N.H. Admin. Code § He-M 503.10

Current through Register No. 45, November 7, 2024

Section He-M 503.10 - Service Agreements

(a) The service coordinator shall create service agreements for all individuals in accordance with (b)-(f) below.

(b) All service agreements shall:

(1) Be understandable to the individual, guardian, or representative and all provider agencies and providers responsible for service provision;

(2) At a minimum, be written in plain language and in a manner accessible to individuals with disabilities and persons who have limited proficiency in English;

(3) Be finalized and agreed to in writing by the individual, guardian, or representative and signed by all provider agencies responsible for the implementation of the service agreement;

(4) Be entered into the electronic platform, Intellect Ability at, and then NH Easy at, when Intellect Ability sunsets; and

(5) Be distributed to the individual, guardian or representative, area agency, and all provider agencies and providers who are responsible for the implementation or monitoring of the service agreement.

(c) Within 14 days of the initial person-centered service planning meeting pursuant to He-M 503.09(e), the service coordinator shall develop a service agreement that includes, but is not limited to, the following:

(1) A statement of the nature of the specific strengths, interests, capacities, disabilities, and specific needs of the individual;

(2) A description of intermediate and long-range habilitation and treatment goals chosen by the individual and their guardian with a projected timetable for their attainment;

(3) A statement of specific services to be provided and the amount, scope, frequency, and duration of each service;

(4) Specification of the provider agencies to furnish each service identified in the service agreement;

(5) Criteria for transfer to less restrictive settings for habilitation, including criteria for termination of service, and a projected date for termination of service;

(6) Demographic information;

(7) A personal profile;

(8) The specific services to be furnished based on the support needs identified in (1) above and how the services selected will support the individual's goals;

(9) Guardianship, supported decision-making, and representative payee information;

(10) Service documentation requirements sufficient to track outcomes;

(11) Identification of the persons and entities responsible for monitoring the services in the service agreement;

(12) Documentation that all settings where the individual receives services meet the criteria of 42 CFR 441.301, are chosen by the individual or representative, and support full access to the greater community, including opportunities to seek employment and work in competitive integrated settings, engage in community life, control personal resources, and receive services in the community to the same degree of access as people not receiving services;

(13) Documentation that the setting is selected by the individual from among setting options, including non-disability specific settings and an option for a private unit in a residential setting, and that the settings options are identified and based on the individual's needs, and preferences;

(14) Documentation that any restriction on the right of an individual is justified by:

a. An identified specific and individualized need that the modification is based on;

b. The positive interventions and supports used prior to any modifications to the individual's rights;

c. The less intrusive methods of meeting the need that were tried but did not work;

d. A clear description of the condition that is directly proportionate to the specific assessed need;

e. The regular collection and review of data to measure the ongoing effectiveness of the modification;

f. Established time limits for periodic reviews of the necessity of the modification;

g. The informed consent of the individual, guardian, or representative; and

h. An assurance that the modification will not cause harm to the individual;

(15) Services needed but not currently available; and

(16) If applicable, risk factors and the measures required to be in place to minimize them, including backup plans and strategies.

(d) For individuals receiving waiver services, the information provided below shall be added to the service agreement:

(1) The specific waiver services to be provided including the amount, scope, frequency, and duration;

(2) The results of the SIS-A ® and the HRST;

(3) Service documentation requirements sufficient to describe progress on goals and the services received; and

(4) If applicable, reporting mechanisms under self-directed services regarding budget updates and individual and guardian satisfaction with services.

(e) For individuals who reside in a provider owned or controlled residential setting, the service agreement shall document any modifications of the individual's rights in said setting to:

(1) Privacy in their sleeping or living unit, including doors lockable by the individual with only appropriate providers having keys to doors as needed;

(2) Freedom and support to control their own schedule and activities;

(3) Access to food at any time;

(4) Having visitors of their choosing at any time; and

(5) Freedom to furnish and decorate sleeping or living units.

(f) A provider agency shall only make modifications pursuant to (e) above by documenting in the service agreement the following:

(1) An identified specific and individualized assessed need that the modifications are based on;

(2) The positive interventions and supports used prior to any modifications to the service agreement;

(3) The less intrusive methods of meeting the need that have been tried but did not work;

(4) A clear description of the condition that is directly proportionate to the specific assessed need;

(5) The regular collection and review of data to measure the ongoing effectiveness of the modification;

(6) Established time limits for periodic reviews to determine if the modification is still necessary or can be terminated;

(7) The informed consent of the individual or representative; and

(8) An assurance that the interventions and support will not cause harm to the individual.

(g) Within 5 business days of completion of a service agreement, or service agreement amendment, the service coordinator shall provide the individual and guardian, or representative the following:

(1) The service agreement, signed by the service coordinator, and all provider agencies identified in the service agreement;

(2) The name, address, email, and phone number of all provider agencies; and

(3) A description of the procedures for challenging the proposed service agreement pursuant to He-M 503.16 for those situations where the individual, guardian, or representative disapproves of the service agreement.

(h) The individual, guardian, or representative shall have 10 business days from the date of receipt of the service agreement, or the service agreement amendment, to respond in writing, indicating approval or disapproval of the service agreement or amendment. Unless otherwise arranged between the individual, guardian, or representative and the service coordinator, failure to respond within the time allowed shall constitute approval of the service agreement or amendment.

(i) When a service agreement has been approved by the individual, guardian, or representative and service coordinator, the services shall be implemented and monitored as follows:

(1) A person responsible for implementing any part of a service agreement, shall collect and record information about services provided and how they have impacted progress on the individual's goals, in a timeframe outlined in the service agreement or, at a minimum, monthly;

(2) On at least a monthly basis, the service coordinator shall visit or have verbal or written contact, as determined by the individual or persons responsible for implementing a service agreement, and document these contacts;

(3) The service coordinator shall visit the individual and contact the guardian, if any, at least quarterly, or more frequently if so specified in the individual's service agreement, to determine and document:

a. Whether services match the interests and needs of the individual;

b. Individual and guardian satisfaction with services; and

c. Progress on the goals in the expanded service agreement; and

(4) If the individual receives services under He-M 1001, or residential services under He-M 521, He-M 524, or He-M 525, all of the service coordinator's quarterly visits with the individual shall be in the home where the individual resides.

N.H. Admin. Code § He-M 503.10

#1969, eff 2-25-82; ss by #2615, eff 2-6-84; ss by #2962, eff 1-22-85; ss by #5211, eff 8-28-91; EXPIRED: 8-28-97

New. #6581, INTERIM, eff 9-19-97, EXPIRED: 1-17-98

New. #6932, eff 1-27-99; ss by #8805, eff 1-27-07

Amended byVolume XXXV Number 06, Filed February 12, 2015, Proposed by #10774, Effective 1/27/2015, Expires7/27/2015.

Amended by Volume XXXV Number 32, Filed August 13, 2015, Proposed by #10900, Effective 7/25/2015, Expires7/25/2025.

Amended by Number 2, Filed January 11, 2024, Proposed by #13841, Effective 12/29/2023, Expires 12/29/2033.