Section He-M 522.05 - Determination of Eligibility as a Person with an Acquired Brain Disorder(a) The area agency shall determine if an applicant is eligible for services under He-M 522.03(a) by: (1) Completing a review of available assessments of the applicant's physical, intellectual, cognitive, and behavioral status and an age-appropriate standardized functional assessment; or(2) If the information available is not adequate to make a determination, coordinating additional physical, neuropsychological, neurological, functional, and behavioral assessments and evaluations as necessary to make the determination.(b) Within 15 business days after the receipt of the application, the area agency shall review the information it has obtained regarding an applicant and make a decision on the applicant's eligibility. If the information required to determine eligibility cannot be obtained within the 15 business day period, the area agency shall request an extension from the applicant or guardian, state the reason for the delay, and obtain approval from the applicant or guardian in writing. This extension shall not exceed 30 business days after the receipt of application.(c) In cases where the information on eligibility under He-M 522.03(a) is inconclusive, the area agency may consult the bureau regarding determination of eligibility. If it is anticipated that eligibility will not be determined within the 15 business day period stated in (b) above, the area agency shall request an extension from the applicant or guardian, state the reason for the delay and, if the applicant or guardian approves, obtain such approval from the applicant or guardian in writing. This extension shall not exceed 30 business days after the receipt of application.(d) If the area agency request for an extension pursuant to (b) or (c) above is denied by the applicant or guardian, the area agency shall determine the applicant to be ineligible for services and shall notify the applicant of the right to appeal as identified in He-M 522.19. The individual or guardian may reapply for services pursuant to (i) below.(e) An area agency may determine an applicant eligible for services pursuant to He-M 522.03(a) prior to the receipt of all components of an applicant's evaluation if there is sufficient information to make this determination. The area agency shall continue to pursue all components of the evaluation, which shall be completed within 30 business days of application and shall be kept in permanent files established for each applicant.(f) The area agency director shall authorize appropriate services to be provided prior to the completion of the eligibility determination process if such services are necessary to protect the health or safety of an applicant whom the area agency director believes is likely to have an acquired brain disorder, based upon available information.(g) For an applicant found ineligible under He-M 522.03(a), within 3 business days of determination, the area agency shall provide the applicant or guardian a written decision that describes the specific legal and factual basis for the denial, including specific citation of the applicable law or department rules, and advise the applicant in writing and verbally of the appeal rights under He-M 522.19.(h) For an applicant found eligible under He-M 522.03(a), within 3 business days the area agency shall:(1) Make a written referral to the bureau for additional determination of eligibility under He-M 522.06(a); and(2) Notify the individual or guardian, if applicable, in writing regarding his or her eligibility for service coordination and that the application is being forwarded to the bureau for eligibility determination under He-M 522.06(a).(i) Following denial of eligibility, the individual, family, or guardian, as applicable, may reapply for services if new information regarding the diagnosis, level of care, or severity of the disability or functional impairment related to the acquired brain disorder becomes available.N.H. Code Admin. R. He-M 522.05
#7120, eff 10-20-99; ss by #8974, INTERIM, eff 10-6-07, EXPIRED: 4-3-08
New. #9734, eff 6-25-10
The amended version of this section by New Hampshire Register Volume 38, Number 50, eff. 11/30/2018 is not yet available.