TITLE XII
PUBLIC SAFETY AND WELFARE

Chapter 167
PUBLIC ASSISTANCE TO BLIND, AGED, OR DISABLED PERSONS, AND TO DEPENDENT CHILDREN

Section 167:1

    167:1 Repealed by 1975, 221:2, eff. Aug. 2, 1975. –

Section 167:2

    167:2 Liability for Support; Recovery. – Assistance rendered under this chapter or RSA 161 to anyone having a father, mother, husband or wife, whose weekly income or other resources are more than sufficient to provide a reasonable subsistence compatible with decency and health, may be recovered in an appropriate proceeding in the superior court brought by the commissioner of health and human services, in the name of the state, from either a father, mother, husband, or wife, who are declared jointly and severally liable for such assistance. A parent shall be liable under this section only for assistance provided to a child under the age of 18, or for as long as the department of health and human services has the authority to recover support under Title IV of the Social Security Act. Such action shall be brought by the attorney general or the county attorney for the county in which any such relative resides when so requested by the commissioner of health and human services. Nothing in this section shall affect assistance eligibility or the amount of services for which an applicant or recipient may be eligible.

Source. 1937, 202:9. RL 126:9. 1951, 139:5. RSA 167:2. 1969, 478:1. 1983, 291:1. 1995, 310:176. 2013, 212:1, eff. Jan. 1, 2014.

Section 167:2-a

    167:2-a Employment of Person Receiving Assistance. – If any person receiving assistance under this chapter or RSA 161 is physically able to work, the commissioner of health and human services may require that such a person receiving aid work for the state at any job which the state has available that is within the capacity of the person receiving assistance.

Source. 1965, 321:3. 1983, 291:1, II. 1995, 310:176, eff. Nov. 1, 1995.

Section 167:2-b

    167:2-b Employment of Relatives of Persons Receiving Public Welfare Assistance. – No person who is otherwise eligible for public assistance based on financial need shall receive public welfare assistance from the state unless and until all able-bodied adult persons, under the age of 65 years, except those regularly attending school, related to such person, and regularly residing in the same household as such person, and legally liable to contribute to the support of such person and not prevented from maintaining employment and contributing to the support of such person by reason of physical or mental disability or other substantial or other justifiable cause, are employed on a full-time basis. The amount or amounts earned by the persons obliged to maintain employment hereunder shall be taken into consideration in determining the level of need for public assistance. Nothing in this section shall be so construed to deny to any minor dependent child any needed public assistance to which he or she would be otherwise entitled. Unrelated adult persons living in the same household in loco parentis as to any such person seeking public assistance shall be obliged to contribute to his or her support to the same extent as the parent of such person, and in default thereof, shall be subject to the same penalties as the parent of such person would be in such case. If anything in this section conflicts with federal law or regulation related thereto, the federal law or regulation shall take precedence.

Source. 1969, 451:1. 2010, 136:1, eff. Aug. 13, 2010.

Section 167:2-c

    167:2-c Crossing Picket Lines Not Required. – If any person receiving assistance under this chapter or RSA 161 is physically able to work, he shall not be required by the state or any of its political subdivisions to cross any lawful picket line in connection with any strike, lock-out, or labor dispute to apply for a job.

Source. 1992, 80:1, eff. June 19, 1992.

Section 167:3

    167:3 Compelling Support. – Upon the request of the commissioner of health and human services, any such father, mother, stepfather, stepmother, son, daughter, husband or wife shall provide the support of the person assisted under this chapter or RSA 161, or contribute thereto. Should such relative refuse to comply with such request, the commissioner of health and human services may bring an appropriate proceeding in the superior court in the name of the state to compel such support or contribution thereto. If upon hearing it shall appear that such relative is able to provide the support of such person or to contribute thereto, the court shall enter an order accordingly and shall fix the amount and method and manner of payment. Failure to comply with any such order, without good cause as determined by the court at a hearing, shall be deemed contempt of court and punished accordingly. Such proceedings shall be brought by the attorney general or the county attorney for the county in which any such relative resides when so requested by the commissioner of health and human services.

Source. 1951, 139:6. RSA 167:3. 1973, 111:1. 1983, 291:1. 1995, 310:176, eff. Nov. 1, 1995.

Section 167:3-a

    167:3-a Liability of Grandparents. – Assistance rendered under this chapter or RSA 161 to anyone who is the child born of an unwed minor whose father or mother, grandparent of the child born of an unwed minor, has a weekly income or other resources more than sufficient to provide a reasonable subsistence compatible with decency and health, may be recovered from such grandparent in the same manner and by the same proceedings as provided in RSA 167:2 and 167:3 for recovery from other legally liable relatives.

Source. 1961, 18:1. 1973, 145:3, eff. July 21, 1973.

Section 167:3-b

    167:3-b Responsibility for Public Medical Assistance. – The provisions of RSA 167:2, 3 and 3-a, do not apply to the administration of medical assistance, except with respect to the spouse of the individual who needs medical care or services, or the parent of such individual, if said individual is under the age of 21.

Source. 1965, 223:1. 1967, 396:2. 1973, 151:1. 1977, 355:1. 2000, 156:1. 2011, 224:44, eff. Jan. 1, 2012.

Section 167:3-c

    167:3-c Rulemaking. –
The commissioner of the department of health and human services shall adopt rules under RSA 541-A relative to:
I. Eligibility for assistance under RSA 167:4.
II. Consolidated standards of need, standards of need and payment standards under RSA 167:7, I, I-a, and II.
II-a. Criteria for special needs and emergency assistance programs under RSA 167:7, V.
II-b. The standard of need for residential care facilities under RSA 167:7, I-a no later than November 1, 1988, and on an annual basis thereafter.
III. [Repealed.]
IV. The misuse of lists and records under RSA 167:31.
V. Personal needs allowance under RSA 167:27-b.
VI. Establishing an optional state coverage group under RSA 167:6, VII to provide medical assistance for children under the age of 19 years who are severely disabled.
VII. [Repealed.]
VIII. Implementing the children's health plan under RSA 167:66-68.
IX. The amount of earned income to be disregarded for purposes of calculating eligibility for aid to the permanently and totally disabled.
X. Establishing the income eligibility limit for child day care services that make child care assistance available to families; provided, however, that the income eligibility limit shall be such that at least those families whose gross monthly income is 185 percent or less of the federal poverty guidelines, and who meet all other eligibility requirements, are eligible for child day care services.
XI. The types of data, frequency, and method of reporting which each health carrier shall be required to cross-match with the department under RSA 167:4-b and RSA 420-G:11, II.
XII. The MEAD work incentive program under RSA 167:6, IX and RSA 167:3-i as follows:
(a) Eligibility for the program, including medical need and asset and income limits.
(b) Participant employment requirements.
(c) Premiums to be paid by participants, on a sliding fee scale based on the net income of program participants.
(d) Termination of participation for nonpayment of premium or other good cause.
(e) Requirements that the participant disclose any employer-sponsored health insurance available to the participant.

[Paragraph XII-a effective on the date the commissioner of the department of health and human services certifies approval of the state plan amendment by the Center for Medicare and Medicaid Services.]


XII-a. Administration of the MOAD work incentive program established pursuant to RSA 167:6, IX-a and RSA 167:3-m.
XIII. The administration of the payment of funds for persons eligible to receive nursing home services. Prior to the submission of proposed rules under RSA 541-A, such rules shall be submitted for review by the county-state finance commission under RSA 28-B.
XIV. [Repealed.]
XV. Procedures for making the home visiting program available to all Medicaid eligible pregnant women, infants, and families with children up to age one pursuant to RSA 167:68, II(e).
XVI. Telehealth services under RSA 167:4-d.

Source. 1983, 242:6; 291:1, II. 1985, 394:1. 1987, 328:4. 1988, 272:1; 289:1. 1992, 111:3; 286:1. 1993, 358:55, 60. 1994, 403:8, I. 1995, 310:32. 1997, 297:1. 1999, 318:2. 2001, 67:3. 2003, 223:7. 2004, 251:8. 2007, 288:2. 2008, 76:2. 2011, 224:321, II, eff. July 1, 2011; 272:1, eff. Jan. 13, 2012. 2017, 156:65, I, eff. July 1, 2017. 2019, 285:2, eff. Sept. 17, 2019; 321:2, eff. Oct. 11, 2019; 346:362. 2021, 91:419, eff. July 1, 2021.

Section 167:3-d

    167:3-d Repealed by 1994, 403:8, II, eff. June 10, 1994. –

Section 167:3-e

    167:3-e Home Care for Children With Severe Disabilities. –
I. If a child is enrolled in the medical assistance program that provides home care for children with severe disabilities, the commissioner shall assist the child's parent or guardian to recover costs for medical care and services under any private health insurance available to the child.
II. The department of health and human services may acquire adaptive equipment and other specialized home health care assets for the purpose of loaning such equipment to participants in the medical assistance program that provides home care for children with severe disabilities. The department shall have authority to contract for the refurbishment of such equipment, to reissue equipment returned to the department, and to dispose of any equipment that is no longer useful.
III. To be eligible for home care for children with severe disabilities, a child shall, at a minimum, have an impairment or combination of impairments that meets, medically equals, or functionally equals the criteria for an impairment as listed in 20 CFR, Part 404, Subpart P, App. 1.
IV. A child who has been determined to meet the requirements of institutional level of care shall receive services to the extent the estimated cost of care outside an institution is no higher than the estimated medicaid cost of appropriate institutional care.

Source. 2004, 251:2, eff. June 15, 2004.

Section 167:3-f

    167:3-f Home Care for Children With Severe Disabilities; Recipient Eligibility. –
I. In this section:
(a) "Active treatment program" means an aggressive, consistent implementation of specialized and generic training, treatment, health, and related services directed toward:
(1) The acquisition of the behaviors necessary for the child to function with as much self-determination and independence as possible; and
(2) The prevention or slowing of deterioration of the ability to function.
(b) "Family centered community-based home care" means an organized network of integrated and coordinated services delivered at the local level which promotes normal patterns of living and which recognizes the pivotal role of families with respect to the provision of services for their children.
(c) "Cost effective" means the estimated medicaid cost of care outside an institution is no higher than the estimated medicaid cost of appropriate institutional care.
II. The purpose of family centered community-based home care shall be to support but not supplant the child's family as the primary caregiver.
III. To be eligible for medical assistance for home care of certain children with severe disabilities, the child shall, in addition to the eligibility criteria in RSA 167:3-e:
(a) Reside in a place maintained as the child's home community.
(b) Be able to receive services in the home as defined in 45 CFR 233.90(c)(1)(v)(B).
(c) Meet the program criteria as described in section 1902(e)(3) of the Social Security Act.
(d) Meet the recipient criteria of He-W 641.04, except that, pursuant to the prohibition in section 1614(f)(2)(B) of the Social Security Act, rules requiring the deeming of parental income shall not apply.
(e) Meet the following medical criteria:
(1) Is chronically ill or impaired, whose illness or disability does not require the level of care provided in an inpatient facility, but whose condition requires ongoing and regular medical monitoring and treatment; and
(2) Has a severe disability which includes at least one of the following:
(A) A developmental disability as defined in RSA 171-A:2, V.
(B) A chronic, degenerative, progressive, or life-threatening condition causing impairment of a vital organ function which requires ongoing and regular medical monitoring.
(C) A sensory impairment which is expected to continue indefinitely, including a hearing loss established by audiometry which functionally impacts the child.
(D) A mental illness, emotional disturbance or behavioral disorder which functionally impacts his or her psychosocial adjustment and the diagnosis for which is recognized by the American Psychiatric Association.
(E) An acquired childhood disease which functionally impacts the child.
(F) A genetic disorder or congenital anomaly requiring ongoing medical monitoring.
(f) Require the same degree of care that is typically provided in a hospital, psychiatric hospital, nursing facility, or intermediate care facility as specified in RSA 167:3-g.
IV. In addition to the eligibility requirements described in paragraph II, the services proposed for the child shall be:
(a) Medically appropriate, as determined by the joint medical review team in accordance with paragraphs V and VI; and
(b) Cost effective as determined by the department in accordance with RSA 167:3-e, IV.
V. The joint medical review team, upon certification by the child's physician, shall determine if it is medically appropriate, in accordance with paragraph VI, for the child to receive family centered community-based home care as opposed to institutional care.
VI. The joint medical review team shall determine that family centered community-based home care is medically appropriate if each of the following conditions are met:
(a) The care can be provided in the home without jeopardizing the medical needs of the child.
(b) Medical and psychological support services are available in the community.
(c) The child's treating physician recommends home care and certifies the safety of home placement.
(d) The child's family or guardian has expressed a willingness and desire to assume responsibility as the primary caregiver for the child in order to maintain the child at home.
(e) The family and household members have been trained to support the child's needs in the home and have the ability to be primary caregivers.

Source. 2005, 181:2. 2008, 52:5, eff. July 11, 2008.

Section 167:3-g

    167:3-g Degree of Care. –
I. In this section, "degree of care" means the level of intensity or extent of medical care, treatment, or intervention required by the child as determined by the medical setting in which the child is being evaluated.
II. In order to determine the most appropriate degree of care under which to evaluate the child, the joint medical review team shall review:
(a) The child's medical condition.
(b) The child's community care needs.
III. The joint medical review team shall determine that the degree of care provided by a hospital is appropriate for the child if the following criteria are met:
(a) The child requires hospitalization for an indefinite period of time; and
(b) Either of the following are met:
(1) The child requires a complex care schedule and the use of sophisticated equipment designed to alert caregivers to potential life-threatening problems; or
(2) The child has the constant potential for aspiration, respiratory obstruction or arrest, and/or other life threatening complications requiring the need for prompt, recurrent, skilled interventions to sustain life.
IV. The joint medical review team shall determine that the degree of care provided by a psychiatric hospital is appropriate for the child if all of the following criteria are met:
(a) The child meets the definition of a child with a serious emotional disturbance established by Department of Health and Human Services Notice, dated May 20, 1993, 58 Federal Register 29422 (1993).
(b) The child has specific symptoms and functional impairments that require professional and community interventions.
(c) The child has problems of a chronic and severe nature requiring an intensive amount of professional supervision which are determined by an inability to function in each of the following major life areas:
(1) Family relations.
(2) Interpersonal and/or social skills.
(3) Educational and/or vocational skills.
V. The joint medical review team shall determine that the degree of care provided by a nursing facility is appropriate for the child if any one of the following criteria are met:
(a) The child is dependent on technologically sophisticated medical equipment such as, but not limited to, ventilators, gastrostomy tubes, or central venous lines to sustain life.
(b) The child requires observations or judgments more than once per hour throughout a 24-hour period or continuously, to maintain health status.
(c) The child requires direct interventions from skilled nursing or skilled rehabilitative professionals to maintain health status.
(d) The child is dependent daily on less sophisticated medical equipment such as, but not limited to, catheters, nebulizers, or oxygen to sustain life.
(e) The child requires observations and judgments less often than once per hour and not less often than once every 3 hours throughout the 24-hour period to maintain health status.
(f) The child requires basic nursing and rehabilitative interventions under the direction and supervision of skilled nursing or skilled rehabilitative professionals.
VI. The joint medical review team shall determine that the degree of care provided by an intermediate care facility is appropriate for the child if each of the following criteria are met:
(a) The child has a developmental disability as defined in RSA 171-A:2, V.
(b) The child requires a continuous and pervasive active treatment program throughout the child's daily routine.
(c) There is a need for the continuity of treatment to and from all home and community-based settings.
(d) Either of the following are met:
(1) The child requires continuous medical monitoring for a chronic severe health problem; or
(2) The child requires continuous supervision, monitoring, and redirection of behaviors associated with any condition, related to an intellectual disability, that results in impairment of general intellectual functioning or adaptive behavior.

Source. 2005, 181:2. 2008, 52:6, 7, eff. July 11, 2008.

Section 167:3-h

    167:3-h Coverage of Services and Items Under the Medical Assistance Program. –
I to III. [Repealed.]
IV. Medical assistance shall include coverage for disposable incontinence supplies under the Medicaid state plan for individuals who have a medical condition resulting in incontinence, as documented by a physician.

Source. 2007, 288:1. 2011, 224:321, I, eff. July 1, 2011.

Section 167:3-i

    167:3-i MEAD Work Incentive Program. –
I. Pursuant to section 1902(a)(10)(A)(ii)(XV) of the Social Security Act, 42 U.S.C. section 1396a(a)(10)(A)(ii)(XV), the department of health and human services shall establish and administer a work incentive program, known as Medicaid for employed adults with disabilities (MEAD). The purpose of the program shall be to ensure the availability of long-term supports to workers with disabilities who are medically eligible for Medicaid, enabling them to maximize their employment potential and financial independence and prevent impoverishment and dependence upon cash assistance programs.
II. In addition to the requirements of RSA 167:6, IX, the MEAD program shall:
(a) Exclude from consideration resources accumulated from earnings, including interest earned by the resource, by a MEAD-eligible individual beginning on or after the date of eligibility through the period of MEAD eligibility and kept in a separate account from other resources, when determining future eligibility for other medical assistance programs.
(b) Provide continued eligibility during periods of temporary unemployment provided that the individual is unable to work for medical reasons but is likely to return to work, or the individual becomes unemployed for other good cause and is actively seeking employment.
(c) Define employment for eligibility purposes in a manner that permits a self-employed individual to earn less than the federal minimum wage.
(d) Permit individuals who are eligible for home and community-based care waiver services and who qualify for a special income limit, to receive medical assistance through the MEAD program, if they so choose, even if their total income is between the standard of need and the special income limit.
(e) Provide notice and an opportunity for a fair hearing in the event of any adverse action affecting eligibility for or enrollment in the MEAD program.
(f) Establish oversight and enforcement procedures to prevent fraud and to assure that participants are consistently engaging in gainful employment.

