N.H. Admin. Code § He-M 507.02

Current through Register No. 45, November 7, 2024

Section He-M 507.02 - Definitions

The words and phrases used in these rules shall mean the following:

(a) "Acquired brain disorder" means a disruption in brain functioning that:

(1) Is not congenital or caused by birth trauma;

(2) Presents a severe and life-long disabling condition which significantly impairs a person's ability to function in society;

(3) Occurs prior to age 60;

(4) Is attributable to one or more of the following reasons:

a. External trauma to the brain as a result of:

1. A motor vehicle incident;

2. A fall;

3. An assault; or

4. Another related traumatic incident or occurrence;

b. Anoxic or hypoxic injury to the brain such as from:

1. Cardiopulmonary arrest;

2. Carbon monoxide poisoning;

3. Airway obstruction;

4. Hemorrhage; or

5. Near drowning;

c. Infectious diseases such as encephalitis and meningitis;

d. Brain tumor;

e. Intracranial surgery;

f. Cerebrovascular disruption such as a stroke;

g. Toxic exposure; or

h. Other neurological disorders such as Huntington's disease or multiple sclerosis which predominantly affect the central nervous system; and

(5) Is manifested by one or more of the following:

a. Significant decline in cognitive functioning and ability; and

b. Deterioration in:

1. Personality;

2. Impulse control;

3. Judgment;

4. Modulation of mood; or

5. Awareness of deficits.

(b) "Area agency" means "area agency" as defined under RSA 171-A:2, I-b, namely, "an entity established as a nonprofit corporation in the state of New Hampshire which is established by rules adopted by the commissioner to provide services to developmentally disabled persons in the area."

(c) "Basic living skills" means activities accomplished each day to acquire, improve, or maintain independence in daily life.

(d) "Bureau" means the bureau of developmental services of the department of health and human services.

(e) "Centralized service site" means a location operated by a provider agency where individuals receive community participation services for more than one hour per day.

(f) "Certification" means the written approval by the bureau of health facilities administration for the operation of community participation services in accordance with the requirements set forth in He-M 507.

(g) "Community participation services", also called "day services" elsewhere in He-M 500 and He-M 1001, means habilitation, assistance, and instruction provided to individuals that:

(1) Improve or maintain their performance of basic living skills;

(2) Offer vocational and community activities, or both;

(3) Enhance their social and personal development;

(4) Include consultation services, in response to individuals' needs, and as specified in service agreements, to improve or maintain communication, mobility, and physical and psychological health; and

(5) At a minimum, meet the needs and achieve the desired goals and outcomes of each individual as specified in the service agreement.

(h) "Covered services" means community participation services described pursuant to He-M 507.04 as reimbursable under the Medicaid program or through grants from the bureau.

(i) "Department" means the department of health and human services.

(j) "Developmental disability" means "developmental disability" as defined in RSA 171-A:2, V, namely, "a disability:

(a) Which is attributable to an intellectual disability, cerebral palsy, epilepsy, autism or a specific learning disability, or any other condition of an individual found to be closely related to an intellectual disability as it refers to general intellectual functioning or impairment in adaptive behavior or requires treatment similar to that required for persons with an intellectual disability; and

(b) Which originates before such individual attains age 22, has continued or can be expected to continue indefinitely, and constitutes a severe handicap to such individual's ability to function normally in society."

(k) "Exploitation" means "exploitation" as defined in RSA 161-F:43, IV.

(l) "Family" means a group of 2 or more persons related by ancestry, marriage, or other legal arrangement.

(m) "Health assessment" means an evaluation of an individual's health status done by a physician or other licensed practitioner for the purpose of making recommendations regarding strategies for promoting and maintaining optimum health.

(n) "Health Risk Screening Tool (HRST) (2009 edition) ", available as noted in Appendix A, means a web-based rating instrument used for performing health risk screenings on individuals in order to:

(1) Determine an individual's vulnerability regarding potential health risks; and

(2) Enable the early identification of health issues and monitoring of health needs.

(o) "Home and community-based care waiver" means the waiver of sections 1902 (a) (10) and 1915 (c) of the Social Security Act which allows the federal Medicaid funding of long-term services for persons in non-institutional settings who are elderly, disabled, or chronically ill.

