1. Program Definition and Services
Residential Support Services in New Hampshire provide supervised, community-based living arrangements for individuals with intellectual or developmental disabilities, acquired brain disorders, or chronic medical needs. The program aims to maximize independent living capacities within an integrated neighborhood setting, preventing or postponing the need for long-term institutionalization or skilled nursing facility stays. Services include:
- Community Residence Habilitation (1–3 Individuals): Continuous, person-centered supervision, skill training, and health-related assistance delivered within an integrated community home serving no more than three individuals.
- Licensed Group Residential Care (4 or More Individuals): Structured personal care assistance, behavioral management, medication administration, and 24/7 supervision provided within larger licensed group facilities.
2. Regulations
The program is governed by the following regulations:
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New Hampshire Code of Administrative Rules, Part He-M 1001 (Certification Standards for Developmental Services Community Residences)
- New Hampshire Code of Administrative Rules, Part He-M 517 (Medicaid-Covered HCBS for Persons with DD and ABD)
- New Hampshire Code of Administrative Rules, Part He-M 504 (Provider and Provider Agency Operations)
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New Hampshire Revised Statutes Annotated (RSA) Chapter 171-A (Services for People with Developmental Disabilities)
- New Hampshire Code of Administrative Rules, Part He-P 814 (Licensing Standards for Residential Care Facilities, if serving 4 or more individuals)
3. Licensing or Certification
Providers must be certified by the Community Residence Certification Unit within the New Hampshire Department of Health and Human Services (DHHS).
4. Responsible State Agency
The New Hampshire Department of Health and Human Services (DHHS), specifically operating through the Bureau of Developmental Services (BDS) and the Bureau of Elderly and Adult Services (BEAS), is responsible for reviewing applications, authorizing provider settings, and issuing certifications.
5. Application Process
The application process is initiated through regional screening protocols managed by New Hampshire's designated Area Agencies. Once preliminary agency alignment is approved under rule He-M 504, providers submit their digital enrollment application through the electronic New Hampshire Medicaid Provider Portal (NHMMIS.nh.gov).
6. Required Documentation
While specific documentation requirements vary based on the target waiver, providers typically need to submit:
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Proof of compliance with municipal safety and operational codes, including an approved Life Safety Report signed by the local fire department within the last 90 days
- Extensive operational policies and procedures detailing person-centered care models, behavior support tracking, and restrictive procedure bans
- Verifiable staff qualifications, specialized administrative training histories, and valid programmatic references
- Proof of broad general liability and professional medical malpractice liability insurance coverage
7. Timeline for Approval
The exact timeline for approval fluctuates based on agency capacity. Providers should coordinate with their regional geographic Area Agency or the BDS certification unit for detailed updates on current application processing cycles.
8. Pre-Application Process
Prospective providers must complete specific foundation tasks before applying. They must legally form their corporate identity with the New Hampshire Secretary of State, secure an IRS Employer Identification Number (EIN), and register a Type 2 Organizational National Provider Identifier (NPI) configured with residential habilitation taxonomies.
9. Pre-Application Training
The state hosts mandatory administrative and compliance training sessions online. Access details are sent to qualified applicants once preliminary intake documents and local fire safety structural blueprints are logged and approved by state inspectors.
10. Additional Notes
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Providers must ensure that all community residence locations strictly adhere to the state environment guidelines under He-M 1001, including hard-wired fire alarm integration and annual multi-point system checks.
- All direct service personnel, administrative managers, and co-habitating adult household members must clear mandatory multi-tiered background check pools, registry reviews, and fingerprinting validations through IdentoGO.
- Under rule He-M 1201, direct care staff administering medications must complete formal healthcare coordination certifications and annual clinical competency renewals.
- Providers must maintain highly accurate electronic documentation tracking face-to-face service interventions, individualized financial ledger logs, and Individualized Service Agreements (ISA) to support official Medicaid billing structures.
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