Source. 2008, 76:3, eff. July 20, 2008.

Section 167:3-j

    167:3-j Aid to the Permanently and Totally Disabled; Duration of Impairment. –
I. The department of health and human services may change the minimum duration of impairment for aid to the permanently and totally disabled (APTD) from 48 months to 12 months upon approval of the fiscal committee of the general court, under the following conditions:
(a) This change results in a net general fund cost savings.
(b) Eligibility for APTD shall be based on a determination of disability as defined in Title II, Social Security Disability Insurance (SSDI), and Title XVI, Supplemental Security Income (SSI), of the Social Security Act, as amended.
(c) A determination of disability by the Social Security Administration or any other federal agency, including the Railroad Retirement Board, using the SSI and SSDI criteria, shall constitute a determination of disability for purposes of APTD.
(d) Applicants for APTD cash assistance shall be recipients of SSI, if eligible therefor.
(e) For persons applying for APTD and SSI, eligibility for both programs shall be determined using the medical and financial eligibility criteria of the SSI program, through a single disability determination process.
(f) As of the date the department implements the 12-month standard and other provisions of this paragraph, all persons who have been determined by the department to be disabled under the 48-month durational standard and are eligible for APTD and who have not been determined to be disabled by the Social Security Administration or other federal agency using the SSI/SSDI standard, shall remain eligible for APTD if they have active and pending applications for or appeals of denials of SSI, SSDI, or any other federal program utilizing the SSI/ SSDI standard, through the level of the Social Security Appeals Council, provided they meet all other eligibility criteria.
(g) Applicants shall have all appeal rights provided in state and federal law.
II. The commissioner of health and human services is authorized to enter into agreements with agencies of the state or federal government to administer any or all parts of the aid to the permanently and totally disabled (APTD) program, including an agreement with the Social Security Administration in accordance with section 1634(a) of the Social Security Act, to the extent such agreements would allow for more cost effective or efficient administration of the program. The department shall implement the most cost-effective organizational and management structure and operational processes, with prior approval of the fiscal committee of the general court, which may include organizational and contractual changes including management responsibility for SSI and SSDI eligibility determinations.
III. [Repealed.]

Source. 2009, 144:284. 2012, 247:20, eff. Aug. 17, 2012. 2021, 122:43, V, eff. July 9, 2021.

Section 167:3-k

    167:3-k Medicaid to Schools For Medical Services Program. –
I. The department of health and human services Medicaid reimbursement program shall be known as the "Medicaid to schools for medical services" program, providing medical assistance for covered services furnished to children in public schools who are enrolled in Medicaid. The purpose of the program is to seek any and all Medicaid reimbursement for medical or health-related services provided by local school districts and school administrative units to children which are reimbursable under federal law. General fund dollars allocated to the department of health and human services shall not be used for matching the federal financial participation for Medicaid reimbursement. All matching dollars for Medicaid to schools medical services shall come from the local school districts or school administrative units. The program shall be voluntary and administered by the department in the same, or similar, manner as the Medicaid to schools program established in RSA 186-C:25. This section shall not be construed to increase school district responsibility or liability beyond what is required by other state or federal law.
II. A reimbursable service under this section shall be:
(a) A covered New Hampshire Medicaid state plan service determined by a Medicaid qualified provider to meet accepted standards of medical practice for the service, or such other necessary health care, diagnostic services, treatment, and other measures described in section 1905(a) of the Social Security Act through the Early and Periodic Screening Diagnosis and Treatment (EPSDT) benefit if medically necessary, meaning that the item or service is reasonably calculated to prevent, diagnose, correct, cure, alleviate or prevent the worsening of conditions that endanger life, cause pain, result in illness or infirmity, threaten to cause or aggravate a handicap, or cause physical deformity or malfunction, and no other equally effective course of treatment is available or suitable for the student/individual requesting the medically necessary service;
(b) Provided to a Medicaid enrolled child after obtaining parental consent;
(c) Provided by a Medicaid qualified provider; and
(d) Provided in compliance with applicable state and federal law and rules.
III. Any provider who orders, refers, prescribes, renders, or provides services under this section shall do so in accordance with the relevant health professional practice act and regulations, including, but not limited to, RSA 137-F, 317-A, 326-B, 326-C, 326-E, 326-F, 326-H, 327, 328-A, 328-D, 328-F, 329, 329-B, 330-A, and 330-C.
(c) Include services delivered through telehealth, as defined in RSA 167:4-d.
IV. The commissioner of the department of health and human services, after consultation with the commissioner of the department of education, shall adopt rules, pursuant to RSA 541-A, relative to:
(a) Further defining services eligible for Medicaid reimbursement under this section. In defining such services, the commissioner shall, to the extent practicable, seek to maximize the availability of federal financial assistance to local school districts and school administrative units.
(b) State plans and reimbursement procedures necessary for local school districts or school administrative units to receive appropriate Medicaid reimbursement for eligible services under paragraph II that are provided or paid for by school districts or school administrative units.
(c) Monitoring mechanisms to ensure that services provided under this section meet the requirements of paragraph II. Monitoring responsibilities shall be consistent with the jurisdiction of the different departments.
(d) A financial mechanism by which the federal mandatory matching requirement is met through collection, or other means, of 50 percent of the cost of allowable services from local school districts and/or school administrative units.
V. New Hampshire local school districts or school administrative units shall be the enrolled Medicaid providers for the purpose of administration and billing.

Source. 2017, 187:1, eff. Aug. 28, 2017. 2020, 6:3, eff. Mar. 9, 2020; 27:33, eff. July 21, 2020.

Section 167:3-l

    167:3-l Home and Community-Based Behavioral Health Services for Children. –
I. The department shall establish a Medicaid home and community-based behavioral health services program for children with severe emotional disturbances whose service needs cannot be met through traditional behavioral health services. The department may establish such services through a state plan amendment as provided in Section 1915(i) of the Social Security Act or a waiver under other provisions of the Act, as needed. If the department proceeds with a waiver, it shall not limit the geographic availability of services.
II. Such services shall include the following services or their functional equivalent:
(a) Wraparound care coordination.
(b) Wraparound participation.
(c) In-home respite care.
(d) Out-of-home respite care.
(e) Customizable goods and services.
(f) Family peer support.
(g) Youth peer support.
III. Mobile crisis response and stabilization services for children under 21 shall be provided and delivered using system of care values and principles in compliance with RSA 135-F.
(a) The department shall contract with one or more third-party entities to ensure that all children in the state under 21 years of age have access to mobile crisis response and stabilization services, that such services are available with a response time of no more than one hour, and that such services are available in every part of the state.
(b) The department shall ensure the development of a performance measurement system for monitoring quality and access to mobile crisis response and stabilization services.
(c) All providers of mobile crisis response and stabilization services shall coordinate with the child's wraparound care coordinator, primary care physician, and any other care management program or other behavioral health providers providing services to the youth throughout the delivery of the service.
(d) Development and procurement of the mobile crises and stabilization services required under this section shall begin on the effective date of this section; implementation shall occur upon completion of the procurement process and approval by the governor and council.

Source. 2017, 156:202, eff. Jan. 1, 2018. 2019, 44:5, eff. June 3, 2019; 346:333, eff. July 1, 2019.

Section 167:3-m


[RSA 167:3-m effective on the date the commissioner of the department of health and human services certifies the approval of the state plan amendment by the Centers for Medicare and Medicaid Services.]
    167:3-m MOAD Work Incentive Program. –
I. Pursuant to section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act, 42 U.S.C. section 1396a(a)(10)(A)(ii)(XIII), the department of health and human services shall establish and administer a work incentive program, known as Medicaid for employed older adults with disabilities (MOAD). The purpose of the program shall be to ensure the availability of long-term supports to workers age 65 and older with disabilities who are medically eligible for Medicaid, enabling them to maximize their employment potential and financial independence and prevent impoverishment and dependence upon cash assistance programs.
II. In addition to the requirements of RSA 167:6, IX-a, the MOAD program shall:
(a) Exclude from consideration resources accumulated from earnings, including interest earned by the resource, by a MOAD-eligible individual beginning on or after the date of eligibility through the period of MOAD eligibility and kept in a separate account from other resources, when determining future eligibility for other medical assistance programs.
(b) Provide continued eligibility during periods of temporary unemployment provided that the individual is unable to work for medical reasons but is likely to return to work, or the individual becomes unemployed for other good cause and is actively seeking employment.
(c) Define employment for eligibility purposes in a manner that permits a self-employed individual to earn less than the federal minimum wage.
(d) Permit individuals who are eligible for home and community-based care waiver services and who qualify for a special income limit, to receive medical assistance through the MOAD program, if they so choose.
(e) Provide notice and an opportunity for a fair hearing in the event of any adverse action affecting eligibility for or enrollment in the MOAD program.
(f) Establish oversight and enforcement procedures to prevent fraud and to assure that participants are consistently engaging in gainful employment.
III. Pursuant to section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act, 42 U.S.C. section 1396a(a)(10)(A)(ii)(XIII), individuals shall be eligible for MOAD if their income does not exceed 250 percent of the federal poverty level, and they meet all criteria for receiving benefits under the Supplemental Security Income (SSI) program.

Source. 2019, 346:361.

Section 167:4

    167:4 Eligibility for Assistance. –
I. Public assistance, including medical assistance and food stamps, shall be granted under this chapter or RSA 161 to any eligible person as defined in RSA 167:6 or RSA 161 who has not sufficient income or other resources to provide a reasonable subsistence compatible with decency and health and may be granted to anyone who is an inmate of a public institution, including a patient in a public medical institution which meets the federal or state standards and is so certified by the appropriate state and federal agency, except that:
(a) In the determination of sufficiency of income and resources, the commissioner of the department of health and human services may disregard such income and resources as may be permitted by the Social Security Act of the United States, as amended, and by the Food Stamp Act of the United States, as amended.
(b) In the case of an applicant for public assistance or medical assistance who has made an assignment or transfer of assets to an individual for less than fair market value within 60 months or in the case of transfers of real estate, or transfers of assets to a trust or portions of a trust that are treated as assets disposed of by the individual within 60 months immediately preceding the date of application or while the application is pending, or in the case of a recipient of public assistance or medical assistance who makes such an assignment or transfer while in receipt of the assistance, the assistance sought shall only be granted or continue to be granted in accordance with rules establishing restrictions and eligibility criteria for such cases as adopted by the commissioner of the department of health and human services under RSA 541-A, subject to applicable federal regulations and waiver approval, if any, and review by the oversight committee on health and human services, established in RSA 126-A:13. The oversight committee on health and human services shall make a report to the legislative fiscal committee which shall have final approval authority.
(c) Public assistance, medical assistance, or food stamps shall not be granted to an applicant, or continue to be granted to a recipient, who has refused to accept suitable employment, in accordance with rules adopted by the commissioner of the department of health and human services under RSA 541-A, subject to federal regulations when applicable.
II, III. [Repealed.]
III-a. Pursuant to section 1917(c)(2)(D) of the federal Social Security Act and the Deficit Reduction Act of 2005, Public Law 109-171, section 6011(d), a transfer of asset penalty shall not be imposed if the penalty would result in an undue hardship to the transferor under any of the following conditions:
(a) The asset was transferred by an agent or authorized representative and it can be demonstrated and documented that the individual lacked the mental capacity to comprehend the disqualifying nature of the act; and
(1) A written and signed statement by a licensed physician states that the individual was mentally incapacitated at the time of the transfer; or
(2) An order of findings from a probate court concerning the individual's competency is provided to the district office.
(b) Application of the penalty would deprive the individual of necessary care such that his or her health or life would be endangered.
(c) Application of the penalty would deprive the individual of food, clothing, shelter, or other necessities of life.
IV. (a) It is hereby found and determined by the general court that the medicaid eligibility laws of this state are in need of amendment to assure that otherwise ineligible individuals are prevented from artificially impoverishing themselves to receive benefits to which they are not otherwise entitled and to facilitate recovery of improperly obtained benefits and to assure the fiscal integrity of the funds appropriated for medicaid.
(b)(1) Notwithstanding any provision of law to the contrary and consistent with section 1917(e) of the Social Security Act as amended by the Deficit Reduction Act of 2005, (DEFRA), Public Law 190-171, for purposes of Medicaid eligibility, investment in annuities shall be limited to those annuities that:
(A) Are actuarially sound as measured against the Social Security Administration Life Expectancy tables as amended;
(B) Provide equal or nearly equal payments for the duration of the device and which exclude "balloon" style final payments; and
(C) Provide state of New Hampshire secondary or contingent beneficiary status ensuring payment if the individual predeceases the duration of the annuity, in an amount equal to the medicaid expenditure made by the state of New Hampshire on the individual's behalf.
(2) All such annuities owned by the applicant or the applicant's spouse shall be disclosed to the department at the time of the application.
(c) Notwithstanding any provision of law to the contrary, for purposes of medicaid eligibility, investment in life insurance policies with cash surrender value in excess of $1,500 shall be limited to policies that ensure payment to the state of New Hampshire of all the proceeds of the policy in excess of amounts spent on burial up to the total of medicaid expenditures made on behalf of the individual.
(d) Pursuant to section 1917(b)(1) of the Social Security Act as amended by DEFRA, the commissioner shall submit a state plan amendment establishing a long-term care partnership recognizing the investment in long-term care insurance policies by Medicaid applicants by disregarding resources or assets in an amount equal to the insurance benefit payments that are made to or on behalf of an individual who is a beneficiary under a long-term care insurance policy which meets the criteria described in DEFRA and regulations promulgated thereunder. The estates of recipients of medical assistance for institutional level of care for whom the resource ceiling has been adjusted as described in this subparagraph, shall be exempt from recovery pursuant to RSA 167:13 and RSA 167:14 in an amount equal to the insurance benefit payments received.
(e) The commissioner of the department of health and human services shall adopt rules, pursuant to RSA 541-A, relative to the proper administration of this paragraph.
V. Distributions of the income or principal, or both, of a special needs trust to or for the benefit of the disabled beneficiary shall be disregarded for income eligibility purposes of all categories of public medical assistance to the same extent that such distributions are disregarded for purposes of Title XVI of the Social Security Act. Funds expended by a trustee of a special needs trust to purchase or maintain assets owned by the trustee in his or her capacity as trustee of the trust shall also be disregarded for such income eligibility purposes. For the purposes of this paragraph "special needs trust" means any trust established by a third party for the sole benefit of an individual who is considered disabled under the provisions of section 1614(a)(3) of the Social Security Act, and any trust funded with the resources of such an individual and complying with the provisions of section 1917(d)(4) of such Act.

Source. 1937, 202:10. RL 126:10. 1951, 139:7. 1953, 87:1. RSA 167:4. 1961, 50:1. 1965, 154:1. 1967, 396:3. 1975, 29:1; 445:1. 1979, 212:1. 1981, 305:1. 1983, 288:1; 291:1, II. 1986, 183:3. 1989, 16:1. 1994, 237:1. 1995, 310:40, 170, VIII. 2003, 154:1. 2005, 175:4, 5. 2006, 278:2-4. 2007, 166:1, eff. Nov. 1, 2007; 193:1, eff. Aug. 17, 2007.

Section 167:4-a

    167:4-a Financial Disclosure by Applicants and Recipients. –
I. Notwithstanding the provisions of RSA 359-C or any other law to the contrary, any person who is an applicant for or recipient of any public assistance shall, by his application for such assistance, or by his continued acceptance of such benefits, whether requested or obtained directly or through another person acting on his behalf, be deemed to have authorized disclosure of his financial records to the department of health and human services, by financial institutions and by clearinghouses which disseminate financial record information.
II. The commissioner is hereby authorized to request and receive from any bank, trust company, savings and loan association, credit union, or other financial institution doing business in this state the financial records of any applicant for or recipient of medical assistance whose eligibility for medical assistance is based upon the applicant's or recipient's age, blindness, or disability. The institution shall furnish the information specified in paragraph VI within 15 days of the department's request.
III. The department or any financial institution that discloses financial records under this section shall not be subject to civil liability or criminal prosecution which is based upon its disclosure under this section, or for any other action taken in good faith to comply with the requirements of this section.
IV. [Repealed.]
V. Any records established or information collected pursuant to the provisions of this section shall be made available only to the commissioner and his or her authorized designee, and the applicant or recipient, and his or her authorized representative as authorized by the rules of the department. Such records and information shall be available and used only for purposes directly connected with the determination and verification of eligibility for medical assistance for applicants and recipients whose eligibility for medical assistance is based upon the applicant's or recipient's age, blindness, or disability. The records and information made available to the applicant or recipient, or his or her authorized representative shall not include information provided to the department that is prohibited from release by federal law, state statute, state case law, or by contract or agreement between the department and another entity if such contract or agreement prohibits release of such information.
VI. The department, in coordination with financial institutions doing business in the state, may develop and operate a data match system, using automated data exchanges to the maximum extent feasible, in which each financial institution is required to provide, when requested by the department and subject to reasonable reimbursement as set forth in Public Law 110-252, up to 5 years of information regarding the name, record address, social security number or other taxpayer identification number, monthly account balance, and other identifying information for each applicant or recipient who maintains an account at the financial institution, as identified by the department by name and social security number or other taxpayer identification number. The system shall be based on a cost-effective search algorithm and shall include means to assure compliance with the provisions of this section.
VII. In this section, "financial institution", except as otherwise provided in 12 U.S.C. section 3414, means any office of a bank, savings bank, card issuer as defined in 15 U.S.C. section 1602(n), industrial loan company, trust company, savings association, building and loan, or homestead association, including cooperative banks, credit union, or consumer finance institution, located in any state or territory of the United States, the District of Columbia, Puerto Rico, Guam, American Samoa, or the Virgin Islands.

