N.H. Admin. Code § He-C 6339.16

Current through Register No. 48, November 27, 2024

Section He-C 6339.16 - Requirements for Child Health Support Services

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

(b) A provider shall not provide services that exceed 90 days per year.

(c) A provider seeking an extension of the 90 day limitation in (b) above shall submit a written request to the CPSW or JPPO, which includes the following information:

(1) The need and justification for continued services;

(2) The beginning and ending dates for continued services;

(3) The goals for the continued period of services;

(4) The revised therapeutic plan; and

(5) The additional anticipated child and family outcomes.

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(4) Families in which ineffective child management techniques are being employed and children who may be withdrawn or depressed, aggressive, delinquent, anxious, or display self-destructive behaviors;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

(11) Foster families who require additional assistance in order to preserve the placement.

(e) 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 support counseling 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 counseling 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. The development and implementation of behavior modification plans 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; and

d. Counseling focused on stress management, conflict resolution, and impulse control;

(5) Health care management that includes an initial physical assessment of the family members, home health care education, and management 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;

(6) Household management that includes safety instruction to eliminate, reduce, or avoid hazards in the home, as well as household management skills, which includes emphasizing the importance of cleanliness to a child's health;

(7) Nutritional education that includes safe food handling procedures and dietary needs of children;

(8) Community resource and support that includes encouraging, instruction, and assistance with accessing community agencies and services, and life skills development and support counseling for securing and maintaining safe housing, food, clothing and heat; and

(9) Supervised visitation between parent(s) and children, as ordered by the Court, DCYF and DJJS to include parent education about age appropriate activities, discipline and behavior modification.

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

(1) Review the case plan;

(2) Complete an initial health and behavioral health assessment for each family within 30 days of the referral;

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

(4) Log each family visit and contact;

(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 as requested by the CPSW or JPPO;

(7) Discuss needs and reasons for termination of services with the family members and the CPSW or JPPO;

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

a. Loss of employment or income;

b. Eviction notice;

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

d. Separation of the parents;

e. Pregnancy;

f. School attendance;

g. Arrests;

h. Police contacts; or

i. Probation or parole violations;

(9) Provide each family with a written description of services, as described in He-C 6339.04 including the cost of the service;

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

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

(12) Provide aides with agency identification; and

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

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

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

(i) The program consultant referenced in (h) 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.

(j) The prescribing practitioner may also serve as the program consultant as long as they meet the definition of prescribing practitioner.

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

(l) 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; or

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

(m) In addition to the requirements in (l) 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 and are not case-specific; and

(2) Maintain documentation of training that includes:

a. The dates of training;

b. The titles of training topics;

c. The number of hours per training; and

d. Certificates of training signed by the trainer, which shall be available at the time of on-site quality assurance monitoring, pursuant to He-C 6339.05.

(n) Child health aides shall:

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

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

(o) The program supervisor shall provide a minimum of one hour per week of individual clinical supervision for a the child health 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.

(p) The agency shall complete annual staff evaluations.

(q) Within 10 working days after service termination, the agency shall forward a report to the CPSW or JPPO and the 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 might change the 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 date and signature of the parent aide, supervisor, parent or parents, and the child, when age appropriate.

N.H. Admin. Code § He-C 6339.16

(See Revision Note at part heading for He-C 6339) #9263, eff 9-20-08

Amended by Volume XXXVI Number 41, Filed October 13, 2016, Proposed by #11180, Effective 9/19/2016, Expires 3/18/2017.

Amended by Volume XXXVII Number 15, Filed April 13, 2017, Proposed by #12136, Effective 3/18/2017, Expires 3/18/2027.