the provisions of RSA 170-E, or any other rules referred to in this part or of any other state agencies, shall not be permitted.

(d) Request for a waiver shall be denied when:

(1) The request does not comply with (a) above;

(2) The department finds that approval of the requested waiver will jeopardize the health or safety of the child(ren) in care;

(3) The department finds that approval of the requested waiver will impair the foster parent’s ability to adequately care for the child(ren) in care; or

(4) The department finds that the written plan described in (a)(4) above does not satisfy the intent of the rule as an alternative to complying with the rule.

Source. (See Revision Note at part heading for He-C 6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17 (formerly He-C 6347.23) ; ss by #13055, eff 6-16-20 (formerly He-C 6347.18)

He-C 6347.23 Denial or Termination of Credential Certification. A request for certification for reimbursement for a category of care for which the foster parent has an initial or renewed credential shall be denied, or certification terminated, if:

(a) The foster parent is no longer licensed pursuant to He-C 6446;

(b) The foster parent or the individual acting on the foster parent’s behalf, submits materially false information to DCYF; or

He-C 6347.24 Notification of Denial or Termination.

(a) If DCYF denies an application request for certification or terminates an existing foster family care credential, DCYF shall send notice of the denial or termination to the foster parent by certified mail.

(b) The notice shall:

(1) Inform the foster parent of the facts or conduct upon which DCYF bases its action;

(2) Advise the foster parent of their right to request reconsideration of DCYF’s decision through informal dispute resolution pursuant to He-C 6347.25; and

(3) In the case of an existing certification, inform the foster parent that the termination shall not take effect until the foster parent has had an opportunity through an appeal, pursuant to RSA 170-G:4-a and He-C 6347.26, to show compliance with all lawful requirements for retention of the credential.

He-C 6347.25 Request for Informal Dispute Resolution.

(a) DCYF shall offer an opportunity for informal dispute resolution to any foster parent who disagrees with a denial or termination of a credential, provided that the foster parent submits a written request for an informal dispute resolution:

(1) The informal dispute resolution shall be requested in writing by the foster parent no later than 14 days from the date the notice was issued by DCYF;

(2) DCYF shall review the evidence presented and provide a written notice to the foster parent of its decision; and

(3) An informal dispute resolution shall not be available for any foster parent against whom DCYF has initiated action to revoke a license or deny a renewal license.

(b) The foster parent may appeal DCYF’s decision pursuant to He-C 6347.26.

He-C 6347.26 Appeals.

(a) Administrative appeals of DHHS decisions to terminate or deny a foster family care credential shall be conducted in accordance with RSA 170-E:37, RSA 541-A, He-C 200, and this section.

(b) Appeal requests shall be filed within 10 days of the date of the notice of action.

(c) Parties to any administrative hearing who are aggrieved by the decision of the departmental hearings officer may request a reconsideration in accordance with He-C 206, or may file an appeal of the decision with the superior court, in accordance with the provisions of RSA 170-E:37.

(d) Parties who are aggrieved by the decision of the hearings officer to deny the request for a reconsideration, or with the hearings officer’s decision after a rehearing has been conducted, may appeal the decision to the superior court, in accordance with the provisions of RSA 170-E:37.

Source. (See Revision Note at part heading for He-C 6347) #9266, eff 9-20-08; ss by #11181, INTERIM, eff 9-19-16, EXPIRES: 3-18-17; ss by #12134, eff 3-18-17 (formerly He-C 6347.23); ss by #13055, eff 6-16-20 (formerly He-C 6347.22)

PART He-C 6348 CERTIFICATION PAYMENT STANDARDS FOR HEALTH CARE AND LABORATORY SERVICE PROVIDERS

Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:5

REVISION NOTE:

Document #9267, effective 9-20-08, adopted Part He-C 6348 relative to certification for payment standards for medical/dental service providers. This part incorporated provisions from the former Part He-C 6352 entitled “Certification for Payment Standards for Community-Based Service Providers” and made extensive changes to the wording, format, structure, and numbering of those provisions.

Document #9267 supersedes all prior filings in the former Part He-C 6352 relative to certification for payment standards for medical/dental service providers. The filings affecting the former Part He-C 6352 include the following documents:

#4446, eff 7-1-88

#5096, eff 3-15-91, EXPIRED 3-15-97

#7292, eff 5-24-00

#8009, eff 1-1-04

#9112, INTERIM, eff 3-24-08, EXPIRED 9-20-08

He-C 6348.01 Purpose. The purpose is to identify the qualifications and compliance requirements to become a provider of health care or laboratory services for the division for children, youth and families (DCYF).

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17

He-C 6348.02 Scope. This part shall apply to health care or laboratory service providers who receive financial reimbursement from DCYF for services provided to children and parents involved with DCYF pursuant to a court order.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17

He-C 6348.03 Definitions.

(a) “Agency” means the board of directors, executive director, and employees of an organization that is incorporated and recognized by the NH secretary of state.

(b) “Applicant” means the person or entity that is requesting certification for payment as a health care or laboratory service provider.

(c) “Certification for payment” means the process by which DCYF approves the qualifications of and reimbursement to providers of health care or laboratory services.

(d) “Child” means “child” as defined in RSA 170-E:25, 1 or “child” as defined in RSA 169-C:3 or “child” as defined by RSA 169-D:2.

(e) “Commissioner” means the commissioner of the New Hampshire department of health and human services or designee.

(f) “Court order” means a written decree that is issued by a district, family, superior, probate, or Supreme Court.

(g) “Department (DHHS)” means the department of health and human services of the state of New Hampshire.

(h) “Division for children, youth, and families (DCYF)” means the organizational unit of the department of health and human services that provides services to children and youth referred by courts pursuant to RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, and RSA 463.

(i) “Health care” means preventive or corrective medical, dental, and psychiatric diagnostic and treatment services provided to Medicaid ineligible children.

(j) “Laboratory” means the testing facility authorized by the State of New Hampshire to screen human specimens for presence of a drug, or drug group, or its metabolites, or other court-ordered laboratory testing that does not qualify for payment by Medicaid.

(k) “NH bridges” means the automated case management, information, tracking, and reimbursement system used by DCYF.

(l) “Parent” means an individual who has a birth, adoptive, or step-parent relationship to a child.

(m) “Provider” means the individual or agency that provides healthcare or laboratory services to a child or parent and receives financial reimbursement from DHHS.

(n) “Service authorization” means the documentation provided by DCYF indicating DHHS’s responsibility for payment of healthcare and laboratory services provided that do not qualify for payment by Medicaid.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17

He-C 6348.04 Requirements for Provider of Health Care and Laboratory Services Enrollment.

(a) DCYF shall authorize payment for preventative or corrective health care services for children ineligible for Medicaid, pursuant to a court order.

(b) DCYF shall authorize payment for Medicaid ineligible laboratory services pursuant to a court order.

(c) Prior to applying for certification, a provider shall be licensed or registered as required by the state licensing entity, and shall maintain compliance with all applicable New Hampshire rules and laws including:

(1) For dentists and dentistry, comply with RSA 317;

(2) For physicians, including psychiatrists and surgeons, comply with RSA 329;

(3) For hospitals and clinics, comply with RSA 151;

(4) For optometrists, comply with RSA 327;

(5) For chiropractors, comply with RSA 316-A;

(6) For pharmacists and pharmacies, comply with RSA 318;

(7) For podiatrists, comply with RSA 315;

(8) For radiologists, comply with RSA 329;

(9) For emergency medical services, comply with RSA 151;

(10) For laboratory testing services providers, comply with RSA 151:2; and

(11) For any other health care providers, comply with their respective New Hampshire law or rule.

(d) Prior to applying for certification, any out of state provider shall be licensed or registered as required by the state licensing entity, and shall maintain compliance with all laws and rules to be authorized to practice in his or her state.

(e) All providers shall comply with:

(1) The confidentiality statutes of RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:23, RSA 170-C:14, and RSA 170-G:8-a;

(2) The child abuse and neglect reporting requirements of RSA 169-C:29-30; and

(3) All applicable provisions of the health insurance portability and accountability act (HIPAA).

(f) A provider of health care services shall meet medical assistance requirements of He-W 500 and He-M 426.

(g) The provider and his or her employees and subcontractors shall not have a conflict of interest, as defined in RSA 21-G:21, II.

(h) The provider shall maintain general and professional liability insurance.

(i) Laboratory services shall be provided by a laboratory service which holds a current New Hampshire license pursuant to RSA 151:2. The laboratory service shall subcontract only to a laboratory service provider which has a valid New Hampshire license or is licensed in the state in which it operates.

(j) Failure to comply with the rules of this chapter shall result in:

(1) Denial of an applicant pursuant to He-C 6348.13;

(2) Revocation of certification for payment pursuant to He-C 6348.13; or

(3) Denial of reimbursement.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17

He-C 6348.05 Application for Payment Process for Providers of Health Care and Laboratory Services.

(a) Providers of health care services providing a service to a Medicaid ineligible child pursuant to a court order shall apply for certification for payment from DCYF.

(b) Providers of laboratory services providing a Medicaid ineligible service to a child or parent pursuant to a court order shall apply for certification for payment from DCYF.

(1) A Form 2619 “Application for Certification of Health Care and Laboratory Service Providers”(September 2016 );

(2) An “Alternate W-9 FORM –CIS (10/97)”; and

(3) A copy of He-C 6348.

(d) Applicants shall return a signed and dated Form 2619 “Application for Certification of Health Care and Laboratory Service Providers" (September 2016) to DCYF.

(e) The applicant shall provide a copy of the verification of his or her state regulatory license or authorization to practice.

(f) The applicant’s signature on the application shall constitute an acceptance of the terms below:

(1) The provider has read and understood He-C 6348; and

(2) The information contained in the application is true and correct to the best of the applicant's knowledge; and

(3) That all employees providing services to the child or parent are licensed and authorized to practice by the appropriate licensing entity in the provider’s state.

(g) The applicant shall complete and return the application within 30 calendar days to the DCYF provider relations together with the alternate W-9 and the appropriate verification.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17

He-C 6348.06 Renewal of Certification and Notification of Changes for Enrolled Providers of Health Care and Laboratory Services.

(a) Health care and laboratory providers shall submit to DCYF a current copy of the verification of licensure by the appropriate state licensing board(s) at the time of license renewal.

(b) Providers shall submit a copy of any renewed license verification to DCYF within 10 calendar days of its receipt.

(c) Review of continued certification shall coincide with the date of expiration of the health care or laboratory provider’s license.

(d) For the period of certification, the provider shall notify DCYF in writing within 10 calendar days of any change in the information contained in the application and provide documentation of the change.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17

He-C 6348.07 Billing Requirements for Providers of Health Care and Laboratory Services.

(a) Providers shall be certified as a provider of health care or laboratory services and enrolled on NH bridges.

(b) Provider shall not bill DCYF for services that are to be reimbursed by any other entity.

(d) Providers shall notify DCYF of any changes in tax information and complete and submit to DCYF a signed Alternate W-9 Form –CIS (10/97) with current tax information.

(e) Providers shall provide services or care without discrimination as required by Title VI of the Civil Rights Act of 1964, as amended, and without discrimination on the basis of handicap as required by Section 504 of the Rehabilitation Act of 1973, as amended.

(f) The provider’s certification and enrollment shall terminate upon date of sale or transfer of ownership or close of the agency.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17

He-C 6348.08 Billing Process for Providers of Health Care and Laboratory Services.

(a) A provider shall receive a service authorization form for each time a service is provided.

(b) A provider shall bill the department through NH Bridges for health care services to Medicaid ineligible children and Medicaid ineligible laboratory services via paper claims.

(1) Copy the service authorization for future billings, if the authorized service dates span a date range; and

(2) Forward the completed and signed service authorization to DCYF with an invoice attached.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17

He-C 6348.09 Billing Period.

(a) Providers shall bill within one year of service provision.

(b) Any bill received for payment one year or more after service date shall be denied pursuant to RSA 126-A:3.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17 (from He-C 6348.15)

He-C 6348.10 Billing Discrepancies. Questions regarding billing discrepancies shall be directed to the provider relations’ staff of the bureau of administrative operations.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17 (from He-C 6348.16)

He-C 6348.11 Record Retention.

(a) A provider shall retain records supporting each bill submitted to DCYF for a period of no less than 7 years after the completion date of services provided.

(b) Records shall clearly document the extent of care and services provided to the children and families, and any information regarding any payment claimed.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17 (from He-C 6348.17)

He-C 6348.12 Monitoring of Enrolled Providers for Health Care and Laboratory Services.

(a) The provider shall allow random or scheduled on-site visits by DCYF, for the purposes of reviewing program documents to determine continued compliance with He-C 6348 regarding the specific child for which the provider is enrolled.

(b) Need for the service shall be reviewed by DCYF, pursuant to RSA 170-G:4 VI and RSA 170-G:4 XVIII.

(c) DCYF shall review communications provided by licensing bodies, regulatory boards, and professional associations for disciplinary actions, or findings of civil liability, professional misconduct, or ethical violation by an enrolled provider.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17

He-C 6348.13 Denial of Application or Revocation of Certification. An application for certification shall be denied or provider certification revoked if:

(a) DCYF determines that the state does not have a need for the service;

(b) The provider, if enrolled with NH Medicaid, loses Medicaid enrollment;

(c) The applicant or provider, or the individual acting on the applicant’s or provider’s behalf, submits materially false information to DCYF;

(d) There has been a conviction for a felony or any crime against a child that has not been annulled or overturned;

(e) There has been disciplinary action taken by a licensing body or professional society, a finding of civil liability made for professional misconduct, or a finding of an ethical violation made by a state or national professional association or any other state’s regulatory board;

(f) There has been revocation of membership on any hospital, medical, or allied health provider staff;

(g) There has been revocation of provider status with any professional health care or laboratory group or health maintenance organization;

(h) There has been revocation of clinical privileges;

(i) There has been termination of academic appointment by an institution;

(j) There has been cancellation of professional or general liability insurance by the insurance company;

(k) There has been abusive or neglectful treatment of a child as determined by any state statute; or

(l) There has been failure to comply with He-C 6348.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17 (from He-C 6348.21)

He-C 6348.14 Notification of Denial or Revocation.

(a) If DCYF denies an application for certification or revokes an existing certification, DCYF shall send notice of the denial or revocation to the applicant or provider by certified mail.

(b) The notice shall:

(1) Inform the applicant or provider of the facts or conduct upon which DCYF bases its action; and

(2) In the case of an existing certification, inform the provider that the revocation shall not take effect until the provider has had an opportunity through an appeal, pursuant to RSA 170-G:4-a and He-C 200, to show compliance with all lawful requirements for retention of the certification.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17 (from He-C 6348.22)

He-C 6348.15 Appeals.

(a) Applicants or providers who wish to appeal a decision to deny an application or revoke certification shall file an appeal with the commissioner, pursuant to RSA 170-G:4-a.; and

(b) In accordance with RSA 170-G:4-a the appeal shall:

(1) Be made in writing;

(2) Be signed and dated;

(3) State the reasons for the appeal pursuant to RSA 170-G:4-a; and

(4) Be filed within 14 working days of the date of receipt of written notification.

Source. (See Revision Note at part heading for He-C 6348) #9267, eff 9-20-08; ss by #12127, eff 3-10-17 (from He-C 6348.24)

PART He-C 6349 CERTIFICATION PAYMENT STANDARDS FOR LICENSED AND LICENSE EXEMPT CHILD CARE SERVICE PROVIDERS

Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:5

REVISION NOTE:

Document #9268, effective 9-20-08, adopted Part He-C 6349 relative to certification for payment standards for child care services providers. This part incorporated provisions from the former Part He-C 6352 entitled “Certification for Payment Standards for Community-Based Service Providers” and made extensive changes to the wording, format, structure, and numbering of those provisions.

Document #9268 supersedes all prior filings in the former Part He-C 6352 relative to certification for payment standards for child care services providers. The filings affecting the former Part He-C 6352 include the following documents:

#4446, eff 7-1-88

#5096, eff 3-15-91, EXPIRED 3-15-97

#7292, eff 5-24-00

#8009, eff 1-1-04

#9112, INTERIM, eff 3-24-08, EXPIRED 9-20-08

He-C 6349.01 Purpose. The purpose of this part is to identify the qualifications and performance requirements to become a provider of licensed and licensed exempt child care services for the division for children, youth and families (DCYF) and the division for juvenile justice services (DJJS) and describe licensed and licensed exempt child care services.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.02 Scope. This part shall apply to licensed and licensed exempt child care service providers who receive financial reimbursement from the department of health and human services (DHHS) for services provided to children and families.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.03 Definitions.

(a) “Agency” means the board of directors, executive director, and employees of an organization that is incorporated and recognized by the NH secretary of state.

(b) “Applicant” means the person or entity that is requesting certification for payment as a child care service provider.

(c) “Case plan” means the division for children, youth and families or the division or juvenile justice services written document, pursuant to RSA 170-G:4, III, that describes the service plan for the child and family, and addresses outcomes, tasks, responsible parties, and timeframes for correcting problems that led to abuse, neglect, delinquency, or child in need of services (CHINS).

(d) “Certification for payment” means the process by which DCYF approves the qualifications of and payment to providers of child care services.

(e) “Child or minor” means an individual from birth through age 20, except as otherwise stated in a specific provision.

(f) “Child care services” means the care and supervision of a child away from the child’s home and apart from the child’s parents.

(h) “Commissioner” means the commissioner of the department of health and human services or his or her designee.

(i) “Conflict of interest” means a situation, circumstance, or financial interest, which has the potential to cause a private interest to interfere with the proper exercise of a public duty.

(j) “Corporal punishment” means the deliberate infliction of pain intended to correct behavior or to punish.

(k) “Court-ordered” means a written decree that is issued by a district, family, superior, probate, or Supreme Court.

(l) “Department (DHHS)” means the department of health and human services.

(m) “Director” means the director of the division for children, youth, and families or his or her designee.

(o) “Division for juvenile justice services (DJJS)” means the organizational unit of the department of health and human services that provides supervision and services to children and youth referred by courts or the juvenile parole board pursuant to RSA 169-B, RSA 169-D and RSA 170-H.

(p) “Founded” means a report of abuse or neglect where the department has determined that there is a preponderance of the evidence to believe that a child has been abused or neglected.

(q) “Juvenile probation and parole officer (JPPO)” means an employee of DJJS who discharges the powers and duties established by RSA 170-G:16, and supervises paroled delinquents pursuant to RSA 170-H.

(r) “Licensed,” means an authorization granted by the commissioner to provide one or more types of child care services.

(s) “Licensed exempt” means a child care provider who is not required to be licensed in accordance with RSA 170-E.

(t) “NH bridges” means the automated case management, information, tracking, and reimbursement system used by DCYF.

(u) “Provider” means the individual or agency that serves a child or family and receives financial reimbursement from DHHS.

(v) “Quality assurance” means the process that DCYF uses to monitor the quality and effectiveness of child care services.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.04 Licensed And Licensed Exempt Child Care Compliance Requirements.

(a) The provider shall comply with:

(1) All applicable licensing and registration requirements prior to applying for certification;

(2) The statutes regarding confidentiality, including RSA 169-B:35, RSA 169-C:25, RSA 169-D:25, RSA 170-B:19, RSA 170-C:14, and RSA 170-G:8-a;

(3) The child abuse and neglect reporting requirements of RSA 169-C 29-30; and

(4) Billing requirements and process described in He-C 6349.11 and He-C 6349.12.

(b) The provider, their employees and any volunteers prior to beginning their work with children and thereafter on an annual basis shall review sections of RSA 169 on definitions, immunity from liability and persons required to report.

(d) The provider shall maintain professional and general liability insurance.

(e) A licensed provider shall:

(1) Comply with He-C 4000, NH child care agency licensing rules; and

(2) Submit a copy of the child care license to DCYF at the time of application for certification and review of continued certification compliance for payment.

(f) Child care services shall be provided for children who are ages birth through 12, unless in the case plan it is determined that a child up to age 17 needs child care, including:

(1) Children in foster care who:

a. Need socialization;

b. Need care during non-school hours; or

c. Require full time court-ordered child care in a licensed care setting while their foster parents are working;

(2) Children who remain in the parents’ home and the family is involved in a founded report of abuse or neglect, pursuant to RSA 169-C:3 XIII-a;

(3) Children who remain in the parents’ home and child care is provided to prevent child abuse or neglect to rehabilitate the family, or to reunite the family; and

(4) Children who are diagnosed by a physician, psychiatrist or psychologist as being physically, mentally or emotionally handicapped and who do not meet the requirements for an educationally disabled child, pursuant to RSA 186-C:2.

(g) A licensed foster parent shall not provide or be reimbursed for child care services for foster children or other children who reside on a full-time basis in his or her foster home unless they meet the provisions of He-C 6446.

(h) Each provider for child care services shall:

(1) Provide a safe and healthy environment and be able to recognize and prevent hazards to the child’s health and safety;

(2) Provide regular activities including nutritious meals, snacks, rest, toileting, and indoor and outdoor play appropriate to the age level of the child in care;

(3) Support the child’s behavior with positive guidance and limits;

(4) At no time use corporal punishment;

(5) Not associate punishment with food, rest or toilet training;

(6) Ensure that sound health practices are followed;

(7) Maintain a valid driver’s license and have no alcohol or other drug related driving convictions for each provider who transports children to child care activities;

(8) Maintain a file at the child care site on each child that includes the following information:

a. Parent’s or guardian’s name, address, and telephone number;

b. Child’s name, age, atypical behaviors, routines, medical history, and special medical considerations;

c. Emergency information for reaching a parent or substitute caregiver;

d. The names of persons authorized to take the child from the child care environment; and

e. DCYF service authorization forms and corresponding billing records.

(9) Maintain attendance records which reflect the dates and hours attended by each child;

(10) Support the child’s relationship with parents or caregivers by regularly sharing information about the needs and progress of the child in care;

(11) Support the case plan by sharing information on the child’s progress with DCYF; and

(12) Submit to a child abuse and neglect state registry and state criminal records check pursuant to RSA 170-E:3-a and 170-E:7.

(i) Failure to comply with the rules of this chapter shall result in:

(1) Denial of an applicant pursuant to He-C 6349.18;

(2) Revocation of certification for payment of a provider pursuant to He-C 6349.18; or

(3) Denial of reimbursement.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.05 Requirements for Licensed Child Care Services.

(a) A provider for child care services shall be:

(1) A family child care home or family group care home licensed pursuant to RSA 170-E:2 IV (a) and RSA 170-E:3 IV (b);

(2) A group child care agency or center-based care licensed pursuant to RSA 170-E:2 IV(c) and RSA 170-E:3 IV(d); or

(3) An individual located in another state who meets the licensing requirements of that state for a child care provider.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.06 Requirements for Licensed Exempt Child Care Services.

(a) In addition to the requirements in He-C 6349.04, a license-exempt provider shall:

(1) Care for no more than 3 unrelated children, regularly for any part of the day, but less than 24 hours;

(2) Be at least 16 years of age;

(3) Be able to communicate his or her needs and the needs of the child in an emergency;

(4) Be in good health and have been examined by a licensed physician within one year prior to applying for certification as a child care provider, and submit the medical information statement as described in He-C 6349.08, verifying health status from a medical professional at the time of application for certification and at review of continued compliance;

(5) Provide the names of references, at the time of application for certification, from 3 unrelated individuals who are familiar with the provider’s experience in caring for children;

(6) Agree that, at the time of application for certification and at review of continued certification compliance for payment, DCYF shall submit his or her name and the names of household members who have contact with children to the department of safety for a criminal records check, pursuant to RSA 170-E:3-a;

(7) Agree that, at the time of application for certification and recertification for payment, DCYF shall submit his or her name and the names of household members who have contact with children to the DCYF child abuse and neglect central registry, and to the central registry in any other state where the applicant, provider, or household member has resided in the previous 5 years, to determine whether there has been a founded child abuse and neglect report, pursuant to RSA 170-E:3-a and RSA 169-C:3 XIII-a;

(8) Agree to allow a CPSW or JPPO or to visit during the application process to ensure that the home provides a healthy, clean, and safe environment for the care of children;

(9) Agree to allow an inspection and approval by the local fire or health officials if an environmental risk to the child is identified by the CPSW/JPPO during the visit;

(10) Agree to allow a CPSW or JPPO to visit, during the time a child receives child care, to observe the child and assure compliance with He-C 6349; and

(11) Agree to allow a CPSW or JPPO to visit during operating hours when DCYF receives a complaint about the provider’s compliance with He-C 6349.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.07 Application Process For Payment Standards For Licensed Child Care Services.

(a) Applicants who seek initial certification for payment standards for child care services shall contact a DCYF/DJJS district office supervisor or designee and request to be referred for certification.

(b) The DCYF/DJJS district office supervisor or DCYF certification specialist shall assess the need for services, based on the following criteria:

(1) The number of children and families who require services exceeds the available community resources;

(2) A specialized service is necessary to meet the unique needs of children and families, and there are no currently certified providers who can provide the specialized service; and

(3) Any other case circumstance which requires the provision of services pursuant to a court order.

(c) If there is a need for a service based on (b) above, DCYF/DJJS shall forward an application packet to the applicant which includes:

(1) An “Application For Certification of Licensed Child Care Service Providers”;

(2) An “Alternate W-9”;

(3) A “Licensed Provider Agreement”; and

(4) He-C 6349.

(d) Each applicant and household member shall provide a statement indicating:

(1) Whether the applicant or any employee has ever been subject to disciplinary action by a licensing body or professional society, been found civilly liable for professional misconduct, or found to have committed an ethical violation by a state or national professional association or any other state’s regulatory board, and if so, the name of the licensing body or professional society, the reasons, dates, and results.

(2) Whether the applicant or any employee is currently listed in any child abuse and neglect state registry as having abused or neglected a child, and if so, the dates and reasons.

(e) The applicant shall sign the application.

(f) The applicant’s signature shall constitute an acceptance of the terms below:

(1) The provider has read and understood He-C 6349;

(2) DCYF shall review financial information submitted for reimbursement for services provided to children and families; and

(3) The information contained in the application is true and correct to the best of the applicant's knowledge.

