HB493 (2011) Detail

Relative to the certification of integrated residential communities.


HB 493-FN – AS INTRODUCED

2011 SESSION

11-0705

01/10

HOUSE BILL 493-FN

AN ACT relative to the certification of integrated residential communities.

SPONSORS: Rep. Millham, Belk 5

COMMITTEE: Health, Human Services and Elderly Affairs

ANALYSIS

This bill establishes the certification of integrated residential communities. Under this bill the number of beds to be certified shall be capped at 24. 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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

11-0705

01/10

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Eleven

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. “Client” means an individual receiving residential care and other services in an integrated residential community.

II. “Commissioner” means the commissioner of the department of health and human services.

III. “Department” means the department of health and human services.

IV. “Integrated residential community” or “community” means a program that provides a scope of residential and other services in a manner consistent with RSA 151-H:2 to individuals with developmental disabilities, mental illness, or traumatic brain injury, is certified by the department in accordance with this chapter, 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; provided that he or she shall only certify up to 24 beds for such purposes. For certification, the following criteria shall be met:

I. The program shall utilize a staffing pattern whereby most staff and volunteers live with the clients. The services of staff and volunteers shall be utilized in a manner that promotes full and active interactions between staff, volunteers, and clients, minimizes disruptions in clients’ lives, and maximizes the stability of the residence. The program shall have clients, staff, and volunteers working together. Staff and volunteers 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 clients, staff, and volunteers.

II. The program shall operate in a manner that ensures, to the greatest extent possible, that clients are fully integrated into all aspects of the community’s operations while also providing meaningful opportunities for clients to access and integrate with the community at large. Clients, staff, and volunteers shall work together performing the same types of tasks. The environment shall be one of shared activities and mutual interdependence among clients, staff, and volunteers.

III. The residences in each community shall maintain a homelike atmosphere and shall be limited to 6 or fewer clients per residence. Communities shall demonstrate that they provide excellent care or, for new communities, that they could provide such care on behalf of client growth and dignity, at a public cost lower than other programs serving a similar client population and providing comparable services. The residence shall demonstrate that the physical environment, services, care, and nurturance are provided in such a way as to maximize each client’s development and the quality of his or her life.

IV. 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 Narrative Plans. Communities shall develop a narrative description for each client served in the program setting. The narrative shall include:

I. A description of the individual’s strengths and needs.

II. An annual summary encompassing the client’s activities and interests in all aspects of life, including work, home, social/leisure, community involvement, family involvement, and the client’s contribution to the program setting. The client’s activities and role in the community shall depend on his or her interests, skill development, and community needs. Included with the narrative shall be a schedule of the client’s program activities.

III. 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 narrative shall be identified.

IV. Quarterly notes addressing changes in the client’s situation specific to paragraphs I-III. As review of the progress of clients is an ongoing, integral part of the program structure, more frequent reassessments of the individual’s strengths and needs as part of the program narrative shall formally occur only when necessary, as indicated by dramatic changes in client behavior or interest, or by staff concerns that warrant such reassessment.

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. The process and procedures for denials of applications for certification and for revocation of certifications.

III. The process and procedures for department inspections of integrated residential communities including inspections of client living areas and common areas to ensure the communities comply with the provisions of this chapter as well as rules adopted under this chapter and any applicable codes, such as the state fire code.

IV. The process and procedures for investigations into complaints filed with the department relative to integrated community residences.

V. Form and content of all forms required under this chapter.

VI. Assessment and reassessment procedures for evaluating the individual narrative plans.

3 Effective Date. This act shall take effect 60 days after its passage.

LBAO

11-0705

Revised 01/31/11

HB 493 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 and revenue by an indeterminable amount in FY 2011 and in each year thereafter. There will be no fiscal impact on county or local revenue or expenditures.

METHODOLOGY:

    The Department states this bill authorizes certification of Integrated Residential Communities as an alternative to residential and day services for individuals with developmental disabilities, mental illness or traumatic brain injury. The Department indicates that currently, the Community Residence Certification Unit inspects and certifies residences within these communities with three or fewer residents, but the Health Facility Licensing Unit inspects and licenses residences within these communities with four or more residences. This bill would allow the Integrated Residential Community to be certified once instead of separately certifying the individual residences within the community. The Department assumes there will be some savings as only one inspection will be required each year instead of two. The Department states there are only a few Integrated Residential Communities in New Hampshire and expects the savings are not likely to be significant.