Section He-W 589.02 - Definitions(a) "Activities of daily living (ADL)" means basic self-care tasks such as personal hygiene, grooming, eating, dressing, transferring, mobility, and toileting.(b) "Applied behavior analysis (ABA)" means a treatment modality that employs the process of systematically applying interventions based on the principles of learning theory to improve socially significant behaviors, and is covered through the EPSDT benefit pursuant to He-W 546 and in accordance with He-W 589.04(at).(c) "Augmentative and alternative communication (AAC) aids" means electronic or non-electronic aids, devices, or systems ordered by a licensed speech-language pathologist that assist a student to overcome or ameliorate the communication limitations that preclude or interfere with meaningful participation in current and projected daily activities, such as communication boards or books, speech amplifiers, and electronic devices that produce speech and/or written output.(d) "Care plan" means a written health care plan, including, but not limited to, an individualized education program or a 504 plan, which is maintained in the student's file and documents and supports the medical necessity of all claims to NH medicaid for FFP.(e) "Carry-over tasks" means tasks, therapies, or activities that a rehabilitative assistant performs as instructed by the licensed clinician in support of the care plan's goals or the clinician's treatment plan.(f) "Durable medical equipment (DME)" means a type of item pursuant to He-W 571 that is:(1) Non-disposable and able to withstand repeated use;(2) Primarily used to serve a medical purpose for the treatment of an acute or chronic medically diagnosed health condition, illness, or injury; and(3) Not useful to an individual in the absence of an acute or chronic medically diagnosed health condition, illness, or injury.(g) "Early and periodic, screening, diagnosis and treatment (EPSDT) services" means a benefit pursuant to 42 CFR 440.40 and He-W 546, designed to provide preventative health care, diagnostic services, and early detection and treatment of disease or abnormalities to medicaid enrolled individuals under age 21.(h) "Enrolled school provider" means a NH local education agency (LEA) or school administrative unit (SAU) that has agreed to participate in NH medicaid pursuant to these rules and enrolled with NH medicaid.(i) "Federal financial participation (FFP)" means the federal share of costs for services.(j) "Group" means 2 or more persons.(k) "Individualized education plan (IEP)" means a written statement for a child with a disability that is developed, reviewed, and revised in accordance with 34 CFR 300.320 through 300.324, and the applicable NH board of education administrative rules. (l) "Instrumental activities of daily living" (IADL) means personal hygiene, light housework, laundry, meal preparation, transportation, grocery shopping, using the telephone, medication management, and money management.(m) "Local education agency (LEA)" means a local school district.(n) "Medical assistance" means the federally financed medical assistance program established pursuant to Title XIX of the Social Security Act also known as the medicaid program.(o) "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 for the student requesting the medically necessary service.(p) "Order" means a written authorization for the provision of services issued by an advance practice registered nurse (APRN), physician assistant, physician, or other licensed clinician with ordering privileges.(q) "Other licensed clinician" means any person licensed under state law and practicing within the scope of his or her licensure as authorized by the appropriate board, commission, or council responsible for licensing and regulating health care professions under the NH office of professional licensure and certification.(r) "Performing-only provider" means a health care provider that the medicaid program does not allow to independently enroll with medicaid and is affiliated with an enrolled school provider. The term includes healthcare providers such as rehabilitative assistants pursuant to this part, personal care service workers for individuals under the age of 21, and Board Certified Behavior Analysts.(s) "Personal care services" means medically necessary services related to assistance with ADL or IADL due to a student's illness, injury, or disability which are furnished to a student who is not an inpatient or resident of a hospital, nursing facility, intermediate care facility for people with developmental disabilities, or institution for mental illness, and are covered through the EPSDT benefit pursuant to He-W 546 and in accordance with He-W 589.04(at).(t) "Physician" means a person licensed to practice medicine in NH or the state in which he or she practices.(u) "Private duty nursing" means the provision of skilled nursing services for students who require more individual and continual skilled nursing observation, judgment, assessment, or interventions than are available from a visiting nurse, in contrast to part-time or intermittent care, such as wound care.(v) "Psychologist" means a person licensed to practice psychotherapy in NH pursuant to RSA 329-B or an equivalent licensing board in the state in which she or he practices.(w) "Psychotherapist" means a licensed clinical social worker, pastoral psychotherapist, clinical mental health counselor, or marriage and family therapist licensed under RSA 330-A who provides mental health services. This term includes psychiatrists licensed as physicians under RSA 329, advanced practice registered nurse (APRN) licensed under RSA 326-B:18 as psychiatric nurse practitioners, and psychologists, school psychologists, or associate school psychologists licensed by the board of psychology under RSA 329-B. This term also includes "mental health practitioner".(x) "Psychotherapy" means the professional treatment, assessment, or counseling of a mental or emotional illness, symptom, or condition.(y) "Rehabilitative assistance services" means non-skilled interventions covered through the EPSDT benefit and ordered by a physician, physicians' assistant, APRN, or other licensed clinician, as listed in the student's care plan.(z) "School administrative unit (SAU)" means a legally organized administrative body responsible for one or more school districts pursuant to RSA 194-C:1. (aa) "Section 504 plan (504 plan)" means a plan for services for a student in accordance with Section 504 of the Rehabilitation Action of 1973 as amended.(ab) "Signature" means: (1) A person's name handwritten by that person, excluding any photocopy, stamp, or other facsimile of such name; or(2) An electronic signature that complies with RSA 294-E.(ac) "Student" means a person who is eligible for and receiving medical assistance under medicaid pursuant to He-W 589.03.(ad) "Under the direction" means that, except as prohibited by state law, the licensed health care clinician, whether or not he or she is physically present at the time that services are provided:(1) Assumes professional responsibility for the services provided;(2) Assures that the services are medically appropriate and performed safely; and(3) Assures compliance with the clinical oversight requirements as required by law or rule adopted by the appropriate board, commission, or council responsible for licensing and regulating health care professions under the NH office of professional licensure and certification.N.H. Admin. Code § He-W 589.02
Derived from Volume XL Number 11, Filed March 12, 2020, Proposed by #12994, Effective 2/21/2020, Expires 2/21/2030.