(g) Each applicant shall complete and return the application within 30 days to the DCYF certification specialist together with the following documents specified in He-C 6349.07(c) above:

(1) The “Licensed Provider Agreement”; and

(2) The “Alternate W-9”.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.08 Application Process For Payment Standards For Licensed Exempt Child Care Services.

(a) Applicants who seek initial certification to provide child in home care services shall contact a DCYF or DJJS district office supervisor or designee and request to be referred for certification for payment.

(b) The DCYF/DJJS district office supervisor or DCYF certification specialist shall assess the need for services, based on the following criteria:

(1) The number of children and families who require services exceeds the available community resources;

(2) A specialized service is necessary to meet the unique needs of children and families, and there are no currently certified providers who can provide the specialized service; and

(3) Any other case circumstance which requires the provision of services pursuant to a court order.

(c) If there is a need for a service based on (b) above, DCYF/DJJS shall forward an application packet to the applicant which includes:

(1) An “Application For Certification of Licensed Exempt Child Care service Providers”;

(2) A “Licensed-Exempt Provider Agreement”;

(3) An “Alternate W-9”;

(4) He-C 6349;

(5) A “Medical information Statement”;

(6) A “Service Provider Reference”;

(7) A “Criminal Record Release Authorization” for the provider and all household members 17 years of age and older; and

(8) A “Central Registry Name Search Authorization” for the provider and all household members 10 years of age and older.

(d) If the individual whose name has been submitted for a criminal background check has been convicted of crimes against a minor or an adult or is the subject of a founded report of child abuse or neglect, the department shall conduct an investigation pursuant to He-C 6920.10 to determine whether the individual poses a threat to the safety of children.

(e) Each applicant and household member shall provide a statement indicating:

(1) Whether the applicant or any household member has ever been subject to disciplinary action by a licensing body or professional society, been found civilly liable for professional misconduct, or found to have committed an ethical violation by a state or national professional association or any other state’s regulatory board, and if so, the name of the licensing body or professional society, the reasons, dates, and results; and

(2) Whether the applicant or any household member is currently listed in any child abuse and neglect state registry as having abused or neglected a child, and if so, the dates and reasons.

(f) The applicant shall sign the application.

(g) The applicant’s signature shall constitute an acceptance of the terms below:

(1) The provider has read and understood He-C 6349;

(2) DCYF shall review financial information submitted for reimbursement for services provided to children and families; and

(3) The information contained in the application is true and correct to the best of the applicant's knowledge.

(h) Each applicant shall complete and return the application within 30 days to the DCYF certification specialist together with the following documents specified in He-C 6349.08(c):

(1) The alternate W-9;

(2) The licensed-exempt provider agreement;

(3) A “Medical information Statement”;

(4) A “"Service Provider Reference”;

(5) The criminal record release authorization form; and

(6) The central registry name search authorization.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.09 Review of Continued Certification Compliance.

(a) All providers shall complete a review form, as provided by DCYF, within 30 days of the receipt.

(b) Providers that do not submit a review form within 30 days of receipt shall have their certification revoked in accordance with He-C 6349.18 and denied payment.

(c) Continuance of certification shall be based on a review and verification of the provider’s compliance with service requirements.

(d) Review of continued certification compliance shall occur every 2 years from the date of issue for licensed-exempt providers and shall coincide with the licensing date for licensed providers.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.10 Notification of Changes.

(a) For the period of certification, all providers shall notify DCYF in writing within 10 days of any change in the information contained in the application and provide documentation of the change.

(b) At the time of expiration of mandatory state licenses, the provider shall submit a copy of the renewed license to DCYF within 10 days.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.11 Billing Requirements for License and Licensed-Exempt Child Care Provider Services.

(a) Prior to the start of service delivery, providers shall be certified and enrolled as a provider of licensed or licensed-exempt child care services.

(b) Providers shall not exceed the rates established in He-C 6910.15 nor shall the rates exceed those charged by the provider for non-DCYF/DJJS children.

(d) Providers shall accept payments made by DCYF/DJJS as payments in full for the services it provides.

(e) DCYF/DJJS shall determine the necessity of care and services and the determination shall be binding on the provider.

(f) The provider shall notify DCYF of any changes in tax information and complete and submit to DCYF a signed alternate W-9 form with current tax information.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.12 Billing Process for Licensed and Licensed Exempt Child Care Services.

(a) A provider shall bill DHHS via paper claims on a bi-weekly basis utilizing the “Child Care Services Authorization” form or on a weekly basis through NH Bridges on the automated billing system.

(b) For paper claim submission, the provider shall:

(1) Complete the number of hours the child attended each day during the billing period and enter the total amount charged in the anticipated payment field; and

(2) Complete the provider signature and mail the completed invoice to:

DHHS, Data Management Unit

PO Box 2000

Concord NH 03301-2000

(1) Be approved and authenticated to submit claims via web billing and have received a logon and password access to provider web billing; and

(2) Select the recipient(s) and timeframe(s) for which they wish to submit claims from their list of approved service authorizations.

(d) Absent units shall be paid only when the following conditions are met:

(1) Other families are billed for absent units;

(2) The child care facility was open for business during the time the absence was claimed;

(3) The child was scheduled to attend on the day the absence was claimed; and

(4) If a child is enrolled part time, the number of units billed for an absent day shall be the number of hours the child was scheduled for that day.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.13 Billing Period.

(a) Providers shall bill within one year of service provision.

(b) Any bill received for payment one year or more after service date shall be denied pursuant to RSA 126-A:3.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.14 Billing Discrepancies. Questions regarding billing discrepancies shall be directed to the provider relations’ staff of the bureau of administrative operations in DCYF.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.15 Record-Keeping and Record Retention.

(a) A provider shall retain records for a period of no less then 7 years after the completion date of services provided for each bill submitted to the department.

(b) The provider shall keep records as are necessary to comply with RSA 170-E:42, when applicable, and to comply with DCYF/DJJS record keeping requirements in He-C 6349.

(c) Records shall clearly document the extent of the care and service provided to the families, including attendance records when those services are charged to the department, and information regarding any payment claimed.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.16 Quality Assurance Activities.

(a) Providers shall be subject to quality assurance reviews conducted by DCYF and DJJS using a variety of activities such as a combination of record reviews, performance data measurements and visits to providers.

(b) Providers shall allow an on-site visit by DCYF or DJJS, which may be random or scheduled, for the purposes of:

(1) Interviewing providers;

(2) Interviewing children and families served;

(3) A review of service billing records; or

(4) Reviewing provider documents to determine continued compliance with He-C 6349.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.17 Waivers.

(a) Applicants or providers who request a waiver of a requirement in He-C 6349 shall submit a written request to the commissioner or his or her designee that includes the following information:

(1) The reason for requesting the waiver;

(2) The anticipated length of time the requested waiver will be needed;

(3) Assurance that if the waiver is granted the quality of service and care to children, youth and families will not be affected;

(4) A written plan to achieve compliance with the rule or explaining how the provider will satisfy the intent of the rule, if the waiver is granted; and

(5) How the service will be affected if the waiver is not granted.

(b) A waiver shall be granted if:

(1) The department concludes that authorizing deviation from compliance with the rule from which waiver is sought does not contradict the intent of the rule; and

(2) The alternative proposed ensures that the object or intent of the rule will be accomplished and shall not affect the health and safety of the child.

(c) When a waiver is approved, the applicant or provider shall be considered in compliance with the rule from which waiver was sought.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.18 Denial of Application Or Revocation of Certification.

(a) An application shall be denied or certification revoked if:

(1) DCYF determines that the state does not have a need for the service;

(2) The applicant or provider, or the individual acting on the applicant’s or provider’s behalf, submits materially false information to DCYF;

(3) The applicant or any household member has been convicted of a felony or any crime against a child that has not been annulled or overturned;

(4) There has been disciplinary action taken by a licensing body or professional society, a finding of civil liability made for professional misconduct, or a finding of an ethical violation made by a state or national professional association or any other state’s regulatory board;

(5) There has been cancellation of liability insurance by the insurance company;

(6) There has been abusive or neglectful treatment of a child as determined by any state statute; and

(7) There has been failure to comply with He-C 6349.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.19 Notification of Denial or Revocation.

(a) If DCYF denies an application for certification or revokes an existing certification, DCYF shall send notice of the denial or revocation to the applicant or provider by certified mail.

(b) The notice shall:

(1) Inform the applicant or provider of the facts or conduct upon which DCYF bases its action;

(2) Advise the applicant or provider of their right to request reconsideration of DCYF’s decision pursuant to He-C 6347.21; and

(3) In the case of an existing certification, inform the provider that the revocation shall not take effect until the provider has had an opportunity through an appeal, pursuant to RSA 170-G:4-a and He-C 6347.23, to show compliance with all lawful requirements for retention of the certification.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.20 Request for Certification Reconsideration.

(a) A request for certification reconsideration shall:

(1) Be filed within 30 calendar days of the date of receipt of the letter sent by DCYF;

(2) Be submitted in writing; and

(3) Be filed with the director of DCYF.

(b) The DCYF director shall uphold or overturn the request pursuant to He-C 6349.

(d) The applicant or provider may appeal the DCYF director’s decision pursuant to He-C 6349.21.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

He-C 6349.21 Appeals.

(a) Applicants or providers who wish to appeal DCYF’s decision shall file an appeal pursuant to RSA 170-G:4-a with the commissioner.

(b) In accordance with RSA 170-G:4-a, the appeal shall:

(1) Be made in writing;

(2) Be signed and dated;

(3) State the reasons for the appeal pursuant to RSA 170-G:4-a; and

(4) Be filed within 14 working days of the date of written notification pursuant to RSA 170-G:4-a.

(c) Pursuant to RSA 170-G:4-a and He-C 200, the commissioner or designee and 2 members of the DCYF advisory board shall hear the appeal.

Source. (See Revision Note at part heading for He-C 6349) #9268, eff 9-20-08; ss by #11166, INTERIM, eff 9-19-16, EXPIRED: 3-18-17

PART He-C 6350 CERTIFICATION FOR PAYMENT STANDARDS FOR RESIDENTIAL TREATMENT PROGRAMS

Statutory Authority: RSA 170-G:5; RSA 170-E:34

He-C 6350.01 Scope.

(a) Certification pursuant to RSA 170-G:4, XVIII, consistent with the system of care pursuant to RSA 135-F, shall apply to the children’s residential treatment programs below:

(1) Residential treatment programs implementing treatment and services and receiving funds from the department for residential care, supervision, and treatment provided to children and the related services provided to families pursuant to RSA 169-F:9; and

(2) Residential independent living programs, also known as independent living programs, which receive funds from the department to provide residential housing, supports, and coordination of treatment in the community in which the program operates and the child lives which is an exception to RSA 169:F-9.

(b) Pursuant to RSA 169-F:9, I, any program not certified by the department shall not be eligible to receive state funds or federal funds disbursed by the state of New Hampshire.

(c) A residential treatment program or independent living program that is not certified under He-C 6350 in accordance with RSA 170-G shall not be reimbursed by the department.

Source. #4442, eff 7-1-88; amd by #4906, eff 8-10-90, EXPIRED 8-10-96

New. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15, ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.02 Definitions.

(a) “Absconder” means a runaway, as defined in (bg) below, for whom a juvenile petition has been filed pursuant to RSA 169-B or RSA 169-D, and who, with the intent to avoid legal process or authorized control, meets at least one of the following criteria:

(1) Fails to report for probation or parole supervisions;

(2) Fails to report for conditional release supervision;

(3) Hides, conceals, or absents themselves; or

(4) Has departed the jurisdiction without permission of the supervising authority, court, or juvenile parole and probation officer (JPPO), and whose whereabouts might be unknown.

(b) “Accredited program” means an agency or program which has met practice and quality standards set by a nationally recognized independent, not-for-profit organization such as but not limited to the Commission on Accreditation of Rehabilitation Facilities (CARF), Council on Accreditation (COA), or The Joint Commission (TJC).

(c) “Adult living preparation” means a process of assessing, planning, and supporting youth through the transition from childhood through adolescence and into independence and young adulthood. This term includes “independent living preparation.”

(d) “Agency” means the board of directors, executive director, and employees of an organization that operates a residential treatment program at a residential facility that is incorporated and recognized by the secretary of state of the state in which it operates and provides an identifiable system of social service interventions designed for an individual child or group of children. This term includes “child care agency” as defined in RSA 170-E:25, II.

(e) “Applied behavioral analysis (ABA)” means the application of behavioral principles to everyday situations, intended to increase or decrease targeted behaviors.

(f) “Applicant” means the person or entity that is requesting certification of a residential treatment program.

(g) “Board certified behavior analyst (BCBA)” means a graduate level certified professional who conducts ABA.

(h) “Bureau for children’s behavioral health (BCBH)” means the bureau within the division for behavioral health in the department of health and human services (department) charged with implementing the children’s system of care.

(i) “Case plan” means the division for children, youth and families’ (DCYF) written plan for the child and the family which outlines how services will be provided, pursuant to RSA 170-G:4, III, and 42 USC 671 and 42 USC 675. This term includes “placement plan.”

(j) “Care management entity (CME)” means “care management entity” as defined in RSA 135-F:4, III namely “an organizational entity that serves as a centralized entity to coordinate all care for youth with complex behavioral health challenges who are involved in multiple systems and their families.”

(k) “Certification for payment” means the process by which the department approves the certification of and payment to certified residential treatment programs and independent living programs.

(l) “Child” means:

a. “Child” as defined in RSA 170-E:25, I. The term includes “youth”, “resident”, and “young adult”;

b. For the purposes of compliance with RSA 126-U, “child” as defined in RSA 126-U:1, I, namely, “a person who has not reached the age of 18 years and who is not under adult criminal prosecution or sentence of actual incarceration resulting therefrom, either due to having reached the age of 18 years or due to the completion of proceedings for transfer to the adult criminal justice system under RSA 169-B:24, RSA 169-B:25, or RSA 169-B:26. ‘Child’ also includes a person in actual attendance at a school who is less than 22 years of age and who has not received a high school diploma.”;

c. “Child with a disability” as defined in RSA 186-C:2, I, and “developmentally delayed child” as defined in RSA 186-C:2 I-a; and

d. For youth in extended foster care pursuant to RSA 170-E:53, a person who has attained the age of 18 but not attained the age of 21.

(m) “Child and adolescent needs and strengths (CANS)” means a multi-purpose tool developed for children's services to support decision making, including level of care and service planning, to facilitate quality improvement initiatives, and to allow for the monitoring of outcomes of services.

(n) “Child protective services worker (CPSW)” means the DCYF representative who has expertise in managing cases resulting from concerns of child abuse or neglect to ensure families and children achieve safety, permanency, and well-being.

(o) “Children’s system of care” means a comprehensive delivery system of services and supports oriented in tiers which supports children, youth, and families based on their individual levels of needs at any time in accordance with RSA 135-F.

(p) “Clinical coordinator” means a staff member employed by the residential treatment program responsible for administrative oversight of the clinical services provided at the program. This term includes “treatment coordinator” and “clinical director.”

(q) “Clinical staff” means individuals who have a master’s degree in a clinical field such as social work, marriage and family therapy, psychology, pastoral counseling, school counseling, or a degree which would make one eligible for a license from the New Hampshire board of mental health practice or New Hampshire board of psychologists.

(r) “Commissioner” means the commissioner of the New Hampshire department of health and human services or the commissioner’s designee.

(s) “Comprehensive assessment for treatment (CAT)” means the biopsychosocial assessment which in part utilizes the CANS and is conducted by a qualified individual as defined by the federal Family First Prevention Services Act of 2017. The CAT is used to recommend whether a child’s behavioral health needs would be supported in a residential treatment program or independent living program as defined by 42 USC 672(k)(4) and if so, recommends the least restrictive and most appropriate level of care.

(t) “Connection” means an individual who the child identifies as an important relationship and who is supported by the treatment team for maintaining the child’s permanency plans. A connection can also qualify as family or kin.

(u) “Corrective action plan” means a plan created by the program and provided to the department within 30 days, which responds to the identified areas of non-compliance with proposed resolutions to rectify all concerns based upon a quality assurance monitoring activity.

(v) “DCYF representative” means an employee of DCYF who has training and experience in managing matters of child protection or juvenile justice cases referred to the department pursuant to RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, and RSA 463.

(w) “Department” means the New Hampshire department of health and human services.

(x) “Direct care staff” means the residential treatment program’s staff who are included in the staff to child ratio, including, but not limited to, child care workers, supervisors, and recreational staff.

(y) “Division for children, youth and families (DCYF)” means the organizational unit in the department of health and human services which includes but is not limited to, child protective services and juvenile justice services.

(z) “Episode of treatment” means a time-limited, voluntary admission to residential treatment approved by BCBH for children, in which the child and the family have voluntarily agreed to residential treatment and who are not court ordered to placement.

(aa) “Executive director” means the individual responsible for the daily administration of a residential treatment program.

(ab) “Facility” means the physical plant or structures, permanent or temporary, on the grounds of the licensed premises. This term includes “facility” as defined in RSA 126-U:1 III.

(ac) “Family” means the individuals to whom the child is related legally or biologically, such as but not limited to, parents, stepparents, siblings, grandparents, aunts, uncles, first or second cousins, stepgrandparents, and step siblings. This term includes “relative”. Family can also include “kin”.

(ad) “Family workers” means individuals who are residential program staff who work directly with the families of children in the residential program on reunification or in establishing a family’s optimum level of functioning and contact with their child. This term includes program “permanency coordinators”, “permanency specialists”, and “case managers”.

(ae) “Foster care bill of rights” means the rights of a child placed in a foster care or out of home placement pursuant to RSA 170-G:21.

(af) “Full time employee” means residential program staff who work a minimum of 34 hours per week unless defined otherwise by the agency.

(ag) “Human services” means helping people in areas which include:

(1) Education;

(2) Mental health and behavioral health;

(3) Recreation;

(4) Child care;

(5) Medical services;

(6) Law enforcement;

(7) Corrections;

(8) Social services;

(9) Independent living or adult living preparation; and

(10) Substance misuse services.

(ah) “Independent living program” means programs that include supportive community level of care and is either supervised living or supported apartments. These settings are designed for youth 18 years of age or older to provide residential housing, support the coordination of treatment services, and independence of youth transitioning into young adulthood.

(ai) “Incident” means:

(1) Resident behavior that is extreme, including but not limited to, behavior that is assaultive, destructive, self-injurious, or self-destructive;

(2) An occurrence involving an accident or injury, or requiring outside agency involvement, which includes a suicide attempt including self-injurious behavior with a non-fatal outcome where there is explicit or implicit evidence that the person intended to die, and medical intervention was needed;

(3) The death of the resident;

(4) Suspected abuse or neglect of the resident;

(5) Emergency medical treatment for the resident;

(6) The impairment of the resident while at the program;

(7) A medication occurrence that required medical intervention for the resident;

(8) The unexplained absence of a resident from the program; and

(9) Restraint and seclusion defined in (bf) and (bh) below.

(aj) “Juvenile probation and parole officer (JPPO)” means the DCYF representative who has expertise in managing cases resulting from concerns of delinquency or children in need of services (CHINS) to ensure families and children achieve safety, permanency, and well-being.

(ak) “Kin” means “kin” as defined in RSA 170-E:25, VIII, namely, “a child or children who for which there is a connection or history between a child or their parents and another responsible adult, including but not limited to related adults”. A person who is kin can also be a connection.

(al) “License” means “license” as defined in RSA 170-E:25, IX or a license issued pursuant to RSA 151 .

(am) “Managed care organization (MCO)” means an entity that has a comprehensive risk-based contract with the department to provide managed medicaid health care services.

(an) “Measurable” means the systematic process of gathering quantitative or qualitative information to show progress or change and achievement of a goal or objective.

(ao) “Monitoring visit” means a quality assurance visit to the residential treatment program or facility performed by the department. This term includes “technical assistance visit”, “site visit”, and “quality assurance visit”.

(ap) “Notice of non-compliance” means written notification provided by the department to a residential treatment program which identifies one or more areas where the program did not comply with He-C 6350, He-C 6420, or the contract, if applicable, and requires an immediate response, action, or corrective action plan to address the non-compliance areas within a specified self identified timeline.

(aq) “NH bridges” means the case management, tracking, finance, and automated billing system used by DCYF and on behalf of BCBH. This term also includes “granite families”.

(ar) “Permanency” means a child’s safe, stable living environment with a life-long relationship with a nurturing caregiver to establish the foundation for a child’s healthy development.

(as) “Psychiatric Residential Treatment Facility (PRTF)” as described in 42 CFR 483.352 means an inpatient program which provides 24 hour care 7 days a week, as well as intensive short term, and long term psychiatric treatment and care to persons who have psychiatric symptoms and disorders or are in an acute phase of their mental illness.

(at) “Physical intervention” means a behavioral management technique in which staff use the minimum amount of physical contact on a child, which is necessary for the circumstances, in accordance with RSA 627:6, II(b) and RSA 126-U, to protect the resident, other residents present, the staff, and the general public. Physical intervention might be reportable under RSA 126-U and He-C 901. This term includes “physical management.”

(au) “Policies” means an agency’s or program’s written guidelines, practices, and procedures specifying the current and future actions to be taken that direct the operation of the residential treatment program.

(av) “Prescribing practitioner” means any of the following state licensed health care providers pursuant to He-C 6420 that provide services identified in 42 CFR 440.130 to reduce a physical or mental disability and in the restoration of the child’s best functional level:

(1) Health care providers licensed in accordance with RSA 326-B;

(2) Physicians;

(3) Physician assistants; and

(4) Any practitioner licensed by the New Hampshire board of mental health practice pursuant to RSA 318 or New Hampshire board of psychologists pursuant to RSA 330-A.

(aw) “Program philosophy” means the underlying theory, or set of ideas, which guides the beliefs and principles of the program and the services provided by the program in accordance with the system of care principles and values pursuant to RSA 135-F.

(ax) “Progress reports” means the written notes sent to DCYF, CME, and parents by the staff of a program which document the residential services being provided to the child. This term includes “monthly progress reports” and “weekly progress reports”.

(ay) “Qualified residential treatment program (QRTP)” means “qualified residential treatment program” as defined in 42 USC 672(k)(4) as reprinted in Appendix C.

(az) “Quality assurance” means the process that department staff use to monitor, support, and provide technical assistance to residential treatment programs to assist in their ability to comply with He-C 6350, He-C 6420, or the contract, if applicable.

(ba) “Reasonable and prudent parent standard” means a standard characterized by careful and sensible parental decisions made by a caregiver for a child in foster care, that maintain the health, safety, and best interests of the child while encouraging the emotional and developmental growth of the child through participation in extracurricular, enrichment, cultural, and social activities as defined by 42 USC 675(10)(A) and any subsequent amendments thereto, and codified in RSA 170-G:20.

(bb) “Rehabilitative and restorative services” means interventions provided including any medical or remedial services recommended by a physician or other prescribing practitioner to reduce a physical or mental disability and restore a child to their best functional level in accordance with He-C 6420.

(bc) “Related” means “related” as defined in RSA 170-E:25, XII, namely “any of the following relationships by blood, marriage, or adoption: parent, grandparent, brother, sister, stepparent, stepgrandparent, stepbrother, stepsister, uncle, aunt, niece, nephew, first cousin or second cousin”. A related person can also be considered family or kin.

(bd) “Residential treatment program ” means the model and implementation of services to meet the treatment and supervision needs of the children pursuant to RSA 170-G:4, XVIII, and provide 24 hour care of children 365 days a year including all of the employees therein. It also includes residential independent living programs which provide residential housing, supports, and coordination of treatment in the community in which the program operates. This term includes “program”.

(be) “Residential levels of care” means the category of care that is provided at the various levels which includes the following:

(1) Level 1 independent living program where supervision and treatment is not required;

(2) Level 2 intermediate treatment program;

(3) Level 3 intensive treatment program;

(4) Level 4 highly intensive treatment program;

(5) Level 5 PRTF;

(6) Assessment treatment program;

(7) Nursing home;

(8) Rehabilitation program; and

(9) Substance use treatment program.

(bf) “Restraint” means “restraint” as defined in RSA 126-U:1, IV. Restraint might also be considered “physical intervention” or “physical management”.

(bg) “Runaway” means a child in an episode of treatment or placed in a program pursuant to RSA 169-B, RSA 169-C, or RSA 169-D, who has failed to return to the child’s placement, has hid, or has concealed themselves without permission of their legal custodian, residential treatment program, or supervising authority. A runaway might also be considered an absconder or a missing child.

(bh) “Seclusion” means “seclusion” as defined in RSA 126-U:1, V-a.

(bi) “Short-term program” means a residential treatment program that is intended to provide services to a child for 60 days or less.

(bj) “Staff secure” means a residential treatment program that provides high levels of supervision and individualized care 24 hours a day to children through the use of a staff to child ratio of one staff to 5 children or fewer and awake night staff in each building used for child care, and can include short-term interventions that require one staff member to care for one child in order to assist the child through a behavioral or emotional crisis, or physical interventions, in accordance with RSA 126-U, to prevent runaways.

(bk) “Staff to child ratio” means the number of program direct care staff to ensure that the necessary resources are available to deliver services and provide supervision to the number of children consistent with He-C 4001 or the licensing requirements of the state in which it operates.

(bl) “Staff supervision” means an administrative and educational process used in residential treatment programs to help child care workers and clinical staff develop and refine their skills so that they are able to provide quality care and treatment.

(bm) “System of care values” means the comprehensive characteristics set forth in RSA 135-F:3, III, which states that services are family-driven, youth-guided, community-based, trauma-informed, and culturally and linguistically competent.

(bn) “Transitional residential-enhanced care coordination (TrECC)” means a program per RSA 135-F:4, III provided by the care management entity designed to support children, families, and their treatment teams to monitor progress in treatment and to support timely transitions home and into the community.

(bo) “Trauma informed care” means treatment and care that realizes the widespread impact of trauma and understands paths for recovery, recognizes the signs and symptoms of trauma in patients, families, and staff, integrates knowledge about trauma into policies, procedures, and practices, and actively avoids re-traumatization. This term includes “trauma-informed approach”.

