1. (a) “Absconder” means a runaway, as defined in (bg) below, for whom a juvenile petition has been filed pursuant to RSA 169-B or RSA 169-D, and who, with the intent to avoid legal process or authorized control, meets at least one of the following criteria:

   1. (1) Fails to report for probation or parole supervisions;
   2. (2) Fails to report for conditional release supervision;
   3. (3) Hides, conceals, or absents themselves; or
   4. (4) Has departed the jurisdiction without permission of the supervising authority, court, or juvenile parole and probation officer (JPPO), and whose whereabouts might be unknown.
2. (b) “Accredited program” means an agency or program which has met practice and quality standards set by a nationally recognized independent, not-for-profit organization such as but not limited to the Commission on Accreditation of Rehabilitation Facilities (CARF), Council on Accreditation (COA), or The Joint Commission (TJC).
3. (c) “Adult living preparation” means a process of assessing, planning, and supporting youth through the transition from childhood through adolescence and into independence and young adulthood. This term includes “independent living preparation.”
4. (d) “Agency” means the board of directors, executive director, and employees of an organization that operates a residential treatment program at a residential facility that is incorporated and recognized by the secretary of state of the state in which it operates and provides an identifiable system of social service interventions designed for an individual child or group of children. This term includes “child care agency” as defined in RSA 170-E:25, II.
5. (e) “Applied behavioral analysis (ABA)” means the application of behavioral principles to everyday situations, intended to increase or decrease targeted behaviors.
6. (f) “Applicant” means the person or entity that is requesting certification of a residential treatment program.
7. (g) “Board certified behavior analyst (BCBA)” means a graduate level certified professional who conducts ABA.
8. (h) “Bureau for children’s behavioral health (BCBH)” means the bureau within the division for behavioral health in the department of health and human services (department) charged with implementing the children’s system of care.
9. (i) “Case plan” means the division for children, youth and families’ (DCYF) written plan for the child and the family which outlines how services will be provided, pursuant to RSA 170-G:4, III, and 42 USC 671 and 42 USC 675. This term includes “placement plan.”
10. (j) “Care management entity (CME)” means “care management entity” as defined in RSA 135-F:4, III namely “an organizational entity that serves as a centralized entity to coordinate all care for youth with complex behavioral health challenges who are involved in multiple systems and their families.”
11. (k) “Certification for payment” means the process by which the department approves the certification of and payment to certified residential treatment programs and independent living programs.

12. (l) “Child” means:

    1. a. “Child” as defined in RSA 170-E:25, I. The term includes “youth”, “resident”, and “young adult”;
    2. b. For the purposes of compliance with RSA 126-U, “child” as defined in RSA 126-U:1, I, namely, “a person who has not reached the age of 18 years and who is not under adult criminal prosecution or sentence of actual incarceration resulting therefrom, either due to having reached the age of 18 years or due to the completion of proceedings for transfer to the adult criminal justice system under RSA 169-B:24, RSA 169-B:25, or RSA 169-B:26. ‘Child’ also includes a person in actual attendance at a school who is less than 22 years of age and who has not received a high school diploma.”;
    3. c. “Child with a disability” as defined in RSA 186-C:2, I, and “developmentally delayed child” as defined in RSA 186-C:2 I-a; and
    4. d. For youth in extended foster care pursuant to RSA 170-E:53, a person who has attained the age of 18 but not attained the age of 21.
13. (m) “Child and adolescent needs and strengths (CANS)” means a multi-purpose tool developed for children's services to support decision making, including level of care and service planning, to facilitate quality improvement initiatives, and to allow for the monitoring of outcomes of services.
14. (n) “Child protective services worker (CPSW)” means the DCYF representative who has expertise in managing cases resulting from concerns of child abuse or neglect to ensure families and children achieve safety, permanency, and well-being.
15. (o) “Children’s system of care” means a comprehensive delivery system of services and supports oriented in tiers which supports children, youth, and families based on their individual levels of needs at any time in accordance with RSA 135-F.
16. (p) “Clinical coordinator” means a staff member employed by the residential treatment program responsible for administrative oversight of the clinical services provided at the program. This term includes “treatment coordinator” and “clinical director.”
17. (q) “Clinical staff” means individuals who have a master’s degree in a clinical field such as social work, marriage and family therapy, psychology, pastoral counseling, school counseling, or a degree which would make one eligible for a license from the New Hampshire board of mental health practice or New Hampshire board of psychologists.
18. (r) “Commissioner” means the commissioner of the New Hampshire department of health and human services or the commissioner’s designee.
19. (s) “Comprehensive assessment for treatment (CAT)” means the biopsychosocial assessment which in part utilizes the CANS and is conducted by a qualified individual as defined by the federal Family First Prevention Services Act of 2017. The CAT is used to recommend whether a child’s behavioral health needs would be supported in a residential treatment program or independent living program as defined by 42 USC 672(k)(4) and if so, recommends the least restrictive and most appropriate level of care.
20. (t) “Connection” means an individual who the child identifies as an important relationship and who is supported by the treatment team for maintaining the child’s permanency plans. A connection can also qualify as family or kin.
21. (u) “Corrective action plan” means a plan created by the program and provided to the department within 30 days, which responds to the identified areas of non-compliance with proposed resolutions to rectify all concerns based upon a quality assurance monitoring activity.
22. (v) “DCYF representative” means an employee of DCYF who has training and experience in managing matters of child protection or juvenile justice cases referred to the department pursuant to RSA 169-B, RSA 169-C, RSA 169-D, RSA 170-B, RSA 170-C, and RSA 463.
23. (w) “Department” means the New Hampshire department of health and human services.
24. (x) “Direct care staff” means the residential treatment program’s staff who are included in the staff to child ratio, including, but not limited to, child care workers, supervisors, and recreational staff.
25. (y) “Division for children, youth and families (DCYF)” means the organizational unit in the department of health and human services which includes but is not limited to, child protective services and juvenile justice services.
26. (z) “Episode of treatment” means a time-limited, voluntary admission to residential treatment approved by BCBH for children, in which the child and the family have voluntarily agreed to residential treatment and who are not court ordered to placement.
27. (aa) “Executive director” means the individual responsible for the daily administration of a residential treatment program.
28. (ab) “Facility” means the physical plant or structures, permanent or temporary, on the grounds of the licensed premises. This term includes “facility” as defined in RSA 126-U:1 III.
29. (ac) “Family” means the individuals to whom the child is related legally or biologically, such as but not limited to, parents, stepparents, siblings, grandparents, aunts, uncles, first or second cousins, stepgrandparents, and step siblings. This term includes “relative”. Family can also include “kin”.
30. (ad) “Family workers” means individuals who are residential program staff who work directly with the families of children in the residential program on reunification or in establishing a family’s optimum level of functioning and contact with their child. This term includes program “permanency coordinators”, “permanency specialists”, and “case managers”.
31. (ae) “Foster care bill of rights” means the rights of a child placed in a foster care or out of home placement pursuant to RSA 170-G:21.
32. (af) “Full time employee” means residential program staff who work a minimum of 34 hours per week unless defined otherwise by the agency.

33. (ag) “Human services” means helping people in areas which include:

    1. (1) Education;
    2. (2) Mental health and behavioral health;
    3. (3) Recreation;
    4. (4) Child care;
    5. (5) Medical services;
    6. (6) Law enforcement;
    7. (7) Corrections;
    8. (8) Social services;
    9. (9) Independent living or adult living preparation; and
    10. (10) Substance misuse services.
34. (ah) “Independent living program” means programs that include supportive community level of care and is either supervised living or supported apartments. These settings are designed for youth 18 years of age or older to provide residential housing, support the coordination of treatment services, and independence of youth transitioning into young adulthood.

35. (ai) “Incident” means:

    1. (1) Resident behavior that is extreme, including but not limited to, behavior that is assaultive, destructive, self-injurious, or self-destructive;
    2. (2) An occurrence involving an accident or injury, or requiring outside agency involvement, which includes a suicide attempt including self-injurious behavior with a non-fatal outcome where there is explicit or implicit evidence that the person intended to die, and medical intervention was needed;
    3. (3) The death of the resident;
    4. (4) Suspected abuse or neglect of the resident;
    5. (5) Emergency medical treatment for the resident;
    6. (6) The impairment of the resident while at the program;
    7. (7) A medication occurrence that required medical intervention for the resident;
    8. (8) The unexplained absence of a resident from the program; and
    9. (9) Restraint and seclusion defined in (bf) and (bh) below.
36. (aj) “Juvenile probation and parole officer (JPPO)” means the DCYF representative who has expertise in managing cases resulting from concerns of delinquency or children in need of services (CHINS) to ensure families and children achieve safety, permanency, and well-being.
37. (ak) “Kin” means “kin” as defined in RSA 170-E:25, VIII, namely, “a child or children who for which there is a connection or history between a child or their parents and another responsible adult, including but not limited to related adults”. A person who is kin can also be a connection.
38. (al) “License” means “license” as defined in RSA 170-E:25, IX or a license issued pursuant to RSA 151 .
39. (am) “Managed care organization (MCO)” means an entity that has a comprehensive risk-based contract with the department to provide managed medicaid health care services.
40. (an) “Measurable” means the systematic process of gathering quantitative or qualitative information to show progress or change and achievement of a goal or objective.
41. (ao) “Monitoring visit” means a quality assurance visit to the residential treatment program or facility performed by the department. This term includes “technical assistance visit”, “site visit”, and “quality assurance visit”.
42. (ap) “Notice of non-compliance” means written notification provided by the department to a residential treatment program which identifies one or more areas where the program did not comply with He-C 6350, He-C 6420, or the contract, if applicable, and requires an immediate response, action, or corrective action plan to address the non-compliance areas within a specified self identified timeline.
43. (aq) “NH bridges” means the case management, tracking, finance, and automated billing system used by DCYF and on behalf of BCBH. This term also includes “granite families”.
44. (ar) “Permanency” means a child’s safe, stable living environment with a life-long relationship with a nurturing caregiver to establish the foundation for a child’s healthy development.
45. (as) “Psychiatric Residential Treatment Facility (PRTF)” as described in 42 CFR 483.352 means an inpatient program which provides 24 hour care 7 days a week, as well as intensive short term, and long term psychiatric treatment and care to persons who have psychiatric symptoms and disorders or are in an acute phase of their mental illness.
46. (at) “Physical intervention” means a behavioral management technique in which staff use the minimum amount of physical contact on a child, which is necessary for the circumstances, in accordance with RSA 627:6, II(b) and RSA 126-U, to protect the resident, other residents present, the staff, and the general public. Physical intervention might be reportable under RSA 126-U and He-C 901. This term includes “physical management.”
47. (au) “Policies” means an agency’s or program’s written guidelines, practices, and procedures specifying the current and future actions to be taken that direct the operation of the residential treatment program.

48. (av) “Prescribing practitioner” means any of the following state licensed health care providers pursuant to He-C 6420 that provide services identified in 42 CFR 440.130 to reduce a physical or mental disability and in the restoration of the child’s best functional level:

    1. (1) Health care providers licensed in accordance with RSA 326-B;
    2. (2) Physicians;
    3. (3) Physician assistants; and
    4. (4) Any practitioner licensed by the New Hampshire board of mental health practice pursuant to RSA 318 or New Hampshire board of psychologists pursuant to RSA 330-A.
49. (aw) “Program philosophy” means the underlying theory, or set of ideas, which guides the beliefs and principles of the program and the services provided by the program in accordance with the system of care principles and values pursuant to RSA 135-F.
50. (ax) “Progress reports” means the written notes sent to DCYF, CME, and parents by the staff of a program which document the residential services being provided to the child. This term includes “monthly progress reports” and “weekly progress reports”.
51. (ay) “Qualified residential treatment program (QRTP)” means “qualified residential treatment program” as defined in 42 USC 672(k)(4) as reprinted in Appendix C.
52. (az) “Quality assurance” means the process that department staff use to monitor, support, and provide technical assistance to residential treatment programs to assist in their ability to comply with He-C 6350, He-C 6420, or the contract, if applicable.
53. (ba) “Reasonable and prudent parent standard” means a standard characterized by careful and sensible parental decisions made by a caregiver for a child in foster care, that maintain the health, safety, and best interests of the child while encouraging the emotional and developmental growth of the child through participation in extracurricular, enrichment, cultural, and social activities as defined by 42 USC 675(10)(A) and any subsequent amendments thereto, and codified in RSA 170-G:20.
54. (bb) “Rehabilitative and restorative services” means interventions provided including any medical or remedial services recommended by a physician or other prescribing practitioner to reduce a physical or mental disability and restore a child to their best functional level in accordance with He-C 6420.
55. (bc) “Related” means “related” as defined in RSA 170-E:25, XII, namely “any of the following relationships by blood, marriage, or adoption: parent, grandparent, brother, sister, stepparent, stepgrandparent, stepbrother, stepsister, uncle, aunt, niece, nephew, first cousin or second cousin”. A related person can also be considered family or kin.
56. (bd) “Residential treatment program ” means the model and implementation of services to meet the treatment and supervision needs of the children pursuant to RSA 170-G:4, XVIII, and provide 24 hour care of children 365 days a year including all of the employees therein. It also includes residential independent living programs which provide residential housing, supports, and coordination of treatment in the community in which the program operates. This term includes “program”.

