N.H. Admin. Code § He-M 510.03

Current through Register No. 45, November 7, 2024

Section He-M 510.03 - Family-Centered Support and Service Categories

(a) Assistive technology services shall directly assist a child in the selection, acquisition, or use of an assistive technology device, including:

(1) The evaluation of the needs of a child, including a functional evaluation of the child in the child's customary environment;

(2) Purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by the family;

(3) Selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices;

(4) Coordinating and using other therapies, interventions, supports, or services with assistive technology devices, such as those associated with existing IFSPs;

(5) Training or technical assistance for a child or, if appropriate, that child's family; and

(6) Training or technical assistance for professionals, including persons providing FCESS and other persons who provide services to, or are otherwise substantially involved in the major life functions of, children.

(b) Audiology services shall include:

(1) Identification of children with auditory impairments, using at risk criteria and appropriate audiologic screening techniques;

(2) Determination of the range, nature, and degree of hearing loss and communication functions, by use of audiological evaluation procedures;

(3) Referral for medical and other services necessary for the habilitation or rehabilitation of children with auditory impairment;

(4) Provision of auditory training, aural rehabilitation, speech reading, and listening device orientation and training, and other services;

(5) Provision of services for prevention of hearing loss; and

(6) Determination of the child's need for individual amplification, including selecting, fitting, and dispensing appropriate listening and vibrotactile devices, and evaluating the effectiveness of those devices.

(c) Family training, counseling, and home visits shall include assistance to the family in understanding the special needs and building on the interests of the child and enhancing the child's development.

(d) Health services shall include services necessary to enable a child to benefit from the other FCESS under He-M 510 during the time that the child is eligible to receive other FCESS, including:

(1) Such services as clean intermittent catheterization, tracheotomy care, tube feeding, the changing of dressings or colostomy collection bags, and other health services; and

(2) Consultation by physicians with other FCESS providers concerning the special health care needs of children that will need to be addressed in the course of providing other FCESS.

(e) Health services shall not include:

(1) Services that are surgical in nature, such as cleft palate surgery, surgery for club foot, or the shunting of hydrocephalus;

(2) Services that are purely medical in nature, such as hospitalization for management of congenital heart ailments or the prescribing of medicine or drugs for any purpose;

(3) Services related to the implementation, maintenance, replacement, or optimization, such as mapping, of a medical device that is surgically implanted, including cochlear implants;

(4) Devices such as heart monitors, respirators and oxygen, and gastrointestinal feeding tubes and pumps necessary to control or treat a medical condition; or

(5) Medical-health services, such as immunizations and regular "well baby" care, that are routinely recommended for all children.

(f) Nothing in He-M 510 shall:

(1) Limit the right of a child who has a surgically implanted device, such as a cochlear implant, to receive the early supports and services that are identified in the child's IFSP as necessary to meet the child's developmental outcomes; or

(2) Prevent the provider from routinely checking that either the hearing aid or the external components of a surgically implanted device, such as a cochlear implant, of a child are functioning properly.

(g) Medical services shall include services provided by a licensed physician for diagnostic or evaluation purposes to determine a child's developmental status and need for FCESS.

(h) Nursing services shall include:

(1) The assessment of a child's health status for the purpose of providing nursing care, including the identification of patterns of human response to actual or potential health problems;

(2) Provision of nursing care to prevent health problems, restore or improve functioning, and promote optimal health and development; and

(3) The administration of medications, treatments, and regimens prescribed by a licensed physician or an advanced practice registered nurse (APRN) in accordance with RSA 326-B:11, III.

(i) Nutrition services shall include:

(1) Conducting individual assessments in:

a. Nutritional history and dietary intake;

b. Anthropometric, biochemical, and clinical variables;

c. Feeding skills and feeding problems; and

d. Food habits and preferences;

(2) Developing and monitoring appropriate plans to address the nutritional needs of children based on the findings in (i)(1) above; and

(3) Making referrals to appropriate community resources to carry out nutrition goals.

(j) Occupational therapy shall be services that:

(1) Address the functional needs of a child related to adaptive development, adaptive behavior and play, and sensory, motor, and postural development;

(2) Are designed to improve the child's functional ability to perform tasks in home, school, and community settings; and

(3) Include:

a. Identification, assessment, and provision of needed supports and services;

b. Adaptation of the environment and selection, design, and fabrication of assistive and orthotic devices to facilitate development and promote the acquisition of functional skills; and

c. Prevention or minimization of the impact of initial or future impairment, delay in development, or loss of functional ability.

(k) Physical therapy shall be services that:

(1) Address the promotion of sensorimotor function through enhancement of:

a. Musculoskeletal status;

b. Neurobehavioral organization;

c. Perceptual and motor development;

d. Cardiopulmonary status; and

e. Effective environmental adaptation; and

(2) Include:

a. Screening, evaluation, and assessment of children to identify movement dysfunction;

b. Obtaining, interpreting, and integrating information to prevent, alleviate, or compensate for movement dysfunction and related functional problems; and

c. Providing individual and group services to prevent, alleviate, or compensate for movement dysfunction and related functional problems.

(l) Preventative and diagnostic services shall be early and periodic screening, diagnosis, and treatment services as specified in He-W 546.05 (a) and (b).