(bp) “Treatment plan” means the residential treatment program’s written, time-limited, goal-oriented, therapeutic plan developed with the child and family by the treatment team which includes the strategies to address the issues that brought the child into placement and is consistent with rehabilitative and restorative services.

(bq) “Treatment team” means the individuals outlined in He-C 6350.13 (j) including at a minimum the child, parent(s) or guardian(s), residential treatment program clinical staff, prescribing practitioner, DCYF staff, and CME.

Source. #4442, eff 7-1-88, EXPIRED 7-1-94

New. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; amd by #12609, eff 8-23-18; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.03 Length of Certification.

(a) Subject to (b) below, certification shall be valid through the state fiscal year and expire on July 1st, unless certification is voluntarily surrendered by the program, the facility closes, or certification is terminated or revoked by the department pursuant to He-C 6350.07.

(b) If initial certification occurs in the months of March, April, May, or June, the certification shall be valid and shall expire on July 1st of the following year.

Source. #4442, eff 7-1-88, EXPIRED 7-1-94

New. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.04 Reimbursement.

(a) Subject to (1) through (4) below, a program’s eligibility for reimbursement shall begin on the child’s day of admission and continue through the day of discharge, as follows:

(1) The department shall only reimburse a certified residential treatment program for a child’s treatment when there is no concurrent payment for placement being made to another residential treatment program, with the exception of the day of admission or the day of discharge, or both;

(2) A certified residential treatment program shall be reimbursed for the day of admission when a child is admitted to the residential treatment program directly from an assessment residential treatment program. If the child is admitted to a residential treatment program of the same agency that provided the assessment residential treatment program, the residential treatment program shall not be reimbursed for the day of discharge from the assessment residential treatment program;

(3) The department shall reimburse a New Hampshire PRTF provider in accordance with 4.19-C of the medicaid state plan; and

(4) The department shall reimburse a New Hampshire private non-medical institution (PNMI) provider in accordance with 4.19-C of the medicaid state plan.

(b) If a child has an identified MCO that will be funding the residential treatment program, the program shall only admit the child if the program is enrolled with that child’s MCO.

(c) The residential treatment program may subcontract with other human services providers to fulfill a service which is intended to be provided by the program. The program shall be reimbursed at the daily per-diem rate and the subcontractor shall be reimbursed by the program.

(d) Any subcontractor used on a temporary or long-term basis shall operate with a current license or operate under the laws that govern that profession, if applicable. If the program is in another state, the subcontractor shall operate in accordance with the laws of the state in which it operates, as applicable.

(e) The department shall have no obligation to reimburse a subcontractor for services performed or provided in accordance with (c) above.

(f) Residential treatment programs shall not request additional reimbursement for residential treatment services identified within this part. If a need for a child is identified in excess of the program budget and residential level of care, prior authorization shall be sought by the residential treatment program to the department for consideration.

(g) In the event that a child is a runaway, is committed or detained pursuant to RSA 169-B, or is admitted to an in-patient psychiatric or acute care hospital, the residential treatment program may bill through the day that the child runs away, is committed or detained, or is admitted to the in-patient psychiatric or acute care hospital.

(h) The program may seek prior approval from an administrator at the department to hold a bed under He-C 6350.35. When approved, the program may choose to hold the bed for up to 7 days. A bed hold shall be approved by the department when:

(1) The program is committed to the youth returning to the program; and

(2) The program is most clinically appropriate to support the child, and family, at this time: and

(3) The program is the most appropriate setting for the child to return to.

(i) If a bed hold is approved by the department the program shall:

(1) Maintain communication with the treatment team, the child, and the family; and

(2) Not bill medicaid for the time when the child is a runaway, absconder, missing, or admitted to a hospital.

(j) If agreed upon by the residential treatment program and the department, the program from which the child ran away or absconded may readmit the child within 10 business days from the date the child ran away or absconded in compliance with He-C 6350.35. Readmission within 10 business days shall not negate the billing requirement identified in (a) or (g) above.

(k) PNMI and PRTF programs shall provide documentation regarding their budgets and rates to the department in accordance with the medicaid state plan.

(l) Out-of-state programs shall submit updated rates established by their state entity or rate request 30 days from the effective date or when requested by the department within 30 days.

Source. #4442, eff 7-1-88, EXPIRED 7-1-94

New. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.05 Application Process for Certification and Procedures for Recertification.

(a) Any residential treatment program licensed in accordance with RSA 170-E or RSA 151, or from another state, that seeks certification in accordance with He-C 6350 shall request application Form 2601 “Certification for Payment Application – Residential Programs” (January 2026) from BCBH and be supported by a need identified by the department in accordance with RSA 170-G:4 and RSA 169-F.

(b) The application form in (a) above shall be completed, signed, and dated by the residential program’s executive director, or designee, affirming the following:

“I have reviewed RSA 126-U, RSA 135-F:3(e), the Administrative Rules He-C 6350 and He-C 6420 and will adhere to the rules as a certified provider. I authorize the Bureau for Children’s Behavioral Health (BCBH) to conduct a certification for payment review to determine the program’s compliance with Administrative Rules He-C 6350 and He-C 6420. I authorize BCBH to access the program for the purpose of Certification and the NH Division for Children, Youth and Families (DCYF) to access the program and children referred by DCYF in accordance with RSA 169-F. I further understand that BCBH has the right to verify information contained in this application.”; and

“The information contained in this application is correct to the best of my knowledge.”

(c) The completed application form in (a) above shall be emailed to the department within 90 days of receipt to ChildrensResidentialCertification@dhhs.nh.gov.

(d) The applicant shall provide the following information with, or in addition to, the application form in (a) above:

(1) Evidence that the board of directors has approved the certification request which may include but is not limited to minutes of the board meeting documenting that the request was approved or a signature of the board’s president;

(2) The names of the residential staff or child care personnel within the program;

(3) An electronic copy of the program description, including a description of the services provided to children and their families, as well as a description of the daily milieu, and how the program promotes the safety, permanency, and well-being of children and their families, adheres to the system of care values, including any specialized services that are supported by any certifications or accreditations, or both;

(4) An electronic copy of Form 2626 “Residential Program Summary” (January 2026) which is an abbreviated program description that can be provided to the court to support placement decision making in accordance with RSA 169-F:8;

(5) The name, office held, professional affiliation, address, and telephone numbers of each person on the program’s board of directors, including whether or not the board member is a present or past recipient of the agency’s services;

(6) A copy of the program’s license or operational approval, in accordance with the following:

a. For programs in New Hampshire, a copy of the license issued in accordance with RSA 170-E:31 or RSA 151:5; or

b. For programs outside of New Hampshire, documentation of approval from the corresponding state’s regulatory agency(ies);

(7) A general liability certificate of insurance for the program;

(8) An electronic copy of Form CBH007 “Qualified Residential Treatment Program Checklist (January 2026);

(9) Organizational information which shall include an organizational chart with personnel titles or positions with the identification of the individuals in those roles, including identification of who in the program is responsible for implementation of reasonable and prudent parent standards. Job descriptions, and the corresponding credentials for those individuals who are meeting the requirements of He-C 6350.11 which shall include the education and experience requirements in He-C 6350.11, as applicable;

(10) Educational certification, in accordance with the following:

a. For programs in New Hampshire which operate and maintain approval as a non-public school pursuant to Ed 400 and a private provider of special education provider pursuant to Ed 1100, a copy of their approval from the New Hampshire state board of education; or

b. For programs outside of New Hampshire with education programs, documentation of educational certification from the corresponding state’s regulatory agency(ies);

(11) The name and contact information for the state’s licensing body and the contact information for the accreditation body;

(12) The staff training plan, including descriptions of orientation and ongoing training, including trauma training requirements as stated in He-C 6350.11;

(13) An electronic copy of the program’s policies required by He-C 6350.10 and any other policies maintained by the program; and

(14) The program’s restraint and seclusion plan, if accredited and required by the accreditation body.

(e) The program administration and staff shall facilitate a tour of the facility for the department’s certification team to conduct a review of all appropriate spaces and certification criteria if necessary.

(f) For residential treatment programs seeking recertification, the executive director shall be notified in writing by the department of the need to apply for recertification 4 months prior to the expiration date of the current certification and failure to receive notice shall not relieve any program of the obligation to renew its certification and comply with RSA 170-G and this part.

(g) If a program does not receive a notice or renewal application as referenced above in (f), the program shall contact department at ChildrensResidentialCertification@dhhs.nh.gov to obtain a renewal application.

(h) The executive director or designee shall complete, sign, and date Form 2601 “Certification for Payment Application – Residential Programs” (January 2026) and indicate that it is for the purpose of recertification.

(i) The completed recertification application form in (h) above and information in (b)-(d) above shall be electronically submitted to the department within 30 days of receipt by email to ChildrensResidentialCertification@dhhs.nh.gov.

(j) The applicant shall provide the recertification and all information included in (b)-(d) above, with the exception of (d)(1), in addition to (h) above according to Form 2601 “Certification for Payment Application – Residential Programs” (January 2026). The recertification attachments shall also include:

(1) The names of the programs residential staff referenced in (d)(2) above shall only require the names of newly hired staff since the initial certification or most recent recertification, as applicable;

(2) Items in (d)(12), (d)(13), and (d)(14) above only if there are changes since the initial certification or last recertification; and

(3) In (d)(9) only the organizational chart with personnel tittles or positions with the identification of the individuals in those roles, unless He-C 6350.09 requires the job descriptions or corresponding credentials to be supplied at recertification.

Source. #4442, eff 7-1-88; amd by #4906, eff 8-10-90; amd by #5122, eff 4-25-91, EXPIRED 4-25-97

New. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; amd by #12609, eff 8-23-18; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.06 Departmental Visits, Quality Assurance Monitoring, Notices of Non-compliance, and Informal Dispute Resolutions.

(a) The department shall conduct quality assurance monitoring visits and reviews in accordance with RSA 126-A:4, IV (a), RSA 170-G:4 XVIII, and RSA 169-F:9 for each residential treatment program certified by the department under this part, consisting of the following:

(1) An annual review of the recertification application as described in He-C 6350.05;

(2) An annual analysis of the referral data, statistics, and outcomes provided at recertification;

(3) Quality assurance monitoring visits at least twice per year, of which at least one shall be unannounced, to all facilities where New Hampshire children are currently placed pursuant to RSA 169-F;

(4) A visit conducted within the first year of a residential treatment program’s operation;

(5) For currently certified residential treatment programs, a site review once every 2 years;

(6) A technical assistance visit in the year when a site review does not occur; and

(7) Ongoing quality assurance monitoring visits and collaboration as needed throughout the year.

(b) The program shall make the below available during a quality assurance monitoring visit as requested by the department including but not limited to:

(1) The facility;

(2) The staff and available sub-contracted providers;

(3) The children and their records who were placed by the department or in an episode of treatment; and

(4) Staff records.

(c) In accordance with RSA 169-F:9, V, if a program is found not in compliance with this part or the program’s contract during quality assurance monitoring visit, if applicable, the department shall issue the program a notice of non-compliance indicating the specific violation(s).

(d) In accordance with RSA 169-F:9, V when there are areas of non-compliance the department shall notify the following:

(1) The program’s licensing agency; and

(2) The New Hampshire office of the child advocate.

(e) The program shall submit a corrective action plan to the department within 30 calendar days of the date of receipt of the notice of non-compliance.

(f) An acceptable corrective action plan shall, at a minimum, include the plan for the corrections and a timeline for when those corrections areas will be completed.

(g) Exceptions to (e) above shall include the following:

(1) If the program seeks clarification after receiving the notice of non-compliance and requests an extension of time to complete and submit the corrective action plan;

(2) When the program has initiated the informal dispute process, as described in (k) below, with the certification team;

(3) When there is a request and an approval for a waiver for the rule, as a result of the non-compliance and as a means to correct the non-compliance; and

(4) When there is a request for an extension to the corrective action plan beyond the 30 calendar days in (e) above.

(h) In accordance with RSA 169-F:9, V, failure to respond to the notice with an acceptable plan as described in (f) above or to take the necessary corrective actions as described in (i) below shall result in the removal of all New Hampshire children from the program’s facility and shall result in revocation of certification for payment.

(i) Failure to take the necessary corrective action as referenced in (h) above shall be a result of a program refusing to submit a corrective action plan or deliberately failing to acknowledge and address the areas of correction which are documented in the notice of non-compliance.

(j) The department shall offer an opportunity for an informal dispute resolution to any program who disagrees with a non-compliance cited by the department as a result of a quality assurance monitoring activity for any program who can provide documented evidence that they were in compliance when the non-compliance was issued.

(k) The program shall submit a request for an informal dispute resolution in writing, no later than 14 calendar days from the date the site review report or notice of non-compliance was issued by the department.

(l) Included in the request by the program shall be evidence of the following:

(1) The rule which was cited for non-compliance; and

(2) The documentation which disputes the citation.

(m) The department shall review the evidence presented in (l) above and provide a written notice to the program of its decision within 30 calendar days of receipt of (l).

(n) An informal dispute resolution shall not be available for any program against whom the department has initiated action to deny or revoke their certification.

Source. #4442, eff 7-1-88; amd by #4906, eff 8-10-90; amd by #5122, eff 4-25-91, EXPIRED 4-25-97

New. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.07 Denial and Revocation of Certification and Process for Administrative Appeals.

(a) The department shall deny an application for certification for payment when it determines that the applicant does not demonstrate compliance with He-C 6350, He-C 6420, or their license has been denied, revoked, or suspended in accordance with RSA 170-E:35 or RSA 151, or for out-of-state programs their license has been denied, revoked, or suspended by their state’s regulatory agency for licensure.

(b) Certification for payment shall be revoked if the department determines that the residential treatment program has failed to comply with one or more of the provisions of He-C 6350, He-C 6420, or the licensing body that governs the out-of-state residential treatment program. Should certification be revoked, the program shall work cooperatively with the department to transition the children to other settings.

(c) Certification for payment shall be voluntarily terminated if a residential treatment program notifies the department that they will no longer be serving children referred from the department in their program.

(d) Certification for payment shall be denied or terminated if the department has determined that there is no need for certification of the residential treatment program pursuant to RSA 170-G:4, XVIII.

(e) Revocation of payment shall include the end of the program’s credentials from the department’s payment system and the recoupment of unused funds, if applicable.

(f) If the department denies or revokes certification for payment, it shall send written notice via United States Postal Service certified mail to the applicant or certified residential treatment program, which sets forth the reason(s) for the department’s determination.

(g) The denial or revocation shall become final 14 business days after receipt of the written notice in (f) above, unless the applicant or certified residential treatment program appeals the department’s determination pursuant to He-C 200, RSA 170-G:4-a, or RSA 151:8, II.

(h) Pursuant to RSA 170-G:4-a, RSA 151:8, II, RSA 541-A, and He-C 200, applicants or programs seeking to appeal a department decision to deny their application or revoke their certification shall file an appeal with the commissioner within 14 business days of the date of the letter or other written notification of the action.

(i) If the program wants to file an appeal it shall:

(1) Be made in writing;

(2) Be signed by a person authorized to submit the appeal;

(3) Be filed with the commissioner of the department; and

(4) State the specific reason(s) for the appeal.

Source. #4442, eff 7-1-88, EXPIRED 7-1-94

New. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.08)

He-C 6350.08 Waivers.

(a) A written request for a waiver of a requirement in He-C 6350 shall be submitted by the program to the department, which shall include the following information:

(1) The rule number for which the waiver is being requested;

(2) The anticipated limited length of time the requested waiver will be needed;

(3) The reason for requesting the waiver;

(4) How the residential treatment program will provide for the safety and quality of care of the children if the waiver is granted;

(5) A written plan to achieve compliance with the rule for the limited length of time requested, detailing how the residential treatment program will satisfy the intent of the rule if the waiver is granted;

(6) How the children and families will be affected if the waiver is not granted; and

(7) A statement attesting that the waiver will not result in a violation of the program’s licensing requirements in RSA 170-E:31 or RSA 151:5, or for out-of-state programs, be in violation of the program’s licensing requirements of the state in which it operates.

(b) When a program submits a waiver request, the program shall wait for approval from the department prior to implementation.

(c) In addition to the requirements in (a) above, waiver requests for program staff requirements pursuant to He-C 6350.11 shall include a written agreement between the staff and program leadership that includes a staff supervision plan, the oversight the program will provide the staff, and the program’s expectations of staff should the condition of the waiver not be met.

(d) In addition to the requirements in (a) above, a short-term program seeking a waiver to allow a child to remain in a program beyond the short-term program length of stay shall submit a waiver request that also includes:

(1) The specific reason for why the requested waiver is needed for the child; and

(2) A statement affirming that the waiver, if approved, will have no impact on staffing ratios or clinical services provided to other residents at the program.

(e) A request for a waiver shall be approved if the department determines that:

(1) Approval of the requested waiver will not jeopardize the safety or quality of care provided to children;

(2) Approval of the requested waiver will not be a violation of a state law, a federal law, or another administrative rule part;

(3) The request is time-limited;

(4) The approval of the requested waiver will not contradict the intent of the rule; and

(5) The applicant or residential treatment program has an alternative plan for complying with the rule in accordance with (a)(5) above.

(f) A request for a waiver shall be denied if any of the grounds for approval in (e) above are not met.

Source. #4442, eff 7-1-88, EXPIRED 7-1-94

New. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.07)

He-C 6350.09 Changes of Personnel, Policies, or Services and Notification Requirements.

(a) The residential treatment program shall notify the department in writing at least 30 days prior to making changes to the approved certification.

(b) The residential treatment program shall notify the department, parents, and legally responsible parties, in writing, when it changes any of the following from what was provided in the initial certification or recertification application:

(1) Program philosophy; or

(2) Program description.

(c) The program shall notify the department in writing within 10 business days of the hiring of a new executive director, assistant director, clinical coordinator, or other executive leadership member.

(d) The written notice required in (c) above shall include:

(1) The individual’s credentials documenting the education and experience requirements in He-C 6350.11, as applicable; and

(2) An updated organizational chart.

(e) The residential treatment program shall notify the department when:

(1) The out-of-state program has any licensing non-compliance and corresponding corrective action plans pursuant to He-C 6350.26 within 30 calendar days;

(2) There is any change to the license, accreditation, or both, within 30 calendar days of the change, including any change to the program’s licensing agency’s contact information;

(3) There has been a revocation of their license, of their accreditation, or of both, within 24 hours of such action;

(4) There is an event or incident at the facility or program that impacts the health and safety of the general population which might also result in media coverage; and

(5) There are any substantive changes to the program’s or agency’s operations and policies relevant to the program model, trauma informed care, clinical service, education service, or residential service offerings or the health and safety of the children.

Source. #4442, eff 7-1-88, EXPIRED 7-1-94

New. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.10 Requirements for Written Policies. Residential treatment programs shall have written policies addressing the following areas in order to ensure quality and consistent care of children which are in accordance with the system of care pursuant to RSA 135-F, III:

(a) Admission criteria and subsequent referral process that identify the children and families the residential treatment program is best designed to serve which shall include the program’s acceptance, waitlist and denial criteria, and procedures;

(b) Provision of a parent handbook which shall identify services that are family and youth driven, community-based, culturally and linguistically competent, and trauma-informed, in accordance with RSA 135-F, III, as well as the opportunities families, kin, and other connections are given to be involved in all aspects of the child’s care including but not limited to:

(1) Activities designed to promote permanency and support continued family, kin, and other connections involvement throughout placement;

(2) Services that promote family involvement and partnership in a therapeutic process from intake to discharge, which supports the identified permanency and transition plans;

(3) Implementation of the reasonable and prudent parent standard by staff including a description of how the program will identify and support normal age and developmental experiences including social, extracurricular, enrichment, and cultural activities in the community;

(4) When possible, activities in the family’s home at the family’s convenience, and other services to support the identified permanency and transition plans;

(5) Parental education and family therapy, as needed to support the child and family’s permanency, safety, and well-being;

(6) Communication that includes the family in the program’s initial orientation process and ongoing activities, visits, and contacts that allow for opportunity for family and identified connections involvement; and

(7) The program’s grievance procedures, which shall ensure that children can constructively address their concerns without fear of retaliation;

(c) Provision of a youth handbook which shall include, at a minimum, services that are family and youth driven, community-based, culturally and linguistically competent, and trauma informed, pursuant to RSA 135-F III;

(d) The provision of a youth handbook shall include a documented effort to obtain written acknowledgment by the child that they received the handbook and shall include a description of the program in which the child has been admitted as well as additional information including but not limited to:

(1) The program’s mission and values;

(2) The therapeutic and clinical services that will be offered to the child and the child’s family;

(3) The structure of the program such as the daily routine;

(4) How the child can access their own personal property;

(5) The children’s access to adequate personal hygiene products and services which shall include culturally and ethnically appropriate items;

(6) The rules and expectations of the program which also may include the personal responsibilities of children such as:

a. Daily living skills;

b. Personal hygiene and access to such products and services;

c. Chores and tasks; and

d. Interpersonal conduct which shall include behavior management and the programs de-escalation model if applicable;

(7) The opportunities available to the child, such as but not limited to recreation or leisure, community access, and communication or contact with family, connections, and other team members;

(8) The program’s grievance procedures, which shall ensure that children may constructively address their concerns without fear of retaliation including:

a. The child’s rights related to restraint and seclusion ; and

b. The child’s right to contact their attorney and the contact information for the state protection and advocacy agency (PA Agency) in that state;

(9) The contact information for New Hampshire’s office of the child advocate pursuant to RSA 21-V, if the child is admitted from NH and was not otherwise provided as part of the admission; and

(10) Programs which are independent living shall only be required to include in the youth handbook (2) through (7) above if it is appropriate for their population and setting;

(e) New and on-going staff training requirements which shall include documentation verifying:

(1) All staff have received an orientation including a review of the program’s policies and procedures; and

(2) That staff have received an overview of trauma-informed care;

(f) Staff job descriptions that include the staff’s general duties and responsibilities;

(g) The responsibilities of staff in the implementation of treatment plans and the process for how staff will familiarize themselves with the needs of each resident;

(h) A staffing plan which describes:

(1) Staff-to-child ratios which are consistent with the program’s category of certification;

(2) The utilization of staff to meet the children’s behavioral and clinical needs;

(3) The routine for staff scheduling to provide for the health and safety of children;

(4) The process for assigning staff to errands, appointments, unplanned local events, field trips, or recreational activities off-site while maintaining appropriate supervision for children in the program;

(5) How staff are accessed for emergency situations; and

(6) The level of supervision provided by staff to children throughout the day and night;

(i) A prohibited item and contraband policy, including:

(1) A list of items that are prohibited or considered contraband;

(2) Procedures which shall ensure that no such items are brought to the premises; and

(3) Procedures for the disposal of such items if they are discovered on the premises;

(j) The daily routine available to children including opportunities for educational, community, recreational, leisure activities, therapeutic services, skill building including independent living preparation, and permanency connections;

(k) The personal responsibilities of children, which shall include expectations for:

(1) Daily living skills and hygiene;

(2) Chores and tasks; and

(3) Interpersonal conduct;

(l) Provision of necessities to children, including which items are provided by the program and which items are the responsibility of the parent or guardian to provide;

(m) The identification of children’s possessions and money that are brought to the program or acquired during placement and the child is discharged with;

(n) The protection of the children’s personal property which shall ensure that their possessions are protected during times when the child is off premises or is absent without leave, and that possessions accompany the child at the time of discharge;

(o) The provision of visitation and other communication between children and their family, kin, friends, and connections both on site and off the premises of the facility;

(p) The process for determining and reporting a runaway or a missing child, including specific procedures for absconders, which shall include efforts to locate the child and the notification of the child’s parents or guardian, CME, DCYF, and law enforcement;

(q) The safeguarding of, use, and limitations that may be placed on children’s money;

(r) The recovery of damages to the facility caused by a child, except:

(1) The residential treatment program shall not charge the parents for damages; and

(2) Restitution paid by a child shall be based upon the child’s ability to pay;

(s) The residential treatment program’s religious affiliation and observances, if any, and any restrictions on admissions resulting therefrom;

(t) The procedures a child or a parent follows to file a grievance;

(u) The promotion of constructive work experiences that have training and developmental components for appropriate children;

(v) The safety and security practices used by the program;

(w) The responsibilities of staff when caring for children who might exhibit behavioral challenges including:

(1) How staff use a trauma-informed treatment approach to respond to children’s behaviors;

(2) De-escalation techniques, individualized crisis plans, individualized treatment, and behavior management techniques;

(3) Acceptable and unacceptable staff responses to children’s behavior;

(4) The procedures and requirements for reporting events governed by RSA 126-U and He-C 901;

(5) The guidelines for using time out, seclusion, and physical intervention, including restraints, in accordance with the program selected behavioral intervention model, RSA 126-U, He-C 901, and the applicable state licensing standards; and

(6) Documentation of children’s behavior, which shall include interventions that staff use in response to the children’s behavior;

(x) Prevention and management of injuries, incidents, emergencies, and infection control for staff and children, consistent with He-C 4001.14 or for out-of-state programs, the licensing standards of the state in which it operates;

(y) The procedures and requirements for reporting child abuse or neglect, including:

(1) Filing the report, including the telephone number to call;

(2) Staff training and orientation about reporting abuse or neglect, which includes providing staff with copies of the relevant state statutes; and

(3) Management of staff who are being investigated for child abuse or neglect;

(z) Acquiring and providing emergency services for children that are demonstrating behaviors that are a threat to self or others;

(aa) Provision of treatment service including frequency of treatment plan and treatment team meetings, and clinical services provided including individual, group, and family therapy which shall at a minimum meet the requirements of this part;

(ab) Provision of aftercare services upon discharge if applicable to the residential treatment program’s category of certification;

(ac) The discharge processes for both planned and unplanned discharges; and

(ad) Record keeping, including provisions which ensure the confidentiality of the residents and their families.

Source. #4442, eff 7-1-88, EXPIRED 7-1-94

New. #6617, eff 10-25-97; ss by #8453, INTERIM, eff10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759,e ff 1-17-15; amd by #12609, eff 8-23-18; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.11 Requirements for Staff.