Source. 1983, 136:1; 291:1. 1995, 310:181, 182. 2004, 251:7. 2008, 342:2. 2010, 308:1, 2, eff. Sept. 11, 2010. 2021, 122:45, eff. July 9, 2021.

Section 167:4-b

    167:4-b Health Carrier Disclosure of Third Party Liability. –
I. In this section, "health carrier" means a health carrier as defined in RSA 420-G:2 and any health insurer; administrator of self-insured plans, group health plans, as defined in section 607(1) of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. section 1167(1), and service benefit plans; any third party administrator of health benefits, provider of health benefits under an ERISA plan, or provider of health benefits under a self administered plan; health management organizations, health service corporations, managed care organizations, pharmacy benefit managers, or other parties that are, by statute, contract, or agreement, legally responsible for payment of a claim for a health care item or service.
II. Each health carrier shall electronically cross-match claims data, policyholder, and subscriber information with the department of health and human services to provide health insurance coverage information, for third party liability purposes, regarding medical assistance recipients and applicants for medical assistance under RSA 167 in accordance with rules adopted by the commissioner of health and human services pursuant to RSA 167:3-c.
III. Such electronic cross-match shall be made by any health carrier upon certification by the department of health and human services that all persons identified on the electronic medium are applicants for or recipients of medical assistance for which the department seeks payment or reimbursement through third party liability. A health carrier shall limit the transfer of electronic cross-match information required under this section to a list of medical assistance recipients and applicants for medical assistance under RSA 167 provided to the health carrier by the department of health and human services.
IV. Any health carrier who supplies information in accordance with this section and with rules adopted under RSA 167:3-c shall have immunity from any civil or criminal liability that might otherwise be imposed or incurred.
V. Each health carrier shall:
(a) Accept the state's right of recovery and assignment to the state of any right of an individual or other entity to payment from the party for an item or service for which payment has been made under the state plan.
(b) Respond to any inquiry by the state regarding a claim for payment for any health care item or service that is submitted not later than 3 years after the date of the provision of such health care item or service.
(c) Not deny a claim submitted by the state solely on the basis of the date of submission of the claim, the type or format of the claim form, or a failure to present proper documentation at the point-of-sale that is the basis of the claim, if:
(1) The claim is submitted by the state within the 3-year period beginning on the date on which the item or service was furnished; and
(2) Any action by the state to enforce its rights with respect to such claim is commenced within 6 years of the state's submission of such claim.
VI. A health carrier may not refuse to furnish payment, benefits, or services to an individual or refuse to enroll an individual based upon the individual's eligibility for medical assistance under Title XIX of the Social Security Act.

Source. 1999, 318:3. 2004, 251:6. 2008, 342:1, eff. Sept. 5, 2008.

Section 167:4-c

    167:4-c Income and Identity Verification System. –
I. The department shall enter into a contract with a vendor to identify, investigate, and resolve potential cases of fraud, misrepresentation, or inadequate documentation prior to determining an applicant's eligibility for assistance under this chapter and RSA 161. The procedures shall ensure that every case is reviewed. Each review shall include utilization of the income and identity verification system established under this section.
II. Payment to the vendor for services provided in this section shall be contingent upon annualized savings realized from implementation of the program, as agreed upon by the commissioner and the vendor.
III. The department shall contract with a vendor to establish a computerized income and identity eligibility verification system in order to verify eligibility, eliminate duplication of assistance, and deter fraud.
IV. Prior to awarding or continuing assistance under this chapter or RSA 161, the department may contract with a vendor, to the extent such databases are available, to match the name, date of birth, and social security number of each applicant and recipient against the following:
(a) Employer quarterly reports of income and unemployment insurance payment information maintained by the department of employment security.
(b) Earned income information maintained by the Social Security Administration.
(c) Immigration status information maintained by the United States Citizenship and Immigration Services.
(d) Death register information maintained by the Social Security Administration.
(e) Prisoner information maintained by the Social Security Administration.
(f) Public housing and Section 8 housing assistance payment information maintained by the Department of Housing and Urban Development.
(g) National fleeing felon information maintained by the Federal Bureau of Investigation.
(h) Wage reporting and similar information maintained by states contiguous to this state.
(i) Beneficiary records and earnings information maintained by the Social Security Administration in its Beneficiary and Earnings Data Exchange (BENDEX) database.
(j) Earnings and pension information maintained by the Social Security Administration in its Beneficiary Earnings Exchange Record System (BEERS) database.
(k) Employment information maintained by the department of employment security in its new hire directory database.
(l) Employment information maintained by the United States Department of Health and Human Services in its National Directory of New Hires database.
(m) Supplemental Security Income information maintained by the Social Security Administration in its State Data Exchange (SDX) database.
(n) Veterans' benefits information maintained by the United States Department of Health and Human Services, in coordination with the department of health and human services and the Department of Veterans Affairs, in the federal Public Assistance Reporting Information System (PARIS) database.
(o) Child care services information maintained by the department of health and human services under its child care assistance program.
(p) Utility payments information maintained by the department of energy under the fuel assistance program.
(q) A database which is substantially similar to or a successor of a database established in this section.
(r) A database of all persons who currently hold a license, permit, or certificate from a state agency.
V. Prior to awarding or continuing assistance under this chapter or RSA 161, the department shall match the name, date of birth, and social security number of each applicant and recipient against the following public records:
(a) A nationwide public records data source of physical asset ownership such as real property, automobiles, watercraft, aircraft, and luxury vehicles.
(b) A nationwide public records data source of incarcerated individuals.
(c) A comprehensive public records database that identifies potential identity fraud or identity theft that can closely associate name, social security number, date of birth, phone, and address information.
VI. If a discrepancy results between an applicant's or recipient's social security number and one or more of the databases or information tools listed under paragraph IV or V, the department shall review the applicant's or recipient's case using the following procedures:
(a) If the information discovered under paragraph IV and V does not result in the department finding the applicant or recipient ineligible for assistance under this section, the department shall take no further action.
(b) If the information discovered results in the department finding the applicant or recipient ineligible for assistance, the applicant or recipient shall be given an opportunity to explain the discrepancy. The department shall provide written notice to the applicant or recipient which shall describe in sufficient detail the circumstances of the discrepancy, the manner in which the applicant or recipient may respond, and the consequences of failing to take action. The applicant or recipient shall have 10 business days to respond in an attempt to resolve the discrepancy. The explanation provided by the recipient or applicant shall be given in writing. After receiving the explanation, the department may request additional documentation if it determines that there is a substantial risk of fraud.
(c) If the applicant or recipient does not respond to the notice, the department shall deny assistance for failure to cooperate, in which case the department shall provide notice of intent to discontinue assistance. Eligibility for assistance shall not be reestablished until the discrepancy has been resolved.
(d) If an applicant or recipient responds to the notice and disagrees with the findings of the match between his or her social security number and one or more databases or information tools listed under this section, the department shall reinvestigate the matter. If the department finds that there has been an error, the department shall take immediate action to correct it and no further action shall be taken. If, after an investigation, the department determines that there is no error, the department shall determine the effect on the applicant's or recipient's case and take appropriate action. Written notice of the department's action shall be given to the applicant or recipient.
(e) If the applicant or recipient agrees with the findings of the match between the applicant's or recipient's social security number and one or more databases or information tools listed under this section, the department shall determine the effect on the applicant's or recipient's case and take appropriate action. Written notice of the department's action shall be given to the applicant or recipient. In no case shall the department discontinue medical assistance coverage as a result of a match between the applicant's or recipient's social security number and one more databases or information tools listed under this section until the applicant or recipient has been given notice of the discrepancy and the opportunity to respond.
(f) The applicant or recipient shall have an opportunity for a fair hearing in the event of any adverse action affecting eligibility for assistance under this chapter or RSA 161.
VII. The department may contract with third party entities to perform the review of such enrollees as authorized under this section or to provide information to facilitate such reviews.
VIII. The department shall, pursuant to RSA 541-A, adopt any rules necessary to implement this section.

Source. 2012, 271:1, eff. Dec. 19, 2012. 2017, 156:64, eff. July 1, 2017. 2021, 91:200, eff. July 1, 2021.

Section 167:4-d

    167:4-d Medicaid Coverage of Telehealth Services. –
I. It is the intent of this section to recognize the application of telehealth for covered services provided within the scope of practice of a physician or other health care provider as a method of delivery of medical care by which an individual at an originating site shall receive medical services which are clinically appropriate for delivery through telehealth from a health care provider at a distant site without in-person contact with the provider.
II. In this section:
(a) "Telehealth services" shall comply with 42 C.F.R. section 410.78, except for 42 C.F.R. section 410.78(b)(4). The use of the term "telemedicine" shall comply with the Centers for Medicare and Medicaid Services requirements governing the aforementioned telehealth services.
(b) "Distant site" means the location of the health care provider delivering services through telemedicine at the time the services are provided.
(c) "Doorways" means the statewide points of entry for the delivery of substance use services.
(d) "Originating site" means the location of the patient, whether or not accompanied by a health care provider, at the time services are provided by a health care provider through telemedicine, including, but not limited to, a health care provider's office, a hospital, or a health care facility, or the patient's home or another nonmedical environment such as a school-based health center, a university-based health center, or the patient's workplace.
(e) "Remote patient monitoring" means the use of electronic technology to remotely monitor a patient's health status through the collection and interpretation of clinical data while the patient remains at an originating site. Remote patient monitoring may or may not take place in real time. Remote patient monitoring shall include assessment, observation, education and virtual visits provided by all covered providers including licensed home health care providers.
(f) "Store and forward," as it pertains to telemedicine and as an exception to 42 C.F.R. section 410.78, means the use of asynchronous electronic communications between a patient at an originating site and a health care service provider at a distant site for the purpose of diagnostic and therapeutic assistance in the care of patients. This includes the forwarding and/or transfer of stored medical data from the originating site to the distant site through the use of any electronic device that records data in its own storage and forwards its data to the distant site via telecommunication for the purpose of diagnostic and therapeutic assistance.
III. (a) Coverage under this section shall include the use of telehealth or telemedicine for Medicaid-covered services provided within the scope of practice of a physician or other health care provider as a method of delivery of medical care:
(1) Which is an appropriate application of telehealth services provided by physicians and other health care providers, as determined by the department based on the Centers for Medicare and Medicaid Services regulations, and also including persons providing psychotherapeutic services as provided in He-M 426.08 and 426.09;
(2) By which telemedicine services for primary care, remote patient monitoring, and substance use disorder services shall only be covered in the event that the patient has already established care at an originating site via face-to-face in-person service. A provider shall not be required to establish care via face-to-face in-person service when:
(a) The provider is a Department of Veteran Affairs (VA) practitioner or VA-contracted practitioner not required to obtain a special registration pursuant to 21 U.S.C. section 831(h);
(b) The patient is being treated by, and is physically located in a correctional facility administered by the state of New Hampshire or a New Hampshire county;
(c) The patient is being treated by, and is physically located in a doorway as defined in RSA 167:4-d, II(c);
(d) The patient is being treated by and is physically located in a state designated community mental health center pursuant to RSA 135; or
(e) The patient is being treated by, and physically located in, a hospital or clinic registered in a manner fully consistent with 21 U.S.C. section 823(f); and
(3) By which an individual shall receive medical services from a physician or other health care provider who is an enrolled Medicaid provider without in-person contact with that provider.
(b) The Medicaid program shall provide coverage and reimbursement for health care services provided through telemedicine on the same basis as the Medicaid program provides coverage and reimbursement for health care services provided in person.
(c) The combined amount of reimbursement that the Medicaid program allows for the compensation to the distant site and the originating site shall not be less that the total amount allowed for health care services provided in person.
(d) There shall be no restriction on eligible originating or distant sites for telehealth services. An originating site means the location of the member at the time the service is being furnished via a telecommunication system. A distant site means the location of the provider at the time the service is being furnished via a telecommunication system.
(e) The Medicaid program shall provide reimbursement for all modes of telehealth, including video and audio, audio-only, or other electronic media provided by medical providers to treat all members for all medically necessary services.
(f) Medical providers below shall be allowed to perform health care services through the use of all modes of telehealth, including video and audio, audio-only, or other electronic media. Medical providers include, but are not limited to, the following:
(1) Physicians and physician assistants, governed by RSA 329 and RSA 328-D;
(2) Advanced practice nurses, governed by RSA 326-B and registered nurses under RSA 326-B employed by home health care providers under RSA 151:2-b;
(3) Midwives, governed by RSA 326-D;
(4) Psychologists, governed by RSA 329-B;
(5) Allied health professionals, governed by RSA 328-F;
(6) Dentists, governed by RSA 317-A;
(7) Mental health practitioners governed by RSA 330-A;
(8) Community mental health providers employed by community mental health programs pursuant to RSA 135-C:7;
(9) Alcohol and other drug use professionals, governed by RSA 330-C;
(10) Dietitians, governed by RSA 326-H; and
(11) Professionals certified by the national behavior analyst certification board or persons performing services under the supervision of a person certified by the national behavior analyst certification board.
(g) Nothing in this section shall be construed to prohibit the Medicaid program from providing coverage for only those services that are medically necessary and subject to all other terms and conditions of the coverage. Services delivered through telehealth under this section shall comply with all applicable state and federal law or regulation as allowed by the Medicaid program. Any conflict with the provisions of this section and federal law or regulation shall preempt and supersede any provision of this section.
IV. This section shall be conditioned upon review and approval of a state plan amendment submitted by the department to the Centers for Medicare and Medicaid Services, as deemed necessary.
IV-a. With written consent of the patient receiving medication assisted treatment through telehealth services provided under this section, the health care provider shall provide notification of the patient's medication assisted treatment to the doorway, as defined in RSA 167:4-d, II(c), within the region where the patient resides.
V. The department shall adopt rules, pursuant to RSA 541-A, necessary to carry out the purposes of this section.

Source. 2015, 206:1, eff. July 6, 2015. 2017, 43:1, eff. July 8, 2017. 2019, 321:1, eff. Oct. 11, 2019. 2020, 27:1, eff. Sept. 19, 2020; 27:6-8, eff. July 21, 2020.

Section 167:4-e

    167:4-e Spend-down Requirements for Medical Expenses. – For the purposes of off-setting the Medicaid spend-down requirements, mental health expenses shall be included as medical expenses.

Source. 2021, 179:2, Pt. I, Sec. 1, eff. July 30, 2021.

Section 167:5

    167:5 Designations. –
I. Assistance granted to needy aged persons shall be designated as old age assistance; assistance granted to needy blind shall be designated as aid to the needy blind; assistance granted to needy dependent children and to the otherwise eligible parents or needy caretaker relatives with whom they live, shall be designated as aid to families with dependent children; assistance granted to the needy permanently and totally disabled shall be designated as aid to the permanently and totally disabled. For purposes of this chapter or RSA 161, the term "adult programs" may be used to mean old age assistance, aid to the needy blind, and aid to the permanently and totally disabled. Medical care and services provided to eligible individuals shall be designated as medical assistance.
II. Assistance granted in these groups shall be in the form of money payments to or vendor payments in behalf of recipients. Such separate records and accounts shall be kept and other requirements met as are necessary to qualify for grants-in-aid from the federal government.

Source. 1937, 202:11. RL 126:11. 1951, 90:3. RSA 167:5. 1961, 271:2. 1967, 396:4. 1969, 451:5. 1970, 34:15. 1986, 183:4. 1993, 5:1, eff. May 25, 1993.