57. (be) “Residential levels of care” means the category of care that is provided at the various levels which includes the following:

    1. (1) Level 1 independent living program where supervision and treatment is not required;
    2. (2) Level 2 intermediate treatment program;
    3. (3) Level 3 intensive treatment program;
    4. (4) Level 4 highly intensive treatment program;
    5. (5) Level 5 PRTF;
    6. (6) Assessment treatment program;
    7. (7) Nursing home;
    8. (8) Rehabilitation program; and
    9. (9) Substance use treatment program.
58. (bf) “Restraint” means “restraint” as defined in RSA 126-U:1, IV. Restraint might also be considered “physical intervention” or “physical management”.
59. (bg) “Runaway” means a child in an episode of treatment or placed in a program pursuant to RSA 169-B, RSA 169-C, or RSA 169-D, who has failed to return to the child’s placement, has hid, or has concealed themselves without permission of their legal custodian, residential treatment program, or supervising authority. A runaway might also be considered an absconder or a missing child.
60. (bh) “Seclusion” means “seclusion” as defined in RSA 126-U:1, V-a.
61. (bi) “Short-term program” means a residential treatment program that is intended to provide services to a child for 60 days or less.
62. (bj) “Staff secure” means a residential treatment program that provides high levels of supervision and individualized care 24 hours a day to children through the use of a staff to child ratio of one staff to 5 children or fewer and awake night staff in each building used for child care, and can include short-term interventions that require one staff member to care for one child in order to assist the child through a behavioral or emotional crisis, or physical interventions, in accordance with RSA 126-U, to prevent runaways.
63. (bk) “Staff to child ratio” means the number of program direct care staff to ensure that the necessary resources are available to deliver services and provide supervision to the number of children consistent with He-C 4001 or the licensing requirements of the state in which it operates.
64. (bl) “Staff supervision” means an administrative and educational process used in residential treatment programs to help child care workers and clinical staff develop and refine their skills so that they are able to provide quality care and treatment.
65. (bm) “System of care values” means the comprehensive characteristics set forth in RSA 135-F:3, III, which states that services are family-driven, youth-guided, community-based, trauma-informed, and culturally and linguistically competent.
66. (bn) “Transitional residential-enhanced care coordination (TrECC)” means a program per RSA 135-F:4, III provided by the care management entity designed to support children, families, and their treatment teams to monitor progress in treatment and to support timely transitions home and into the community.
67. (bo) “Trauma informed care” means treatment and care that realizes the widespread impact of trauma and understands paths for recovery, recognizes the signs and symptoms of trauma in patients, families, and staff, integrates knowledge about trauma into policies, procedures, and practices, and actively avoids re-traumatization. This term includes “trauma-informed approach”.
68. (bp) “Treatment plan” means the residential treatment program’s written, time-limited, goal-oriented, therapeutic plan developed with the child and family by the treatment team which includes the strategies to address the issues that brought the child into placement and is consistent with rehabilitative and restorative services.
69. (bq) “Treatment team” means the individuals outlined in He-C 6350.13 (j) including at a minimum the child, parent(s) or guardian(s), residential treatment program clinical staff, prescribing practitioner, DCYF staff, and CME.

Source. #4442, eff 7-1-88, EXPIRED 7-1-94 New. #6617, eff 10-25-97; ss by #8453, INTERIM, eff 10-25-05, EXPIRED: 4-23-06 New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; amd by #12609, eff 8-23-18; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36