(a) The executive director of an intermediate or level 2 treatment program shall:

(1) Be a full-time employee; and

(2) Either:

a. Possess a master’s degree in education, business, criminal justice, administration, human services, or a field related to one of these disciplines, or meet the definition of clinical staff in He-C 6350.02(q) and have 2 years of experience in human services; or

b. Possess a bachelor’s degree in a discipline listed in a. above and have 5 years of experience in human services.

(b) The clinical coordinator of an intermediate or level 2 treatment program shall:

(1) Be a full-time employee;

(2) Meet the definition of clinical staff in He-C 6350.02(q); and

(3) Have 2 years of post-graduate experience in human services.

(1) Be a full-time employee;

(2) Possess at a minimum a master’s degree in a field identified in (a)(2)a. above; and

(3) Have 2 years of supervisory experience in human services.

(d) The assistant director of an intensive or level 3 treatment program shall:

(1) Be a full-time employee; and

(2) Either:

a. Possess a master’s degree in a field identified in (a)(2)a. above; or

b. Possess a bachelor’s degree in a field identified in (a)(2)a. above and have 5 years of experience in human services, one year of which shall have included administrative responsibility.

(e) The clinical coordinator of an intensive or level 3 treatment program shall:

(1) Be a full-time employee;

(2) Meet the definition of clinical staff in He-C 6350.02(q); and

(3) Have a clinical license, 2 years of supervisory experience in human services, or 2 years of post-masters experience in human services.

(f) The clinical staff of an residential treatment program shall:

(1) Be a full-time employee or a part-time employee who works a minimum of 22 hours per week; and

(2) Meet the definition of clinical staff in He-C 6350.02(q).

(g) The prescribing practitioner for a residential treatment program shall:

(1) Meet the requirements set forth in He-C 6420 for prescribing practitioner or be licensed by the New Hampshire board of psychologists pursuant to RSA 329-B;

(2) Be employed by the agency or have a current contract with the agency or like agreement; and

(3) Collaborate cooperatively with DCYF and the CME to coordinate children’s care pursuant to 170-G:4 and RSA 170-G:4-i.

(h) If the program employs medical staff, they shall be licensed by the appropriate licensing board.

(i) Each residential treatment program shall identify one staff, consistent as reported on the Form 2601 “Certification for Payment Application – Residential Programs” (January 2026), trained to implement the reasonable and prudent parent standard for all children within the program. Any changes to the identified staff shall be reported to the department within 10 days of the new assignment.

(j) Each residential treatment program with funded family worker positions shall meet the following minimum staffing requirements:

(1) Family workers shall have a minimum of a bachelor’s degree in a clinical field identified in (a)(2)a. above, education, or a related field with emphasis in human services and family systems, and have 2 years of human services experience;

(2) All family workers shall be supervised by clinical or master’s level staff; and

(3) Except for short-term programs, family workers shall maintain a transitional and aftercare caseload and availability to provide aftercare services for families pursuant to the discharge plan for a minimum of 30 days after the child has made the transition to home.

(k) The training requirements for family workers shall include:

(1) A minimum of one hour each week of individual or group clinical supervision by clinical staff; and

(2) A minimum of 40 hours per year of in-service training, at least 8 hours of which shall be in working with and supporting families in communities, including creating intervention plans that assist with reunification and transition efforts.

(l) For programs located in NH, each full-time direct care and clinical staff shall complete 40 hours of training annually, of which up to 15 hours of documented supervision may be applied towards the total hours of training.

(m) For programs located in another state, staff shall meet the annual training requirements of the applicable state’s licensing entity, provided that the training meets the requirements of (o) below, and that supervision hours shall not be applied toward the required training if the total is less than 25 hours.

(n) All direct care and clinical staff working less than full-time shall annually receive at a minimum 8 hours of the required trainings in (o) below.

(o) The training required in (l), (m), and (n) above shall include annual reviews of:

(1) Emergency and safety procedures;

(2) Principles and practices of child care and child development including the reasonable and prudent parent standard;

(3) Family-centered practices including transition and permanency planning;

(4) RSA 169-C:29, the child protection reporting law, or, if the program is in another state, the program shall review and follow its state’s child protection reporting law;

(5) Administrative procedures and program goals;

(6) Trauma-informed care;

(7) De-escalation techniques;

(8) Physical intervention techniques in accordance with RSA 126-U, if applicable; and

(9) Professional boundaries, liabilities, and ethics.

(p) The in-service training component provided by the residential treatment program shall be designed to prepare staff to care for the children served and may include, but not be limited to, training that corresponds to the specific needs of the population of children and families the program serves.

(q) College courses taken for credit shall only be counted towards the training requirements in a ratio of one credit equals 15 hours of training, if the course is related to human services identified in (k) above. Staff who apply college course credits toward required training hours shall not be precluded from meeting the requirements of (o) above.

(r) All training shall be documented in the employee’s personnel file or through an electronic equivalent.

(s) Each employee shall have at least one evaluation and planning conference per year.

(t) The evaluation required in (s) above shall be documented in the employee’s personnel file and shall be signed by the employee and the supervisor, indicating that the employee has read the evaluation or indicating why the employee did not sign the evaluation.

(u) The executive director shall receive an annual performance evaluation conducted and signed by the board of directors or the executive director’s direct supervisor or designee.

(v) The evaluation of the executive director shall be documented in the executive director’s personnel file.

(w) Employees of nursing homes and rehabilitation programs shall be excluded from the training requirements with the exception of (o) above.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; amd by #12609, eff 8-23-18; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.12 Admissions Criteria and Discharge Procedures.

(a) Upon referral by the JPPO, CPSW, CME, or upon admission of a child, the residential treatment program shall document the child’s needs and, if known, the primary areas of treatment identified and services to be provided based on previous assessments provided including the child and adolescent needs and strengths (CANS), the comprehensive assessment for treatment (CAT), and the referral information.

(b) As soon as possible after a child’s admission, the program shall develop the required plan as described in RSA 126-U:3.

(d) The residential treatment program shall make the following available to the parent(s) or guardian during the admission process:

(1) The program philosophy, as stated on Form 2601 “Certification for Payment Application – Residential Programs” (January 2026)”;

(2) The daily routines;

(3) Behavior management and disciplinary practices of the program;

(4) Any specific treatment strategy used by the program;

(5) Policies on visitation and other communication with the child;

(6) The services provided to families;

(7) Procedures which the parent or guardian can use to provide input about the care of the child;

(8) The name and telephone number of staff at the residential treatment program that the parent(s) or guardian can contact;

(9) A description of any religious services available;

(10) Limitations placed on personal possessions and the policies on how children acquire necessities;

(11) How the educational needs of children are met;

(12) How health and medical needs of children are met;

(13) The residential treatment program liaison identified to provide information and coordination to an insurance carrier, if applicable; and

(14) The parent handbook referenced in He-C 6350.10(b).

(e) If the parent(s) or guardian do not participate in the admissions process, the same information required in (d) above shall be sent to them within 7 days of admission.

(f) Once admitted to the residential treatment program, the child shall not be discharged unless one or more of the following conditions exist:

(1) The child is a danger to other children or staff as determined via delinquency proceedings conducted pursuant to RSA 169-B;

(2) The child is determined to need psychiatric hospitalization after an emergency mental health evaluation;

(3) The child is a danger to themselves or others and, after intensive staff intervention, it is determined that a more restrictive environment is necessary in order to maintain safety;

(4) The child's clinical needs can be best met in another setting as determined in the treatment planning process and the child has been accepted into that setting; or

(5) The child is ready to achieve their identified permanency plan, concurrent permanency plan, or transition plan.

(g) If the residential treatment program determines a discharge is necessary in accordance with (f)(1)-(f)(4) above, the program shall provide DCYF, the CME, and parent with written or electronic notice at least 14 calendar days prior to the date that the program is requesting the removal of the child in placement from the program which shall include the detailed reasons for such request. A residential treatment program may request an immediate discharge due to a circumstance identified in (f)(1)-(f)(3) above.

(h) Prior to a discharge, with the exception of a discharge in accordance with (g) above, the residential treatment program in conjunction with the family and the JPPO, CPSW, DCYF representative, or CME, or a combination of these individuals, shall discuss the transitional services, and aftercare services as applicable, provided by the residential treatment program to support family reunification or the child’s transition to an alternative setting.

(i) When the child is discharged, the residential treatment program shall provide details around medication management and medical concerns to the entity the child is discharged to, in writing, on the day of discharge.

(j) The discharge summary or packet shall be filed in the residential treatment program’s record and a copy shall be sent to the JPPO, CPSW, DCYF representative, CME, and the parent or guardian no later than 15 calendar days after the child’s discharge.

(k) The child’s discharge summary or packet shall include, but not be limited to:

(1) A summary of the child’s placement or episode of treatment at the residential treatment program;

(2) The results of the services provided, including the outcomes of the goals and objectives identified in the child’s treatment plan over the course of treatment in the program;

(3) Documentation of interventions utilized and the success or ineffectiveness of those interventions;

(4) Identification of the needs of the child and family which remain to be met upon discharge and the services, if known at discharge, which will meet those needs, including:

a. Upcoming appointments; and

b. Referrals to be made or made by the team in accordance with the child’s community reintegration tasks pursuant to He-C 6350.13(g)(3);

(5) An individualized transition and aftercare plan including support provided by the program post discharge if applicable;

(6) Adult living post-care packet pursuant to He-C 6350.28(i) and (j), if applicable;

(7) An updated Form 1552 “Child/Youth Information Sheet” (June 2020) if previously provided to the program by DCYF;

(8) An accounting of the child’s money which includes how much money they are discharging the child with; and

(9) A medical discharge summary which includes the below:

a. A list of upcoming appointments;

b. Current medical providers with corresponding contact information;

c. Medications inventory with which the child was discharged; and

d. An updated medications list individually identified with the prescribing practitioner of each medication.

(l) If litigation involves a child’s record, all information pertaining to the case shall be maintained until a settlement is reached.

(m) Unless otherwise specified by state or federal requirements, the child’s records shall be maintained by the residential treatment program for a minimum of 5 years after the child’s discharge.

(n) If the program surrenders their certification, have their certification terminated or revoked, or the program or agency closes, the residential program shall notify the department of the location where the files will be maintained and the entity which will oversee their file storage.

(o) Programs which are independent living shall be exempted from the requirements in (k)(3), (8), and (9) in this section above if there are no medicaid covered services being provided under He-C 6420.

(p) Nursing homes, and rehabilitation programs shall be exempt from the requirements in (k)(3), (6), (7), and (8) if there are no medicaid covered services being provided under He-C 6420.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; amd by #12609, eff 8-23-18; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.13 Treatment Planning Process.

(a) Residential treatment programs shall develop and document treatment planning for each child in accordance with He-C 6420.

(b) Pursuant to RSA 170-G:-4-e, III, the program shall coordinate transition and discharge planning from the day of admission. A discharge plan shall :

(1) Be written and available to the child’s parents or guardians no later than 10 days after the child’s admission to the program;

(2) Begin upon admission to any treatment program and be reflected in ongoing treatment plans and treatment team meetings through the community reintegration and transition tasks;

(3) Include documentation of the identification of the transition resource that the child will be discharged to pursuant to (g)(2)c. below, if known at the time of admission; and

(4) Indicate the child’s identified permanency goal and concurrent goal if provided by DCYF pursuant to (g)(2)c. below.

(c) Within 30 days of a child’s admission to a residential treatment program, the program shall conduct a psycho-social assessment with recommendations for treatment and shall incorporate the results and recommendations of any assessments including standard assessments conducted if clinically indicated. A PRTF shall conduct the psycho-social assessment within 14 calendar days of admission.

(d) Within 30 days of admission to the residential treatment program, the residential treatment program shall conduct a treatment team meeting and, in accordance with RSA 170-G:4-e, develop a treatment plan which shall be based on the treatment team meeting and recommendations of the psycho-social assessment in (c). A PRTF shall conduct the treatment plan and treatment team meeting within 14 calendar days of admission.

(e) For programs that offer short-term programming that serves children 60 calendar days or less, the psycho-social assessment, treatment team meeting, and treatment plan shall be completed within 10 calendar days of the child’s admission.

(f) Nursing homes, rehabilitation programs, and independent living programs shall be exempt from the requirements in this section if there are no medicaid covered services being provided under He-C 6420. Nursing and rehabilitation programs shall follow their respective treatment planning and care planning requirements.

(g) The treatment plan shall include:

(1) The summary of the psycho-social assessment;

(2) A transitional and discharge section for the child and family that includes:

a. An estimate by the treatment team members of the child’s length of stay, based upon referral information and the residential treatment program’s assessment;

b. For a child in a voluntary episode of treatment, the identification of the family who the child will be returning to; and

c. For a child placement through DCYF, identification of the child’s permanency plan and concurrent plan including the identified resource if known at the time of the treatment plan and provided by DCYF. The permanency plan and concurrent plan shall identify the following:

1. Reunification with the family;

2. Adoption;

3. Guardianship by a relative or other appropriate person; or

4. Another planned permanent living arrangement (APPLA) in accordance with RSA 169-C:24-b; and

(3) Community reintegration and transition tasks that identify the following:

a. Specific needed supports or services that would provide for the child to successfully transition out of the residential treatment program and into the community;

b. The treatment team member who is responsible for completing the task necessary; and

c. The projected time frame for completion of each task.

(h) The treatment plan shall, at a minimum, contain the following domains relating to rehabilitative and restorative services provided by the residential treatment program:

(1) Safety and behavior of the child;

(2) Family;

(3) Medical;

(4) Education, if clinically necessary; and

(5) Adult living preparation if the child meets the requirements of He-C 6350.28 or if determined clinically necessary.

(i) Each domain identified in (h) above shall address:

(1) The goals of the child and family, if applicable;

(2) The measurable objectives to be achieved by the child and family;

(3) The time frames for completion of objectives; and

(4) The individualized interventions that will be used to address the objectives, including:

a. Identification of the staff or individual providing or implementing the stated intervention;

b. The frequency of the intervention;

c. How that intervention is documented; and

d. Identification of the medicaid covered services that will be provided directly or arranged for through He-C 6420.

(j) The treatment plan shall include the date and signatures of the following team members indicating that they participated in the process:

(1) The child;

(2) The child’s parent or guardian;

(3) A prescribing practitioner from the program as required by He-C 6420;

(4) A representative of DCYF, if applicable;

(5) A representative of the child’s CME, if applicable; and

(6) The clinical coordinator, the residential treatment program’s executive director, or the child’s clinician. If the prescribing practitioner is also the clinical coordinator, they shall indicate both roles and only one signature shall be required.

(k) When any of the individuals in (j) above do not participate, the residential treatment program shall document their effort to involve them.

(l) Revisions to the treatment plan outside the scheduled treatment plan reviews shall include the signatures of the prescribing practitioner. It shall also include the clinical coordinator or clinician, and other team members identified in (j) above, as available, and shall be explained in writing to any individuals of the team who are unable to participate.

(m) The treatment plan shall be implemented by the treatment team and the residential treatment program’s staff and shall be reflected in the child’s daily routine, logs, progress notes, and discharge summary.

(n) The treatment team shall consist of the individuals identified in (j) above in addition to the following invited participants:

(1) Clinical staff of the residential treatment program;

(2) Attorney, court appointed special advocate (CASA), and guardian ad litem (GAL) for the child;

(3) A representative of the local educational agency when clinically appropriate; and

(4) Other persons significant in the child’s life, if clinically appropriate, including but not limited to:

a. Teachers;

b. Staff members from the residential treatment program;

c. Counselors;

d. Important connections, or friends;

e. Kin or relatives; and

f. Educational surrogate.

(o) Subject to (1) and (2) below, residential treatment programs shall acquire signatures on the treatment plans of individuals identified in (j) above within 7 calendar days of the treatment team meeting:

(1) If the residential treatment program is unable to obtain the signature(s) of the parent(s), guardians(s), CME, or DCYF representative, then the residential treatment program shall document the reasonable efforts made to acquire the signature(s); and

(2) Any team members participating through electronic means, other than the prescribing practitioner or clinical coordinator, may provide verbal assent in lieu of signature on the treatment plan but this shall not preclude efforts identified in (1) above.

(p) The treatment plan shall be filed in the child’s record and copies provided to the individuals identified in (j) above.

(q) The treatment plan shall be reviewed and updated as necessary by the treatment team at the treatment team meeting, at a minimum as follows:

(1) Three months from the initial treatment plan; and

(2) Every 3 months thereafter until discharge, at no point exceeding 3 months.

(r) Changes and updates to the treatment plan per (q) above shall show change over time. The treatment plan shall be made based on progress identified by the treatment team, identified areas of continued treatment needs, and shall include the treatment recommendations of any assessments conducted if clinically indicated. The treatment plan shall show achievement or changes of goals or objectives, and effectiveness or ineffectiveness of interventions. Subsequent treatment plans shall be in accordance with the requirements of (g) through (o) above.

(s) Once the treatment plan is completed, all clinical and direct care staff shall receive supervision and instruction to ensure that each child’s treatment plan is consistently implemented.

(t) Programs which are independent living shall be exempt from the requirements in this section if there are no medicaid covered services being provided under He-C 6420. Independent living programs shall follow documentation requirements of He-C 6350.16.

(u) Nursing homes, and rehabilitation programs shall be exempt from the requirements in this section if there are no medicaid covered services being provided under He-C 6420. They shall follow the requirements of their applicable treatment planning and medicaid rules.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff

10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.14 Daily Logs and Progress Reports.

(a) Each residential treatment program shall provide maintenance of logs, which shall occur daily pursuant to He-C 6420, documenting progress and summarizing the medicaid covered services which were provided to the child in accordance with the written treatment plan in He-C 6350.13.

(b) Unless excepted by He-C 6350.15(o), each residential treatment program shall provide a progress report for each child in its care, pursuant to He-C 6420, to DCYF, CME, and to parents and guardians, as follows:

(1) Short-term programs shall provide weekly progress reports and shall comply with (c) through (e) below; and

(2) All other programs shall provide monthly progress reports no later than the 15th day of each month and shall comply with (c) through (f) below. If a child has been at the residential treatment program for fewer than 7 calendar days, the information may be included in the most appropriate monthly progress report or discharge summary.

(1) The child’s name;

(2) The child’s date of birth;

(3) The name of the person completing the report;

(4) The date of the report;

(5) The name of the residential treatment program; and

(6) The date of admission.

(d) Progress reports shall address the following areas of care and treatment within the content of the report:

(1) General summary of the care provided to the child in that month;

(2) Status of each domain identified in the treatment plan including notable changes in particular goals or objectives;

(3) A summary of contacts with family, kin, or identified connections;

(4) Contact with other professionals such as DCYF representatives, the CME, a guardian ad litem, and attorneys;

(5) Dates of incidents that occurred during the previous month if applicable, including any notable observations or changes in behavior;

(6) A summary of the child’s educational progress of the current month, including any challenges experienced; and

(7) The following areas if there are updates:

a. Proposed modifications to the treatment plan;

b. Community reintegration and transition tasks; and

c. Disposition of grievances.

(e) Progress reports shall include the following information about each child’s medical status, behavioral health care, and dental issues throughout the reporting period:

(1) The prescriptions and current dosages;

(2) List of over-the-counter medication provided by the residential treatment program;

(3) The dates of visits during the month being reported;

(4) Any new health care issues and diagnoses, if applicable;

(5) The dates of future scheduled visits; and

(6) The name(s) of the child’s health care provider(s) and their office addresses.

(f) When children meet the requirements in He-C 6350.28(b), progress reports shall include documentation of adult living preparation progress if progress was completed during the month, including:

(1) Independent living training that was completed by staff and the child;

(2) Post-care planning completed with the child; and

(3) When the child is placed through DCYF, a completed Form 1969 “Monthly National Youth in Transition Database NYTD Checklist” (January 2026), completed by residential program staff, for the purpose of collecting data for the National Youth in Transition Database (NYTD) pursuant to 45 CFR 1356.80.

(g) Programs which are independent living shall be exempted from the requirements in this section if there are no medicaid covered services being provided under He-C 6420. Independent living programs shall follow documentation requirements of He-C 6350.16.

(h) Nursing homes and rehabilitation programs shall be exempt from the requirements in this section if there are no medicaid covered services being provided under He-C 6420. They shall follow the requirements of their applicable logs and medicaid rules.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.15 Basic Standards for Residential Treatment Programs.

(a) Except as identified elsewhere in He-C 6350, all residential treatment programs shall comply with this section.

(b) Residential treatment programs shall be licensed in accordance with RSA 170-E or RSA 151, or the equivalent applicable licensure in the state in which they operate. Residential independent living programs which operate supported independent living, for example apartments, shall not be required to maintain a license for the child’s apartment under RSA 170-E or RSA 151.

(c) Residential treatment programs shall be enrolled in New Hampshire medicaid and shall comply with administrative rule He-C 6420.

(d) Providers shall maintain general liability insurance pursuant to 42 USC 671(a)(10)(C).

(e) Residential programs shall comply with the following:

(1) Any administrative rules specific to their category of service;

(2) The Juvenile Justice and Delinquency Prevention Act, 42 USC 5601-5681;

(3) RSA 170-A, and RSA 169-A, as applicable;

(4) RSA 126-U, and He-C 901; and

(5) Foster care bill of rights pursuant to RSA 170-G:21.

(f) Residential treatment programs shall provide the following at the program:

(1) Care in a structured, trauma informed, therapeutic environment and milieu;

(2) Support to children and families 365 days a year including nights, weekends, and during visits;

(3) Monitoring and assessment of the whereabouts and safety when a child is in the immediate care of the residential treatment program;

(4) Age and developmentally appropriate opportunities and activities consistent with the reasonable and prudent parent standard that positively support the education, physical, intellectual, and social needs of children within the residential treatment program and community;

(5) Positive youth development techniques that emphasize providing services and opportunities to support youth in developing a sense of competence, usefulness, belonging, and empowerment;

(6) Opportunities for children to maintain contact with their siblings and other family, kin, and identified connections;

(7) Daily programming to include:

a. Supervision;

b. Access to education pursuant to He-C 6350.29;

c. Social and family services;

d. Adult living preparation;

e. Recreation;

f. Rehabilitative services in accordance with He-C 6420;

g. Behavioral health services in accordance with He-C 6420; and

h. Independent living programs are not required to provide the above and they shall not be required to provide 24 hours a day 7 days a week of supervision. Supervision schedules shall be based on program model and individual needs of the child;

(8) Coordination of services to transition the child from the residential program to the identified discharge plan, permanency plan, or concurrent plan;

(9) Communication and documentation for children who are in court-ordered placement. The program shall provide court reports to DCYF for distribution and corresponding presence at hearings when requested by the court or by DCYF where DCYF may request court reports for a regular review hearing and provide 14 calendar day’s notice before the scheduled hearing unless otherwise mutually agreed upon with the program and department or ordered by the court; and

(10) Coordination of medical care with the guardian including but not limited to working collaboratively with DCYF so they are able to provide monitoring of children receiving psychotropic medications pursuant RSA 170-G:4, XXIII.

(g) DCYF shall provide the program with a completed Form 1552 “Child/Youth Information Sheet” (September 2025) signed and dated by the child’s parent or guardian. Every 6 months thereafter, the program shall review the information on the form, update the form as necessary, sign and date the form, and provide the updated form to DCYF, indicating changes or no changes. Additional attachments to the forms may be used to accompany the required information.

(h) Residential treatment programs shall have relief staff to respond to emergency situations and additional staff available to contact for support and consultation.

(i) Residential treatment programs shall follow staff training requirements and use effective de-escalation techniques to support the children’s individualized treatment needs and ensure the safety of all children at the program.

(j) For any initial placement of a child due to a petition filed under RSA 169-C, a program shall ensure a child’s health needs are met by arranging, in conjunction with the CPSW, a comprehensive physical exam to occur within the first 30 days of admission.

(k) All residential treatment programs shall provide and coordinate services and individual treatment interventions to meet the goals identified in the treatment plan, as follows:

(1) The treatment plan for children placed through DCYF shall be consistent with the DCYF case plan, or for children in an episode of treatment through BCBH, the treatment plan shall be consistent with the CME transitional enhanced care coordination (TRECC) care plan, when either has been provided to the program;

(2) Treatment interventions shall be trauma-informed and meet the individual needs of the children and families in therapeutic and group-living experiences;

(3) Treatment programs shall include individual and group problem solving and support decision-making which may include individual counseling or group counseling, or both;

(4) The clinical coordinator shall ensure therapeutic interventions and other services are implemented and integrated into the treatment programming for the individual child and family;

(5) Services required by the treatment plan including individual, group, and family counseling to children shall be available within the residential treatment program or shall be referred to community agencies depending on the specialized need of the child and family, and the category of service;

(6) Direct care staff that provides group counseling shall receive supervision from clinical staff;

(7) Programs shall collaborate cooperatively with DCYF and CME for transition and discharge planning; and

(8) Treatment plans shall be time-limited for the purpose of providing treatment and stabilization to the child and preparing the family or the identified resource for a transition to home and community or another identified setting.

(l) ABA shall be provided by a register behavioral technician, BCBA, or staff who have been trained to implement the intervention, as applicable.

(m) Treatment programs shall support family-centered practices and incorporate the family-centered focus in the program’s milieu.

(n) Residential treatment programs shall make normal daily decisions in the life of the child and grant permission for participation in family, school, community, cultural, and social leisure time activities based on their age, ability, development, treatment plan, case plan, or court order consistent with the reasonable and prudent parent standard.

(o) During the course of treatment, if there is a court order that limits or prohibits the child’s contact with the parent or guardian, or if DCYF is in the process of securing such court order, the program shall not be required to engage the parent or guardian in the treatment planning process or provide them with documentation of progress reports or incident reports.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; amd by #12609, eff 8-23-18; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.16 Independent Living Programs.

(a) Residential independent living or level 1 programs shall provide housing and residences to young adults and may be either supervised independent living or supported independent living. For certification the program shall comply with RSA 135-F and RSA 126-U.

