1. (a) Services outlined in (c) below shall be provided outside of New Hampshire as follows:

   1. (1) When the only safe and accessible setting is outside of New Hampshire;
   2. (2) Only until a safe and accessible setting is available in New Hampshire or in their community in accordance with (d) below;
   3. (3) The services are approved by the bureau in accordance with (b) below; and
   4. (4) The services are outlined in the individual’s service agreement to reflect the amount, scope, duration, and frequency of the service and the oversight and monitoring of the service agreement.

2. (b) Out-of-state service provisions shall be requested via written request to the bureau and include:

   1. (1) A transition plan with a timeframe for return to New Hampshire;
   2. (2) Verification that the provider agency meets criteria in accordance with He-M 504, He-M 506, He-M 507, and He-M 518, as applicable;
   3. (3) Demonstration that the provider is in good standing through licensing or certification reports from the previous 5 years, or the maximum number available for providers established within the previous 5 years, from any in-state or out-of-state entity, including deficiency reports and compliance records;
   4. (4) A plan articulated in the service agreement to demonstrate how an individual will access acute care as well as ongoing medical and clinical needs that are not covered by the home and community-based waiver; and
   5. (5) A plan articulated in the service agreement for oversight and monitoring of the service plan in accordance with He-M 503 or He-M 522.

3. (c) Services that may be provided out-of-state pursuant to (a)-(b) shall include:

   1. (1) Community participation services;
   2. (2) Residential habilitation;
   3. (3) Supported employment;
   4. (4) Assistive technology;
   5. (5) Community integration services;
   6. (6) Community support services;
   7. (7) Crisis response services;
   8. (8) Environmental and vehicle modification services;
   9. (9) Individual goods and services;
   10. (10) Non-medical transportation;
   11. (11) Personal emergency response services;
   12. (12) Removable prosthodontic services;
   13. (13) Specialty services; and
   14. (14) Wellness coaching.
4. (d) The provisions outlined in (a)-(b) shall not apply when an individual is requesting services in a town outside of New Hampshire that is not more than a 30 minute drive.

Source. #4315, eff 9-25-87; EXPIRED: 9-25-93 New. #6360, eff 10-23-96, EXPIRED: 10-23-04 New. #8195, INTERIM, eff 10-29-04, EXPIRED: 4-27-05 New. #8424, eff 9-1-05; amd by #9370, eff 1-24-09; ss by #10454, eff 10-31-13; ss by #13988, eff 5-30-24