Revision: Dec. 10, 2009, midnight
HB 1572-FN – AS INTRODUCED
2010 SESSION
01/04
HOUSE BILL 1572-FN
AN ACT relative to the certification of integrated residential communities.
SPONSORS: Rep. Donovan, Sull 4; Rep. Beck, Hills 2
COMMITTEE: Health, Human Services and Elderly Affairs
This bill establishes the certification of integrated residential communities. This bill exempts such entities from the licensure law regulating health care facilities.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
10-2429
01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Ten
AN ACT relative to the certification of integrated residential communities.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Health Facility Licensure; Exemption. Amend the introductory paragraph of RSA 151:2, I(e) to read as follows:
(e) Residential care facilities, except integrated residential communities, whether or not they are private homes or other structures built or adapted for the purpose of providing residential care, offering services beyond room and board to 2 or more individuals who may or may not be elderly or suffering from illness, injury, deformity, infirmity or other permanent or temporary physical or mental disability. Such facilities shall include those:
2 New Chapter; Integrated Residential Communities. Amend RSA by inserting after chapter 151-G the following new chapter:
CHAPTER 151-H
INTEGRATED RESIDENTIAL COMMUNITIES
151-H:1 Definitions. In this chapter:
I. “Commissioner” means the commissioner of the department of health and human services.
II. “Department” means the department of health and human services.
III. “Integrated residential community” or “community” means a program that provides residential and other services to individuals with developmental disabilities, mental illness, or traumatic brain injury, is certified by the department as a residential program, and is recognized by the department as a service delivery alternative to community living facilities and day programs certified under RSA 126-A and residential care facilities licensed under RSA 151.
151-H:2 Integrated Residential Community Programs. Integrated residential community programs shall be certified by the commissioner. For certification, the following criteria shall be met:
I. The program shall utilize a live-in staffing pattern, which promotes full and active interactions, between staff and clients, minimizes disruptions in clients’ lives, and maximizes the stability of the residence. Not only are staff required to live with mentally retarded and developmentally disabled clients, but the facility should be the staff person’s primary domicile. The program shall have disabled and nondisabled individuals working together. Staff shall actively participate in all aspects of daily living with clients interacting with them on a 24-hour, continual basis to provide a home community for both clients and staff.
II. Developmentally disabled persons shall be integrated into most aspects of the program’s operation. Developmentally disabled persons shall not do more work or specific kinds of work than are done by program, support, or administrative staff. The environment shall be one of shared activities and mutual interdependence among disabled persons, program staff, and administrators.
III. The residence, the corporate entity and the program’s principles of care shall be recognized as providing exemplary and excellent levels of care through evidence of national or international awards, testimonies and/or letters of reference from recognized persons in the mental health and developmental disability or government fields, or as recognized in scholarly literature.
IV. The majority of staff directly or indirectly caring for the clients and administering the residence shall be unsalaried.
V. The residence shall demonstrate that it provides excellent care, or for new residences, could provide such care on behalf of client growth and dignity, at a public cost lower than other programs serving a similar client population. The residence shall be able to demonstrate that services, care, and nurturance are given in such a way as to maximize each client’s development and the quality of his or her life.
VI. Integrated residential community programs serving persons with developmental disabilities shall be considered a part of the service delivery system, as defined in RSA 171-A.
151-H:3 Individual Service Plans.
I. Appropriate members of each community’s staff shall establish for each patient a written individual service plan. For outpatients, this plan shall include those elements below which are appropriate to the goals of service. For inpatients, the plan shall include:
(a) A comprehensive statement of the physical, psychological, social, economic, educational, and vocational assets and disabilities stated in terms of performance and functional capabilities of the patient;
(b) A statement of the goals of the services to be provided, derived from, and based on the statement of assets and disabilities and related to plans for return to the larger community;
(c) A statement of the methods, procedures, techniques, and activities to be provided towards the attainment of these goals; and
(d) A statement identifying the specific staff who will be involved in carrying out the several aspects of the plan.
II. Directors of communities shall designate appropriate staff members to make periodic review of the functional assets and disabilities of the patient, and of the goals, methods, and effects of services provided. In communities for the mentally ill, the timing of the reviews shall be as stipulated in the utilization review plans of the community. In communities for the developmentally disabled, the review shall be no less often than every 6 months.
III. Communities shall develop a narrative description for each client served in the program setting. The narrative shall include:
(a) A description of the individual’s strengths and needs;
(b) An annual summary encompassing the client’s activities and interests in all aspects of life, including work, home, social/leisure, community involvement, and family involvement wherein the resident’s contribution to the program setting is described. The client’s activities and role in the community will depend on his or her interests, skill development, and community needs;
(c) A description of the approaches that will be used to address each identified need within the integrated 24-hour setting. Staff responsible for implementing components specified in the program narrative shall be identified;
(d) A means of identifying how the client’s overall degree of independence, capacity for responsibility, and involvement in the community has been facilitated or enhanced; and
(e) For clients who are receiving psychotropic medications, a full description of the reasons justifying the use of such medications and a specific program plan designed to eliminate the need for the use of said psychotropic medications.
151-H:4 Rulemaking. The commissioner shall adopt rules pursuant to RSA 541-A relative to:
I. The application process and procedures for certification under this chapter.
II. Form and content of all forms required under this chapter.
III. Assessment and reassessment procedures for evaluating the individual service plans.
IV. Any matter deemed relevant and necessary to the proper administration of this chapter.
3 Effective Date. This act shall take effect 60 days after its passage.
LBAO
10-2429
12/07/09
HB 1572-FN - FISCAL NOTE
AN ACT relative to the certification of integrated residential communities.
FISCAL IMPACT:
The Department of Health and Human Services states this bill may decrease state expenditures by an indeterminable amount in FY 2010 and each year thereafter. This bill will have no fiscal impact on state, county, and local revenue or county and local expenditures.
METHODOLOGY:
The Department of Health and Human Services states this bill would authorize the certification of Integrated Residential Communities. These communities are a residential and day service delivery alternative for individuals with developmental disabilities, mental illness, and traumatic brain injury. The Department currently conducts inspections of residences in these communities. The Community Residence Certification Unit inspects and certifies residences with three or fewer residents, while the Health Facility Licensing Unit inspects and licenses residences with four or more residents. This bill would allow for the communities themselves to be certified as opposed to certifying or licensing the individual residences. This should result in some cost savings to the Department as only one inspection would be required each year as opposed to the current two. The Department states any cost saving likely would not be significant as there are only a few Integrated Residential Communities operating in New Hampshire. The exact fiscal impact cannot be determined at this time.