(b) Supervised independent living programs shall:

(1) Maintain a license through RSA 170-E; and

(2) Have a program model with dedicated staff to support young adults in a shared living environment.

(1) Not be required to be licensed through RSA 170-E;

(2) Require case management licensure pursuant to RSA 151 and adhere to rules He-P 819, if applicable; and

(3) Have a program model with dedicated staffing to support young adults in independent apartments which are maintained by the program.

(d) Independent living programs shall:

(1) Coordinate with the young adult’s CPSW or JPPO and team;

(2) Not require enrollment with New Hampshire medicaid or compliance with He-6420; and

(3) Not be required to comply with He-C 6350.13, through He-C 6350.15.

(e) Independent living programs shall have policies on:

(1) The program model offered, including admissions, and discharge procedures;

(2) Positive youth development techniques that are trauma informed and emphasize providing services and opportunities to support young adults in developing a sense of competence, usefulness, belonging, and empowerment;

(3) Onboarding and ongoing training of staff which shall include trainings on trauma informed care; and

(4) Required background and criminal records checks.

(f) Independent living programs shall be in a location that provides young adults with access to educational or vocational opportunities, places of employment, counseling, and other services that meet the needs of young adult.

(g) Independent living programs shall follow He-C 6350.11(a). They shall follow He-C 6350.11(b) if there is a clinical director at the program.

(h) Independent living program staff shall maintain documentation of the services provided to the young adult which shall include at a minimum:

(1) A social history and life skills assessment within 30 days;

(2) A team meeting 30 days from admission and every 3 months thereafter;

(3) A plan of care which shall be developed within 30 days of admission. The plan of care shall utilize the assessments which were conducted with the young adult and their team and include the strengths, needs, goals, and objectives identified by the young adult and contain the minimum following domains:

a. Education or vocational;

b. Daily living;

c. Medical and behavioral health; and

d. Adult living preparation in accordance with He-C 6350.28;

(4) A monthly progress report by the 15th of each month which reviews the goals and objectives for the young adult and any other pertinent information in accordance with He-C 6350.14(c) and (h)(3) above;

(5) A discharge summary which includes an overview of the services provided as well as the progress of goals and objectives for the young adult; and

(6) Daily notes providing an overview and summary of the services provided.

Source. #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.17 Intermediate Treatment Program Requirements. In order for a residential treatment program to be certified as an intermediate treatment or level 2 program, it shall comply with the following:

(a) He-C 4001 or the laws or rules of the state in which they operate;

(b) Staff to child ratios of one staff to 6 children while children are awake and one staff to 12 children while children are asleep;

(c) An out-of-state program shall comply with the staffing requirements of the state in which it operates provided that the staff ratio is sufficient to ensure the residents’ safety and that children have prompt access to services and treatment. The program shall provide the documentation of the staff ratio maintained by the program to the department if it does not comply with (b);

(d) Except for residential treatment programs that have an independent living component housed in a separate area and have the capability of moving children that need more supervision back to the intermediate care level, there shall be an awake staff member in each building housing children;

(e) Services required by the treatment plan, including counseling of children and families, shall be available within the residential treatment program or shall be provided through the local community, as follows:

(1) Treatment plans shall provide and allow for increased community-based integration and involvement, based on progress and individualized needs; and

(2) Individual or family counseling may be provided by the clinical coordinator, or other staff meeting the requirements of clinical staff; and

(f) Educational services to children shall include the use of public schools pursuant to Ed 300, non-public schools pursuant to Ed 400, or private providers of special education pursuant to Ed 1100 as approved by the NH state board of education or approved schools in the state in which the program operates.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.17); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.16)

He-C 6350.18 Intensive Treatment Program Requirements. In order for a residential treatment program to be certified as an intensive treatment or level 3 program, the program shall comply with the following:

(a) He-C 4001 or the laws or rules of the state in which they operate;

(b) The program shall have the capacity to provide highly structured services, both on-site and in the community, as needed to directly affect the educational, physical, intellectual, emotional, and social needs of the children and families;

(c) The program shall maintain a multi-disciplinary, self-contained means of service delivery to meet the needs identified within the treatment plan, as follows:

(1) There shall be a clinical staff to child ratio of one clinical staff to 10 children;

(2) Clinical services shall be provided through the residential treatment program’s on-site program unless a special circumstance is identified through the treatment plan to support utilizing a community provider;

(3) Clinical staff shall provide treatment interventions to meet the individual needs of the children and families served and shall provide a therapeutic group-living experience;

(4) Unless otherwise specified in the child’s treatment plan, any combination of individual, group, or family counseling services shall be provided to each child or the family a minimum of 3 times a week consisting of a minimum of 45 minutes per session, or the equivalent of that time over several sessions;

(5) The family-centered services component shall operate in accordance with the written policy required by He-C 6350.10(b) and with staffing in accordance with He-C 6350.11(j) and (k); and

(6) The residential treatment program shall organize its clinical staff and family workers in a flexible manner so long as families are seen face-to-face no less than one time per week, unless otherwise specified in the child’s treatment plan, as follows:

a. Technology may be used to supplement clinical services as a part of the child’s treatment; and

b. The utilization of a video-conferencing technology shall not replace face-to-face contact unless documented in the child’s treatment plan with the agreement of the treatment team as identified in He-C 6350.13;

(d) The program shall be staff-secure and be able to serve those children whose needs require a high level of treatment and supervision, as follows:

(1) There shall be a minimum staff to child ratio of one staff to 4 children during hours when children are awake;

(2) Except for residential treatment programs that have an independent living component housed in a separate area and have the capability of moving children that need more supervision back to the intensive care level, there shall be an awake staff member in each building housing children; and

(3) An out-of-state program shall comply with the staffing requirements of the state in which it operates, provided that the staff to child ratio is sufficient to ensure the residents’ safety and that children have prompt access to services and treatment. The program shall provide the documentation of the staff and nursing ratio maintained by the program to the department if it does not comply with (1) above;

(e) Educational services to children shall comply with RSA 193:1 and Ed 306, as follows:

(1) The program shall use public schools pursuant to Ed 300, non-public schools pursuant to Ed 400, or private providers of special education pursuant to Ed 1100 as approved by the NH state board of education;

(2) The agency shall operate and maintain approval as a non-public school pursuant to Ed 400 and a private provider of special education pursuant to Ed 1100 as approved by the NH state board of education; and

(3) Programs in another state shall follow the requirements of their state agency or local authority which approves educational programs; and

(f) When a child is discharged to a family home, the program shall provide transitional and aftercare services for a minimum of 30 days.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.18); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.17)

He-C 6350.19 Highly Intensive Treatment Program Requirements. In order for a residential treatment program to be certified as a highly intensive or level 4 treatment program it shall comply with the following:

(a) He-C 4001 or for out-of-state programs, the applicable licensing rules and laws in their state;

(b) Providing highly structured services, both on-site and in the community, as needed to directly affect the educational, physical, intellectual, emotional, and social needs of the children and families;

(c) Maintaining a multi-disciplinary, self-contained means of service delivery to meet the needs identified within the treatment plan, as follows:

(1) There shall be a clinical staff to child ratio of one clinical staff to 8 children;

(3) Clinical staff shall provide treatment interventions to meet the individual needs of the children and families served and shall provide a therapeutic group-living experience;

(5) The staff requirements shall be in accordance with He-C 6530.11 (c), d), (j) and (k), and family-centered services component shall operate in accordance with the written policy required by as described in He-C 6350.10(b); and

a. Technology shall be allowed to be used to supplement clinical services as a part of the child’s treatment; and

(d) Be staff-secure and be able to serve those children whose needs require a high level of treatment and supervision as follows:

(1) There shall be a minimum of direct care staff to child ratio of one staff to 3 children during hours when children are awake;

(2) During sleeping hours there shall be a staff to child ratio of one staff to 5 children with a minimum 2 staff in a program building at all times regardless of ratio; and

(3) An out-of-state program shall comply with the staffing requirements of the state in which it operates, provided that the staff to child ratio is sufficient to ensure the residents’ safety and that children have prompt access to services and treatment. The program shall provide the documentation of the staff ratio as defined in He-C 6350.02(x) and maintained by the program, to the department if it does not comply with (c)(1) above and (d)(1) and (2) above;

(e) Educational services to children shall comply with RSA 193:1 and Ed 306 as follows:

(3) Programs in another state shall follow the requirements of their state agency or local authority which approves educational programs; and

(4) Agencies which operate community based acute treatment (CBAT) or intensive community based acute treatment (ICBAT) shall coordinate tutoring with the child’s sending school district;

(f) When a child is discharged to a family home, the program shall provide transitional and aftercare services for a minimum of 30 days unless that program is an CBAT or ICBAT; and

(g) Highly intensive programs may also include the short term category of CBAT and ICBAT and shall follow the above.

Source. #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.20 Psychiatric Residential Treatment Facility (PRTF). In order for a residential treatment program to be certified as a PRTF program, it shall:

(a) Be an inpatient treatment facility where treatment is directed by a physician in a highly clinical, active treatment setting in accordance with 42 CFR 441.151(a)(1), and shall be:

(1) A psychiatric hospital that undergoes CMS approved surveys;

(2) A hospital with an inpatient psychiatric program; or

(3) A psychiatric facility that is not a hospital and is appropriately accredited;

(b) Be licensed in accordance with RSA 151, equivalent license of the state in which it operates, or applicable license approved by the department;

(d) Comply with He-C 830 or applicable rules from the state in which they operate;

(e) Comply with He-C 6420;

(f) Comply with 42 CFR 441 Subpart D and 42 CFR 483 Subpart G and all applicable laws;

(g) Demonstrate accreditation with a national accrediting body in accordance with 42 CFR 441.151;

(h) Maintain the treatment documentation required in He-C 6350.12(j) and (k), He-C 6350.13, He-C 6350.14, and He-C 6420;

(i) Maintain a multi-disciplinary, self-contained means of service delivery to meet the needs identified within the treatment plan as follows:

(1) There shall be a clinical staff to child ratio of one clinical staff to 6 children;

(2) There shall be a psychiatrist who is available 24 hours a day and 7 days a week;

(3) There shall be nursing staff onsite 24 hours a day and 7 days a week;

(4) Clinical services shall be provided through the residential treatment program’s on-site program unless a special circumstance is identified through the treatment plan to supplement specialized treatment through utilizing a community provider;

(5) Clinical staff shall provide treatment interventions to meet the individual needs of the children and families served and shall provide a therapeutic group-living experience;

(6) Unless otherwise specified in the child’s treatment plan or court order, any combination of individual, group, or family counseling services shall be provided to each child or the family a minimum of 3 times a week consisting of a minimum of 45 minutes per session, or the equivalent of that total time over several sessions. This shall include family therapy if clinically indicated;

(7) The staff requirements shall be in accordance with He-C 6530.11 (c), (d), (j) and (k), and the family-centered component shall operate pursuant to the parent handbook required by He-C 6350.10(b); and

(8) The residential treatment program shall organize its clinical staff and family workers in a flexible manner so long as families are seen face-to-face no less than one time per week, unless otherwise specified in the child’s treatment plan, as follows:

a. Technology may be used to supplement clinical services as a part of the child’s treatment; and

(j) The program shall be staff-secure and may be structurally secure to be able to serve those children whose needs require the highest level of treatment and supervision, as follows:

(1) There shall be a minimum staff to child ratio of one staff to 4 children during hours when children are awake and a staff to child ratio of one staff to 6 children during sleeping hours;

(2) Programs shall be prepared to provide supplemental staff during times of need or crisis;

(3) Out-of-state programs shall adhere to the staffing requirements of the state in which the services are provided only if the staff ratio is sufficient to ensure child safety and that children have prompt access to treatment and services. The program shall provide documentation of the ratio maintained by the program to the department if it does not comply with (i)(1)-(3) above and (j)(1) above, as long as they maintain the ratio required by the equivalent license in (b) above and the required ratio of (f) above;

(4) The facility shall not use staff who are also counted in ratio on other units of the facility in order to meet the unit staffing ratios; and

(5) Justification of the ratio maintained by the program in accordance with the statutory or regulatory authority of the state or other entity dictating the ratio; and

(k) If there is an educational program on site the educational services to children shall comply with RSA 193:1 and Ed 306, as follows:

(3) Programs in another state shall follow the requirements of their state agency or local authority which approves educational programs; or

(4) The agency shall coordinate tutoring with the child’s sending school district.

Source. #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.21 Nursing Homes. In order for a residential treatment program to be certified as a nursing home, it shall:

(a) Be licensed in accordance with RSA 151 and He-P 815 or the equivalent in the state for which they operate;

(b) Not be required to comply with He-C 6350.13, He-C 6350.14, or He-C 6350.15(k) unless providing services under He-C 6420;

(c) Provide children with trauma informed programming and milieu, domiciliary board, room, laundry services, health supervision under medical and nursing direction, and nursing care as might be individually required; and

(d) Provide access to tutoring, the use of public schools pursuant to Ed 300, non-public schools pursuant to Ed 400, or private providers of special education pursuant to Ed 1100 as approved by the NH state board of education or approved schools in the state in which the program operates.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.21); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.19)

He-C 6350.22 Rehabilitation Programs. In order for a residential treatment program to be certified as a rehabilitation program, it shall:

(a) Be licensed in accordance with RSA 151 and He-P 807, or the applicable license and rules from the state in which they operate;

(b) Not be required to comply with He-C 6350.13, He-C 6350.14 and He-C 6350.15(k) unless providing services under He-C 6420;

(c) Assist in the rehabilitation of disabled children through an integrated program of medical and other services, which are provided under professional supervision and provided in accordance with trauma informed care; and

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.22); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.20)

He-C 6350.23 Substance Use Treatment Programs.

(a) In order for a residential treatment program to be certified as a substance use treatment program, the program shall comply with the requirements to certify for, and follow the rules of, either an intermediate treatment program in accordance with He-C 6350.17, an intensive treatment program in accordance with He-C 6350.18, a highly intensive treatment program in accordance with He-C 6350.19, or a PRTF in accordance with He-C 6350.20.

(b) A substance use treatment program shall maintain a license through RSA 151 or RSA 170-E and be licensed in accordance with He-P 826 or the applicable license from the state in which they operate.

(c) Substance use treatment programs shall involve the families as an integral part of the therapeutic milieu as they provide residential care and rehabilitative and restorative treatment to children who meet the criteria for substance use disorder as documented in the “Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition-Text Revision” (2022), published by the American Psychiatric Association and available as listed in Appendix B.

(d) Substance use treatment programs shall maintain a New Hampshire licensed alcohol and drug counselor (LADC) or master licensed drug and alcohol counselor (MLADC) on staff or contract with a New Hampshire LADC or MLADC, licensed clinical supervisor (LCS ), or a licensed clinical staff as defined in He-C 6350.02(q) who is trained in substance use disorder treatment, or the equivalent in the state in which they operate.

(e) Substance use treatment programs shall provide access to education which may include tutoring, the use of public schools pursuant to Ed 300, access to non-public schools pursuant to Ed 400, or access to private providers of special education pursuant to Ed 1100 as approved by the New Hampshire state board of education or approved schools in the state in which the program operates.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.23); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.21)

He-C 6350.24 Assessment Treatment Program.

(a) In order for a residential treatment program to be certified as an assessment treatment program, it shall comply with the requirements to certify for, and follow the rules of, either an intermediate treatment program in accordance with He-C 6350.17, an intensive treatment program in accordance with He-C 6350.18, a highly intensive treatment program in accordance with He-C 6350.19, a PRTF in accordance with He-C 6350.20, or a substance use treatment program pursuant to He-C 6350.23, and this section.

(b) Assessment treatment programs shall provide short-term care and treatment of children through comprehensive assessments and initial treatment while their specific needs are being determined or identified.

(1) Admit children for assessment treatment program services, including placement in the least restrictive therapeutic option with the expectation that the child will be discharged within 60 days or less;

(2) Focus on thorough evaluation, assessments, and screenings beyond the standard practice for the residential treatment program for which they meet the requirements of pursuant to (a) above;

(3) Provide educational services parallel to the educational services provided to children of the residential treatment program for which they meet the requirements of pursuant to (a) above;

(4) Provide treatment and assessment to the child, as follows:

a. Assessment tools that are completed shall be dependent on the specific needs of the respective child or family; and

b. Develop a treatment plan in compliance with He-C 6350.13;

(5) Complete weekly progress reports of the assessment and treatment services the child is receiving, pursuant to He-C 6350.14;

(6) Not be required to comply with the following:

a. Submission of monthly reports in accordance with He-C 6350.14(b)(1); and

b. Programming for adult living preparation pursuant to He-C 6350.28;

(7) Hold a transition and discharge meeting where the comprehensive assessments and treatment completed by the program and the recommendations resulting from the services provided shall be reviewed. Such a meeting shall be:

a. Held at least 2 weeks prior to the expected discharge, or held within 2 weeks of discharge if circumstances or the availability of a treatment team member do not allow the meeting to take place sooner; and

b. In the event that the transition and discharge meeting cannot happen within 2 weeks prior to discharge, the program shall notify the child’s treatment team and document in the child’s record with a justification and alternative plan for the discharge meeting; and

(8) If a child is discharged from the assessment treatment program to be admitted to another residential treatment program within the same agency, comply with He-C 6350.12(k) and He-C 6350.13.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.22)

He-C 6350.25 Access to In-Patient Care.

(a) If a child is admitted to an in-patient psychiatric or acute care hospital, the placement or episode of treatment shall continue through the date the child was admitted.

(b) With prior approval from an administrator, the department shall choose to hold the bed for up to 7 days in accordance with He-C 6350.04.

(c) If a child is admitted to an in-patient psychiatric or acute care hospital, the residential treatment program shall attempt to contact the appropriate JPPO, CPSW, CME representative, or family immediately.

(d) Unless (g) below applies, the initial psycho-social assessment, the initial treatment plan, and the discharge summary, described in He-C 6350.12 and He-C 6350.13, shall not be required if one of the following criteria is met:

(1) In the case of an unplanned admittance pursuant to (a) above, and the child returns to the residential treatment program within 10 business days; or

(2) In the case of planned or unplanned admittance pursuant to (a) above due to a known pre-existing condition which was identified in the residential treatment program’s documentation prior to the admittance, and the child returns to the residential treatment program within 30 days.

(e) If documentation referenced in (d) is not completed, there shall be documentation in the child’s file of the treatment team’s consent to these decisions.

(f) If a child returns to the residential treatment program after an admittance pursuant to (a) and (d)(2) above , the lapse in placement exceeds 30 days and the bed is closed pursuant to (d)(1) above, it shall be considered a new placement and the program shall comply with He-C 6350.12 and He-C 6350.13.

(g) If extenuating circumstances, including clinical regression or extreme behaviors such as, but not limited to, assaultive, destructive, self-injurious, or self-destructive behaviors, have occurred during an admittance through (a) above, updates or revisions shall be made to the psycho-social assessment and treatment plan in accordance with He-C 6350.13.

(h) If the department determines that additional services are required, the department shall authorize one staff to one child services outside the residential treatment placement, notwithstanding He-C 6350.04(f).

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.25); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.23)

He-C 6350.26 Regulatory Compliance Requirements for Out-of-State Residential Treatment Programs.

(a) Certification of out-of-state residential treatment programs shall be conditioned on continued compliance with the licensing requirements in the state in which they operate.

(b) Out-of-state residential treatment programs shall provide the department with documentation of any quality assurance records or regulatory visits upon completion by their licensing or overseeing entity which shall include any corrective action plans submitted.

(c) Out-of-state residential programs shall comply with the applicable parts of He-C 6350 that pertain to the type of care provided to children and families, and shall comply with RSA 170 G, RSA 126-U, He-C 6420, and He-C 901.

(d) Out-of-state residential programs shall respond to communications with the department, families, CME, and DCYF to collaborate and cooperate with DCYF representatives, including case workers, CPSWs, JPPOs, and supervisors for each child to facilitate the department’s monthly oversight duties pursuant to RSA 169-F:7.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.26); ss by #14176, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.24)

He-C 6350.27 Visits.

(a) All visits shall be implemented in accordance with court orders, DCYF’s case plan, as applicable, and treatment plan for the child.

(b) During a visit, the residential treatment program shall not be responsible for the supervision of the child unless otherwise established in the contract while the child is in the care of the child’s family, kin, identified connection, or a foster family care provider licensed in accordance with RSA 170-E.

(c) The residential treatment program shall remain available to respond to any crisis during a child’s visit, with the exception of transitions to a foster care agency within the provisions of He-C 6355.18.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.27); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.25)

He-C 6350.28 Adult Living Preparation.

(a) Residential treatment programs shall assist children to improve their developmentally appropriate independent living skills and prepare for adulthood, by complying with the adult living preparation requirements and completing the DCYF adult living preparation documents as described below.

(b) Residential treatment programs shall identify and meet the adult living needs of children who are age 14 or older, and if clinically appropriate, coordinate activities which may be included in support of independent living such as employment, volunteering, and driver’s education.

(c) Information obtained through the adult living preparation shall be included in the treatment plan, daily logs, monthly progress reports, and discharge summary, as appropriate.

(d) Residential treatment programs providing short-term residential treatment or short-term assessment treatment programming pursuant to He-C 6350.24, shall not be required to complete the adult living preparation requirements due to the brevity of stay.

(e) The process of completing adult living preparation shall be done in collaboration with the child, and shall include the following:

(1) Within 30 days of admission, staff shall assist children age 14 and 15, and children with a documented developmental or intellectual delay or disability, in completing Form 1691 “Needs Assessment for Adult Living: 14-15 Years Old and All Youth with Intellectual and Delays” (January 2026);

(2) Within 30 days of admission or within 30 days of their 16^th birthday staff shall assist children in the completion of Form 1690 “Needs Assessment for Adult Living: 16+ Years Old” (January 2026);

(3) The needs assessment in (1) and (2) above shall be updated annually, and more frequently as necessary, to reflect any updated information in the child’s DCYF case plan;

(4) Completed Forms 1690 and 1691 shall be dated and signed by the child, the person assisting the child in completing the form, the child’s CPSW or JPPO, and any other individual involved in completing the form;

(5) Within 30 days of admission, and every 6 months thereafter, staff shall assist children age 14 years or older with completing the “Casey Life Skills Assessment” (October 2021) or the most recent version available at https://www.casey.org/casey-life-skills/ or provided by DCYF ;

(6) Within 60 days of admission, staff shall assist the child with completing the “Choices360 Career Planning Interest Profiler” available at choices360.com using the access code provided by DCYF. Program staff shall ensure neither staff nor the child enters any personally identifiable information about the child on the website;

(7) Within 60 days of admission, staff shall assist the child with completing Form 1695 “Adult Living Preparation Plan,” (January 2026), which shall incorporate the results of the assessments in (5) and (6) above, and any follow-up tasks to be completed by the child, member of the treatment team, or another identified support person. The completed form shall be signed and dated by the child, the person assisting the child in completing the form, the child’s CPSW or JPPO, and any other individual involved in completing the form. The form shall be reviewed and updated at least annually with more frequent updates as needed;

(8) Thirty days prior to the child’s 18th birthday, or 30 days prior to the child’s planned discharge if the child will not discharge upon the child’s 18th birthday, staff shall assist the child with completing Form 1984 “Post Care Plan” (January 2026). The completed form shall be signed and dated by the child and the child’s CPSW or JPPO, the person assisting in completion of the form with the child, and any other individual involved in completing the form; and

(9) If the documents outlined in (1)-(8) above have been completed at a previous out-of-home placement within the previous 6 months, the previous documents, if available, shall be provided by DCYF or the CME and then reviewed and amended by the program as appropriate based on any changes in circumstances.

(f) Staff shall complete and submit Form 1969 “Monthly National Youth in Transition Database (NYTD) Checklist,” (January 2026), each month pursuant to He-C 6350.14(f)(3) to DCYF.

(g) The residential treatment program shall provide children with weekly skills training using the DCYF adult living preparation curriculum.

(h) If an out-of-state program has an adult living preparation curriculum, training program, or forms which are used by the state in which it operates, the program may submit the documents to DCYF for review. If DCYF determines the documents meet the requirements of this part, then the documents may be used in lieu of (e) and (g) above.

(i) To assist children in their transition out of placement, staff shall prepare a post-care packet for each child 30 days prior to the child’s 18th birthday or 30 days prior to the child’s planned discharge to independent living, or home setting, if the child will not discharge upon the child’s 18th birthday, which includes:

(1) Form 1984 “Post-Care Plan” (January 2026) as referenced in (e)(8) above;

(2) Resources pertaining to post-secondary education and adult education programs or vocational programs in the community to which the child will be returning;

(3) Copies of school transcripts and individual educational plan, if the child’s education was provided by the residential treatment program; and

(4) Career assessment results, completed by the residential treatment program pursuant to (e)(6), above.

(j) The staff shall prepare a transition packet for each child prior to the child leaving placement to be utilized by the child, including:

(1) The names and telephone numbers of people identified as supports for the child in aftercare, including:

a. The CPSW, JPPO, or CME;

b. The residential treatment program counselors and foster parents;

c. The counselors and mental health therapist;

d. Adult advocates, teachers, or coaches; or

e. Other individuals who will assist the child such as primary caring adult, identified connections, or kin;

(2) The date of the child’s last medical physical or visit to the doctor and any upcoming appointments;

(3) The child’s medical history, immunizations updates, and family medical history, if available;

(4) A list of medications currently prescribed for the child; and

(5) The identification of any specific long-term medical conditions and any health concerns pertaining to the child.

(k) Independent living documentation and preparation and skills training shall be provided as appropriate for children in an episode of treatment through BCBH.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.28); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.26)

He-C 6350.29 Education.

(a) Residential treatment programs shall make time and space available for studying and shall ensure that children have access to necessary educational materials.

(b) Residential treatment programs shall collaborate and coordinate with the child’s school in order to ensure they have access to an appropriate education based upon the child’s needs.

(c) Based on the residential treatment program’s category of service, the child shall be enrolled in a New Hampshire state board of education approved program or a general equivalency diploma program for children over 16 when the program complies with RSA 186-C:9 . For out-of-state programs children shall have access to state approved public school, or the program shall have an approved educational program for the state in which they operate pursuant to He-C 6350.17 through He-C 6350.20.