Section 167:6

    167:6 Definitions. –
I. For the purposes hereof, a person shall be eligible for old age assistance who is 65 years of age and a resident of this state. No person shall be eligible to receive such aid while receiving aid to the needy blind, aid to the permanently and totally disabled, or aid to families with dependent children.
II, III. [Repealed.]
IV. For the purposes hereof a person shall be eligible for aid to needy blind who has no vision or whose vision with correcting glasses is so defective as to prevent the performance of ordinary activities for which eyesight is essential and is a resident of the state. No person shall be eligible to receive such aid while receiving old age assistance, aid to the permanently and totally disabled, or aid to families with dependent children.
V. For purposes hereof, a person shall be eligible for aid to families with dependent children who is a needy child 17 years of age or under or 18 years of age, a full-time student in a secondary school as defined by the commissioner of the department of health and human services, and reasonably expected to complete the program before reaching 19 years of age; who has been deprived of parental support or care by reason of death, continued absence from the home, or physical or mental incapacity of a parent, or the unemployment of his or her parent who is the principal wage-earner; and who is living with his father, mother, grandfather, grandmother, brother, sister, stepfather, stepmother, stepbrother, stepsister, first cousin, nephew or niece, uncle, or aunt (including relatives of half-blood, relatives of preceding generations as denoted by the prefixes of grand, great, or great-great, adoptive parents and their relatives to the same degree as blood relatives and spouses of the above relatives even after the marriage is terminated by death or divorce) in a place of residence in the state maintained by one or more of such relatives as his or their home; or who is an otherwise eligible parent or needy caretaker relative with whom such child lives. For purposes of this section, a child who meets the above requirements shall be eligible, even if the child was removed from the home of a relative as a result of a judicial determination and was placed in a foster home and care, when the care and placement of the child are the responsibility of the department of health and human services or another public agency which meets federal requirements and the state plan, and when the child received or would have been eligible to receive aid to families with dependent children in the month in which court proceedings were initiated except that such a child need not have lived with a specified relative. No person shall be eligible to receive such aid while receiving old age assistance, aid to the needy blind, or aid to the permanently and totally disabled.
VI. For the purposes hereof, a person shall be eligible for aid to the permanently and totally disabled who is between the ages of 18 and 64 years of age inclusive; is a resident of the state; and is disabled as defined in the federal Social Security Act, Titles II and XVI and the regulations adopted under such act, except that the minimum required duration of the impairment shall be 48 months, unless and until the department adopts a 12-month standard in accordance with RSA 167:3-j. In determining disability, the standards for "substantial gainful activity" as used in the Social Security Act shall apply, including all work incentive provisions including Impairment Related Work Expenses, Plans to Achieve Self Support, and subsidies. Notwithstanding any provision of law to the contrary, eligibility for state cash assistance and medical assistance shall be conditioned upon the person filing an application or applications for any federal cash benefits for which the individual may be entitled and pursuing all appeals available for those federal cash benefits. State cash assistance for an applicant shall be denied, or for a recipient shall be terminated, upon a finding of clinical ineligibility for such federal cash benefits, except that any individual receiving cash assistance on June 30, 2011 shall only be ineligible for cash assistance upon a second finding of clinical ineligibility. Notwithstanding any provision of the law to the contrary, an individual who appeals the termination of state cash assistance, pursuant to RSA 161:4, IV, for the reasons set forth in this paragraph, shall not continue to receive such state cash assistance benefits during the pendency of such appeal unless otherwise specified by the commissioner of the department of health and human services in accordance with rules adopted under RSA 541-A. No person shall be eligible to receive such aid while receiving old age assistance, aid to the needy blind, or state cash assistance to families with dependent children.
VII. For purposes hereof, a person shall be eligible for medical assistance as categorically needy or as medically needy. A person shall be eligible as categorically needy if such person receives financial assistance under RSA 167:6, I, IV, V or VI, or is otherwise eligible to receive such assistance but does not, or is otherwise eligible, but does not due to receiving a finding of clinical ineligibility for federal cash benefits under paragraph VI. A person shall be eligible as medically needy if such person meets the categorical, age, and technical requirements under RSA 167:6, I, IV, V or VI, and if his or her income and assets meet the standards as prescribed for the medically needy program. A person shall also be eligible as categorically needy or as medically needy who is eligible for medical assistance pursuant to the mandates of federal law or regulation or pursuant to optional state coverage groups which are allowed by federal regulation and defined by the commissioner of the department of health and human services in accordance with rules adopted under RSA 541-A, but who does not receive assistance or would not be otherwise eligible to receive assistance under paragraph I, IV, V, or VI of this section.
VIII. For purposes hereof, the terms "spouse" and "surviving spouse" shall include anyone currently legally married to a recipient, or who was legally married to a recipient at the time of the recipient's death, and shall not include those to whom a legal separation has been granted by a court of competent jurisdiction.
IX. For purposes hereof, a person with a disability between 18 and 64 years of age who is eligible to participate in the work incentive program, known as Medicaid for employed adults with disabilities (MEAD), shall be eligible for medical assistance as medically needy or categorically needy. The department of health and human services shall establish a sliding fee scale for participants to contribute to the cost of such medical assistance. Participants in the MEAD program shall be employed at the time of enrollment, and may remain enrolled during temporary unemployment for medical reasons or other good cause.

[Paragraph IX-a effective on the date the commissioner of the department of health and human services certifies approval of the state plan amendment by the Centers for Medicare and Medicaid Services.]


IX-a. A person with a disability age 65 and older who is eligible to participate in the work incentive program, known as Medicaid for employed older adults with disabilities (MOAD), shall be eligible for medical assistance as medically needy or categorically needy but not to exclude Medicare coverage. The department of health and human services shall establish a sliding fee scale for participants to contribute to the cost of such medical assistance. Participants in the MOAD program shall be employed at the time of enrollment, and may remain enrolled during temporary unemployment for medical reasons or other good cause.
X. (a) For purposes hereof, an individual is ineligible for cash assistance benefits under the aid to the needy blind, aid to the permanently and totally disabled, and old age assistance programs for any month during which he or she is:
(1) Fleeing to avoid prosecution for a crime which is a felony under the laws of the place from which the individual flees, or which, in the case of the state of New Jersey, is a high misdemeanor under the laws of that state; or
(2) Fleeing to avoid custody or confinement after conviction for a crime, or an attempt to commit a crime, which is a felony under the laws of the place from which the individual flees, or which, in the case of the state of New Jersey, is a high misdemeanor under the laws of that state; or
(3) Violating any condition of probation or parole imposed under federal or state law.
(b) Suspension of benefit payments because an individual is a fugitive as described in subparagraph (a)(1) or (a)(2) or a probation or parole violator as described in subparagraph (a)(3) is effective on the first day of whichever of the following months is earlier:
(1) The month in which a warrant or order for the individual's arrest or apprehension, an order requiring the individual's appearance before a court or other appropriate tribunal, such as a parole board, or a similar order is issued by a court or other duly authorized tribunal on the basis of an appropriate finding that the individual:
(A) Is fleeing, or has fled, to avoid prosecution as described in subparagraph (a)(1);
(B) Is fleeing, or has fled, to avoid custody or confinement after conviction as described in subparagraph (a)(2);
(C) Is violating, or has violated, a condition of his or her probation or parole as described in subparagraph (a)(3); or
(D) The first month during which the individual fled to avoid such prosecution, fled to avoid such custody or confinement after conviction, or violated a condition of his or her probation or parole, if indicated in such warrant or order, or in a decision by a court or other appropriate tribunal.
(2) If benefits are otherwise payable, they shall be resumed effective on the first month throughout which the individual is determined to be no longer fleeing to avoid such prosecution, fleeing to avoid such custody or confinement after conviction, or violating a condition of his or her probation or parole.

Source. 1937, 202:12. 1939, 55:1. RL 126:12. 1945, 43:1; 179:1. 1951, 90:4; 206:1; 223:1. RSA 167:6. 1957, 116:3. 1959, 177:1, 2. 1961, 271:3. 1967, 396:5. 1969, 451:4. 1973, 423:1-4. 1983, 291:1. 1985, 394:2. 1986, 183:5-7. 1990, 45:1. 1993, 5:2; 358:58. 1994, 212:2; 301:3. 1995, 308:12; 310:181, 182. 2000, 156:2. 2001, 67:2. 2008, 76:1. 2009, 144:283. 2011, 224:289, eff. Jan. 1, 2012; 224:290, eff. July 1, 2011. 2016, 184:1, eff. June 3, 2016. 2019, 346:60, eff. July 1, 2019; 346:360.

Section 167:7

    167:7 Amount of Assistance. –
I. The commissioner of health and human services may establish consolidated standards of need for the adult programs he administers, subject to appropriated funds and federal regulations.
I-a. (a) The commissioner of health and human services may establish different standards of need in the adult programs he administers for residents of residential care facilities and community living homes, subject to appropriated funds and federal regulations. Standards of need may differ between the 2 types of homes and with respect to the level of services and care required by and provided to the recipient. The standards shall be rational and reasonably cost related.
(b) If the standard of need for residential care facilities is increased pursuant to the annual review required under RSA 167:3-c, II-b, an amount equal to such increase shall be added to the standard of need established for residents of enhanced family care facilities.
II. The commissioner of health and human services shall establish for the aid to families with dependent children consolidated standards of need, or consolidated standards of need except for shelter, which may be separate from the payment standards and which shall be annually revised to accurately reflect the current cost of the basic necessities of living compatible with decency and health as determined by reliable market data. The commissioner may further establish consolidated standards of payment, or consolidated standards of payment except for shelter, subject to appropriated funds and applicable federal regulations.
III. The commissioner of health and human services shall determine the level of benefits in both programs so that recipients shall be allowed to subsist compatibly with decency and health, subject to the amount of appropriated funds and applicable federal regulations.
IV. In determination of the amount of payments or other assistance under RSA 167 or RSA 161, due regard shall be given to the income and resources of applicants.
V. Subject to applicable federal regulations, the commissioner may establish criteria to operate a special needs program, subject to the amount of available funds in the budget of the department of health and human services.
VI. Persons who are aid to families with dependent children financial assistance recipients and are participating in an associate's degree or bachelor's degree training program or course of study shall be eligible for up to 2 years of child day care service payments, provided that the program or course of study is necessary to meet individual goals that are directly related to obtaining useful employment in a recognized occupation, and further provided that such child day care service payments shall be subject to the requirements of federal law.

Source. 1937, 202:13. RL 126:13. RSA 167:7. 1974, 48:2. 1977, 207:1. 1981, 568:48, I. 1983, 291:1. 1985, 394:3. 1986, 183:9. 1988, 289:2. 1992, 10:2; 111:2; 167:1. 1993, 358:61, 63. 1995, 308:15; 310:179, 180, 183. 2011, 224:288, eff. July 1, 2011.

Section 167:7-a

    167:7-a Repealed by 1977, 207:2, eff. Aug. 14, 1977. –

Section 167:7-b

    167:7-b Prohibited Use of Electronic Benefit Transfer Cards. –
I. Any person receiving public assistance is prohibited from using electronic benefit transfer (EBT) cards or cash obtained with EBT cards for the purpose of purchasing or participating in any activities in any location listed in paragraph II. Any person receiving public assistance who uses an EBT card in violation of paragraph II shall be subject to the following penalties:
(a) Suspension of cash assistance benefits for that person for 2 pay periods for the first offense.
(b) Suspension of cash assistance benefits for that person for 4 pay periods for the second offense.
(c) Suspension of cash assistance benefits for that person for 6 pay periods for the third and subsequent offense.
II. After January 1, 2014, the businesses listed in this paragraph shall not knowingly accept direct cash assistance funds held on electronic benefit transfer cards or cash obtained with electronic benefit transfer cards through any electronic fund transaction using an automated teller machine or point-of-sale device on the business premises. The following businesses are required to comply with this paragraph:
(a) State liquor stores and agency liquor stores established by or under the authority of the New Hampshire liquor commission.
(b) Off-premises retail licensees that exclusively or primarily sell beer, wine, or other alcoholic beverages.
(c) Gaming establishments licensed under the authority of New Hampshire racing and charitable gaming commission that also meet the definition of casino, gambling casino, or gaming establishment under the Social Security Act, 42 U.S.C. section 608(a)(12).
(d) Retail establishments which provide adult-oriented entertainment in which performers disrobe or perform in an unclothed state for entertainment.
(e) Business establishments primarily engaged in the practice of body piercing, branding, or tattooing.
(f) Cigar stores and stands, pipe stores, smoke shops, and tobacco shops using merchant category code 5993 identified in the Internal Revenue Bulletin 2004-31 Revenue Procedure 2004-43 and any subsequent Internal Revenue Service publication thereto.
(g) Marijuana dispensaries, excluding an alternative treatment center as defined in RSA 126-X:1, I.
III. The department may notify the licensing authority of any business listed in paragraph II in the event that such business has continued to allow the use of the EBT card in violation of this section. The licensing authority may take reasonable action as deemed appropriate under existing licensing provisions. Notwithstanding any provision of law to the contrary, the department is authorized to provide information and cooperate with the licensing authority regarding any investigation commenced under this section.
IV. Any business listed in paragraph II that knowingly accepts direct cash assistance funds held on electronic benefit transfer cards or cash obtained with electronic benefit transfer cards in violation of this section shall be guilty of a violation.

Source. 2013, 144:128, eff. Jan. 1, 2014. 2015, 269:1, eff. Sept. 18, 2015.

Section 167:8

    167:8 Application for Assistance. –
I. Application for assistance under this chapter or RSA 161 shall be made in the first instance to the commissioner of the department of health and human services, or his duly authorized agent. The application shall be in writing and upon a form prescribed by the department of health and human services. Except in cases of emergency no aid shall be granted until completion of the investigation required by this section. Whenever an application for old age assistance or for aid to the permanently and totally disabled is received, the commissioner of health and human services shall immediately give notice of such application to the county commissioners of the county in which said applicant resides or is found, or the appropriate county as provided in RSA 166:8, and shall also notify them of any decision on the application
II. When an individual applies for Temporary Assistance to Needy Families, food stamps, medical assistance, or other programs under this chapter or RSA 161, the commissioner of health and human services or designee shall provide the individual with application forms and information about the Link-Up New Hampshire and Lifeline Telephone Assistance programs, shall offer to assist the individual to apply for these programs, and shall provide such assistance.

Source. 1937, 202:14. RL 126:14. 1951, 90:5. RSA 167:8. 1983, 291:1. 1985, 380:30. 1995, 310:176, 180. 2007, 263:170, eff. July 1, 2007.

Section 167:9

    167:9 Repealed by 1967, 396:6, eff. July 1, 1967. –

Section 167:10

    167:10 Granting of Assistance. – Upon the completion of the investigation, the commissioner of the department of health and human services shall decide whether the applicant is eligible for assistance under the provisions of this chapter or RSA 161 and shall determine in accordance with the rules of the department the amount of such assistance and the date upon which assistance shall begin. The commissioner shall, however, in all cases, first consult with the proper officials of counties hereby required to contribute to the cost of the assistance. The commissioner shall notify the applicant of his decision and send a copy of the decision to the proper county officials.

Source. 1937, 202:16. RL 126:16. RSA 167:10. 1983, 291:1, I. 1985, 380:31. 1995, 310:175, 182, 183, eff. Nov. 1, 1995.

Section 167:10-a

    167:10-a Payments to Recipients; Insurance Contracts. –
I. No accident or health insurance policy issued, renewed or continued after August 28, 1981 shall contain any provision denying or limiting insurance benefits because services are rendered to an insured or a dependent who is eligible for or who receives medical assistance under RSA 167 or RSA 161.
II. The commissioner of health and human services shall not pay for any services provided under RSA 167 or RSA 161 if the recipient has coverage for the services under an accident or health insurance policy.

Source. 1981, 502:1. 1983, 291:1, II. 1995, 310:179, eff. Nov. 1, 1995.

Section 167:11

    167:11 Repealed by 2017, 156:65, II, eff. July 1, 2017. –

Section 167:11-a

    167:11-a Repealed by 1979, 277:1, eff. Aug. 20, 1979. –

Section 167:12

    167:12 Repealed by 1967, 396:7, eff. July 1, 1967. –

Section 167:13

    167:13 Recovery for Assistance Furnished. –
I. Except as provided in paragraph II, if at any time during the continuance of assistance, the recipient or the husband or wife of the recipient becomes possessed of any property or income in excess of the amount stated in the application, it shall be the duty of the recipient within 10 calendar days to notify the commissioner of the department of health and human services of the receipt or possession of such property or income. On the death of a recipient of old age assistance, aid to the needy blind, medicaid for employed adults with disabilities, or aid to the permanently and totally disabled, the total amount of assistance paid under this chapter or RSA 161 shall be allowed as a claim against the estate of such person after payment of the charges in the priority set forth in RSA 554:19. No lien filed in accordance with RSA 167:14 shall be extended to enforce recovery nor shall any sale be forced against the real estate of a recipient of old age assistance, aid to the needy blind, medicaid for employed adults with disabilities, or aid to the permanently and totally disabled while it is occupied as a home by a surviving spouse. The federal government shall be entitled, as long as required as a condition to federal financial participation, to such proportion of the net amount collected from the estate of a recipient of old age assistance, aid to the needy blind, medicaid for employed adults with disabilities, or aid to the permanently and totally disabled as the federal participation bears to the total amount of assistance granted said recipient.
II. Notwithstanding paragraph I, for medical assistance, no resources of the community spouse shall be deemed available to the institutionalized spouse during the continuous period in which an institutionalized spouse is in an institution, and after the month in which an institutionalized spouse is determined to be eligible for medical assistance benefits.
III. The department may waive adjustment or recovery in cases in which:
(a) It is not cost-effective to recover from an individual's estate; or
(b) Recovery would result in an undue hardship as determined in accordance with rules adopted pursuant to RSA 541-A.
IV. There is established in the state treasury an estate administration fund for use as a depository account by the department of health and human services for the purpose of estate administration conducted pursuant to RSA 553:2, III. The fund shall be used to receive and temporarily hold estate funds subject to supervision of the probate court until funds are disbursed, in accordance with RSA 554:19, to creditors, including the state, for public assistance provided under this chapter.

Source. 1937, 202:19. RL 126:19. 1947, 44:1. 1949, 100:1. 1951, 90:6. RSA 167:13. 1979, 227:2. 1983, 291:1, II. 1995, 310:182. 1998, 5:2. 2000, 156:3. 2005, 175:6. 2007, 263:55, eff. July 1, 2007.