(p) "Individual" means any person with a developmental disability or acquired brain disorder who receives, or has been found eligible to receive, area agency services.

(q) "Personal development" means supporting or increasing an individual's capacity to make choices, to communicate interests and preferences, and to have sufficient opportunities for exploring and meeting those interests.

(r) "Personal profile" means a narrative description prepared pursuant to He-M 503.11(f) (1) a.

1. that includes:

(1) A personal statement from the individual and those who know him or her best that summarizes the individual's strengths and capacities, communication and learning style, challenges, needs, interests, and any health concerns, as well as the individual's hopes and dreams;

(2) A personal history covering significant life events, relationships, living arrangements, health, use of assistive technology, and results of evaluations which contribute to an understanding of the individual's needs;

(3) A review of the past year that:

a. Summarizes the individual's:

1. Personal achievements;

2. Relationships;

3. Degree of community involvement;

4. Challenging issues or behavior;

5. Health status and any changes in health; and

6. Safety considerations during the year;

b. Addresses the previous year's desired goals and outcomes with level of success and, if applicable, identifies any obstacles encountered;

c. Identifies the desired goals and outcomes of the individual for the coming year;

d. Identifies the type and amount of services the individual receives and the support services provided under each service category;

e. Identifies the individual's health needs;

f. Identifies the individual's safety needs;

g. Identifies any follow-up action needed on concerns and the persons responsible for the follow-up; and

h. Includes a statement of the individual's and guardian's satisfaction with services;

(4) An attached work history of the individual's paid employment and volunteer positions, as applicable, that includes:

a. Dates of employment;

b. Type of work;

c. Hours worked per week; and

d. Reason for leaving, if applicable; and

(5) A reference to sensitive historical information in other sections of the record when the individual or guardian, as applicable, prefers not to have this included in the profile.

(s) "Primary staff" means staff who are regularly assigned to provide services to specific individuals.

(t) "Provider" means a person receiving any form of remuneration for the provision of services to an individual.

(u) "Provider agency" means an area agency or an entity under contract with an area agency that is responsible for providing community participation services to individuals.

(v) "Risk management plan" means a person-centered document that describes the services, supports, approaches and guidelines to be utilized to meet the individual's needs and mitigate risks to community safety and which is consistent with the service guarantees and protections articulated in He-M 503.

(w) "Service agreement" means a written agreement between an individual or guardian and the area agency that describes the services that the individual will receive and constitutes an individual service agreement as defined in RSA 171-A:2, X. The term includes a basic service agreement for all individuals who receive services and an expanded service agreement for those who receive more complex services pursuant to He-M 503.11.

(x) "Service coordinator" means a person who is chosen or approved by an individual and his or her guardian and designated by the area agency to organize, facilitate and document service planning and to negotiate and monitor the provision of the individual's services and who is:

(1) An area agency service coordinator, family support coordinator, or any other area agency or provider agency employee;

(2) A member of the individual's family;

(3) A friend of the individual; or

(4) Another person chosen to represent the individual.

(y) "Sheltered workshop" means a program that provides a segregated service environment where the contract objectives of the provider agency are the primary focus and goal.

(z) "Supports Intensity Scale (2004 edition) ", available as noted in Appendix A, means an assessment tool intended to assist in service planning by measuring the individual's support needs in the areas of home living, community living, lifelong learning, employment, health and safety, social activities, and protection and advocacy. The tool uses a formal rating scale to identify the type of supports needed, frequency of supports needed, and daily support time.

(aa) "Systematic, therapeutic, assessment, respite and treatment (START) " means the model of service supports that is intended to optimize independence, treatment, and community living for individuals with developmental disabilities and mental health needs.

N.H. Admin. Code § He-M 507.02

#2269, eff 1-10-83; ss by #2963, eff 1-22-85; ss by #4314, eff 9-27-87; ss by #4659, eff 8-4-89; EXPIRED:8-4-95

New. #6285, eff 7-12-96, EXPIRED: 7-12-04

New. #8142, INTERIM, eff 8-21-04, EXPIRED: 2-17-05

New. #8324, eff 4-16-05, EXPIRED: 4-16-13

New. #10320, INTERIM, eff 4-25-13, EXPIRES: 10-22-13; ss by #10426, eff 10-1-13