(d) CBAT, ICBAT, PRTF, nursing homes, or rehabilitation programs, shall have an approved school pursuant to (c) above or an education program that includes tutoring as an alternative education plan based on their state’s expectations and requirements.

(e) The residential treatment program shall not prevent children from going to school as a consequence for misbehavior. The program shall provide the school with any information regarding circumstances which might present a concern for the safety of the child or community in order for the school to determine if the school is able to support the safety of the child or community.

(f) Children attending school outside the residential treatment program shall be encouraged to take part in the school's extracurricular activities, unless contraindicated by the treatment team.

(g) Using the reasonable and prudent parent standard, the residential treatment program shall allow and encourage the child in care to participate in school-related activities and events based on their age, ability, treatment, and development if there are no existing safety concerns for their inclusion and the activity is otherwise not prohibited by the treatment plan, case plan, or court order.

(h) The residential treatment program shall ensure that life-skills training is available and appropriate to the age and abilities of the child.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.29); amd by #12609, eff 8-23-18; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.27)

He-C 6350.30 Communication with Family, Kin, and Identified Connections.

(a) The residential treatment program shall encourage visits and other forms of communication between the child and family members, kin, and identified connections.

(b) The residential treatment program shall make available space and times that are convenient for visiting.

(d) Programs shall encourage frequent contact between the child and appropriate family, kin, and connections when clinically appropriate.

(e) Staff shall facilitate, support, supervise, or enforce the limit of visits with others in accordance with the court orders, case plan, and treatment plan.

(f) Staff shall provide privacy for visits and telephone contacts between children and their families, kin, or identified connections if appropriate.

(g) Staff shall allow a child in care to receive and send mail.

(h) Staff shall not read children’s mail unless the reason is documented in the treatment plan or approved by DCYF at the request of the residential treatment program to meet the supervision needs of the child.

(i) The residential treatment program shall be equipped with telephones for the children’s use and shall have procedures about their use.

(j) The residential treatment program shall provide privacy for and not prevent a child from communicating verbally, in writing, or directly with their attorney, GAL, CASA, the New Hampshire office the child advocate, ordained representative of the child’s faith, or DCYF representative unless the access to the phone or materials would present a safety concern at the time.

(k) If there were a safety issue which prevented a child from communicating, the program shall notify the applicable individual listed in (j) above of the concern and of the intent the child had to communicate with the individual.

(l) If the treatment team has planned with the child around the frequency of communication, the team will be made aware of the approximate frequency of the request made by the child with the intent to communicate with the individual through the monthly progress reports if the amount requested exceeds the allowable frequency.

(m) The residential treatment program shall make efforts to communicate with the parent or guardian about the implementation of the reasonable and prudent parent standard in structuring activities for the child within the operation of the program.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.30); amd by #12609, eff 8-23-18; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.28)

He-C 6350.31 Reporting of Incidents.

(a) In accordance with He-C 4001, each residential treatment program shall maintain incident reports on all accidents and personal injuries.

(b) Programs which are licensed in another state shall follow the laws and rules of their state licensing agency regarding incidents in addition to maintaining compliance with (c) below.

(c) The residential treatment program shall share information regarding reports of incidents, as defined in He-C 6350.02(ai), as follows:

(1) Parents, guardians, and either DCYF or CME shall be notified as soon as possible but no later than the end of the next day and provided with the details of the incident unless prohibited by court order;

(2) A copy of the written incident report shall be provided electronically or mailed in accordance with the program’s policy to the individuals identified in (1) above;

(3) Should any of the required contacts in (1) above have no phone or email, a written copy of the incident report shall be mailed to the last known address;

(4) Incidents as defined in He-C 6350.02(ai)(9), shall be reported and documented in accordance with RSA 126-U and He-C 901; and

(5) Incidents, as defined in He-C 6350.02(ai)(2), (3), (5), and (9) shall be reported to the department’s incident management system within a minimum of 7 calendar days.

Source. #14490, eff 1-22-26, EXPIRES: 1-22-36

He-C 6350.32 Requirements for Staff Communications.

(a) The residential treatment program shall maintain a daily log for staff communication which may include those circumstances requiring continued attention by staff, in addition to logs specific to medicaid covered services in accordance with He-C 6420.

(b) Direct care staff shall only have access to the children's records at the residential treatment program which are necessary in order to provide care and supervision of the child and facilitate treatment plan goals.

(c) Direct care staff shall have input into children’s treatment planning, program policy development, and planning when appropriate.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.31); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.29)

He-C 6350.33 Children’s Money.

(a) Children may have access to their own money by receiving an allowance from the residential treatment program, by having opportunities for paid work within the residential treatment program, or through outside employment, unless otherwise indicated by the treatment plan, court order, or consistent with the program’s written policy.

(b) Money owned, earned, or received as a gift or as an allowance shall be the child's personal property and shall not be taken or borrowed by any staff member.

(c) Children shall not be required to pay for daily hygiene items, grooming supplies, and haircuts which shall include culturally and ethnically appropriate items.

(d) The residential treatment program shall have a separate accounting system for each child's money from any source with the exception of children in level 1 independent living programs in which case the child can be responsible for their own finances.

(e) The residential treatment program shall comply with RSA 170-E:51-a as it relates to certain minors in DCYF custody obtaining consent from the department to open a banking account.

(f) For purchases made by the residential treatment program using the children's money, the child shall sign a receipt, which shall identify the item, the date received, and the amount of the exchange.

(g) In cases where restitution is due to damage caused by the children at the residential program, an agreement with the child’s legal guardian and CPSW or JPPO shall be made in writing prior to restitution being made with the child. For court ordered restitution using the children's money, the child shall sign a receipt, which shall identify the expense, the date of the payment, and the amount of the restitution payment.

(h) The receipt referenced in (f) above shall be filed in the child’s record and in the residential accounting system in (d) above.

(i) Residential treatment programs shall have a written policy regarding the documentation of money in a child’s possession at the time of admission to the program including procedures for returning the child’s money at discharge from the program.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.32); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.30)

He-C 6350.34 Religion.

(a) During the admission process, the staff shall determine if the family has wishes regarding the child’s religion or faith and any accommodations the program can make to support the child’s religion or faith. The program staff shall discuss any religious affiliation of the residential treatment program with the child and the parent or guardian.

(b) A residential treatment program shall not require any child to participate in any religious observance or practice except with the written permission of the parent or guardian and agreement of the child.

(c) The residential treatment program shall obtain written permission of the child's parent or guardian before any child changes their religious affiliation.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (from He-C 6350.33); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.31)

He-C 6350.35 Absconders, Runaways, or Missing Children.

(a) Pursuant to the definitions in He-C 6350.02(a) and (bg), all absconders are deemed runaways.

(b) Programs shall be reimbursed by the department, pursuant to He-C 6350.04, at their authorized rate through the day the child runs away, absconds, or is missing and shall resume on the date the child returns to the residential treatment program, if applicable.

(c) If a child runs away, absconds, or is missing, the program shall immediately notify the local law enforcement agency, the parent(s), DCYF, if the child is placed through DCYF, and the CME if the child is in a voluntary episode of treatment. When reporting to law enforcement, the program’s report shall include information if the child is court ordered in placement at the residential treatment program.

(d) If the court order for placement at the residential treatment program is still in effect during the time that the child is absent as a runaway, absconds, or is missing it shall be at the program’s discretion whether to remain involved with the child’s case, if approved by DCYF.

(e) Upon a child’s return from running away, the program shall:

(1) Immediately notify the local law enforcement agency, DCYF, or CME and the child’s parent(s) or guardian unless instructed otherwise by law enforcement;

(2) Ensure the child’s immediate medical and mental health needs are assessed and addressed; and

(3) Observe the child for indications that the child might have been a victim of human trafficking. If the child is placed through DCYF, the program shall notify DCYF of all information gathered as soon as practicable, and shall cooperate with DCYF to meet the child’s needs related to the runaway event.

(f) Subject to (g) below, if a child returns to the program within 10 business days of running away, the program shall not be required to make updates to the psycho-social assessment and treatment plan and the discharge summary described in He-C 6350.12 and He-C 6350.13 unless (g) below is applicable.

(g) If a child exhibits significant changes, clinical regression, or extreme behaviors such as, but not limited to, assaultive, destructive, self-injurious, or self-destructive behaviors upon return to the program, updates or revisions shall be made to the psycho-social assessment and treatment plan in accordance with He-C 6350.13.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (formerly He-C 6350.34); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.32)

He-C 6350.36 Grievance Procedures.

(a) Each residential treatment program shall establish a grievance procedure and provide the procedure in the parent and youth handbooks, so children may constructively address their concerns without fear of retaliation.

(b) For any grievance filed, its disposition shall be recorded in the child’s record and in the monthly progress report.

Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06

New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15 (formerly He-C 6350.35); ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.33)

He-C 6350.37 DCYF Visits and Oversight.

(a) For any child placed through DCYF or in a court-ordered residential treatment pursuant to RSA 169-B, RSA 169-C, or RSA 169-D, the residential treatment program shall accommodate monthly child-specific visits between the child and DCYF representatives, including case workers, CPSWs, JPPOs, and supervisors.

(b) The residential treatment program shall provide a safe and private space, as determined by the DCYF representatives and the child, for the DCYF representatives to meet with the child during each monthly in-person DCYF visit.

(c) For each monthly visit with each child, the program staff shall provide the DCYF representatives with an in-person tour of the facility which shall include the areas of the facility where the child may have access to and the child's living quarters.

(d) During the DCYF representatives’ visit, the residential treatment program shall make program leadership available to speak with the DCYF representatives about the program culture and therapeutic programming.

(e) Direct care staff shall be available during the in-person visit to speak with the DCYF representatives about the child's progress in the program.

(f) The residential treatment program shall make available the child's therapeutic provider, the clinical director, or both, to speak with the DCYF representatives about the program culture, therapeutic programming, and the child's individual progress, strengths, and challenges in the program. This communication shall occur:

(l) In-person during the DCYF visit to the facility; or

(2) In virtual real-time by telephone or video conference if the conversation cannot occur during the in-person DCYF visit due to scheduling conflicts beyond the control of the participants.

(g) The residential treatment program shall facilitate monthly contact between the DCYF representatives and the child's educational provider at the program, if applicable to the services provided by the program. Contact with the child's educational provider shall occur:

(1) In virtual real-time by telephone or video conference; or

(2) If the contact cannot occur in virtual real-time due to conflicts beyond the control of the participants, the communication shall be in writing.

Source. #14176, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36 (formerly He-C 6350.34)

PART He-C 6351 - RESERVED

PART He-C 6352 CERTIFICATION FOR PAYMENT STANDARDS FOR COMMUNITY-BASED SERVICE PROVIDERS

Statutory Authority: RSA 170-G:4, XVIII, RSA 170-G:5

He-C 6352.01 – He-C 6352.10 - EXPIRED

Source. #4446, eff 7-1-88, EXPIRED: 7-1-94

New. #7292, eff 5-24-00; ss by #9112, INTERIM, eff 3-24-08, EXPIRED: 9-20-08

He-C 6352.11 – He-C 6352.31 - EXPIRED

Source. #7292, eff 5-24-00; ss by #9112, INTERIM, eff 3-24-08, EXPIRED: 9-20-08

PART He-C 6353 ALLOCATION AND DISTRIBUTION OF INCENTIVE FUND GRANTS - REPEALED

He-C 6353.01 – He-C 6353.08

Source. #4714, eff 11-30-89, EXPIRED 11-30-95

New. #7363, eff 9-19-00, EXPIRED: 9-19-08

New. #9640, eff 1-23-10; rpld by #12332, eff 7-21-17

PART He-C 6354 MONITORING HOME-BASED THERAPEUTIC SERVICES PROVIDERS

Statutory Authority: RSA 170-G:4 XVIII, RSA 170-G:4 VI, RSA 170-G:5.

He-C 6354.01 – He-C 6354.03

Source. #8009, eff 1-1-04, EXPIRED: 1-1-12

PART He-C 6355 CERTIFICATION FOR PAYMENT OF FOSTER CARE PROGRAMS

He-C 6355.01 Definitions.

(a) “Agency” means the board of directors, executive director, employees, foster parents, and volunteers of an organization that is incorporated and recognized by the secretary of state and licensed by the department as a child placing agency in accordance with RSA 170-E:24.

(b) “Applicant” means the person or entity that is requesting certification of a foster care program.

(1) A bachelor’s degree in social work, psychology, education or a related field with an emphasis in human services; and

(2) At least 2 years of experience working with children and families.

(d) “Case plan” means the division for children, youth and families (DCYF) written plan for the child and the family which outlines how services will be provided, pursuant to RSA 170-G:4, III and 42 U.S.C. 671, PART E-Federal Payments for Foster Care and Adoption Assistance SEC.471(a)(16), 475(1) and (5)(A and D) State Plan For Foster Care and Adoption Assistance.

(e) “Certification for payment” means the process by which DCYF approves the operation of and payment to foster care programs.

(f) “Child” means:

(1) “Child” as defined in RSA 170-E:25, I. The term includes “youth;” or

(2) For the purposes of compliance with RSA 126-U, “child” as defined in RSA 126-U:1, I, namely “a person who has not reached the age of 18 years and who is not under adult criminal prosecution or sentence of actual incarceration resulting therefrom, either due to having reached the age of 17 years or due to the completion of proceedings for transfer to the adult criminal justice under RSA 169-B:24, RSA 169-B:25, or RSA 169-B:26. ‘Child’ also includes a person in actual attendance at a school who is less than 22 years of age and who has not received a high school diploma.”

(g) “Child placing agency” means “child placing agency” as defined in RSA 170-E:25, IV.

(h) “Child protective services worker (CPSW)” means an employee of DCYF who has expertise in managing cases to ensure families and children achieve safety, permanency, and well-being referred to the department pursuant to RSA 169-C, RSA 170-B, RSA 170-C and RSA 463.

(i) “Clinician” means an individual who has a master’s degree in a clinical field such as social work, marriage and family therapy, psychology, education, counseling, human services, or a degree which would make one eligible for a New Hampshire license or certification in a field related to human services.

(j) “Clinical coordinator” means a staff member employed by the foster care program responsible for administrative oversight of the clinical services provided at the program. This term includes “treatment coordinator”.

(k) “Commissioner” means “commissioner” as defined in RSA 170-E:25, V.

(l) “Contact” means any communications including face-to-face, via telephone, postal mail, electronic mail, or internet networking.

(m) “Corrective action plan” means “corrective action plan” as defined in RSA 170-E:25, VI.

(n) “Department” means the New Hampshire department of health and human services.

(o) “Division for children, youth, and families (DCYF)” means the organizational unit of the department of health and human services that provides services to children and youth referred by courts pursuant to RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, and RSA 463.

(p) “Eligible” means that a provider demonstrates the ability to meet required quality and performance standards of certification for payment.

(q) “Eligible youth for adult living preparation” means youth in out-of-home care who are age 14 years or older.

(r) “Family” means the individuals to whom the child is related legally or biologically, such as, but not limited to parents, siblings, grandparents, aunts, and uncles.

(s) “Foster family home” means child care in a family setting as defined in RSA 170-E:25.

(t) “Foster care program” means a licensed child placing agency which recruits, trains and licenses and supervises foster family homes and provides parental care in a licensed foster family home on a regular, 24 hour a day, residential basis.

(u) “Human services” means helping people in areas, which include:

(1) Education;

(2) Mental health;

(3) Recreation;

(4) Child care;

(5) Medical services;

(6) Law enforcement;

(7) Corrections; and

(8) Social services.

(v) “Incident” means:

(1) A child’s behavior that is extreme, including, but not limited, to behavior that is assaultive, destructive, self-injurious, or self-destructive;

(2) Any behavior leading to physical intervention or seclusion of a child; or

(3) An occurrence involving an accident or injury, or requiring involvement of outside agencies.

(w) “Juvenile probation and parole officer (JPPO)” means the DCYF representative who has an expertise in managing cases resulting from concerns of delinquency pursuant to RSA 169-B or children in need of services (CHINS) pursuant to RSA 169-D, to ensure families and children achieve safety, permanency, and well-being.

(x) “License” means “license” as defined in RSA 170-E:25, XI.

(y) “NH bridges” means the case management, tracking, and automated billing system used by DCYF for children who are in out-of-home placement or for whom the department has a legal responsibility, or both.

(z) “Permanency plan” means the set of goal-directed activities designed by DCYF, the parents, and the child that will achieve legal, emotional and physical permanency for children in foster care.

(aa) “Physical intervention” means a behavior management technique through which staff or foster parent(s) use the minimum amount of physical contact on a child, which is necessary for the circumstances. This term includes “physical management.” Physical intervention might be reportable under RSA 126-U.

(ab) “Policies” mean written guidelines, practices, and procedures specifying the current and future actions to be taken that direct the operation of the foster care program.

(ac) “Prescribing practitioner” means any of the following state licensed healthcare providers, that provide services identified in 42 CFR 440.130 to reduce a physical or mental disability, and aid in the restoration of a recipient to their best functioning level:

(1) Health care providers licensed in accordance with RSA 326-B;

(2) Physicians;

(3) Physician’s assistants;

(4) Any practitioner licensed by the New Hampshire board of mental health practice; and

(5) Any practitioner licensed by the New Hampshire board of psychologists.

(ad) “Program” means an identifiable system of social service interventions designed for an individual child or groups of children.

(ae) “Program coordinator” means the individual responsible for the daily administration of a foster care program.

(af) “Progress reports” means the monthly written notes sent to DCYF and the parent(s) or guardian(s) by the staff of a foster care program which document the services being provided to the child.

(ag) “Psycho-social assessment” means a type of professional assessment, which provides a clinical summary derived from a multidimensional evaluation of psychological, sociocultural, and environmental factors that are components of a presenting issue. It includes results of tests and evaluations, brief expressive descriptions of the problem, and an inventory of actual and potential assets and resources, the prognosis, and analysis of what is needed or planned to achieve the desired outcomes. The term “psycho-social assessment” includes a psychosocial diagnosis.

(ah) “Quality assurance” means the process that DCYF staff use to monitor, support, and provide technical assistance to foster care programs to assist in their ability to comply with He-C 6355.

(ai) “Residential treatment program” means the model and implementation of services to meet the treatment and supervision needs of the children pursuant to RSA 170-G:4, XVIII, and provide 24 hour care of children 365 days a year including all of the employees therein.

(aj) “Respite care” means “respite care” as defined in RSA 170-E:25, XV.

(ak) “Restraint” means “restraint” as defined in RSA 126-U:1, IV.

(al) “Runaway” means a child who has failed to return to the child’s placement, has hid, or concealed themself without permission of their legal custodian, foster care provider, or supervising authority.

(am) “Seclusion” means “seclusion” as defined in RSA 126-U:1, V-a.

(an) “Supervision” means an administrative, supportive, and educational process used extensively in foster care programs to help case managers and clinical staff develop and refine their skills, so they are able to provide quality care and treatment to the child and their family.

(ao) “Transitional plan” means an agreement made between a foster care program and the residential treatment team to set responsibilities, roles, and timeframes for the completion of tasks to complete the transition of a child from a residential treatment program to a foster care program.

(ap) “Transitional visit” means a visit which is part of the child’s community re-integration and transition process approved in the transitional plan that will support the matching and temporary overnight visitation of a child into a licensed foster family home towards the goal of achieving a successful permanent placement.

(aq) “Treatment plan” means the written, time-limited, goal-oriented, therapeutic plan developed by the treatment team for the child and family, which includes the strategies to address the issues that brought the child into placement, and which is consistent with rehabilitative and restorative services.

(ar) “Treatment team” means the individuals including, at a minimum, the child, if developmentally appropriate, the child’s parent(s) and guardian(s), foster parent, foster care program clinical staff, prescribing practitioner, and DCYF staff.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.02 Application Process.

(a) A licensed foster family home shall be considered compliant with certification standards when it is determined to be in compliance with He-C 6446.

(b) A staffed foster family home shall be considered compliant with certification standards when it is determined to be in compliance with He-C 6355.11 and He-C 6446.

(c) Each foster care program shall be determined eligible for certification by demonstrating in its application that it meets the quality and performance certification standards in He-C 6355.

(d) Each foster care program applicant shall demonstrate compliance with RSA 170-G:4, XVII, He-C 6380, enrollment and payment requirements, and He-C 6420, Medicaid covered services in residential facilities.

(e) Any foster care program as defined in He-C 6355.01(t) above, licensed in accordance with RSA 170-E, He-C 6446, or from another state, that seeks certification in accordance with He-C 6355 shall request application Form 2612 “Certification For Payment Application - Foster Care Program,” (March 2025) from DCYF and be supported by a need identified by DCYF in accordance with RSA 170-G:4.

(f) The application in (e) above shall be completed, signed and dated by the foster care program’s executive director, or designee, affirming or agreeing with all of the following:

“I have reviewed the Administrative Rules He-C 6355 and He-C 6446 and will adhere to the rules as a certified provider. I authorize the NH Division for Children, Youth and Families (DCYF) to conduct a certification for payment review to determine the program’s compliance with Administrative Rules He-C 6355 and He-C 6446. I further understand that DCYF has the right to verify information contained in this application.

I attest that the program is in compliance with He-C 6355, He-C 6446 and the applicable Medicaid rules, and that all information provided as part of the application, and in the required attachments is true and complete to the best of my knowledge.

I certify that the following pre-employment checks were completed for all staff, and reviewed as required in He-C 6355.04, a criminal record check, a BAAS state registry check, a DCYF central registry check and a NH motor vehicle record check.

I understand and agree to cooperate with a site visit as part of the application process.

The information contained in this application is correct to the best of my knowledge.”

(g) The completed application in (e) above shall be returned to DCYF within 90 days of receipt.

(h) The applicant shall provide the following information with the application in (e) above:

(1) A narrative, which shall include:

a. A description of the foster care program being proposed, to include any specialized services and the population the program desires to serve;

b. The documented need for the program as required by RSA 170-G:4, XVIII;

c. A description of how individual needs of children and families will be met, including but not limited to clinical provisions, educational, recreational, independent living, transitional services and case management, as applicable;

d. A description of how the program promotes the safety, permanency, and well-being of children and families;

e. A description of medical services provided or arranged in order to meet the individual needs of children; and

f. The quality assurance process that the applicant intends to use for the program, including all supporting documentation.

(2) Attachments, which shall include:

a. The name, office held, professional affiliation, address, and telephone number of each person on the program’s board of directors;

b. A copy of the program’s license issued in accordance with the following:

1. For programs in New Hampshire, a copy of the license issued in accordance with RSA 170-E:31 and He-C 6446; or

2. For programs outside of New Hampshire, documentation from the corresponding state’s regulatory agency(ies);

c. A completed Form 2426 “Residential Resource Guide Provider Form,” (March 2025);

d. A detailed budget describing the costs associated with the delivery of the foster care program; and

e. An organizational chart, to include names, titles, and job descriptions of personnel, and the corresponding credentials which document the education and experience requirements in He-C 6355.16, as applicable; and

(3) A copy of the program’s policies required by He-C 6355.09 and any other policies maintained by the program.

(i) If the type of certification being sought in (e) above is for staffed foster family home care, the following additional information shall be included:

(1) The name and address of 3 non-family members as references for the director, including the most recent employer, if applicable;

(2) The names, addresses, and telephone numbers of the members of the board of directors and advisory board; and

(3) Documentation that the residence and staff have met the requirements of He-C 6446.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by 14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.03 Renewal of Applications.

(a) A licensed foster care program seeking to renew the certification as a foster care program shall file for renewal of certification no later than 3 months prior to the expiration date of the current certification.

(b) The executive director or designee shall complete and sign Form 2612R “Certification for Payment Renewal Application – Foster Care Programs” (March 2025), affirming or agreeing to the following:

(1) “I have reviewed the Administrative Rules He-C 6355 and He-C 6446 and will adhere to the rules as a certified provider. I authorize the NH Division for Children, Youth and Families (DCYF) to conduct a certification for payment review to determine the program’s compliance with administrative rules He-C 6355 and He-C 6446. I further understand that DCYF has the right to verify information contained in this application.”

(2) “I attest that the program is in compliance with He-C 6355, He-C 6446 and the applicable Medicaid rules, and that all information provided as part of the application, and in the required attachments is true and complete to the best of my knowledge.”

(3) “I certify that the following pre-employment checks were completed for all staff, and reviewed as required in He-C 6355.04, a criminal record check, a BAAS state registry check, a DCYF central registry check and a NH motor vehicle record check.”

(4) “I understand and agree to cooperate with a site visit as part of the application process.”

(5) “The information contained in this application is correct to the best of my knowledge.”

(1) A narrative which shall include:

a. A description of any changes made to the program during the last certification period; and

b. The results of the most recent self-evaluation reviewing the program’s performance in meeting identified goals and outcomes; and

(2) Attachments documenting the following:

a. A description of the foster care program being proposed, the documented need for the program, and how individual needs of children and families will be met, including but not limited to, clinical provisions, medical, educational, recreational, independent living, transitional and permanency services, as applicable and how the program promotes the safety, permanency and well-being of children and families, including specialized services that are supported by certifications or accreditations;

b. Any changes made to the program’s board of directors and the names, addresses, and telephone numbers of the new board members;

c. The names and job functions of any personnel hired since the last certification; and

d. A copy of the program’s license or operational approval, in accordance with the following:

1. For programs in New Hampshire, a copy of the license issued in accordance with RSA 170-E:31; or

2. For programs outside of New Hampshire, documentation from the corresponding state’s regulatory agency(ies);

e. A completed Form 2426 “Residential Resource Guide Provider Form,” (March 2025).

(d) The foster care program shall cooperate with the department during all site visits conducted in accordance with He-C 6355.27(b)(2).

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.04 Requirements for Background Checks.

(a) The foster care program shall, within 30 days of employment, submit the following for each new staff member who will work directly with children in foster care:

(1) The full name;

(2) The date of birth;

(3) The position for which he or she was hired; and

(4) A notarized statement to confirm that the following pre-employment checks were completed and reviewed:

a. A criminal record;

b. BAAS state registry;

c. DCYF central registry; and

d. A NH motor vehicle record.