Section 167:14

    167:14 Claims and Liens. –
I. The estate of every recipient and the estate of a recipient's spouse, if any, owned severally or as joint tenants, shall be liable for all financial old age assistance, aid to the needy blind, or aid to the permanently and totally disabled granted to the recipient; provided, however, that the estate of a recipient's spouse shall be liable only for such financial assistance as was granted to the recipient during the time that the recipient and the recipient's spouse were neither legally separated nor divorced. After providing all owners of the real property known to the department with prior notice and an opportunity for a hearing, the commissioner of the department of health and human services shall file with the register of deeds of the county in which the recipient, or the spouse of the recipient, if any, owns real property, notice of the lien. Such notice of lien shall contain the names of the recipient and the recipient's spouse, if any. All such liens shall continue during the lifetime of the recipient and of the spouse of the recipient, if any, and until enforced as provided in this section, unless sooner released by the commissioner of the department of health and human services. The register of deeds shall keep a suitable record of such notices of lien without charging any fee therefore and enter on the record an acknowledgment of satisfaction or release upon written request from the commissioner of the department of health and human services.
II. Subject to RSA 167:16-a, the estate of every recipient shall be liable for all medical assistance granted to the recipient, and the commissioner of the department of health and human services shall file a claim for recovery against the recipient's estate. No notice of lien may be filed against real property with respect to medical assistance except in conformance with RSA 167:16-a.

Source. 1937, 202:34. RL 126:32. 1949, 173:1, par. 32. 1951, 139:8. RSA 167:14. 1983, 291:1, I. 1985, 380:32. 1992, 30:4. 1995, 310:182. 2000, 156:4. 2005, 175:7, eff. Aug. 29, 2005.

Section 167:14-a

    167:14-a Recovery of Assistance. –
I. Any person who is a recipient of financial assistance, medical assistance, old age assistance, aid to the needy blind, medicaid for employed adults with disabilities, or aid to the permanently and totally disabled shall, by his acceptance of such assistance, be deemed to have assigned any claim or right of action against any person or party to the commissioner of health and human services, to the extent that such assistance is furnished.
II. Whenever a recipient of financial assistance, medical assistance, old age assistance, aid to the needy blind, medicaid for employed adults with disabilities, or aid to the permanently and totally disabled shall have a legally cognizable claim against any person or party for expenses or support and the department of health and human services has already furnished assistance to such recipient, the amount of assistance furnished may be recovered in an action brought in the name of the state from such person or party against whom the recipient has a legally cognizable claim for expenses or support.
II-a. The commissioner may recover the amount of medical assistance furnished to a dependent child from the child's responsible parents to the extent authorized under Title XXI of the Social Security Act. In such cases, the amount of assistance furnished and subject to reimbursement shall include, but not be limited to, expenditures for medical care and health insurance premiums and other expenditures paid by the state for enrollment or other fees for participation in the program.
III. The state medical assistance program is the payor of last resort and shall provide medical coverage only when there are no other available resources. Whenever a recipient of medical assistance shall receive a settlement or an award from a liable third person or party, such recipient shall repay the amount of medical assistance furnished by the state to the extent that the amount of the recovery makes repayment possible. If a recipient of medical assistance receives a settlement or an award from a third party, the settlement or award is subject to disbursement as provided in paragraphs III-a and IV.
III-a. The commissioner of health and human services may recover the full amount of medical assistance furnished by the state from the portion of any settlement or judgment reasonably attributable to medical expenses. The commissioner may waive or reduce the amount due the state for good cause upon written request from a recipient or recipient's attorney. The acceptance of any waiver or the payment of any reduced amount due shall create a rebuttable presumption that the apportionment was equitable in any action brought pursuant to paragraph IV.
IV. A disbursement of any award, judgment, or settlement shall not be made to a recipient without the recipient or the recipient's attorney first providing at least 30-days written notice of any scheduled trial, alternative dispute resolution hearing, or settlement to the commissioner of health and human services that the recipient has a claim which could result in a recovery from a third party or obtaining from the commissioner a written release of any obligation owed to the state for medical assistance provided to the recipient. The commissioner shall notify the recipient or the recipient's attorney of the amount of the commissioner's claim within 21 days of the notice. If a dispute arises between the recipient and the commissioner of health and human services as to the settlement of any claim that arises under this section, the third party or the recipient's attorney shall withhold from disbursement to the recipient or to any legal instrument created for the benefit of the recipient, an amount equal to the commissioner's claim. Either party may apply to the superior court or the district court in which an action based upon the recipient's claim could have been commenced for an order to determine an equitable apportionment between the commissioner and the recipient of the amount withheld. The court shall have broad discretion to apportion the amount withheld as justice may require. An order of apportionment has the effect of a judgment. The obligation of a third party under this paragraph to withhold all or part of a disbursement is conditional upon the receipt by the third party of written notice from the commissioner, the recipient, or the recipient's attorney that the commissioner is asserting a claim.
V. All property, real or personal, in a revocable trust is subject to recovery by the department for recovery for any medical assistance provided the decedent. Upon the death of the grantor, the department shall provide the trustee with a statement containing the amount of medical assistance which was provided to the decedent.
VI. (a) For purposes of recovering the costs of medical assistance, the estate of a recipient shall include all property, real or personal, which at the time of a recipient's death was held by the recipient in joint tenancy with rights of survivorship, or life estate for all such title or interest established on or after July 1, 2005. Recovery shall be limited to the value of the recipient's ownership interest and in no case shall such amount exceed the total amount of medical assistance provided to the deceased recipient, nor shall recovery extend to any interest in property, real or personal, for which a non-recipient owner paid fair market value at the time said ownership interest was acquired.
(b) No sooner than 45 days from the death of the recipient, the department shall provide the other joint owner or owners notice of the department's claim. Written notice shall include a description of all categories of individuals exempt from recovery by reason of familial status as allowed under 42 U.S.C. section 1396p(b)(2) and RSA 167:16-a, IV, as well as the availability and method of requesting a hardship waiver. Within 30 days of the receipt of notification of the department's claim, the joint owner or owners shall acknowledge receipt of the department's claim and, provided that there shall not be undue hardship imposed upon the surviving joint owner or owners, either tender an amount equal to the deceased recipient's interest in the identified property and/or financial instrument to the state of New Hampshire toward the deceased's medical assistance bill, but such amount shall not exceed the total amount of medical assistance provided to the deceased recipient, or enter into a binding agreement to make such payment as soon as is practicable. If the joint owner or owners refuse to acknowledge receipt of the department's claim or to tender payment or fail to fulfill the agreement to pay without good cause, as required by this paragraph, the commissioner may bring an action in superior court or probate court, as the case may be, to compel such payment. Nothing in this paragraph shall be interpreted or applied so as to violate RSA 167:16-a or 42 U.S.C. section 1396p(b)(2)(A) and (B) prohibiting recovery when the recipient is survived by a spouse, minor children, or disabled children or when the recipient is survived by either siblings or children under certain circumstances.

Source. 1973, 412:1. 1981, 191:1. 1983, 288:2; 291:1. 1995, 310:176, 181. 1998, 322:1; 360:1. 2002, 84:1, 2. 2005, 175:8, 9; 177:115. 2006, 45:1; 278:5. 2008, 253:1. 2009, 316:1. 2010, 15:1, eff. May 7, 2010.

Section 167:15

    167:15 Existing Liens. – All liens for old age assistance existing on May 3, 1949, shall continue unaffected by this chapter until discharged by the commissioner of the department of health and human services.

Source. 1949, 173:1, par. 32-b. RSA 167:15. 1983, 291:1, II. 1995, 310:182, eff. Nov. 1, 1995.

Section 167:16

    167:16 Enforcement of Assistance Liens. –
I. Assistance liens arising under this chapter or RSA 161 may be enforced by a bill in equity, or, in the case of liens against real estate which have been duly filed under RSA 167:14, by filing a timely and verified notice of lien with the probate court with jurisdiction over the estate of the recipient and mailing a copy of said notice and a verified claim for recovery of assistance payments to the administrator of the estate.
II. The commissioner may enforce the liquidated amount of an assistance lien against real estate by filing a timely and verified notice with the probate court and submitting a timely and verified claim against the estate of the recipient which sets forth the dates and amounts of assistance paid. Such claims shall be timely if filed within 6 months from the initial grant of administration for the estate in question.
III. Notwithstanding RSA 556:5 and any other provision of law to the contrary, the administrator of a recipient's estate shall be conclusively presumed to have accepted a claim for recovery of assistance which is subject to the jurisdiction of the probate court unless, within 12 months from the initial grant of administration, the administrator commences an equitable action in the superior court challenging the validity or amount of the commissioner's claim and lien.
IV. When a timely notice of lien has been filed with a probate court pursuant to this section, approval of a request to sell real estate or to distribute probate assets shall not occur until and unless the court enters a finding that the assistance claim has been satisfied or the commissioner's lien is otherwise protected.

Source. 1951, 139:9. RSA 167:16. 1992, 30:2. 1995, 310:120, 183. 2000, 156:5, eff. Jan. 1, 2001.

Section 167:16-a

    167:16-a Limitations on Recovery of Assistance. –
I. Notwithstanding RSA 167:14 and any other provision of law to the contrary, no lien may be imposed by equitable or legal action undertaken by the state to evict, partition, or force sale of the property of any individual prior to death on account of medical assistance paid or to be paid on behalf of that individual at any time, except:
(a) Pursuant to a court order or judgment on account of benefits incorrectly paid on behalf of such individual; or
(b) In the case of the real property of an individual:
(1) Who is an inpatient in a nursing facility, intermediate care facility, or other medical institution, and
(2) With respect to whom it is determined by the department, after notice and an opportunity for a hearing, that the individual cannot reasonably be expected to be discharged from the facility or institution and to return home.
II. No lien may be imposed under subparagraph I(b) on such individual's home if any of the following are currently residing in the home:
(a) Such individual's spouse;
(b) Such individual's child who is under age 21, or is blind or permanently and totally disabled as defined in section 1614 of the Social Security Act; or
(c) Such individual's sibling who has an equity interest in such home and who was residing in such individual's home for a period of at least one year immediately before the date of the individual's admission to the medical institution.
III. Any lien imposed with respect to subparagraph I(b) shall dissolve upon such individual's discharge from the medical institution and return home.
IV. Notwithstanding any provision of law to the contrary, there shall be no adjustment or recovery of medical assistance correctly paid on behalf of such an individual, except from the estate of an individual who was 55 years of age or older when the individual received such assistance, and then only after the death of the surviving spouse, if any, and only at a time when:
(a) The individual has no surviving child who is under 21 years of age or is blind or permanently and totally disabled.
(b) In the case of a lien on an individual's home under subparagraph I(b):
(1) There is no sibling of the individual who was residing in the individual's home for a period of at least one year immediately before the date of the individual's admission to the medical institution, nursing facility, or intermediate care facility and is lawfully residing in such home on a continuous basis since the date of the individual's admission to the medical institution, nursing facility, or intermediate care facility.
(2) There is no son or daughter of the individual who was residing in the individual's home for a period of at least 2 years immediately before the date of the individual's admission to the medical institution, nursing facility, or intermediate care facility and who establishes to the satisfaction of the state that he or she provided care to such individual which permitted such individual to reside at home rather than in an institution and is lawfully residing in such home and has done so on a continuous basis since the date of the individual's admission to the medical institution, nursing facility, or intermediate care facility.
V. All demands for adjustment or recovery under paragraph IV may be filed pursuant to the requirements in RSA 556:6.

Source. 1961, 271:6. 1967, 396:8. 1973, 72:9. 1979, 227:3. 1992, 30:3. 1994, 403:2. 1995, 310:41. 2000, 156:6. 2008, 52:8, 9, eff. July 11, 2008.

Section 167:17

    167:17 Report of Collateral Resources. –
The following persons shall report the receipt of any property, wages, income or resources of any kind, or changes of any kind that would affect the amount of assistance under this chapter or RSA 161 for which a person is eligible, to the commissioner of the department of health and human services in writing within 10 calendar days after receiving such property, wages, income or resources:
I. Any person receiving assistance for the care of any dependent child or children;
II. Any person legally liable for the support of a dependent child or children;
III. Any person who receives assistance pursuant to the provisions of RSA 167;
IV. Any person who is legally liable pursuant to RSA 167:2 or RSA 546-A:2 for the support of any person who receives assistance pursuant to the provisions of RSA 167.
V. Any person receiving medical assistance who receives a settlement or an award from a liable third person or party against whom the recipient has a legally cognizable claim for expenses or support.
No person who is required to report the receipt of property, wages, income or resources by this section shall within any one month sell, assign, transfer, encumber or otherwise dispose of any property with a total value of $30 or more without the consent of the commissioner of the department of health and human services.

Source. 1937, 202:20. RL 126:20. RSA 167:17. 1973, 364:1. 1977, 165:1; 490:1. 1979, 227:1. 1983, 288:3; 291:1, II. 1995, 310:182, eff. Nov. 1, 1995.

Section 167:17-a

    167:17-a Unauthorized Payments; Recovery by State. – Any sums paid to or on behalf of any person under the provisions of RSA 167 as a result of any false statement, misrepresentation or concealment of or failure to disclose the receipt of property, wages, income or resources by him or by any person legally liable for his support may be recovered in an action brought by the state against such person. The commissioner of the department of health and human services shall recover any unauthorized payments by reasonably adjusting current and future grant amounts received by the person violating the provisions of this section.

Source. 1973, 364:2. 1983, 291:1, II. 1995, 310:182, eff. Nov. 1, 1995.

Section 167:17-b

    167:17-b Prohibited Acts. –
I. No person shall:
(a) By means of an intentionally false statement or misrepresentation or by impersonation or other fraudulent act or device, obtain or attempt to obtain, or aid or abet any person in obtaining any assistance or benefit or payment under RSA 161 or RSA 167 to which he is not entitled;
(b) With intent to defraud the department of health and human services, buy or aid or abet in the purchase or the disposal of the property of a person receiving assistance or food stamps under RSA 161 or RSA 167, so as to affect the recipient's eligibility for assistance, without the consent of the commissioner of the department of health and human services;
(c) [Repealed.]
(d) Intentionally fail to disclose the receipt of property, wages, income or resources or any change in circumstances which would affect his eligibility for assistance or his initial or continued right to any benefit or payment for the purpose of receiving any assistance, benefit or payment under RSA 167 or RSA 161 to which he is not entitled;
(e) Knowingly use, transfer, acquire, alter, sell or possess food stamps or authorization to issue food stamps in any manner not authorized by the Federal Food Stamp Act, as amended, or by the federal regulations or state rules adopted pursuant to the act;
(f) Present or cause to be presented food stamps for payment or redemption, knowing the stamps were received, transferred or used in any manner not authorized by the Federal Food Stamp Act, as amended, or by the federal regulations or state rules adopted pursuant to the act;
(g), (h) [Repealed.]
II. When a person receiving assistance is convicted of an offense under this section, the commissioner of the department of health and human services shall discontinue his assistance, if such action has not already been taken.

Source. 1973, 364:2. 1975, 399:5, 6; 406:2. 1981, 189:3. 1983, 291:1, II. 1987, 207:2. 1990, 260:4. 1995, 310:180, 182, eff. Nov. 1, 1995.

Section 167:17-c

    167:17-c Penalties. –
I. Any natural person who violates RSA 167:17-b shall, unless otherwise specified, be guilty of:
(a) A class A felony if the value of the monetary award or goods or services in question exceeds $1,500;
(b) A class B felony if the value of the monetary award or goods or services in question exceeds $1,000 but does not exceed $1,500; or
(c) A misdemeanor if the value of the monetary award or goods or services in question is $1,000 or less.
II. Any other person who violates RSA 167:17-b shall, unless otherwise specified, be guilty of:
(a) A felony if the value of the monetary award or goods or services in question exceeds $1,000; or
(b) A misdemeanor if the value of the monetary award or goods or services in question is $1,000 or less.
III. In the case of any natural person convicted of fraudulently using, presenting, transferring, acquiring, receiving, possessing or altering food stamps, the court may permit such person to perform work approved by the court for the purpose of providing restitution for losses incurred by the United States and the department of health and human services as a result of the offense for which such person was convicted. If the court permits such person to perform such work and such person agrees thereto, the court shall withhold the imposition of the sentence on the condition that such person perform the assigned work. Upon the successful completion of the assigned work the court may suspend such sentence.

Source. 1981, 189:4. 1983, 387:2; 291:1. 1995, 310:181, eff. Nov. 1, 1995. 2018, 277:1, eff. June 18, 2018. 2019, 326:8, eff. Aug. 16, 2019.

Section 167:17-d

    167:17-d Discontinuation of Food Stamps. –
I. When a person receiving food stamps assistance is convicted of a violation of RSA 167:17-b, the commissioner shall discontinue his assistance for a minimum period of 6 months upon the first conviction, one year upon the second conviction, and permanently upon the third conviction, unless the court orders that assistance be discontinued for longer periods of time after the first or second convictions.
II. In addition to any criminal penalties which may be imposed, a court of appropriate jurisdiction may discontinue the food stamps assistance of any person convicted of fraudulently using, presenting, transferring, acquiring, receiving, possessing, or altering food stamps for an additional period of up to 18 months, consecutive to that period of suspension mandated in paragraph I.

Source. 1981, 189:4. 1983, 387:1. 1995, 310:183, eff. Nov. 1, 1995.

