1. (a) Residential treatment programs shall develop and document treatment planning for each child in accordance with He-C 6420.

2. (b) Pursuant to RSA 170-G:-4-e, III, the program shall coordinate transition and discharge planning from the day of admission. A discharge plan shall :

   1. (1) Be written and available to the child’s parents or guardians no later than 10 days after the child’s admission to the program;
   2. (2) Begin upon admission to any treatment program and be reflected in ongoing treatment plans and treatment team meetings through the community reintegration and transition tasks;
   3. (3) Include documentation of the identification of the transition resource that the child will be discharged to pursuant to (g)(2)c. below, if known at the time of admission; and
   4. (4) Indicate the child’s identified permanency goal and concurrent goal if provided by DCYF pursuant to (g)(2)c. below.
3. (c) Within 30 days of a child’s admission to a residential treatment program, the program shall conduct a psycho-social assessment with recommendations for treatment and shall incorporate the results and recommendations of any assessments including standard assessments conducted if clinically indicated. A PRTF shall conduct the psycho-social assessment within 14 calendar days of admission.
4. (d) Within 30 days of admission to the residential treatment program, the residential treatment program shall conduct a treatment team meeting and, in accordance with RSA 170-G:4-e, develop a treatment plan which shall be based on the treatment team meeting and recommendations of the psycho-social assessment in (c). A PRTF shall conduct the treatment plan and treatment team meeting within 14 calendar days of admission.
5. (e) For programs that offer short-term programming that serves children 60 calendar days or less, the psycho-social assessment, treatment team meeting, and treatment plan shall be completed within 10 calendar days of the child’s admission.
6. (f) Nursing homes, rehabilitation programs, and independent living programs shall be exempt from the requirements in this section if there are no medicaid covered services being provided under He-C 6420. Nursing and rehabilitation programs shall follow their respective treatment planning and care planning requirements.

7. (g) The treatment plan shall include:

   1. (1) The summary of the psycho-social assessment;

   2. (2) A transitional and discharge section for the child and family that includes:

      1. a. An estimate by the treatment team members of the child’s length of stay, based upon referral information and the residential treatment program’s assessment;
      2. b. For a child in a voluntary episode of treatment, the identification of the family who the child will be returning to; and

      3. c. For a child placement through DCYF, identification of the child’s permanency plan and concurrent plan including the identified resource if known at the time of the treatment plan and provided by DCYF. The permanency plan and concurrent plan shall identify the following:

         1. 1. Reunification with the family;
         2. 2. Adoption;
         3. 3. Guardianship by a relative or other appropriate person; or
         4. 4. Another planned permanent living arrangement (APPLA) in accordance with RSA 169-C:24-b; and

   3. (3) Community reintegration and transition tasks that identify the following:

      1. a. Specific needed supports or services that would provide for the child to successfully transition out of the residential treatment program and into the community;
      2. b. The treatment team member who is responsible for completing the task necessary; and
      3. c. The projected time frame for completion of each task.

8. (h) The treatment plan shall, at a minimum, contain the following domains relating to rehabilitative and restorative services provided by the residential treatment program:

   1. (1) Safety and behavior of the child;
   2. (2) Family;
   3. (3) Medical;
   4. (4) Education, if clinically necessary; and
   5. (5) Adult living preparation if the child meets the requirements of He-C 6350.28 or if determined clinically necessary.

9. (i) Each domain identified in (h) above shall address:

   1. (1) The goals of the child and family, if applicable;
   2. (2) The measurable objectives to be achieved by the child and family;
   3. (3) The time frames for completion of objectives; and

   4. (4) The individualized interventions that will be used to address the objectives, including:

      1. a. Identification of the staff or individual providing or implementing the stated intervention;
      2. b. The frequency of the intervention;
      3. c. How that intervention is documented; and
      4. d. Identification of the medicaid covered services that will be provided directly or arranged for through He-C 6420.