(b) The foster care program shall not make a final offer of employment to an individual until:

(1) It has reviewed the criminal record, BAAS state registry, and DCYF central registry and NH motor vehicle record information; and

(2) Has determined if any finding, arrest, criminal conviction, and motor vehicle violation or offense of the employee affects the care and safety of children.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.05 Length of Certification. Certification shall be valid for 2 years from the date issued, unless certification is voluntarily surrendered by the foster care program, the program closes, or the program’s certification is revoked by the department pursuant to He-C 6355.29.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.06 Reimbursement.

(a) Billing shall begin on the day of admission and continue through the day of discharge.

(b) The department shall only reimburse a certified provider as long as there is no concurrent payment for placement being made to another paid placement. The certified provider shall be reimbursed for the day of admission and the day of discharge, or both if applicable, pursuant to (a) above.

(c) The foster care program may sub-contract with other providers for the range of services required by He-C 6355.12(e)(1)-(11) and He-C 6355.13(n)(1)-(14) as long as the DCYF staff member responsible for the child’s case has approved the arrangement.

(d) Any sub-contractor used on a temporary or long-term basis, as authorized in (c) above, shall operate with a current license in accordance with RSA 170-E or within the scope of their professional license, if required.

(e) DCYF shall not be responsible for payments made by a foster care program to a sub-contractor for services provided in accordance with (d) above.

(f) Any foster care program that readmits a child who has run away or had an acute hospitalization shall be reimbursed pursuant to sections He-C 6355.20 and He-C 6355.21.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.07 Referrals and Admissions to a Foster Care Program.

(a) The foster care program shall make the following information available to the parent(s) or guardian(s) during the admission process:

(1) The philosophy of the program;

(2) Typical routines of the foster family;

(3) The behavior management and disciplinary practices of the program;

(4) Any specific treatment strategy used by the program;

(5) Policies on visitation and other communication with the child;

(6) The services provided to families and the associated costs;

(7) Procedures that the parent(s) or guardian(s) may use to provide input about the care of the child;

(8) The name and telephone number of staff at the foster care program that the parent(s) or guardian(s) may contact;

(9) A description of any religious practices or services available to children;

(10) How the educational needs of children are met; and

(11) How health and medical needs of children are met.

(b) Should the parent(s) or guardian(s) not participate in the admissions process, the same information required in (a) above shall be mailed to them within 7 days of intake. If the parent’s location is unknown, the information shall be provided to DCYF for service to the parent when located.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.08 Discharge Conditions.

(a) Once admitted to the foster care program, the child shall not be discharged unless one or more of the following conditions exist:

(1) The child has successfully completed the program and is ready to transition to their identified permanency plan or concurrent permanency plan;

(2) The treatment team has determined that a less restrictive environment is in the child’s best interest;

(3) The child is a danger to themselves or others and, after intensive staff intervention or crisis stabilization, it is determined that a more restrictive placement is necessary in order to maintain safety;

(4) The child is determined to be in need of psychiatric hospitalization after an emergency mental health evaluation;

(5) The child is a danger to others as determined via delinquency proceedings conducted pursuant to RSA 169-B; or

(6) The child's clinical needs can be best met in another setting as determined in the treatment planning process and the child has been accepted into that setting.

(b) If DCYF or the foster care program determines an unplanned discharge is necessary, all treatment team members shall be provided written, or electronic, notice at least 14 calendar days prior to the requested date that the child in placement is to be removed from their program including the detailed reasons for such request, except if a request for an immediate unplanned discharge is granted due to a circumstance identified in (a)(3), (a)(4), or (a)(5) above.

(c) Prior to a discharge, with the exception of a discharge relative to (a)(3), (a)(4), or (a)(5) above, the foster care program in conjunction with the family and the DCYF representative, or both, shall discuss the transitional services to support family reunification, or the child’s transition to an alternative placement.

(d) When the child is discharged, the foster care program shall provide details around medication management and medical concerns to the entity the child is discharged to, in writing, on the day of discharge.

(e) A written discharge summary shall be completed no later than 15 days after the child's discharge.

(f) The discharge summary shall be filed in the foster care program’s record and a copy shall be sent to the representative from DCYF and the parent(s) or guardian(s).

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.09 Requirements for Written Policies of a Foster Care Program. The program shall have written policies and procedures on:

(a) The referral, admission, and discharge process;

(b) Recruiting and screening of foster parents;

(d) The services provided to both the foster family and the child’s family to promote permanency and support continued family involvement through placement;

(e) Respite care options;

(f) The array of social and clinical services provided and limitations or conditions for use;

(g) The foster care program’s processes for:

(1) Filing a grievance,

(2) Discharging a child; and

(3) Emergency planning.

(h) The foster care program’s general behavioral and conduct expectations of children including discipline, conduct, and management of children’s adverse behaviors, including:

(1) The methods and tools used for the creation of the individualized treatment plan;

(2) The child management techniques identified to assist foster parents and staff in making decisions regarding children’s behavior;

(3) Acceptable and unacceptable foster parents and staff responses to inappropriate behavior;

(4) The procedures and requirements for reporting and documenting events governed by RSA 126-U;

(5) The guidelines for using timeout, seclusion, and physical intervention in accordance with RSA 126-U and He-C 4001; and

(6) Documentation, by foster parents and staff, of inappropriate behaviors of children and interventions used in response to the child’s conduct;

(7) Obtaining emergency services by foster parents and staff, for children who are demonstrating behaviors that are a threat to self or others;

(8) Documentation and reporting of incidents;

(9) Documentation and reporting of inappropriate conduct of foster parents and staff; and

(10) Use of seclusion and restraint in accordance with RSA 126-U;

(i) The foster care program’s record keeping policies regarding confidentiality; and

(j) The foster care program’s administrative procedures.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.10 Compliance Requirements for Foster Family Homes.

(a) Foster family homes shall provide substitute family life experiences for a child in a home for a planned, temporary time, in accordance with He-C 6446.

(b) These experiences shall include but not be limited to:

(1) Care in a family environment for children who have pending petitions for, or have been adjudicated as, abused or neglected, in need of services, or delinquent;

(2) Access to age and developmentally appropriate opportunities and activities that positively support the child’s education, physical, intellectual, and social needs; and

(3) Opportunities to maintain contact with family and identified connections, as deemed appropriate.

(1) He-C 6446, Foster Family Care Licensing Requirements;

(2) RSA 170-E; and

(3) RSA 126-U.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.11 Compliance Requirements for Staffed Foster Family Homes.

(a) Staffed foster family homes shall provide substitute family life experiences for a child in a home staffed by program personnel, for a planned, temporary time, in accordance with He-C 6446, including but not limited to:

(1) Care in a family environment for children who have pending petitions for, or have been adjudicated as, abused or neglected, in need of services, or delinquent;

(2) Access to age and developmentally appropriate opportunities and activities that positively support the child’s education, physical, intellectual, and social needs;

(3) Opportunities to maintain contact with family and identified connections, as deemed appropriate; and

(4) Staffed foster family homes shall not allow the possession or storage of weapons or firearms on the premises.

(b) Staffed foster family homes shall serve a maximum of 4 children in the foster family home.

(1) He-C 6446, Foster Family Care Licensing Requirements;

(2) RSA 170-E; and

(3) RSA 126-U.

(d) Staffed foster family homes shall be licensed and supervised by the child-placing agency that owns, rents, or leases the property, applied for the certification, and employs the staff assigned to the home.

(e) Staffed foster family homes shall not be required to have full-time resident staff, but shall comply with 24-hour staff coverage for the foster family home, as follows:

(1) Employs direct care staff who meet the education, background, and experience requirements to be a foster parent pursuant to He-C 6446;

(2) Employ a minimum of 2 staff or caregivers during waking hours to provide care and supervision; and

(3) Provide overnight coverage with a minimum of one available staff on the premises.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.12 Compliance Requirements for Therapeutic Foster Care.

(a) Foster care programs certified to provide therapeutic foster care shall demonstrate compliance with this section and:

(1) He-C 6446, Foster Family Care Licensing Requirements;

(2) He-C 6448, Standards for Child Placing Agencies;

(3) He-C 6420, Medicaid Covered Services;

(4) RSA 170-E:25, IV; and

(5) RSA 126-U.

(b) Foster care programs certified to provide therapeutic foster care shall be a licensed child placing agency in New Hampshire or any other state.

(c) Foster care programs certified to provide therapeutic foster care shall be provided in an experienced foster family home that is licensed in accordance with He-C 6446.

(d) Foster care programs certified to provide therapeutic foster care shall provide services to children who have chronic mental, emotional, physical, or behavioral problems that require individual supervision and consistent programmatic structure, in a treatment intensive family environment.

(e) The foster care programs certified to provide therapeutic foster care shall provide, at a minimum, the following services:

(1) Placements in a licensed foster family home in the region where the child has resided unless otherwise requested by DCYF;

(2) Case management services for parents and children;

(3) Counseling and therapeutic interventions;

(4) Coordination of treatment teams, case conferences, and services;

(5) A system for 24-hour, 7-days-per-week crisis response that includes at a minimum, on-call services;

(6) Transportation for the children in the therapeutic foster family home;

(7) Child health support assistance;

(8) Parent education and training;

(9) Behavior and clinical consultation for foster parents, staff, and parents;

(10) Assistance with social development of the child, including but not limited to, child care, developmental pre-school, camp, community, and recreational activities for children; and

(11) A treatment planning process in accordance with this section.

(f) Therapeutic foster family homes shall be supervised by a child placing agency that has a family-centered focus in which foster parents and clinical support staff provide intensive services to children and their families and implement a structured treatment plan.

(g) The foster care program shall be established and designed so that the service delivery system is responsive to the needs of the foster children, families, and therapeutic foster families.

(h) The foster care programs certified to provide therapeutic foster care shall employ at a minimum:

(1) A program coordinator;

(2) A recruitment and licensing specialist;

(3) Clinicians who provide assistance and clinical support to therapeutic foster families; and

(4) A prescribing practitioner.

(i) Unless otherwise determined in the case plan, supportive and clinical services needed to implement the treatment plan shall be provided to the child, family, and the foster parents by the therapeutic foster care program.

(j) The program shall maintain daily documentation of supportive services to the child and foster family to assess and monitor the child's progress. This shall include daily notes completed by the therapeutic foster care parent.

(k) At all treatment team meetings, the program shall outline in the treatment plan the level of support provided to the therapeutic foster care parents to meet the needs of the child and foster family.

(l) The clinician from the foster care program certified to provide therapeutic foster care shall:

(1) Meet the qualifications to be clinical staff in accordance He-C 6355.01(i);

(2) Be supervised by a prescribing practitioner or licensed clinician for a minimum of one hour every 2 weeks;

(3) Deliver the level of support foster parents need to implement the child’s treatment plan in the foster family home and the community;

(4) Coordinate and facilitate the meetings of the treatment team and the services to the child, family, and foster family; and

(5) Provide supportive individual and family counseling and clinical services as determined in the treatment plan for the child, family, and foster family, unless otherwise determined in the case plan.

(m) Therapeutic foster families shall:

(1) Participate in weekly face-to-face supervisory visits in the foster family home provided by the program;

(2) Provide daily written notes each week to the therapeutic foster care program that reflect progress towards the goals and objectives established in the child’s treatment plan;

(3) Care for not more than one foster child, unless assisting DCYF in coordinating care for a sibling group or an approved respite situation; and

(4) Provide no other certified or licensed child care services in the home.

(n) The primary therapeutic foster parent shall:

(1) Be a licensed foster parent who is at least 25 years of age and who has not experienced any major life changes within the past year, including but not limited to: a divorce, death of a spouse or child, or loss of employment;

(2) Have at least 4 years experience providing foster care, and an interest and demonstrated skill in working with children with significant clinical needs;

(3) Demonstrate 24 hour per day availability to meet the child’s needs and provide case management responsibilities;

(4) Complete 24 hours of foster parent training per year, including ongoing and situation-specific topics including but not limited to:

a. Trauma-informed care which incorporates in the treatment an awareness of the impact of traumatic stress on the abused or neglected children and their families;

b. Parenting a child with attachment difficulties;

c. Siblings and family relationships;

d. Educational advocacy;

e. Crisis management and positive behavioral interventions;

f. Understanding and facilitating transitions to permanency; and

g. Self-care of the foster parent; and

(5) Access foster parent support, which shall include, at a minimum, respite care, support groups, social events, and activities.

(o) If the primary therapeutic foster parent is unable to meet the requirements in He-C 6355.12 (n)(3) above, the treatment team or program shall implement a pre-approved plan to support the therapeutic foster parent in meeting the needs of the child.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.13 Compliance Requirements for Individual Service Options Programs.

(a) Individual Service Options (ISOs) programs shall demonstrate compliance with this section and:

(1) He-C 6446, Foster Family Care Licensing Requirements;

(2) He-C 6420, Medicaid Covered Services;

(3) RSA 126-U;

(4) RSA 170-E; and

(5) One of the following:

a. He-C 6448, Standards for Child Placing Agencies; or

b. He-C 4001, New Hampshire Residential Child Care Licensing rules.

(b) An ISO program shall have a current license to operate a residential facility or child placing agency in New Hampshire or any other state.

(c) ISO foster care services shall be provided in an experienced foster family home that is licensed in accordance with He-C 6446.

(d) The ISO program applying for certification shall either be a child placing agency, or a licensed residential child care facility that has foster family homes licensed by another child placing agency, provided that the requirements in (a) above are met.

(e) An ISO program shall have an array of professional, social, and community services that may be accessed to meet the individual needs of a child and the child’s family.

(f) An ISO program shall develop and implement a service delivery system that shall be designed primarily to wrap around individualized programming for children who have chronic mental, emotional, physical, or behavioral problems.

(g) An ISO program shall place only one foster child with a family unless:

(1) A sibling group is being placed together; or

(2) The department and the ISO program determine, following an assessment of the foster parents ability, experience, and skill, that a second unrelated child may be cared for and the safety and well-being of both children can be maintained.

(h) The ISO program shall be designed in such a way that the service delivery system is able to respond immediately and directly to the needs of the child.

(i) ISO programs shall provide services to children who meet the following criteria:

(1) Abused and neglected children, children in need of services (CHINS), and delinquents who have a court order, or children using voluntary services for an ISO foster care placement; and

(2) Children from birth to under 21 years of age, who display or have symptoms of any combination of the following:

a. Chronic mental, emotional, physical, or behavioral problems;

b. Present post-traumatic stress symptoms;

c. Challenging and provocative behaviors;

d. A mental health diagnosis; and

e. Are sexually reactive;

(3) Can participate in a local education program;

(4) Will benefit from out-of-home placement in a foster family home care setting; and

(5) Require intensive supervision and consistent structure.

(j) The ISO program shall determine a child’s acceptance within 10 days of the date of receipt of the referral form, Form 1906 “Referral to Individual Service Options Provider,” (March 2025) completed by the CPSW or JPPO, and the following:

(1) Copies of court orders relating to the approval of and payment for the foster care;

(2) The family’s social history, if completed or as soon as available;

(3) The child’s and family’s available medical history;

(4) The current case plan in its entirety, if completed or as soon as available;

(5) The child’s predispositional investigation, if completed or as soon as available; and

(6) The ISO’s release of information form signed by the parent or guardian.

(k) The ISO program shall provide or coordinate services that meet the clinical needs of the child, child and parent, and the foster family either through services within the program or accessing community services. The program shall coordinate community-based services for the birth family, when requested.

(l) The service delivery system shall be based on the individual needs of the child as identified in the treatment plan.

(m) The ISO program shall conduct and document a psycho-social assessment and develop a treatment plan for each child in accordance with He-C 6355.15.

(n) ISO programs shall provide or coordinate the following services for the child identified for ISO foster care services, as applicable:

(1) Placements in a licensed foster family home in the region where the child has resided, unless otherwise requested by DCYF;

(2) Planned visitation, both supervised and unsupervised, among the parents and the child and siblings or extended family;

(3) Case management, treatment planning, and service coordination, to include assistance in the coordination of:

a. Medical, community mental health, and dental care;

b. Public or private school education;

c. Recreation;

d. Vocational services; and

e. Substance abuse evaluations and random drug testing, if applicable;

(4) Individual counseling and family counseling for the child;

(5) Emergency on-call 24-hour response to crises;

(6) Crisis stabilization;

(7) Respite care in a licensed foster family home or program;

(8) Licensed child care;

(9) Transportation;

(10) Adult living preparation for adolescents;

(11) Administration of medications;

(12) Identification of relatives, mentors, and others who will support or assist the child and family;

(13) Transitional assistance to adult care, if applicable; and

(14) Transitional assistance to reach the permanency goal for the child;

(o) If the program is unable to comply with He-C 6355.13 (n)(1) above, it shall document justification for a placement outside of the region, in accordance with the child’s treatment or service needs.

(p) If the child identified for ISO services is placed with a sibling or sibling group, the foster care program shall only be financially responsible for the child identified for ISO services, and shall assist DCYF in coordinating services for the siblings in the same home.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.14 Crisis Stabilization for a Foster Care Program.

(a) The foster program shall contact the DCYF administrator or designee to request approval of residential crisis stabilization for a child, prior to service delivery.

(b) Crisis stabilization in residential care provided by a foster care program shall not exceed 10 days within each 12-month period that the child is in placement.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.15 Treatment Planning Process for a Foster Care Program.

(a) The treatment planning process shall only apply to therapeutic foster care programs (TFCs) and ISOs.

(b) All foster care programs shall conduct and document a psycho-social assessment of the child with recommendations for treatment. Based on the assessment and recommendations, the program shall conduct a treatment team meeting and develop a treatment plan within 30 calendar days of admitting the child.

(1) The summary of the psycho-social assessment;

(2) Treatment recommendations based on the psycho-social assessment; and

(3) A transition plan for the child and family that includes:

a. An estimate by the treatment team members of the child’s length of stay, based upon referral information and the foster care program’s assessment;

b. The child’s permanency plan and concurrent plan identifying one of the following alternatives for the child in care:

1. Reunification;

2. Adoption;

3. Guardianship by a relative or other person;

4. Permanent relative placement; or

5. Another planned permanent living arrangement; and

c. Community reintegration and transition tasks that identify:

1. Specific necessary supports or services that would enable the child to successfully return to the child’s community;

2. The treatment team member who is responsible for completing the necessary task; and

3. The projected time frame for completion of each task.

(d) The treatment plan shall, at a minimum, contain the following domains relating to rehabilitative and restorative services:

(1) Safety and behavior of the child;

(2) Family;

(3) Medical, including community mental health and dental care;

(4) Education; and

(5) Children 14 years of age or older, shall have adult living preparation in addition to general independent living skills.

(e) Each domain identified in (d) above shall address:

(1) The goals and measurable objectives to be achieved by the child and family;

(2) The time frames for completion of goals and objectives;

(3) The method to be used for evaluating the child’s and family’s progress; and

(4) The individualized interventions that shall be used to address the objectives, including:

a. An identification of the services that will be provided directly or arranged for, and any measures for ensuring their integration with the child’s activities including identifying how the child’s family and foster family will participate in the child’s care;

b. An identification of the individuals responsible for implementing the stated interventions in the treatment plan;

c. The frequency of the intervention; and

d. How the intervention is documented.

(f) The treatment team shall consist of the following participants:

(1) The child, if they are of an age, or developmentally appropriate to participate;

(2) The child's parents or guardian;

(3) The child’s foster parent(s);

(4) A representative of DCYF;

(5) The prescribing practitioner;

(6) The sending school district personnel for an identified child, as determined by the school district;

(7) The case manager or clinician from the foster care program; and

(8) Other persons significant in the child's life or case, including but not limited to:

a. Teachers;

b. Counselors;

c. Friends;

d. Relatives;

e. CASA or GAL;

f. Family Assessment and Inclusive Reunification (FAIR) facilitator, which is the administrative reviewer required pursuant to 42 USC 675;

g. Educational surrogate; and

h. Other advocates assigned by the court.

(g) The treatment plan shall include the date and signatures of the following team members, indicating they participated in the process:

(1) The foster care program’s program director or clinical coordinator;

(2) A representative of DCYF;

(3) For Medicaid funding, the name of the prescribing practitioner. If the prescribing practitioner is also the clinical coordinator, they shall indicate these dual functions;

(4) The clinician or the case manager of the foster care program;

(5) The child, if appropriate for the age or developmental level;

(6) The child’s parents or guardian. If DCYF is the guardian, the worker shall sign to indicate the dual functions; and

(7) The child’s foster parent(s).

(h) When any of the individuals in (g) above do not participate, the foster care program shall document its efforts to involve them.

(i) Revisions to the treatment plan shall be explained in writing to any individuals of the team who are unable to participate and documented in the child’s file.

(j) The treatment team shall implement the treatment plan, which shall be reflected in the child’s daily routine, logs, progress notes, and discharge summary.

(k) The treatment plan shall be filed in the child’s record and copies sent to the individuals identified in (g) above and the legally liable school district.

(l) An internal treatment plan review meeting shall be held by the foster care program’s staff 3 months from the date of the initial treatment plan meeting, to evaluate progress made towards the established goals and objectives.

(m) The treatment team shall meet 6 months from the date of the initial plan to:

(1) Update the treatment plan;

(2) Document progress towards objectives; and

(3) Review the requirements in (d) through (e) above.

(n) For children whose care is extended beyond the 6-month treatment plan meeting, the treatment team shall meet every 3 months thereafter, as in (m) above, or more frequently if necessary until the community reintegration and transition plan is implemented or an alternative discharge plan has occurred.

(o) The foster care program shall be allowed a 7 calendar day extension to acquire signatures on the treatment plans. Reasonable efforts to obtain the signature of the parent(s) or guardian(s) and DCYF shall be documented as meeting this requirement.

(p) Once the treatment plan is completed, foster parents, case managers, and clinicians shall receive direct supervision and instruction from the foster care program with oversight by the prescribing practitioner to assure that each child’s treatment plan is consistently implemented.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.16 Staffing and Training Requirements for a Foster Care Program.

(a) Foster care programs shall provide the following staff:

(1) A program coordinator who has the following minimum qualifications:

a. A master’s degree in social work, psychology, education or a related field, with an emphasis in human services;

b. Two years of clinical experience working with families; and

c. Two years of supervisory or management experience;

(2) At least one clinician pursuant to He-C 6355.01(i), who has 2 years clinically supervised experience working with children and families.

(3) Case managers pursuant to He-C 6355.01(c);

(4) A prescribing practitioner who is employed by the program or has a current contract or like agreement with the program;

(5) A recruitment and licensing specialist who shall:

a. Recruit and screen applicants to be licensed as a foster family care provider;

b. Perform or coordinate a home study and recommend foster parents for licensure;

c. Coordinate pre-service training for prospective foster parents;

d. Coordinate ongoing training opportunities and monthly support groups for foster parents in accordance with the requirements of He-C 6446;

e. Participate in the matching of children with licensed foster family homes; and

f. Monitor foster family homes for compliance with He-C 6446; and

(6) Trained foster parents available to meet the needs of the children accepted into the program.

(b) Clinicians who provide services to the children, foster care programs, and families shall:

(1) Participate in weekly supervision with the prescribing practitioner or clinical coordinator, which shall include a discussion of each case and a review of the progress made by the child and family towards the goals of the treatment plan;

(2) Receive 40 hours of specialized training during each year of employment, which shall be in individual and family issues and include:

a. Current family systems theory;

b. Current psychology of family systems;

c. Ethics;

d. Trauma-informed care;

e. Any evidence-based programs pertinent to the service population; and

f. Up to 15 hours of weekly supervision; and

(3) Clinicians shall not exceed a maximum of 10 concurrent cases.

(1) Receive weekly supervision by a licensed clinician, or clinical coordinator, for a minimum of one hour every week, including a discussion of each case and a review of the progress made by the child and family towards the goals of the treatment plan;

(2) Receive 30 hours of specialized training during each year of employment which shall include:

a. Ethics;

b. Current practice;

c. Needs of the service population; and

d. Up to 8 hours of weekly supervision; and

(3) Case managers shall not exceed a maximum of 6 concurrent cases.

(d) Recruitment and licensing specialists shall receive 20 hours of training during each year of employment on topics related to foster care, which shall include recruitment techniques, and retention and training of foster parents.

(e) Foster parents shall receive a minimum of 24 hours of training each year on the provision of care based on the direction of the foster care program.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.17 Record Keeping and Reporting Requirements for a Foster Care Program.

(a) Each foster care program shall provide DCYF with a monthly progress report for each child in its care.

(b) Progress reports on the child’s involvement in services shall be provided to the child’s parent(s) or guardian(s) unless contraindicated by a court order, or if DCYF has applied for or is in the process of applying for a court order.

(c) Progress reports shall be mailed to DCYF, and parent(s) or guardian(s) no later than the 15th day of the month following the date of the progress report. If the child has been in care for fewer than 14 calendar days, the information may be included in the most appropriate monthly progress note or discharge summary.

(d) The progress report shall include:

(1) The child’s name and date of birth;

(2) The name of the person completing the report and the date of the report;

(3) The name of the foster care program; and

(4) The date of placement.

(e) Progress reports shall address the following areas of care:

(1) Status of each domain identified in the treatment plan including notable changes in specific goals or objectives;

(2) Summary of contacts with the child’s family and identified connections;

(3) Modifications to the treatment plan;

(4) Educational data;

(5) Contact with other professionals;

(6) Information about the child’s medical status, behavioral health care, and dental issues, including but not limited to:

a. Prescriptions and current dosages;

b. List of over the counter medication;

c. Dates of visits during the month being reported;

d. New health care issues and diagnosis;

e. Next scheduled visits; and

f. Name of health care practitioner and office address;

(7) Summary of any incidents or incident reports including reports of the use of seclusion and restraint as required by RSA 126-U during the period being reported on; and

(8) Disposition of grievances.

