N.H. Code Admin. R. He-M 517.04 - Provider Participation

(a) Except as allowed by (b) below, all community residences shall be certified pursuant to He-M 1001. Community residences that serve 4 or more people shall also be licensed by the bureau of health facilities administration in accordance with RSA 151:2, I, (e) and He-P 814.

(b) A residence funded under the home and community-based care waiver that provides services to persons with acquired brain disorders and is licensed as a supported residential care facility or a residential treatment and rehabilitation facility under RSA 151:2, I, (e) shall not be required to be certified as a community residence pursuant to He-M 1001.

(c) Personal care services described in He-M 521.03 and provided in the family home of an individual who is 18 years of age or older shall be certified pursuant to He-M 521.09.

(d) Participant directed and managed services described in He-M 525.05 shall be certified pursuant to He-M 525.07.

(e) Area agencies shall be enrolled with the New Hampshire medicaid program as providers in order to receive reimbursement for the provision of services under the home and community-based care waiver.

(f) An area agency or provider agency shall allow the bureau to examine its service and financial records at any time for the purposes of audit or review.

(g) When services are to be provided by a subcontractor of an area agency, the area agency shall establish a contract specifying the roles of the area agency and subcontractor agency in service planning, provision and oversight including:

(1) Implementation of the service agreement;

(2) Specific training and supervision required for the service providers;

(3) Compensation amounts and procedures for paying providers;

(4) Oversight of the service provision, as required by the service agreement;

(5) Documentation of administrative activities and services provided;

(6) Fiscal intermediary services provided by the area agency or subcontractor agency to facilitate the delivery of consumer-directed services;

(7) Quality assessment and improvement activities as required by rules pertaining to the service provided;

(8) Compliance with applicable laws and rules, including delegation of tasks by a nurse to unlicensed providers pursuant to RSA 326-B and He-M 1201;

(9) Family support service coordination provided by the area agency;

(10) Procedures for review and revision of the service agreement as deemed necessary by any of the parties; and

(11) Provision for any of the parties to dissolve the contract with notice.

Notes

N.H. Code Admin. R. He-M 517.04

#4315, eff 9-25-87; EXPIRED: 9-25-93

New. #6360, eff 10-23-96, EXPIRED: 10-23-04

New. #8195, INTERIM, eff 10-29-04, EXPIRED: 4-27-05

New. #8424, eff 9-1-05; ss by #10454, eff 10-31-13