(m) Psychological services shall include:

(1) Administering psychological and developmental tests and other assessment procedures;

(2) Interpreting assessment results;

(3) Obtaining, integrating, and interpreting information about child behavior and child and family conditions related to learning, mental health, and development; and

(4) Planning and managing a program of psychological services, including:

a. Psychological counseling for children and parents;

b. Family counseling;

c. Consultation on child development;

d. Parent training; and

e. Education programs.

(n) Service coordination shall:

(1) Be services provided by a service coordinator to assist and enable a child and the child's family to receive the services and rights, including procedural safeguards, required under this part, He-M 203, and He-M 310;

(2) Be an active, ongoing process that involves:

a. Assisting parents of children in gaining access to, and coordinating the provision of, the FCESS required under this part; and

b. Coordinating the other services identified in the IFSP that are needed by, or are being provided to, the child and that child's family; and

(3) Include:

a. Coordinating all services required under this part across agency lines;

b. Serving as the single point of contact for carrying out the activities described in c. - l. below;

c. Assisting parents of children in obtaining access to needed supports and services and other services identified in the IFSP, including making referrals to providers for needed services and scheduling appointments for children and their families;

d. Coordinating the provision of FCESS and other services, such as educational, social, and medical services that are not provided for diagnostic or evaluative purposes, that the child needs or are being provided;

e. Coordinating evaluations and assessments;

f. Facilitating and participating in the development, review, and evaluation of IFSPs;

g. Conducting referral and other activities to assist families in identifying available providers;

h. Coordinating, facilitating, and monitoring the delivery of services required under this part to ensure that the services are provided in a timely manner;

i. Conducting follow-up activities to determine that appropriate services are being provided;

j. Informing families of their rights and procedural safeguards, as set forth in He-M 203 and He-M 310, and related resources, including organizations with their addresses and telephone numbers that might be available to provide legal assistance and advocacy, such as the Disabilities Rights Center, Inc. and NH Legal Assistance;

k. Coordinating the funding sources for services required under this part; and

l. Facilitating the development of a transition plan to preschool, school, or, if appropriate, to other services.

(o) Use of the term "service coordination" or "service coordination services" by an FCESS program or provider shall not preclude characterization of the services as case management or any other service that is covered by another payor of last resort, such as Title XIX of the Social Security Act-Medicaid, for purposes of claims in compliance with the requirements of 34 CFR 303.501 through 303.521.

(p) Sign language and cued language services shall include:

(1) Teaching sign language, cued language, and auditory and oral language;

(2) Providing oral transliteration services, such as amplification; and

(3) Providing sign and cued language interpretation.

(q) Social work services shall include:

(1) Home visits to evaluate a child's living conditions and patterns of parent-child interaction;

(2) Preparing a social or emotional developmental assessment of the child within the family context;

(3) Providing individual and family counseling with parents and other family members and appropriate social skill building activities with the child and parents;

(4) Working with the family to resolve problems in the family's living situation, home, or community that affect the child's and family's maximum utilization of FCESS; and

(5) Identifying, mobilizing, and coordinating community resources and services to enable the child and family to receive maximum benefit from FCESS.

(r) Special instruction shall include:

(1) Designing learning environments and activities that promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction;

(2) Curriculum planning, including the planned interaction of personnel, materials, and time and space, that leads to achieving the outcomes in the IFSP;

(3) Providing families with information, skills, and support related to enhancing the skill development of the child; and

(4) Working with the child to enhance the child's development.

(s) Speech-language pathology services shall include:

(1) Identification of children with communicative or language disorders and delays in development of communication skills, including the diagnosis and appraisal of specific disorders and delays in those skills;

(2) Referral for medical or other professional services necessary for the habilitation or rehabilitation of children with communicative or language disorders and delays in development of communication skills; and

(3) Provision of services for the habilitation, rehabilitation, or prevention of communication or language disorders and delays in development of communication skills.

(t) Transportation services shall include reimbursing the family for the cost of travel such as mileage, or travel by taxi, common carrier, or other means, and other related costs such as tolls and parking expenses, that are necessary to enable an eligible child and the child's family to receive FCESS.

(u) Vision services shall include:

(1) Evaluation and assessment of visual functioning, including the diagnosis and appraisal of specific visual disorders, delays, and abilities that affect early childhood development;

(2) Referral for medical or other professional services necessary for the habilitation or rehabilitation of visual functioning disorders, or both; and

(3) Communication skills training, orientation and mobility training for all environments, visual training, independent living skills training, and additional training necessary to activate visual motor abilities.

(v) The services and personnel identified and defined in (a)-(u) above shall not comprise exhaustive lists of the types of services that may constitute FCESS or the types of qualified personnel that may provide FCESS. Nothing in this section shall prohibit the identification in the IFSP of another type of service as an FCESS provided that the service meets the criteria in He-M 510.04.

(w) Children and families who qualify for services under He-M 510 may have access to respite services under He-M 513 and He-M 519 as well as other services authorized by the department that meet the intent and purpose and are consistent with evidence-based nationally recognized treatment standards.

N.H. Admin. Code § He-M 510.03

(See Revision Note at part heading for He-M 510) #5745, eff 12-1-93, EXPIRED: 12-1-99

New. #7234, eff 4-22-00; amd by #7822, eff 2-8-03; ss by #9135, INTERIM, eff 4-22-08, EXPIRED: 10-19-08

New. #9594, eff 11-11-09; ss by #10325, eff 4-26-13

Amended by Number 41, Filed October 12, 2023, Proposed by #13753, Effective 9/27/2023, Expires 9/27/2033.