Section 167:18

    167:18 Repealed by 1985, 380:51, VII, eff. Jan. 1, 1986. –

Section 167:18-a

    167:18-a County Reimbursement of Funds; Limitations on Payments. –
I. These expenditures shall in the first instance be made by the state, but each county shall make monthly payments to the state for the amounts due under this section within 45 days from notice thereof.
(a) Counties shall reimburse the state for expenditures for recipients for whom such county is liable who are eligible for nursing home care and are receiving services from a licensed nursing home, or in another New Hampshire setting as an alternative to a licensed nursing home placement and are supported under the Medicaid home and community-based care waiver for the elderly and chronically ill, as such waiver may be amended from time to time, to the extent of 100 percent of the non-federal share of such expenditures. If at any point the Federal Medical Assistance Percentage increases, the counties' portion of the non-federal share shall be reduced by the amount of the increased federal percentage, if allowable under federal law and subject to any conditions on the funding. Expenditures shall not include payments made for skilled care.
(b) Counties shall not be liable for Medicaid recipients in state institutions, the Crotched Mountain Rehabilitation Center, and intermediate care facilities (ICF) approved by the department of health and human services and servicing developmentally impaired persons.
II. (a) The total billings to all counties made pursuant to this section shall not exceed the amounts set forth below for state fiscal years 2022-2023:
(1) State fiscal year 2022, $129,362,411.
(2) State fiscal year 2023, $131,849,659.
(b) The caps on total billings for fiscal years after fiscal year 2015 shall be established by the legislature at least on a biennial basis.
III. (a) The cap in total billings shall not exceed an annual increase of 2 percent in any year of the biennium.
(b) The counties shall have an aggregate credit of $5,000,000 against amounts due under this section for each fiscal year beginning July 1, 2008. The credit shall be allocated as follows:
(1) For fiscal year 2009, $4,000,000 shall be allocated among the counties based upon the proportion each paid for such expenditures in the prior fiscal year, and $1,000,000 shall be allocated among the counties based upon their relative proportions of residents age 65 or older who are Medicaid recipients.
(2) For fiscal year 2010, $2,000,000 shall be allocated among the counties based upon the proportion each paid for such expenditures in the prior fiscal year, and $3,000,000 shall be allocated among the counties based upon their relative proportions of residents age 65 or older who are Medicaid recipients.
(3) For fiscal year 2011 and for each fiscal year thereafter, $5,000,000 shall be allocated among the counties based upon their relative proportions of residents age 65 or older who are Medicaid recipients.
(4) For fiscal year 2021, in addition to the $5,000,000 allocated pursuant to subparagraph III(b)(3), a credit of $9,721,305 shall be allocated among the counties based upon their relative proportions of residents aged 65 years of age or older who are Medicaid recipients.
(c) The credit shall be made available as soon as possible after the start of the fiscal year. The department shall adopt county credit criteria in consultation with the county-state finance commission and in accordance with the provisions of RSA 541-A. The total aggregate obligation of the counties shall be reduced by the amount of the credit in each fiscal year.
IV. Budgeted general funds shall be applied to the funding of Medicaid long-term services and supports after the allocation of the credit and prior to any county funds.
V. Notwithstanding the procedures of paragraphs I-III of this section, no county shall be liable for total billings in fiscal year 2009 or fiscal year 2010 in an amount which would be greater than the amount of liability projected for that fiscal year using the methodology for determining county payments in former RSA 167:18-a, 167:18-b, and 167:18-f prior to its repeal together with the amount of liability projected for that fiscal year using the repealed methodology for determining county payments in RSA 169-B, 169-C, and 169-D.
VI. (a) Any shortfall between the state audited Medicaid allowances incurred by the state's county operated nursing homes and amounts otherwise reimbursed by federal 50 percent Medicaid matching funds or other income, shall be certified as a public expenditure and be eligible for additional federal funding match.
(b) The department of health and human services shall seek federal Medicaid assistance match for any state audited county nursing home Medicaid expense which is not fully reimbursed through rates. Any revenue realized through such a match shall be paid to the nursing homes which incurred the unreimbursed expense.

Source. 1973, 423:6. 1985, 380:33. 2007, 263:17. 2008, 52:10; 296:19, 20. 2009, 144:22. 2011, 224:21, 22. 2013, 144:8, eff. July 1, 2013. 2015, 276:153, eff. July 1, 2015. 2017, 156:84, eff. July 1, 2017. 2019, 346:59, eff. July 1, 2019. 2021, 91:26, eff. July 1, 2021.

Section 167:18-b

    167:18-b Repealed by 2007, 263:24, I, eff. July 1, 2008. –

Section 167:18-c

    167:18-c Repealed by 1985, 380:51, VIII, eff. Jan. 1, 1986. –

Section 167:18-d

    167:18-d Repealed by 1985, 308:1, eff. Oct. 1, 1987. –

Section 167:18-e

    167:18-e Delinquent Payments. – Delinquent payments due under RSA 167:18-a with interest at the rate of 12 per centum per annum, may be recovered by action in a court of competent jurisdiction against the political subdivision liable therefor or may, at the request of the state agency, be deducted from any other moneys payable to such subdivision by any department or agency of the state.

Source. 1981, 568:50. 1983, 469:90. 2007, 263:18, eff. July 1, 2008.

Section 167:18-f

    167:18-f Repealed by 2007, 263:24, II, eff. July 1, 2008. –

Section 167:18-g

    167:18-g Reimbursement of General Assistance Funds. – The department of health and human services shall reimburse each county and town for the amounts paid in general assistance for the cost of prescription drugs for recipients who are later determined to be eligible for medical assistance retroactive to the time when such county or town rendered such assistance.

Source. 1989, 227:1. 1995, 310:180, eff. Nov. 1, 1995.

Section 167:18-h

    167:18-h County Nursing Homes; Proportionate Share Payments. –
I. Proportionate share payments to county nursing homes shall be made each state fiscal year in an amount equal to the maximum permissible by federal regulations. All payments shall be specific to each facility in accordance with the methodology in the approved Medicaid state plan amendment. If the federal government makes adjustments to any proportionate share payments that have been made by the state, the amounts due under this section shall be amended accordingly and adjusted payments shall be made to or from the state as necessary.
II. (a) The certified public expenditure (CPE) nursing facilities group shall be financed on the basis of a CPE methodology and shall not require a transfer of funds from the respective county to the state to effectuate the federal match.
(b) Any intergovernmental transfers (IGT) specific to the IGT nursing facilities group that serve as the basis for generating the federal match shall be in accordance with the approved Medicaid state plan amendment.

Source. 1998, 387:2. 2004, 260:7, eff. July 1, 2005. 2019, 346:369, eff. July 1, 2019.

Section 167:19

    167:19 Local Administration. – Each county or town shall pay all costs incurred by its officials when acting as authorized agents of the commissioner of the department of health and human services under this chapter or RSA 161.

Source. 1937, 202:22. RL 126:22. RSA 167:19. 1983, 291:1. 1995, 310:182, eff. Nov. 1, 1995.

Section 167:20

    167:20 Repealed by 2007, 263:24, III, eff. July 1, 2008. –

Section 167:20-a

    167:20-a Authorization. – For the purpose of medical care services, the department of health and human services may be authorized to make an advance, through the state treasurer, and under a contract approved by governor and council, of funds necessary to provide working capital funds, to a fiscal agent processing payments to medical vendors. The fiscal agent shall post bond in the amount of said advance and shall thereafter submit monthly, or more often, required detail of payments processed which shall then be reimbursed by the state to the said fiscal agent.

Source. 1967, 396:10. 1983, 291:1. 1995, 310:181, eff. Nov. 1, 1995.

Section 167:20-b

    167:20-b Authorization for Work Incentive Program. – For purposes of complying with federal requirements of the social security act in the joint administration of the work incentive program by the appropriate agency of state government, the commissioner of the department of health and human services is hereby authorized to manifest, upon presentation of statement of costs, the non-federal contribution required by the social security act.

Source. 1969, 451:6. 1973, 423:7. 1983, 291:1, II. 1995, 310:182, eff. Nov. 1, 1995.

Section 167:21

    167:21 State Aid. – Should a county find that it is impossible to pay the amounts required under this chapter or RSA 161, it may file a petition with the commissioner of the department of health and human services requesting financial aid. The commissioner of health and human services shall cause an investigation to be made of all pertinent factors relating to the financial circumstances of the petitioning county. The commissioner of health and human services may, with the approval of the governor and council, loan or grant to such county such amount as may be necessary.

Source. 1937, 202:25. RL 126:24. RSA 167:21. 1983, 291:1. 1985, 380:46. 1995, 310:176, 182, eff. Nov. 1, 1995.

Section 167:22

    167:22 Voting Rights Not Affected. – While federal funds are available the receipt of public assistance granted under the provisions hereof or of RSA 161 shall not make the recipient thereof, or any member of his family, an assisted person within the terms of the election laws of this state, nor affect his or their civil or political status in any way.

Source. 1937, 202:28. RL 126:26. RSA 167:22. 1985, 380:47, eff. Jan. 1, 1986.

Section 167:23

    167:23 Summons of Witnesses. – The commissioner of health and human services or his duly authorized agent shall have the power to issue subpoenas for witnesses and compel their attendance and the production of papers and writings.

Source. 1937, 202:29. RL 126:27. RSA 167:23. 1983, 291:1. 1995, 310:176, eff. Nov. 1, 1995.

Section 167:24

    167:24 Acceptance of Funds. – The governor and council are hereby authorized on behalf of the state to accept and to apply to the carrying out of the purposes of this chapter or RSA 161 all moneys that may be advanced to, or otherwise placed at the disposal of, the state by the federal government or any of its agencies for the purposes of this chapter or RSA 161. Said funds shall be disbursed by the commissioner of health and human services.

Source. 1937, 202:30. RL 126:28. RSA 167:24. 1983, 291:1. 1995, 310:176, eff. Nov. 1, 1995.

Section 167:25

    167:25 Assignability of Assistance. – All assistance given hereunder shall be inalienable by any assignment or transfer and shall be exempt from levy or execution under the laws of this state including periodic payments on any judgment of any kind under RSA 524:6-a.

Source. 1937, 202:31. RL 126:29. 2014, 186:2, eff. Jan. 1, 2015.

Section 167:26

    167:26 Protective Payee. – If the person receiving public assistance is, on the testimony of reliable witnesses who are not officials or employees of the department of health and human services, found to be incapable of taking care of himself or his money, the commissioner of health and human services may make the payments of such assistance to a protective payee, as defined by federal regulations, for the benefit of such person.

Source. 1937, 202:32. RL 126:30. 1951, 90:9. RSA 167:26. 1969, 451:7. 1975, 223:1. 1983, 291:1. 1995, 310:176, 181, eff. Nov. 1, 1995.

Section 167:27

    167:27 Eligibility for State and Local Assistance, Confidentiality. –
I. Except as provided in paragraph II, no person receiving old age assistance or aid to the permanently and totally disabled under this chapter or RSA 161 shall at the same time receive any other relief from the state, or from any political subdivision thereof, except for medical and surgical assistance.
II. Notwithstanding paragraph I, a municipality may provide assistance under RSA 165 to a person who is also receiving old age assistance or aid to the permanently and totally disabled if the guidelines adopted by the governing body under RSA 165:1 authorize assistance to such persons, and the acceptance of such relief shall not operate as a revocation of old age assistance or aid to the permanently and totally disabled.
III. The names of persons receiving old age assistance or aid to the permanently and totally disabled under the provisions of this chapter or RSA 161 shall not be printed in any report of the county commissioners or of the commissioner of health and human services nor published in any state, county, or town report.

Source. 1937, 202:33. RL 126:31. 1951, 90:10. RSA 167:27. 1983, 291:1. 1995, 310:176. 2013, 183:1, eff. Jan. 1, 2014.

Section 167:27-a

    167:27-a Personal Needs Allowance of Residents of Nursing Homes. –
I. The commissioner of health and human services shall permit each medical assistance recipient approved for nursing home payments to retain from the recipient's monthly income a certain amount a month for personal needs. Such amount shall be established by the commissioner pursuant to RSA 541-A and in accordance with federal regulations, but in no event shall the amount be less than $56. If the net monthly income of such a recipient is less than the amount established by the commissioner, the commissioner shall provide sufficient old age assistance, aid to the permanently and totally disabled, or aid to the needy blind to allow the recipient an amount equal to the monthly amount established as allowance for the recipient's personal needs.
II. Every 5 years, the commissioner shall make the adjustment for cost of living increases in the personal needs allowance to reflect social security increases.

Source. 1983, 291:1; 469:133. 1986, 183:8. 1987, 328:1. 1989, 304:1. 1995, 310:176, 183. 1999, 298:1. 2005, 213:1, eff. July 1, 2005.

Section 167:27-b

    167:27-b Personal Needs Allowance of Residents in Residential Care Facilities and Community Residences. – Recipients of assistance who are approved by the department of health and human services for residential care facility or community residence payments shall be allowed to retain from their income an amount not less than the amount established by the commissioner of the department of health and human services as provided in RSA 167:27-a as the monthly allowance for their personal needs, in accordance with rules adopted by the commissioner of the department of health and human services pursuant to RSA 541-A. This amount shall not be used to reimburse facilities for the cost of care.

Source. 1987, 328:3. 1988, 289:2. 1989, 304:2. 1995, 310:181, 182, eff. Nov. 1, 1995.

Section 167:27-c

    167:27-c Cost-of-Living Increases to Residents of Residential Care Facilities and Community Residences. – The state shall maintain its minimum supplementary payment levels to recipients of assistance at residential care facilities and community residences in conjunction with supplemental and social security increases. The commissioner of the department of health and human services, shall not decrease the amount of the state's contribution paid to recipients of financial assistance in residential care facilities and community residences because of such supplemental and social security increases.

Source. 1994, 127:1. 1995, 310:182, eff. Nov. 1, 1995.

Section 167:28

    167:28 Condition of Granting Assistance. – The commissioner of the department of health and human services shall require as a condition to granting old age assistance, aid to the permanently and totally disabled, or aid to the needy blind in any case that the applicant, and the spouse of the applicant, if any, residing with the applicant, submit a properly acknowledged agreement to reimburse the federal government, the state and the county for all assistance granted. In such agreement such applicant, and the spouse of the applicant, if any, shall assign as collateral security for such assistance such part of his or her personal property as the commissioner of health and human services shall demand. All funds recovered under the provisions of this section and RSA 167:27, after any necessary reimbursement to the federal government as provided in RSA 167:13, shall be allocated to the county and to the state in the same proportion as the assistance paid by each.

Source. 1949, 173:1, par. 32-a. 1951, 90:11. RSA 167:28. 1983, 291:1. 1985, 380:46. 1995, 310:176, 182. 2006, 278:1, eff. June 15, 2006.

Section 167:29

    167:29 Assignment of Property. – If the commissioner of the department of health and human services shall deem it necessary he may require as a condition to the grant or continuance of old age assistance or aid to the permanently and totally disabled in any case that all or any part of the property of a person applying for such aid be transferred to the commissioner of the department of health and human services in trust as follows: Such property shall be managed by said commissioner of health and human services and the net income thereof shall be paid to such person; said commissioner of health and human services shall have the power to sell, lease, or transfer such property or defend or prosecute all suits concerning it and to pay all just claims against it and to do all things necessary for the protection, preservation, and management thereof. If the old age assistance or aid to the permanently and totally disabled of such person is discontinued during his lifetime, the property thus transferred shall be returned to him subject to a lien on such property for any sums paid to him as old age assistance or aid to the permanently and totally disabled under this chapter or RSA 161, or the remainder of such property after deducting therefrom the sums paid to him as such assistance shall be returned to him. In the event of his death, the remainder of such property, after deducting therefrom the sums paid him as old age assistance or aid to the permanently and totally disabled under this chapter or RSA 161, shall be considered as the property of the estate of the beneficiary for administrative proceedings. The commissioner of health and human services shall execute and deliver all necessary instruments to give effect to this section.

Source. 1937, 202:35. RL 126:33. 1951, 90:12. RSA 167:29. 1983, 291:1. 1995, 310:176, 182, eff. Nov. 1, 1995.

Section 167:30

    167:30 Confidential Character of Public Assistance Records. – Whenever under provisions of law names and addresses of recipients of assistance or child welfare services under this chapter or RSA 161 are furnished to or held by any other agency or department of government, such agency or department of government shall be required to adopt regulations necessary to prevent the publication of lists thereof or their use for purposes not directly connected with the administration of this chapter or RSA 161.

Source. 1941, 107:3. RL 126:34. 1951, 90:13. RSA 167:30. 1973, 353:3, eff. Aug. 26, 1973.

Section 167:31

    167:31 Misuse of Lists and Records. – It shall be unlawful except for purposes directly connected with the administration of assistance or child welfare services under this chapter or RSA 161, and in accordance with regulations prescribed by the commissioner for any person, to solicit, disclose, receive, make use of or to authorize, knowingly permit, participate in or acquiesce in the use of, any list of or names of, or any information concerning persons applying for or receiving such assistance or services directly or indirectly derived from the records, papers, files or communications of the department of health and human services, or agencies thereof, or acquired in the course of the performance of official duties.

Source. 1941, 107:3. RL 126:35. 1951, 90:13. RSA 167:31. 1973, 353:4. 1983, 291:1. 1995, 310:181, 183, eff. Nov. 1, 1995.

