1. (a) Once an applicant has been determined eligible to receive Title XX services and has completed BAAS Form 3000 “Application for Social Services” (June 2025), one or more of the following services shall be authorized by the provider based on the needs identified in the individual’s person-centered plan:

   1. (1) Adult day services;
   2. (2) Home-delivered meals; and
   3. (3) In-home care services.

2. (b) The provider shall complete BAAS Form 3502, “Contract Service Authorization-New Authorization” (June 2025) and submit to:

   Department of Health and Human Services

   Bureau of Data Management

   129 Pleasant Street

   Concord, NH 03301

3. (c) Payment shall not be made to the provider unless BAAS Form 3502, is submitted to data management as indicated above.

Source. #9849-A, eff 1-12-11, EXPIRED: 1-12-19 New. #12720, INTERIM, eff 1-29-19, EXPIRED: 7-29-19 New. #12936, eff 12-7-19 (formerly He-E 501.15); ss by #14298, eff 7-1-25, EXPIRES: 7-1-35