10. (j) The treatment plan shall include the date and signatures of the following team members indicating that they participated in the process:

    1. (1) The child;
    2. (2) The child’s parent or guardian;
    3. (3) A prescribing practitioner from the program as required by He-C 6420;
    4. (4) A representative of DCYF, if applicable;
    5. (5) A representative of the child’s CME, if applicable; and
    6. (6) The clinical coordinator, the residential treatment program’s executive director, or the child’s clinician. If the prescribing practitioner is also the clinical coordinator, they shall indicate both roles and only one signature shall be required.
11. (k) When any of the individuals in (j) above do not participate, the residential treatment program shall document their effort to involve them.
12. (l) Revisions to the treatment plan outside the scheduled treatment plan reviews shall include the signatures of the prescribing practitioner. It shall also include the clinical coordinator or clinician, and other team members identified in (j) above, as available, and shall be explained in writing to any individuals of the team who are unable to participate.
13. (m) The treatment plan shall be implemented by the treatment team and the residential treatment program’s staff and shall be reflected in the child’s daily routine, logs, progress notes, and discharge summary.

14. (n) The treatment team shall consist of the individuals identified in (j) above in addition to the following invited participants:

    1. (1) Clinical staff of the residential treatment program;
    2. (2) Attorney, court appointed special advocate (CASA), and guardian ad litem (GAL) for the child;
    3. (3) A representative of the local educational agency when clinically appropriate; and

    4. (4) Other persons significant in the child’s life, if clinically appropriate, including but not limited to:

       1. a. Teachers;
       2. b. Staff members from the residential treatment program;
       3. c. Counselors;
       4. d. Important connections, or friends;
       5. e. Kin or relatives; and
       6. f. Educational surrogate.

15. (o) Subject to (1) and (2) below, residential treatment programs shall acquire signatures on the treatment plans of individuals identified in (j) above within 7 calendar days of the treatment team meeting:

    1. (1) If the residential treatment program is unable to obtain the signature(s) of the parent(s), guardians(s), CME, or DCYF representative, then the residential treatment program shall document the reasonable efforts made to acquire the signature(s); and
    2. (2) Any team members participating through electronic means, other than the prescribing practitioner or clinical coordinator, may provide verbal assent in lieu of signature on the treatment plan but this shall not preclude efforts identified in (1) above.
16. (p) The treatment plan shall be filed in the child’s record and copies provided to the individuals identified in (j) above.

17. (q) The treatment plan shall be reviewed and updated as necessary by the treatment team at the treatment team meeting, at a minimum as follows:

    1. (1) Three months from the initial treatment plan; and
    2. (2) Every 3 months thereafter until discharge, at no point exceeding 3 months.
18. (r) Changes and updates to the treatment plan per (q) above shall show change over time. The treatment plan shall be made based on progress identified by the treatment team, identified areas of continued treatment needs, and shall include the treatment recommendations of any assessments conducted if clinically indicated. The treatment plan shall show achievement or changes of goals or objectives, and effectiveness or ineffectiveness of interventions. Subsequent treatment plans shall be in accordance with the requirements of (g) through (o) above.
19. (s) Once the treatment plan is completed, all clinical and direct care staff shall receive supervision and instruction to ensure that each child’s treatment plan is consistently implemented.
20. (t) Programs which are independent living shall be exempt from the requirements in this section if there are no medicaid covered services being provided under He-C 6420. Independent living programs shall follow documentation requirements of He-C 6350.16.

21. (u) Nursing homes, and rehabilitation programs shall be exempt from the requirements in this section if there are no medicaid covered services being provided under He-C 6420. They shall follow the requirements of their applicable treatment planning and medicaid rules.

    Source. #6617, eff 10-25-97; ss by #8453, INTERIM, eff

    10-25-05, EXPIRED: 4-23-06

Source. New. #8693, eff 7-27-06; ss by #10759, eff 1-17-15; ss by #14178, INTERIM, eff 1-18-25; ss by #14490, eff 1-22-26, EXPIRES: 1-22-36