Section 167:32

    167:32 Penalties. – Any person who shall violate the provisions of RSA 167:31 shall be guilty of a violation.

Source. 1941, 107:3. RL 126:36. RSA 167:32. 1973, 531:39, eff. Oct. 31, 1973 at 11:59 p.m.

Section 167:33

    167:33 Legal Proceedings. – Any suit, action, petition, or other legal proceeding to enforce a lien recovering any money or property from any recipient of old age assistance or aid to the permanently and totally disabled, under this chapter or RSA 161, or his estate shall be instituted and prosecuted in the name of the state of New Hampshire, and any recovery shall be for the benefit of and, after any necessary reimbursement of the federal government, be allocated and paid to the state and the county in proportion to the assistance paid.

Source. 1937, 202:36. RL 126:37. 1951, 90:13. RSA 167:33. 1985, 380:46, eff. Jan. 1, 1986.

Section 167:34

    167:34 Reports by Counties. – The counties shall, from time to time, make such reports relative to direct relief, and shall transfer to said department of health and human services such records relative to old age assistance and aid to the blind, as the commissioner of health and human services may determine.

Source. 1937, 202:37. RL 126:38. RSA 167:34. 1983, 291:1. 1985, 380:46. 1995, 310:176, 181, eff. Nov. 1, 1995.

Aid to the Blind

Section 167:35 to 167:37

    167:35 to 167:37 Repealed by 1970, 34:4-6, eff. July 1, 1970. –

Industrial Workshop and Homework Program

Section 167:37-a to 167:42

    167:37-a to 167:42 Repealed by 1970, 34:7-12, eff. July 1, 1970. –

Section 167:42-a

    167:42-a Repealed by 1983, 275:4, eff. Aug. 17, 1983. –

Support of Dependent Children

Section 167:43

    167:43 Repealed by 1995, 310:170, IX, eff. Nov. 1, 1995. –

Section 167:44 to 167:49

    167:44 to 167:49 Repealed by 1973, 117:2, I, eff. July 7, 1973. –

Section 167:50 to 167:52

    167:50 to 167:52 Repealed by 1990, 201:19, eff. June 26, 1990. –

Section 167:53

    167:53 Notice of Placing. – It shall be the duty of any person, public official, society, or institution, placing any dependent or neglected child in any family home or institution, to give notice in writing to the commissioner within 10 days after such placing, stating the name of such child and the name, residence, or location of the person or institution with whom or in which such child is placed.

Source. 1917, 104:1. PL 109:11. RL 127:11. RSA 167:53. 1995, 310:183, eff. Nov. 1, 1995.

Section 167:54 to 167:56

    167:54 to 167:56 Repealed by 1973, 117:2, II, eff. July 7, 1973. –

Section 167:57

    167:57 Repealed by 1973, 266:3, eff. Aug. 21, 1973. –

Medicaid Fraud and False Claims

Section 167:58

    167:58 Definitions. –
In this subdivision:
I. "Abuse" means provider practices that are inconsistent with sound fiscal, business, or medical practices, and result in an unnecessary cost to the medicaid program, or in reimbursement for services that are above those actually rendered, that are not medically necessary, or that fail to meet professionally recognized standards for health care.
I-a. "Commissioner" means the commissioner of the department of health and human services.
II. "Data" means information of any kind in any form, including computer software as defined in RSA 638:16, VI.
III. "Department" means the department of health and human services.
IV. "Fraud" means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person. It includes any act that constitutes fraud under New Hampshire criminal code, RSA title LXII.
V. "Provider" means any individual, partnership, corporation or entity furnishing services under a written contract with the department.
VI. "Suspension" means the removal of a provider from participation in the medicaid program for not less than 60 days nor more than 6 months.
VII. "Termination" means the removal of a provider from participation in the medicaid program for an indefinite period of time.

Source. 1981, 189:2. 1983, 291:1. 1990, 260:1. 1995, 310:121, 175, eff. Nov. 1, 1995.

Section 167:59

    167:59 Duties of the Commissioner. –
The commissioner shall:
I. Provide medical assistance to all individuals who are eligible for the medicaid program, pursuant to RSA 161 and RSA 167.
II. Cooperate with the attorney general in the investigation of all identified instances of possible fraud or abuse in the medicaid program.
III. Refer to the attorney general for prosecution all cases where there is substantial potential for fraud and abuse in the medicaid program.
IV. Suspend or terminate from participation in the medicaid program any provider who is convicted of fraud or abuse in the medicaid program or any provider who violates rules adopted by the commissioner relative to medicaid.

Source. 1981, 189:2. 1987, 207:3. 1995, 310:183, eff. Nov. 1, 1995.

Section 167:60

    167:60 Suspension or Termination of a Medicaid Provider. –
The commissioner shall suspend or terminate any provider from the medicaid program:
I. Who has been found guilty of violating RSA 167:17-b or 167:61-a; or
II. Who, after notice of overpayment and identification of claims resulting in the overpayment, does not reimburse the department by the amount of overpayment.

Source. 1981, 189:2. 1990, 260:2. 1995, 310:175, 183, eff. Nov. 1, 1995.

Section 167:61

    167:61 Repealed by 2004, 167:3, eff. Jan. 1, 2010. –

Section 167:61-a

    167:61-a Prohibited Acts. –
I. No person shall:
(a) Knowingly make, present or cause to be made or presented, with intent to defraud, any false or fraudulent claim for payment for any good, service, or accommodation for which payment may be made in whole or in part under RSA 161 or RSA 167;
(b) Knowingly make, present, or cause to be made or presented, with intent to defraud, any false or fraudulent statement or representation for use in determining rights to benefits or payments which may be made in whole or in part under RSA 161 or RSA 167;
(c) Knowingly make, present, or cause to be made or presented, with intent to defraud, any false or fraudulent report or filing which is or may be used in computing or determining a rate of payment for goods, services, or accommodations for which payment may be made in whole or in part under RSA 161 or RSA 167; or make, present, or cause to be made or presented any false or fraudulent statement or representation in connection with any such report or filing;
(d) Knowingly make, present, or cause to be made or presented, with intent to defraud, any claim for payment, for any good, service, or accommodation for which payment may be made in whole or in part under RSA 161 or RSA 167, which is not medically necessary in accordance with professionally recognized standards;
(e) Knowingly make or cause to be made, with intent to defraud, any wholly or partially false or fraudulent book, record, document, data, or instrument, which is required to be kept or which is kept as documentation:
(1) For any good, service, or accommodation for which payment is or has been sought in whole or in part under RSA 161 or RSA 167; or
(2) Of any cost or expense claimed for reimbursement for any good, service, or accommodation for which payment is or has been sought in whole or in part under RSA 161 or RSA 167;
(f) Knowingly:
(1) Make or cause to be made, with intent to defraud, any false or fraudulent statement to; or
(2) Offer or present or cause to be offered or presented, with intent to defraud, any wholly or partially false or fraudulent record, document, data, or instrument to any law enforcement officer, including any employee or agent of the attorney general, or to any employee or agent of the department of health and human services, in connection with any audit or investigation involving any claim for payment or rate of payment for any good, service, or accommodation payable in whole or in part under RSA 161 or RSA 167;
(g) Destroy or conceal or cause to be destroyed or concealed any book, record, document, data, or instrument required to be kept or which is kept as documentation:
(1) For any good, service, or accommodation for which payment is or has been sought in whole or in part under RSA 161 or RSA 167; or
(2) Of any cost or expense claimed for reimbursement for any good, service, or accommodation for which payment is or has been sought in whole or in part under RSA 161 or RSA 167; with the purpose of hindering or impeding any audit or investigation conducted by any law enforcement officer, including any employee or agent of the attorney general, or to any employee or agent of the department of health and human services;
(h) Knowingly make, present, or cause to be made or presented, with intent to defraud, any claim for payment for any good, service, or accommodation for which payment may be made in whole or in part under RSA 161 or RSA 167, which may only be furnished by a person who is licensed by an appropriate licensing authority, and the person who furnished the good, service, or accommodation:
(1) Was not licensed by the appropriate licensing authority; or
(2) Was licensed by the appropriate licensing authority but such license was obtained through a misrepresentation of material fact, including cheating on any examination required for licensing;
(i) Knowingly solicit or receive any remuneration, including any bribe or rebate, directly or indirectly, overtly or covertly, in cash or in kind, in return for purchasing, leasing, ordering, or arranging for or recommending the purchase, lease, or ordering of any good, service, accommodation or facility for which payment may be made in whole or in part under RSA 161 or RSA 167, or knowingly offer or pay any remuneration, including any bribe or rebate, directly or indirectly, overtly or covertly, in cash or in kind, to induce a person to purchase, lease, order, or arrange for or recommend the purchase, lease, or ordering of any good, service, accommodation or facility for which payment may be made in whole or in part under RSA 161 or RSA 167; or
(j) Knowingly charge, solicit, accept or receive, in addition to any amount otherwise required to be paid under RSA 161 or RSA 167, any gift, money, donation, or other consideration either as a precondition of admitting or expediting the admission of a patient to a hospital, skilled nursing facility, or intermediate care facility, when the cost of the services provided in such facility to the patient is paid for in whole or in part under RSA 161 or RSA 167.
II. (a) Any natural person who violates any provision of this section shall be guilty of a class B felony.
(b) Any other person who violates any provision of this section shall be guilty of a felony.

Source. 1990, 260:3, eff. June 27, 1990.

Section 167:61-b

    167:61-b False Claims Against the Department; Definitions. –
I. Any person shall be liable to the state for a civil penalty of not less than $5,000 and not more than $10,000, plus 3 times the amount of damages that the state sustains because of the act of that person, who:
(a) Knowingly presents, or causes to be presented, to an officer or employee of the department, a false or fraudulent claim for payment or approval.
(b) Knowingly makes, uses, or causes to be made or used, a false record or statement to get a false or fraudulent claim paid or approved by the department.
(c) Conspires to defraud the department by getting a false or fraudulent claim allowed or paid.
(d) Has possession, custody, or control of property or money used, or to be used, by the department and, intending to defraud the department or willfully to conceal the property, delivers, or causes to be delivered, less property than the amount for which the person receives a certificate or receipt.
(e) Knowingly makes, uses, or causes to be made or used, a false record or statement to conceal, avoid, or decrease an obligation to pay or transmit money or property to the department.
(f) Is a beneficiary of an inadvertent submission of a false claim to the department, who subsequently discovers the falsity of the claim, and fails to disclose the false claim to the department within a reasonable time after discovery of the false claim.
II. (a) Notwithstanding the damages provisions of paragraph I, the court may assess not less than 2 or more than 3 times the amount of damages that the state sustains because of the act of the person and no civil penalty, if the court finds that a person who has violated paragraph I:
(1) Furnished officials of the state responsible for investigating false claims violations with all information known to the person about the violation within 30 days after the date on which the defendant first obtained the information;
(2) Fully cooperated with any state investigation of such violation; and
(3) At the time the person furnished the state with the information about the violation, no criminal prosecution, civil action, or administrative action had commenced under this chapter with respect to such violation, and the person did not have actual knowledge of the existence of an investigation into such violation.
(b) A person violating paragraph I shall also be liable to the state for the costs and attorneys' fees arising from any civil action brought to recover the penalty or damages.
III. Liability under this section shall be joint and several for any act committed by 2 or more persons.
IV. This section shall not apply to any controversy involving damages to the department of less than $5,000 in value. For purposes of this paragraph, "controversy" means the aggregate of any one or more false claims submitted by the same person.
V. In RSA 167:61-b through RSA 167:61-e:
(a) "Claim" means any request or demand, whether under a contract or otherwise, for money or property that is made to an officer, employee, agent, or other representative of the department or to a contractor, grantee, or other person, if the department provides any portion of the money or property that is requested or demanded, or if the department will reimburse the contractor, grantee, or other recipient for any portion of the money or property that is requested or demanded.
(b)(1) "Knowing" and "knowingly" means that a person, with respect to information:
(A) Has actual knowledge of the information;
(B) Acts in deliberate ignorance of the truth or falsity of the information; or
(C) Acts in reckless disregard of the truth or falsity of the information.
(2) No proof of specific intent to defraud is required for an act to be knowing.
(c) "Original source" means an individual who has direct and independent knowledge of the information on which the allegations are based and has voluntarily provided the information to the state before filing an action under RSA 167:61-c that is based on the information, and whose information provided the basis or catalyst for the investigation, hearing, audit, or report that led to the public disclosure.
(d) "Person" means any natural person, corporation, firm, association, organization, partnership, business, or trust.
(e) "Relator" means an individual who brings an action under RSA 167:61-c.
VI. In any action brought under RSA 167:61-c, the state shall be required to prove all essential elements of the cause of action, including damages, by a preponderance of the evidence.
VII. An action for false claims under RSA 167:61-c shall not be brought:
(a) More than 6 years after the date on which the violation of RSA 167:61-b is committed; or
(b) More than 3 years after the date when facts material to the right of action are known or reasonably should have been known by the official within the office of the attorney general charged with responsibility to act in the circumstances, but in no event more than 10 years after the date on which the violation is committed, whichever occurs last.

Source. 2004, 167:2, eff. Jan. 1, 2005.

Section 167:61-c

    167:61-c Actions by Attorney General and Private Persons. –
I. The attorney general shall investigate violations under RSA 167:61-b. If the attorney general finds that a person has violated or is violating RSA 167:61-b, the attorney general may bring a civil action in superior court against the person.
II. (a) An individual, hereafter referred to as "relator," may bring a civil action for a violation of RSA 167:61-b, I on behalf of the relator and for the state. The action shall be brought in the name of the state against a defendant that (1) has its principal place of business within the state or (2) during the 12-month period immediately preceding the date the action is filed, received reimbursement from the Medicaid program of this state, as defined under RSA 167:63, V, equal to 10 percent or more of the defendant's aggregate reimbursement from all state medical assistance programs governed by Title XIX of the Social Security Act. No court shall have jurisdiction over an action brought by a relator under this paragraph, and no award shall be paid under RSA 167:61-e, I or V, unless the action satisfies the requirements of this paragraph.
(b) When a relator brings an action under this section, no person other than the state may intervene or bring a related action based on the facts underlying the pending action.
(c) A copy of the complaint and written disclosure of substantially all material evidence and information the relator possesses shall be served on the state in accordance with the New Hampshire rules of civil procedure. The complaint shall be filed in camera, shall remain under seal for at least 60 days, and shall not be served on the defendant until the court so orders. The state may elect to intervene and proceed with the action within 60 days after it receives both the complaint and the material evidence and information.
(d) The state may, for good cause shown, move the court for one or more extensions of the 60-day time period during which the complaint shall remain under seal. Any such motion may be supported by affidavits or other submissions filed under seal.
(e) Before the expiration of the 60-day period or any extension obtained, the state shall:
(1) Proceed with the action, in which case the action shall be conducted by the state; or
(2) Notify the court that it declines to take over the action, in which case the relator who initiated the proceeding may conduct the action. If the state, having elected not to proceed with the action, so requests, it shall be served with copies of all pleadings filed in the action and shall receive copies of all deposition transcripts. The court, without limiting the status and rights of the relator, may subsequently permit the state to intervene upon a showing of good cause.
III. The defendant shall not be required to respond to any complaint filed under this section until after the complaint is unsealed and served upon the defendant in accordance with the New Hampshire rules of civil procedure.
IV. Notwithstanding any provision of RSA 275-E to the contrary, any employee who is discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against in the terms and conditions of employment by his or her employer because of lawful acts done by the employee on behalf of the employee or others in furtherance of an action under this section, including investigation for, initiation of, testimony for, or assistance in an action filed or to be filed under this section, shall be entitled to all relief necessary to make the employee whole. Such relief shall include reinstatement with the same seniority status such employee would have had but for the discrimination, 2 times the amount of back pay, interest on the back pay, and compensation for any special damages sustained as a result of the discrimination, including litigation costs and reasonable attorneys' fees. An employee may bring an action in the superior court for the relief provided in this paragraph. For purposes of this paragraph, "employee" has the same meaning as in RSA 275-E:1, I.

Source. 2004, 167:2. 2009, 141:1. 2011, 186:1, eff. June 14, 2011.

Section 167:61-d

    167:61-d Rights of Parties to Actions. –
I. If the state proceeds with an action under RSA 167:61-c, the state shall have the primary responsibility for prosecuting the action and shall not be bound by an act of the relator bringing the action. The relator shall have the right to continue as a party to the action, subject to the following limitations:
(a) The state may dismiss the action notwithstanding the objections of the relator initiating the action if the court determines, after a hearing on the motion, that dismissal should be allowed.
(b) The state may settle the action with the defendant notwithstanding the objections of the relator initiating the action if the court determines, after a hearing, that the proposed settlement is fair, adequate, and reasonable under all the circumstances. Upon a showing of good cause, the hearing may be held in camera.
II. Notwithstanding RSA 167:61-c, the state may elect to pursue its claim through any alternate remedy available to the state, including any administrative proceeding to determine a civil monetary penalty. If any such alternate remedy is pursued in another proceeding, the relator initiating the action shall have the same rights in the proceeding as the relator would have had if the action had continued under this section. Any finding of fact or conclusion of law made in such other proceeding that has become final shall be conclusive on all parties to an action under this section.
III. The parties to the action shall receive court approval of any settlements reached.

Source. 2004, 167:2, eff. Jan. 1, 2005.

