N.H. Code Admin. R. 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.
Notes
#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
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