Amendment 2023-1534s to HB238 (2023)

Relative to the role of quality control and the developmental disability service system.

Revision: April 27, 2023, 8:59 a.m.

Senate Executive Departments and Administration

April 26, 2023





Amendment to HB 238


Amend RSA 171-A:33 as inserted by section 1 of the bill by replacing it with the following:


1  Developmental Services Quality Council; Developmental Services Quality Council Established; Membership; Duties.  RSA 171-A:33 is repealed and reenacted to read as follows:

171-A:33  Developmental Services Quality Council Established; Membership; Duties.

I.  There is established the developmental services quality council to provide leadership for consistent, systemic review and improvement of the quality of the developmental disability and acquired brain disorder services provided within New Hampshire's developmental services system.  At least 51 percent of the members of the council shall be individuals with disabilities served by the system or parents of individuals served by the system.  The members of the council shall be as follows:

(a)  The commissioner of the department of health and human services, or designee.

(b)  A representative of People First of New Hampshire, appointed by such organization.

(c)  A representative of Advocates Building Lasting Equality in New Hampshire (ABLE NH), appointed by such organization.

(d)  A representative of the New Hampshire council on autism spectrum disorders who shall be either the individual who has an autism spectrum disorder or the family member of a person who has an autism spectrum disorder, appointed by the council.

(e)  A representative of the Brain Injury Association of New Hampshire, appointed by the association.

(f)  Two representatives of the New Hampshire Developmental Disabilities Council, at least one of whom shall be a person with a developmental disability, appointed by the council.

(g)  Three representatives of local Family Support Councils, appointed by the state Family Support Council.

(h)  One direct support professional and one enhanced family care provider, appointed by the New Hampshire Developmental Disabilities Council.

(i)  Three representatives of area agency boards of directors including at least 2 persons with a developmental disability or family members of such persons, appointed by the Community Support Network Incorporated.

(j)  A representative of the Community Support Network Incorporated, appointed by such organization.

(k)  A representative of the Private Provider Network, appointed by such organization.

(l)  The director of the Institute on Disability, University of New Hampshire, or designee.

(m)  A representative of the Disability Rights Center - NH, appointed by the center.

(n)  Up to 5 additional members, nominated by the council and appointed by the governor.

II.  The groups represented under paragraph I are encouraged to provide, according to their ability, the in-kind and other resources necessary for the council to succeed.  The council may request information and analysis on quality from the department of health and human services, area agencies, and providers.  The council shall have access to all non-confidential information on quality for services funded all or in part by public funds.

III.  The council shall regularly review information on the quality of developmental services in New Hampshire and make recommendations for improving service quality and the quality assurance and continuous improvement systems, including, but not limited to:

(a)  Standards of quality and performance expected of area agencies and provider agencies.

(b)  Types of data to be collected, analyzed, and disseminated to determine whether standards are being met.

(c)  Quality assurance and oversight mechanisms to be used to gather data and information.

(d)  Content, frequency, and recipients of quality evaluation and improvement reports.

(e)  Expectations and procedures for following up on identified areas where improvements are needed.

(f)  Structures, policies, rules, and practices, including staffing or organizational changes, to ensure that the developmental services system works as intended in RSA 171-A:1, including:

(1)  Ways of supporting values-based and person-centered service planning and provision, as well as problem solving, innovation, and learning;

(2)  Recognizing and disseminating what is working well (best/model practices);  

(3)  Significant changes proposed by the department relating to, or which may impact any of, the practices, policies, standards, rates, budgets, funding formulae, or rights pertaining to eligibility or provision of supports and services under RSA 171-A; and

(4)  Reviewing, clarifying, and disseminating data and information on a regular basis to bring about transparency for all stakeholders and the public.

IV. The council shall provide the department with recommendations for improving service quality and the quality assurance and continuous improvement systems, no more frequently than quarterly.  The department shall respond in writing within 30 business days of receipt of the council's recommendations with a statement indicating whether it agrees or disagrees with each of the council’s recommendations.  Following receipt of the department’s response, the council shall place the response on the next council meeting agenda for discussion by the commissioner’s designee on the council.  Within 60 business days of the council meeting, discussion, and record of the discussion in the minutes, the department shall provide:

(a)  For each recommendation it agrees with, a detailed plan for how the department will address the areas identified as needing improvement including the specific steps the department plans to take, along with a timeline for each step;

(b)  For any recommendation it does not agree with, an explanation of the basis for its disagreement and rationale for its decision not to take action on any specific recommendation; and

(c)  If the department is unable to respond to the council’s recommendations within the time frames above, the department shall inform the council in writing and include the reasons for not being able respond within the time frames.

V.  The quarterly limit as described in paragraph IV is not intended restrict the council's ability to comment on rules, regulations, proposals, or other initiatives impacting the quality of services for people with developmental disabilities and acquired brain disorders as needed throughout the year.

VI.  The council shall make an annual report beginning on November 1, 2010 that includes its recommendations and an assessment of the actions taken in response to previous recommendations to the governor, the speaker of the house of representatives, the president of the senate, the members of the house committee on health, human services and elderly affairs and the members of the senate committee on health and human services.

VII.  The meetings shall be convened by the chair or vice chair of the council or commissioner of the department of health and human services, or designee, and shall meet regularly as determined by the council.  The meetings shall be open to the public and subject to the provisions of RSA 91-A, the right-to-know law.  The council may establish bylaws for governing its meetings, decisions, and other operations.  For the purpose of convening council meetings in compliance with RSA 91-A, a quorum of the council shall be a majority plus one member of the appointed members of the council.  Members who are not able to be physically present at council meetings due to their disabilities or the disability of a family member shall be counted as attending "in person" for the purpose of the establishment of a quorum provided that each member participating electronically or otherwise is able to simultaneously hear and speak to each of the other council members during the meeting, and shall be audible or otherwise discernable to public in attendance at the meeting's location.  Any member participating in such fashion shall identify the persons present in the location from which the member is participating.




This bill directs the developmental services quality council to provide periodic recommendations to the department of health and human services and directs the department to respond to the council within a specified period of time.