Section 167:61-e

    167:61-e Award to Relator. –
I. If the state proceeds with an action brought by a relator under RSA 167:61-c, the relator shall, except as otherwise provided in this paragraph, receive at least 15 percent but not more than 25 percent of the proceeds of the action or settlement of the claim, depending upon the extent to which the relator substantially contributed to the prosecution of the action. Where the action is one that the court finds to be based primarily on disclosures of specific information, other than information provided by the relator bringing the action, relating to allegations or transactions in a criminal, civil, or administrative hearing, in a legislative or administrative report, hearing, audit, or investigation, or from the news media, the court may award sums as it considers appropriate, but in no case more than 10 percent of the proceeds, taking into account the significance of the information furnished by the relator and the role of the relator bringing the action in advancing the case to litigation. Any payment to a relator under this paragraph shall be made from the proceeds. The relator shall also receive an amount for reasonable expenses that the court finds to have been necessarily incurred, plus reasonable attorneys' fees and costs. All expenses, fees, and costs shall be awarded against the defendant.
II. Whether or not the state proceeds with the action, if the court finds that the action was brought by a relator who planned and initiated the violation of RSA 167:61-b upon which the action was brought, then the court may, to the extent the court considers appropriate, reduce the share of the proceeds of the action that the relator would otherwise receive under paragraph I, taking into account the role of the relator in advancing the case to litigation and any relevant circumstances pertaining to the violation. If the relator bringing the action is convicted of criminal conduct arising from the relator's role in the violation of RSA 167:61-b, the relator shall be dismissed from the civil action and shall not receive any share of the proceeds of the action. The dismissal shall not prejudice the right of the state to continue the action represented by the attorney general.
III. No court shall have jurisdiction over an action brought under RSA 167:61-c:
(a) Against any department official or any division, board, bureau, commission or agency within the department;
(b) When the relator is a present or former employee of the state and the action is based upon information discovered by the employee during the course of the employee's employment, unless the employee first, in good faith, exhausted any existing internal procedures for reporting and seeking recovery of the falsely claimed sums through official channels and the state failed to act on the information provided within a reasonable period of time;
(c) That is based upon allegations or transactions that are the subject of a civil suit or an administrative civil money penalty proceeding, in which the state is already a party; or
(d) That is based upon the public disclosure of allegations or transactions in a criminal, civil, or administrative hearing, in a legislative or administrative report, hearing, audit, or investigation, or from the news media, unless the action is brought by the attorney general or the relator bringing the action is an original source of the information.
IV. The state shall not be liable for expenses or fees, including attorneys' fees, that a relator incurs in bringing an action under RSA 167:61-c and shall not elect to pay those expenses or fees.
V. If the state does not proceed with an action brought by a relator under RSA 167:61-c, the relator bringing the action or settling the claim shall receive an amount that the court decides is reasonable for collecting the civil penalty and damages. The amount shall not be less than 25 percent and not more than 30 percent of the proceeds of the action or settlement and shall be paid out of the proceeds. The relator shall also receive an amount for reasonable expenses that the court finds to have been necessarily incurred, plus reasonable attorneys fees and costs. All expenses, fees, and costs shall be awarded against the defendant.
VI. If the state does not proceed with an action brought by a relator under RSA 167:61-c and the relator conducts the action, the court may award to the defendant reasonable attorneys fees and expenses if the defendant prevails in the action and the court finds that the claim was clearly frivolous, clearly vexatious, or brought primarily for purposes of harassment.

Source. 2004, 167:2. 2009, 141:2-4, eff. June 29, 2009.

Section 167:62

    167:62 Repealed by 1990, 228:4, eff. June 26, 1990. –

Uncompensated Care and Medicaid Fund

Section 167:63

    167:63 Definitions. –
As used in this subdivision:
I. "Commissioner" means the commissioner of health and human services.
II. "Department" means New Hampshire department of health and human services.
III. [Repealed.]
IV. "Hospital" means general hospitals required to be licensed under RSA 151, but not including government facilities.
V. "Medicaid" means the New Hampshire medicaid assistance program as described in RSA 161 and RSA 167, and in Title XIX of the Social Security Act as amended.

Source. 1991, 299:5. 1993, 4:16, III. 2011, 224:35, eff. July 1, 2011. 2014, 158:14, eff. July 1, 2014.

Section 167:64

    167:64 Uncompensated Care and Medicaid Fund. –
I. There is hereby established in the state treasury an uncompensated care and Medicaid fund which shall consist of the moneys collected pursuant to RSA 84-A. Investment earnings of the fund shall be credited to the fund. Moneys paid into the fund shall be exempt from any state budget reductions, and the commissioner is authorized to expend these funds, together with matching federal funds, as follows:
(a)(1) The commissioner shall provide reimbursement for uncompensated care costs from the uncompensated care and Medicaid fund through either Medicaid rate adjustments, Medicaid supplemental payments, MCO directed payments to hospitals, disproportionate share hospital payment adjustments, or any other allowable Medicaid payment, including a combination thereof, provided however that no hospital shall receive any such reimbursement for uncompensated care costs unless it is a qualified hospital as defined in subparagraph (b)(1). Funds available under this section shall also be used to make provider payments and to support Medicaid services and programs administered by the department in amounts directed by the budget in each year of the biennium.
(2) Expenditure of revenues deposited to the uncompensated care and Medicaid fund shall be made for the following purposes in the following order of priority in fiscal years 2018 through 2024. However, no hospital shall be paid uncompensated care cost payments of more than 100 percent of the governing hospital-specific limit on disproportional share hospital payments under Title XIX of the Social Security Act and the provisions of all federal regulations promulgated thereunder:
(A) To make uncompensated care cost payments, including the state share and matching federal share, to New Hampshire hospitals with and without critical access designation in the following order of priority, and in the following amounts: fiscal year 2018-a sum equaling 92.2 percent of money collected pursuant to RSA 84-A for the fiscal year; fiscal year 2019-a sum equaling 90.2 percent of money collected pursuant to RSA 84-A for the fiscal year; and fiscal years 2020 through 2024-a sum equaling 86 percent of money collected pursuant to RSA 84-A for the fiscal year. Notwithstanding the foregoing sums for each fiscal year, in no event shall the amounts paid to hospitals as uncompensated care cost hospital payments, including the New Hampshire Hospital, in any particular fiscal year exceed the state share for matching the maximum state disproportionate share hospital allotment established under 42 U.S.C. section 1396r-4(f) for that fiscal year plus the matching federal share. If the maximum state disproportionate share hospital allotment established under 42 U.S.C. section 1396r-4(f) for any fiscal year, less the uncompensated care cost hospital payments to be made to New Hampshire Hospital, plus state matching funds equal to the available federal state disproportionate share hospital allotment for uncompensated care cost hospital payments is less than a sum equaling the percentage of money collected pursuant to RSA 84-A for the fiscal year, any remaining amount, including state and federal share, of the foregoing sums equaling the percentage of money collected pursuant to RSA 84-A for the fiscal year shall be paid to the hospitals as supplemental Medicaid payments, MCO directed payments to hospitals, increased hospital service provider rates, or any other allowable Medicaid payment:
(i) To support 75 percent of the uncompensated care costs of New Hampshire's hospitals with critical access designation consistent with the requirements of 42 U.S.C. section 1396r-4(g) and any relevant federal regulations promulgated thereunder to be shared among such hospitals in proportion to the amount of uncompensated care provided;
(ii) To make payments for uncompensated care costs to New Hampshire's hospitals without critical access hospital designation in proportion to the amount of uncompensated care provided by each hospital from the sum equal to the remainder of the percentage of money collected pursuant to RSA 84-A for the fiscal year specified in subparagraph (a)(2)(A).
(iii) If there is a change to the federal definition of uncompensated care costs that would result in a decrease to the calculation in subparagraph (i), the percentage of allowable uncompensated care costs for New Hampshire's hospitals with critical access designation percentage of allowable uncompensated care costs shall increase from 75 percent to a percentage that would be equivalent to their receiving 75 percent of uncompensated care costs calculated without regard to payments from Medicare or third party payers as allowable on the date of the enactment of this provision, except that no hospital shall be paid disproportionate share hospital payments of more than 100 percent of the governing hospital-specific limit on disproportional share hospital payments under Title XIX of the Social Security Act. If increasing the percentage of the allowable uncompensated care costs would exceed 100 percent of the governing hospital specific limit, any amount in excess shall be paid to the New Hampshire hospitals with critical access designation as supplemental Medicaid payments, MCO directed payments to hospitals, increased hospital service provider rates, or any other allowable Medicaid payments.
(B) To make a payment for uncompensated care costs to each hospital that meets the criteria set forth for "deemed disproportionate share hospitals" as that term is defined under 42 U.S.C. section 1396r-4 up to $250,000 in each year of the biennium as set forth in subparagraph (b)(1)(A). For fiscal years 2018 and 2019 only, any payment under this subparagraph shall not reduce the payments made under subparagraphs (a)(2)(A)(i)-(iii).
(C) To increase hospital service provider rates in fiscal year 2020 through fiscal year 2024, by an amount equal to 5 percent of the revenue collected pursuant to RSA 84-A for the fiscal year.
(D) Any remaining funds produced from the Medicaid enhancement tax shall be used to support provider payments and to support Medicaid services and programs administered by the department.
(E) Hospitals entitled to payments under subparagraphs (a)(2)(A)(i)-(iii) or (a)(2)(C) have a vested contractual right to receive these payments in fiscal years 2018 through 2024 as limited by paragraph IV.
(b)(1) The commissioner is hereby authorized and directed to develop and implement a schedule of payments for reimbursement of the uncompensated care costs consistent with the level of funding made available for such payments in each year of any biennium, incurred by those hospitals that are qualified as follows:
(A) The hospital is a "deemed disproportionate share hospital" as defined by criteria set forth under 42 U.S.C. section 1396r-4 and is not otherwise receiving a disproportionate share hospital payment; or
(B) The hospital:
(i) Meets the minimum criteria for disproportionate share eligibility under relevant federal statutory changes at 42 U.S.C. 1396r-4(d);
(ii) Is not a special hospital for rehabilitation; and
(iii) Participates in the provider network of the state Medicaid care management program.
(2) The reimbursement of uncompensated care costs paid in state fiscal year 2015 and thereafter shall be in accordance with the schedule of payments to hospitals consistent with this section and shall be structured in a manner that is consistent with all federal laws and regulations governing (i) Title XIX disproportionate share hospital payment adjustments and other rate payments, (ii) conditions for receiving federal financial participation, and (iii) permissible sources of state financial participation as provided for under 42 C.F.R. part 433 and all other applicable federal regulations. Disproportionate share hospital payments shall be made under this paragraph by May 31 in any fiscal year.
(c) For purposes of this section, uncompensated care costs shall include: any charity care cost, and any portion of Medicaid-covered patient care costs unreimbursed by Medicaid payments, that the commissioner determines would meet the criteria under 42 U.S.C. section 1396r-4(g) governing hospital-specific limits on disproportionate share hospital payments under Title XIX of the Social Security Act and the provisions of all federal regulations promulgated thereunder.
(d) One percent of the funds made available for uncompensated care payments shall be placed in a separate class line reserved for the expenses of the department in administering this subdivision.
II. Moneys in the uncompensated care and Medicaid fund shall be continually appropriated to the department for the purposes of this subdivision.
III. The department shall secure all necessary waivers pursuant to 42 C.F.R. section 433.68 and approvals of state plan amendments from the Centers for Medicare and Medicaid Services (CMS).
IV. Payment of the federal share of uncompensated care cost hospital payments, supplemental Medicaid payments, MCO directed payments to hospitals, increased hospital service provider rates, and any other allowable Medicaid payment under this section is contingent upon New Hampshire receiving those federal funds and any necessary CMS approvals that the department is required to secure pursuant to paragraph III.

Source. 1991, 299:5; 390:6, 7. 1993, 4:10-12, 16, IV; 358:8. 1994, 122:8. 2009, 144:212. 2011, 224:36. 2013, 144:47, eff. July 1, 2013. 2014, 158:13, eff. June 30, 2014. 2018, 162:32, 33, eff. June 6, 2018.

Section 167:65

    167:65 Duties of Commissioner. –
The commissioner shall:
I. Develop the uncompensated care payment system in a manner that is consistent with the requirements of RSA 167:64 and Title XIX of the Social Security Act as amended and describe the system in an amendment to the state Medicaid plan.
II. [Repealed.]
III. [Repealed.]
IV. Adopt rules pursuant to RSA 541-A, as necessary, to implement this system.

Source. 1991, 299:5; 390:8. 1993, 4:13, 16, V. 2009, 144:212. 2011, 224:37, 41. 2013, 144:49, eff. July 1, 2013.

The Children's Health Plan

Section 167:66

    167:66 Short Title. – This subdivision may be referred to as "The Children's Health Plan."

Source. 1993, 358:54, eff. July 8, 1993.

Section 167:67

    167:67 Findings and Purpose. –
I. The general court finds that at least 30,000 New Hampshire children lack health insurance. The lack of available, comprehensive maternity and child health services imposes a great cost, in both human and financial terms, on the citizens of this state. Both government and industry have long recognized the need for continual reinvestment in physical plant, public infrastructure, marketing, research and development, but less attention has been paid to the need for investment in our state's human resources. At a time when growing economic competition makes it essential that New Hampshire have a high quality work force, spending on programs to develop that work force is a necessary investment.
II. That investment begins with healthy beginnings for children, including early and comprehensive prenatal care and comprehensive primary and preventive child health and developmental services. Equally important, maternal and child preventive health and child development programs are highly cost effective simply from the perspective of health care and special education cost avoidance. Studies show that modest investments in preventive programs today will reduce long-term health and welfare spending by the states tomorrow. Thus, the cost to New Hampshire of not providing adequate access to maternal and child health services can be measured in wasted lives, rising costs of remedial health and social programs, and a work force increasingly unprepared for the challenges of international economic competition. Recent federal legislation regarding medicaid coverage for low-income pregnant women and children has created an unparalleled opportunity for federal cost sharing in state programs that serve this high risk population.
III. The purpose of this subdivision is to make a needed and strategic investment in this state's human resources by taking advantage of federally created options to obtain additional federal financial assistance by expanding medicaid eligibility for low income pregnant women and children. This subdivision also provides for improved outreach and enrollment of medicaid eligible pregnant women and children and improved coordination of medicaid services for pregnant women and children with other publicly-funded programs providing maternal and child health services.

Source. 1993, 358:54, eff. July 8, 1993.

Section 167:68

    167:68 Medicaid Enhancement for Children and Pregnant Women. –
The commissioner of the department of health and human services shall adopt rules under RSA 541-A which:
I. Establish by July 1, 1999, categorically needy coverage groups under RSA 167:6, VII and Title XIX of the Social Security Act, sections 1902(a)(10)(A)(i)(IV), 1902(a)(10)(A)(i)(VI) and 1902(a)(10)(i)(VII) and establish less restrictive income and resource methodologies under section 1902(r)(2) of Title XIX of the Social Security Act as necessary to increase the eligibility level for medicaid coverage to a minimum of 185 percent of the federal poverty level disregarding resources for a family size equal to the size of the family including the woman, infant or child. This includes:
(a) Women during pregnancy and during the 60-day period beginning on the last day of the pregnancy; and
(b) Infants under one year of age; and
(c) Children who have attained one year of age but have not attained 6 years of age; and
(d) Children born after September 30, 1983, who have attained 6 years of age but have not attained 19 years of age; and
(e) Children born on or before September 30, 1983, who have not yet attained 19 years of age.
II. Establish by January 1, 1994, procedures in the medical assistance program for improved outreach and enrollment for pregnant women and children. Such procedures shall include:
(a) Implementing shortened, simplified medicaid-only application forms for the individuals covered under paragraphs I and II.
(b) Providing for the receipt and initial processing of medicaid applications from individuals covered under paragraphs I and II at locations which are other than those used for the receipt and processing of applications for aid to families with dependent children and which include providers of Title V Maternal and Child Health Services, Title X Family Planning Services, the Special Supplemental Food Program for Women, Infants and Children and Early Intervention program sites, as well as those required under 42 U.S.C. 1396a(a)(55). Individuals submitting applications at sites, other than the department of health and human services district offices, shall not be required to subsequently visit the department of health and human services district office to complete the initial eligibility determination process.
(c) Instituting a formal procedure for taking maternity-related medical assistance applications at the offices of "qualified providers" including the providers listed in RSA 167:68, III(b) and for making medicaid services available to a pregnant woman during a "presumptive eligibility period" as provided in 42 U.S.C. 1396r-1. Presumptive eligibility shall be made available to pregnant women applying at department of health and human services district offices as well as to pregnant women applying at non-district office sites.
(d) Instituting an aggressive public education campaign regarding the availability of medicaid coverage for maternal and child health services, the existence of other publicly-funded health programs serving mothers and children, and the advantages of preventive health care.
(e) Instituting a newborn home visiting program whereby a licensed health professional makes a home visit to targeted households with medicaid covered newborns within 60 days after birth to encourage families to participate in the Early and Periodic, Screening, Diagnosis and Treatment Program, to conduct a health screen, to better link the family with primary health care, and to better ensure continued medicaid coverage for the infant.
III. Establish by January 1, 1994, procedures for improved coordination of the medicaid program for pregnant women and children with other publicly-funded health programs serving mothers and children, including Title V Maternal and Child Health, