N.H. Code Admin. R. He-M 522.10 - Service Coordination

(a) The service coordinator shall be a person chosen or approved by the individual or guardian and approved by the area agency pursuant to paragraph (d) below, provided that the area agency shall retain ultimate responsibility for service coordination. The area agency shall advise the individual and guardian verbally and in writing prior to the preliminary planning stage under He-M 522.08 and prior to the initial and yearly individual service agreement planning process under He-M 522.11 and He-M 522.12 that he or she has a right to choose his or her own service coordinator, including one who is not employed by the area agency.

(b) For those individuals not eligible for Medicaid home- and community-based care services pursuant to He-M 517, the service coordinator shall:

(1) Hold a planning session to identify service needs and goals and appropriate community resources;

(2) Make appropriate referrals to community agencies; and

(3) Advocate on behalf of the individual for services to be provided in accordance with He-M 522.

(c) For those individuals eligible under He-M 517.03, the service coordinator shall:

(1) Advocate on behalf of individuals for services to be provided in accordance with He-M 522.09(b) ;

(2) Coordinate the service planning process in accordance with He-M 522.09 and He-M 522.11;

(3) Describe to the individual or guardian service provision options such as consolidated services;

(4) Monitor and document services provided to the individual;

(5) Ensure the continuity and quality of services provided;

(6) Ensure that service documentation is maintained pursuant to He-M 522.12(d) (1) and (g) (2) -(3) ;

(7) Determine and implement necessary action and document resolution when goals are not being addressed, support services are not being provided in accordance with the service agreement, or health or safety issues have arisen;

(8) Convene service planning meetings at least annually and whenever:

a. The individual or guardian is not satisfied with the services received;

b. There is no progress on the goals after follow-up interventions;

c. The individual's needs change; or

d. There is a need for a new provider; and

(9) Document service coordination visits and contacts pursuant to He-M 522.11(j) and He-M 522.12(g) (2) -(4) .

(d) A service coordinator shall not:

(1) Be a guardian of the individual whose services he or she is coordinating;

(2) Have a felony conviction;

(3) Have been found to have abused or neglected an adult with a disability based on a protective investigation performed by the bureau of elderly and adult services in accordance with He-E 700 and an administrative hearing held pursuant to He-C 200, if such a hearing is requested;

(4) Be listed in the state registry of abuse and neglect pursuant to RSA 169-C:35 or RSA 161-F:49; or

(5) Have a conflict of interest concerning the individual, such as providing other direct services to the individual.

(e) If the service coordinator chosen by the individual or guardian is not employed by the area agency or its subcontractor the following requirements shall apply:

(1) The service coordinator and area agency shall enter into an agreement that describes:

a. The role(s) set forth in He-M 522.10 for which the service coordinator assumes responsibility;

b. The reimbursement, if any, provided by the area agency to the service coordinator; and

c. The oversight activities to be provided by the area agency;

(2) If the area agency determines that the service coordinator is not ensuring the implementation of the service agreement or is not fulfilling his or her obligations as described in the letter of agreement, the area agency shall revoke the designation of the service coordinator with a 30-day notice and designate a new service coordinator, with input from the individual or guardian, pursuant to He-M 522.10(a) ; and

(3) If the area agency determines that a service coordinator chosen by the individual or guardian is posing a serious threat to the health or safety of the individual, the area agency shall terminate the designation of the service coordinator immediately upon issuance of written notice specifying the reasons for the action and designate a new service coordinator, with input from the individual or guardian, pursuant to He-M 522.10(a) .

(f) For individuals who receive both acquired brain disorder services and behavioral health services, service coordination shall be billed only by the area agency or behavioral health agency that is the primary service provider pursuant to He-M 426.15(b) .

(g) The role of service coordinator may, by mutual agreement, be shared by an employee of the area agency and another person. Such agreements shall be in writing and clearly indicate which functions each service coordinator will perform.

(h) The individual or guardian may appeal the area agency's decision under (e) (2) or (3) above pursuant to He-M 522.19. At the time it provides notice under (e) (2) or (3) above, the area agency shall advise the individual or guardian verbally and in writing of his or her appeal rights under He-M 522.19.

Notes

N.H. Code Admin. R. He-M 522.10

#7120, eff 10-20-99; ss by #8974, INTERIM, eff 10-6-07, EXPIRED: 4-3-08

New. #9734, eff 6-25-10 (from He-M 522.09 )

The amended version of this section by New Hampshire Register Volume 38, Number 50, eff. 11/30/2018 is not yet available.