(f) For youth who are age 14 or older, progress reports shall include documentation of adult living preparation progress, including:

(1) Independent living training that was completed by staff or foster parents and the child;

(2) Post-care planning completed with the child; and

(3) A Form 1969 “Monthly NYTD Checklist” (March 2025)) completed by the foster care program, for the purpose of collecting data for the National Youth in Transition Database (NYTD) pursuant to 45 CFR 1356.80.

(g) The program shall keep records including a case record on each child and the child’s family that contains:

(1) The assessment used for the development of the treatment plan;

(2) The signed treatment plan and revisions thereto;

(3) Weekly contact logs completed by the case manager or clinician documenting at least one Medicaid covered service;

(4) Daily child and family progress notes documented by the foster parent, including at least one Medicaid covered service provided every 7 days;

(5) Documentation of therapeutic work with the child(ren) and all identified members of the family system, in support of the case plan and treatment goals;

(6) Copies of medical release(s);

(7) Copies of the completed Form 1552 “Child/Youth Information Sheet” (June 2020), as provided by DCYF;

(8) A record of health care visits including the date, the reason for the visit, provider name, and address;

(9) Any protocol for the handling and transferring of psychotropic meds;

(10) Monthly progress reports;

(11) Any incident reports including reports of the use of seclusion and restraint as required by RSA 126-U; and

(12) A discharge summary, if applicable, sent within 15 days of discharge including the following information:

a. The results of the services provided, including the outcomes of the goals and objectives identified in the child’s treatment plan;

b. The needs of the child and family which remain to be met and the services which will meet those needs;

c. For planned discharges, an individualized aftercare plan for each child being reunified with their family;

d. Form 1552 “Child/Youth Information Sheet” (June 2020), as provided by the department and updated by the foster care program; and

e. Documentation of interventions utilized and the success or ineffectiveness of those interventions.

(h) Upon discharge from the foster care program, the program shall transfer the child’s health care information to the new provider or to the parents or guardian.

(i) Incident reports, including reports of seclusion and restraint required by RSA 126-U:7-a, shall include, at a minimum:

(1) The date;

(2) Where the incident occurred, if applicable;

(3) A detailed description of what occurred prior to, during and after the incident;

(4) The names of all parties involved;

(5) A description of any injuries sustained by, and any medical care administered to, the child, employees, or others before, during or after the incident; and

(6) How the incident was resolved and any outstanding need for follow-up.

(j) Unless prohibited by court order, the foster care program shall provide notification and documentation of the incident, as follows:

(1) The foster care program shall provide verbal notification of the incident to the parent(s), guardian(s), and DCYF as soon as practicable or within 24 hours whichever is earlier;

(2) For any incident where a child is missing or runs away, or the child suffers an injury, which requires emergency care, the foster care program shall provide immediate verbal notice to the parent(s), guardian(s) and DCYF;

(3) The foster care program shall provide a copy of the written incident report described in (i) above to the child’s parent(s), guardian(s) and DCYF within 5 business days of the incident; and

(4) Pursuant to RSA 126-U:7-a, for an incident involving serious injury or death during the use of seclusion or restraint:

a. The foster care program shall provide verbal notice of the incident immediately to DCYF;

b. The foster care program shall provide a copy of the incident report shall be delivered to DCYF within 48 hours of the incident;

c. DCYF shall provide verbal notice to the commissioner, the attorney general, and the state’s federally-designated protection and advocacy agency for individuals with disabilities as soon as practicable or within 24 hours of the incident, whichever is earlier; and

d. DCYF shall send a copy of the incident report to the commissioner, the attorney general, and the state’s federally-designated protection and advocacy agency for individuals with disabilities within 5 business days of receipt of the report of the incident.

(k) Child-specific reports written by the program shall be available for review by the child’s parent(s) or guardian(s) unless contraindicated by the court order or if DCYF has applied for or is in the process of applying for a court order.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.18 Transitions to a Foster Care Program from a Residential Treatment Program.

(a) All transitional visits shall be implemented in accordance with DCYF’s case plan and the residential program’s treatment plan for the child.

(b) The identified foster care program shall become a member of the child’s treatment team.

(c) The treatment team shall develop a written transitional plan and agreement in accordance with the case plan, which shall address the length of the transition not to exceed 3 months, the transportation needs, and other services required to make the transition successful.

(d) The foster care program shall be responsible for:

(1) Coordinating transitional visits with DCYF and the residential program;

(2) Preparing foster parents for the child’s visits;

(3) Providing support and services to the foster parents as identified in the transition plan;

(4) Responding to the foster parents’ needs during the visit; and

(5) Providing information to the residential program and DCYF concerning the outcome of the visit.

(e) Pursuant to He-C 6350.25(c), the residential program shall remain available to respond to any crisis during a transitional visit including returning the child to the program.

(f) The foster care program shall be responsible for the supervision of the child during a transitional visit.

(g) The foster family shall receive a stipend for the DCYF identified respite rate for overnight transitional visits. The foster care program shall provide any additional support requested by the foster family, as identified in the transitional plan.

(h) The process for transitional visits shall not exceed a total of 10 overnights as specified in the child’s transitional plan.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.19 Respite Care.

(a) Foster care programs shall provide an array of respite options, including at a minimum:

(1) Hourly staff support;

(2) In-home and out-of-home care;

(3) Alternative child care arrangements as described in the treatment plan; and

(4) Emergency respite care.

(b) Overnight respite care providers shall be licensed providers, relatives of the child who are approved, or anyone who has another connection with the child and who has been approved by the treatment team.

(c) Foster care programs may provide respite services for another foster child in care, unless contraindicated by either child’s treatment plan, and as approved by DCYF.

(d) If a sibling group is placed together, the foster care programs shall assist DCYF in coordinating respite care for the sibling group, and shall be financially responsible only for the child identified for ISO services.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.20 Access to In-Patient Care.

(a) A foster care program shall notify DCYF immediately upon learning of a child’s need for inpatient or acute care.

(b) Should a child be admitted to an in-patient psychiatric or acute care hospital, the sending foster care program shall be reimbursed by the department at the authorized board, care, and treatment rate for up to 10 consecutive days, if the following criteria are met:

(1) The foster care program remains available to expedite the return of the child to the foster family home; and

(2) The foster care program and the placement provider remain in contact with the child during the child’s hospitalization through attendance at treatment team meetings, phone contact, and visitation.

(c) While the child is admitted or hospitalized in accordance with (a) above, the sending foster care program shall not bill medicaid.

(d) If it is known at the time of the admission or hospitalization that the child will not be returning to the foster care program then the child’s payment authorization to the program shall be closed out immediately.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.21 Runaways.

(a) Foster care programs shall notify DCYF immediately upon learning that the child has run away.

(b) Foster care programs shall continue to be reimbursed by DCYF at their authorized board and care and treatment rate for up to 10 consecutive days if the following conditions are met:

(1) The foster care program remains available to expedite the return of the child to the program; and

(2) The child has not been placed into another DCYF funded residential treatment program during that time period.

(c) If a child runs away, the foster care program shall not bill medicaid during the time that the child is absent without leave.

(d) If it is known at the time a child runs away that the child will not be returning to the foster care program then the child’s payment authorization to the program shall be closed out immediately.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.22 Education.

(a) Foster care programs shall work cooperatively with the licensing agency, DCYF, the parent(s) or guardian(s) of the child in care, and the school in providing for the education of the child in care.

(b) The child shall be enrolled in the local public school unless the child’s needs require an alternative approved educational program.

(c) The foster care program shall assist in implementing the individual education plan for a child in care who has been identified as educationally disabled.

(d) The foster care program shall make time and space available for studying and shall ensure that children have access to reference materials.

(e) The foster care program shall support the on-going education and career planning for youth over the age of 14.

(f) The foster care program shall ensure that life skills training is available and appropriate to the age and abilities of the child, including life skills training in:

(1) Family roles;

(2) Sex education;

(3) Hygiene;

(4) Social development; and

(5) Self-care.

(g) Foster care programs shall assist a child who is eligible, to participate in the DCYF adult living program, and receive education in the following:

(1) Consumer education;

(2) Money management;

(3) Housing needs;

(4) Higher education; and

(5) Career planning.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.23 Adult Living Preparation.

(a) Foster care programs shall assist children to restore their developmentally appropriate skills and prepare for adulthood, by complying with the adult living preparation requirements and assisting in the completion of the DCYF adult living preparation documents.

(b) Foster care programs shall identify and meet the adult living needs of children who are age 14 or older.

(c) Information obtained through the adult living preparation shall be shared with the program through DCYF and included in the treatment plan, daily logs, monthly progress reports, and discharge summary, as appropriate.

(d) The process of completing or updating adult living preparation plans shall be done in collaboration with the DCYF worker and the child.

(e) Foster parents or program staff shall complete and submit Form 1969 “Monthly NYTD Checklist,” ( March 2025)) each month pursuant to He-C 6355.17(f).

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.24 Health Care.

(a) Pursuant to He-C 6355.15(d)(3), foster care programs shall comply with the child’s treatment plan for health care by:

(1) Arranging for health care services as set forth in the child’s treatment plan;

(2) Consulting with the DCYF health care coordinator at the state office when planning for the psychotropic needs of a child in care.

(3) Ensuring that the prescribed program of immunizations is followed.

(b) Arranging for other routine and emergency health care visits and services as appropriate and as needed.

(c) Foster care programs shall maintain a record of the health care visits of a child in care, in accordance with He-C 6355.17(e)(6).

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15; ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.25 Out-of-State Travel.

(a) The foster care program’s staff shall obtain written permission from a child’s parent(s) or legal guardian(s) before transporting a child outside the state of New Hampshire.

(b) The foster care program’s staff shall obtain written permission from a child’s parent(s), legal guardian(s) and DCYF before allowing out-of-state travel for overnight visits.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15 (from He-C 6355.24); ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.26 Visitation and Interactions with Family and Friends.

(a) The foster care program shall encourage positive social relationships and life-long permanent connections with nurturing adults.

(b) The foster care program shall create and implement a plan with DCYF and the child’s parent(s) or guardian(s) to maintain a strong and consistent relationship between the child and the child’s family in accordance with the court order, if family interactions are supported by the permanency plan required in He-C 6355.15(c)(3)(b).

(1) Include the location where visits will take place and outline the plan for transportation arrangements;

(2) Ensure visitation environments and locations present optimal opportunities for positive interactions between the child and the visiting individual(s);

(3) Specify the length of time and frequency of visits;

(4) Address privacy and safety issues, including the need for supervised visitation if required;

(5) Identify a variety of ways by which family, guardian(s) and friends may interact with the child including, but not limited to, phone contact and postal and electronic communication; and

(6) Provide feedback to the team regarding how the visits have been and the needs and expectations of future visitation.

(d) The foster care program shall further support the child in maintaining connections through receiving and sending mail, use of electronic web-based communications, and phone, unless contraindicated in the treatment plan.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15 (from He-C 6355.25); ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.27 Quality Assurance.

(a) The foster care program shall cooperate with DCYF in gathering data relative to outcome measures, as follows:

(1) Provide quarterly data as requested by DCYF;

(2) Provide an annual data report to DCYF, 30 days after the end of the calendar year; and

(3) Provide an annual narrative report on the number of children served, work that was accomplished, and any system barriers to the DCYF foster care specialist.

(b) DCYF shall conduct quality assurance reviews with each foster care program, consisting of the following:

(1) A review of all case records, including all foster family home and child treatment records;

(2) A review of the renewal application as described in He-C 6355.03;

(3) An annual analysis of the referral data and statistics;

(4) An initial on-site visit conducted within the first year of a new foster care agency program’s operation;

(5) For currently certified programs, an on-site visit once every 2 years; and

(6) An exit interview held with the executive director to review issues of noncompliance, areas of concern, observations, and commendations.

(c) Should it be determined during any departmental visit or quality assurance review that there are areas of non-compliance with this section, DCYF will require the foster care program to submit a plan of correction within 30 calendar days of the date of receipt of the notice of non-compliance.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15 (from He-C 6355.26); ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.28 Waiver Process for a Foster Care Program.

(a) Waivers of requirements for a specific foster family home shall comply with He-C 6446.26.

(b) Applicants or programs seeking a waiver of a requirement set forth in He-C 6355.02 – He-C 6355.13 shall submit a written request to the department, including the following information:

(1) The rule number for which the waiver is being requested;

(2) The anticipated length of time for which the requested waiver will be needed;

(3) The reason for requesting the waiver;

(4) If the waiver is granted, how the foster care program shall continue to provide for quality care of the children in light of the waiver;

(5) A plan specifying how the foster care program shall meet the intent of He-C 6355.02 – He-C 6355.13 if the waiver is granted;

(6) The impact on the child and family if the waiver is not granted;

(7) The potential impact on all children affected by the waiver request; and

(8) A statement attesting that the request is not out of compliance with the program’s licensing requirements in RSA 170-E:31.

(c) When a waiver request involves prospective staff who do not meet the certification qualifications, the program shall not hire the individual until the department has made a decision to grant or deny the waiver request.

(d) A request for a waiver shall be approved if the department determines it meets the following criteria:

(1) The requested waiver will not jeopardize the quality of care and service provided to children;

(2) The requested waiver will not be a violation of a state law; and

(3) The foster care program has an alternative plan for complying with the intent of the rule.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15 (from He-C 6355.27); ); ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.29 Denial and Revocation of Certification for Payment.

(a) The department shall deny an initial application when the applicant has not met the requirements set forth in He-C 6355.02.

(b) The department shall revoke certification for payment when it determines that the applicant is non-compliant with He-C 6355, or has had its license denied, revoked or suspended in accordance with RSA 170-E:35.

(c) The department shall not renew the request for certification for payment if a foster care program notifies the department that it will no longer accept children from NH into its program when the program is not at full capacity.

(d) Revocation of certification for payment shall include removal of the program from the NH bridges payment system, and initiate the department’s recoupment of unused funds, if applicable.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15 (from He-C 6355.28); ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.30 Notification of Denial or Revocation.

(a) If the department denies or revokes certification for payment to an applicant or a foster care program, a letter shall be sent to the applicant or foster care program by certified mail that sets forth the reasons for the denial or revocation.

(b) The denial or revocation shall become final 10 business days after receipt of the letter referenced in (a) above, unless the applicant or certified program requests a hearing pursuant to RSA 170-G:4-a.

Source. #8696, eff 7-29-06; ss by #10640, INTERIM, eff 7-29-14, EXPIRED: 1-26-15

New. #10783, eff 2-13-15 (from He-C 6355.29); ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

He-C 6355.31 Administrative Appeals and Hearings.

(a) Applicants or certified programs that plan to appeal a decision made by the department relative to the denial of an application or revocation of certification, shall file an appeal with the commissioner, within 10 business days of the date of the letter or other written notification of the action, pursuant to RSA 170-G:4-a, RSA 541-A and He-C 200.

(b) The appeal shall be:

(1) Made in writing;

(2) Signed by a person authorized to submit the appeal; and

(3) State the reasons for the appeal pursuant to RSA 170-G:4-a.

Source. #10783, eff 2-13-15 (from He-C 6355.30); ss by #14224, INTERIM, eff 3-29-25, EXPIRES: 9-25-25

Appendix A

Documents Incorporated by Reference

Location in the Rule of the Document to be Incorporated by Reference	Title of the Document to be Incorporated by Reference	How to Obtain the Document and the Cost of Document to be Incorporated by Reference
He-C 6344.05(e) and He-C 6344.06(e)	“Mental Health Domestic Violence Protocols” (1996) NH Governor’s Commission on Domestic Violence”	The document is available free of charge on line at: http://doj.nh.gov/criminal/victim-assistance/protocols.htm

APPENDIX B

RULE	SPECIFIC STATE OR FEDERAL STATUTE THE RULE IMPLEMENTS
He-C 6339.01	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6339.02	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6339.03	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6339.04	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6339.05	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6339.06	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6339.07	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6339.08	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6339.09	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6339.10	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6339.11	RSA 170-G:4, XVII; RSA 170-G:5; RSA 170-E:42
He-C 6339.12	RSA 170-G:4, XVIII; RSA 170-G:5;RSA 170-E:42
He-C 6339.13	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:42
He-C 6339.14	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:42
He-C 6339.15	RSA 170-G:4, XVIII;RSA 170-G:5; RSA 170-E:42
He-C 6339.16	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:42
He-C 6339.17	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:42
He-C 6339.18	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:42
He-C 6339.19	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:42
He-C 6339.20	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:42
He-C 6339.21	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:42
He-C 6339.22	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:42
He-C 6339.23	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:42
He-C 6339.24	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:42
He-C 6339.25	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-G:4-a

He-C 6340.01- 6340.10	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6340.11	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 126-A:3
He-C 6340.12-6340.19	RSA 170-G:4, XVIII; RSA 170-G:5

He-C 6341.01	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.02	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.03	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.04	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.05	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 326-I
He-C 6341.06	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.07	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.08	RSA 170-G:4, XVIII; RSA 170-G:5 and RSA 161:2, VI
He-C 6341.09	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.10	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.11	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.12	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.13	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.14	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.15	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.16	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.17	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.18	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.19	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.20	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.21	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6341.22	RSA 170-G:4, XVIII; RSA 170-G:5

He-C 6342.01	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.02	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.03	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.04	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.05	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.06	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.07	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.08	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.09	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.10	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.11	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.12	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.13	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.14	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.15	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.16	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6342.17	RSA 170-G:4, XVIII; RSA 170-G:4-a; RSA 170-G:5

He-C 6343.01	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.02	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.03	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.04	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.05	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.06	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.07	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.08	RSA 170-G:4, XVIII; RSA 170-G:5 and RSA 161:2, VI
He-C 6343.09	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.10	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.11	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.12	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.13	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.14	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.15	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.16	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.17	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.18	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.19	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.20	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.21	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.22	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.23	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.24	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.25	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.26	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6343.27	RSA 170-G:4, XVIII; RSA 170-G:5

He-C 6344.01	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.02	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.03	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.04	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.05	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 330-A
He-C 6344.06	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 135-C:10
He-C 6344.07	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 330-A:10, XII
He-C 6344.08	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 135-C:7
He-C 6344.09	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.10	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.11	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.12	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.13	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.14	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.15	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 126-A:3, II
He-C 6344.16	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.17	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.18	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.19	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.20	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.21	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.22	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.23	RSA 170-G:4, XVIII; RSA 170-G:5; and RSA 330-A:23
He-C 6344.24	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.25	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 330-A:10, VI-X
He-C 6344.26	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6344.27	RSA 170-G:4, XVIII; RSA 170-G:5 RSA 170-G:4-a. I

He-C 6346.01	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.02	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.03	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.04	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.05	RSA 170-G:4, XVIII, RSA 170-G:5
He-C 6346.06	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.07	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.08	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.09	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.10	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.11	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 126-A:3
He-C 6346.12	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.13	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.14	RSA 170-G:4, VIII; RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.15	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.16	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.17	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.18	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6346.19	RSA 170-G:4-a,I; RSA 170-G:4, XVIII; RSA 170-G:5

He-C 6347.01	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6347.02	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6347.03	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6347.04	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:27; RSA 169-C:29-30
He-C 6347.05	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:25
He-C 6347.06	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6347.07	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:34
He-C 6347.08	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:34
He-C 6347.09	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:34
He-C 6347.10	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:34
He-C 6347.11	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:34; RSA 170-E:53
He-C 6347.12	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:34
He-C 6347.13	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:34
He-C 6347.14	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:31
He-C 6347.15	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:32
He-C 6347.16	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:34
He-C 6347.17	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6347.18	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6347.19	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 126-A:3
He-C 6347.20	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6347.21	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:42
He-C 6347.22	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 541-A:22,IV
He-C 6347.23	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:35
He-C 6347.24	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:36
He-C 6347.25	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E: 36;
He-C 6347.26	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:34,I(e); RSA 170-E:35-37

He-C 6348.01-He-C 6348.04	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6348.05	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 126-A:3,II
He-C 6348.06-He-C 6348.08	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6348.09	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 161:2, VI
He-C 6348.10-He-C 6348.14	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6348.15	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-G:4a,I

He-C 6349.01	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6349.02	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6349.03	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6349.04	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:3, I (c); RSA 170-E:4
He-C 6349.05	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:3 (a); RSA 170-E:4
He-C 6349.06	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:3(a); RSA 170-E:4
He-C 6349.07	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:4; RSA 170-E:6; RSA 170-E:7
He-C 6349.08	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:3(a)
He-C 6349.09	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6349.10	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E 7
He-C 6349.11	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6349.12	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6349.13	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6349.14	RSA 170-G:4, XVIII; RSA 170-G:5
He-C 6349.15	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:19
He-C 6349.16	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-G:4, VIII
He-C 6349.17	RSA 170-G:4, XVIII ;RSA 170-G:5; RSA 170-E:11, I(m)
He-C 6349.18	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E:12
He-C 6349.19	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-E: 13
He-C 6349.20	RSA 170-G:4,XVIII; RSA 169-GL4-a; RSA 170-E:13
He-C 6349.21	RSA 170-G:4, XVIII; RSA 170-G:5; RSA 170-G:4a,I

He-C 6350.01 - He-C 6350.04	RSA 170-E:25; RSA 170-G:5; RSA 135-F; RSA 169-F
He-C 6350.05 - He-C 6350.07	RSA 170-G:4, XVIII; RSA 135-F; RSA 169-F
He-C 6350.08	RSA 170-G:4, XVIII; RSA 170-G:4-a
He-C 6350.09	RSA 170-G:4, XVIII; RSA 170-G:4, VII
He-C 6350.10	RSA 170-G:4, XVIII; RSA 135-F
He-C 6350.11	RSA 170-G:4, VII; RSA 170-G:4, XVIII
He-C 6350.12 - He-C 6350.14	RSA 170-G:4, XVIII; 45 CFR 1356.80
He-C 6350.15	RSA 126-U; RSA 170-E:25; RSA 170-G:4, III; RSA 170-G:4, XVIII
He-C 6350.16 - He-C 6350.17	RSA 170-E:25, II(b); RSA 170-G:4, III; RSA 170-G:4, XVIII; RSA 193:28
He-C 6350.18	RSA 170-G:4, III; RSA 170-G:4, XVIII
He-C 6350.19 - He-C 6350.22	RSA 170-E:25, II(c); RSA 170-G:4, III; RSA 170-G:4, XVIII
He-C 6350.23	RSA 170-G:4, III; RSA 170-G:4, XVIII; RSA 193:27
He-C 6350.24	RSA 169-F:7; RSA 170-G:4, III; RSA 170-G:4, XVIII; RSA 193:27
He-C 6350.25 - He-C 6350.33	RSA 170-G:4, III; RSA 170-G:4, XVIII; RSA 193:27
He-C 6350.34	RSA 169-F:7; RSA 170-E:25; RSA 170-G:5
He-C 6350.35	RSA 169-B; RSA 169-C; RSA 169-D; RSA 170-E:25; RSA 170-G:5
He-C 6350.36	RSA 170-E:25; RSA 170-G:5
He-C 6350.37	RSA 169-B; RSA 169-C; RSA 169-D; RSA 169-F:7; RSA 170-E:25; RSA 170-G:5

He-C 6354.01	RSA 170-G:4, VI
He-C 6354.02	RSA 170-G:4, VI
He-C 6354.03	RSA 170-G:4, VI

He-C 6355.01	RSA 170-G:5; Title IV-E 45 CFR 1355.20
He-C 6355.02 – He-C 6355.08	RSA 170-G:5
He-C 6355.09	RSA 170-G:5; RSA 126-U:7-a
He-C 6355. 10 – He-C 6355.16	RSA 170-G:5; 42 USC 675
He-C 6355.17	RSA 170-G:5; RSA 126-U:7-a; 45 CFR 1356.80
He-C 6355.18 – He-C 6355.27	RSA 170-G:5
He-C 6355.28 – He-C 6355.30	RSA 170-G:5; RSA 170-G:4, XVIII

APPENDIX B

Location of Incorporated by Reference Document	Title of Document to be Incorporated by Reference	Cost and How to Obtain the Document
He-C 6350.23(c)	Diagnostic and Statistical Manual of Mental Disorders, Text Revision (DSM-5-TR), 2022	Publisher: American Psychiatric Association Cost: $170.00 The incorporated document is available at: https://www.appi.org/products/dsm
He-C 6350.28(e)(5)	“Casey Life Skills Assessment”, October 2021	Publisher: Casey Life Skills Cost: none Available online at no cost at https://www.casey.org/casey-life-skills/.
He-C 6350.28(e)(6) and (7)	“Choices 360 Career Planning Interest Profiler”	Publisher: XAP, LLC Cost: none Available online at no cost at http://choices360.com

APPENDIX C

42 USC 672(k)(4)

For purposes of this part, the term “qualified residential treatment program” means a program that—

(A) has a trauma-informed treatment model that is designed to address the needs, including clinical needs as appropriate, of children with serious emotional or behavioral disorders or disturbances and, with respect to a child, is able to implement the treatment identified for the child by the assessment of the child required under section 675a(c) of this title;

(B) subject to paragraphs (5) and (6), has registered or licensed nursing staff and other licensed clinical staff who—

(i) provide care within the scope of their practice as defined by State law;

(ii) are on-site according to the treatment model referred to in subparagraph (A); and

(iii) are available 24 hours a day and 7 days a week;

(C) to extent appropriate, and in accordance with the child’s best interests, facilitates participation of family members in the child’s treatment program;

(D) facilitates outreach to the family members of the child, including siblings, documents how the outreach is made (including contact information), and maintains contact information for any known biological family and fictive kin of the child;

(E) documents how family members are integrated into the treatment process for the child, including post-discharge, and how sibling connections are maintained;

(F) provides discharge planning and family-based aftercare support for at least 6 months post-discharge; and

(G) is licensed in accordance with section 671(a)(10) of this title and is accredited by any of the following independent, not-for-profit organizations:

(i) The Commission on Accreditation of Rehabilitation Facilities (CARF).

(ii) The Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

(iii) The Council on Accreditation (COA).

(iv) Any other independent, not-for-profit accrediting organization approved by the Secretary.

RSA 169-F:7; RSA 170-G:4, III; RSA 170-G:4, XVIII; RSA 193:27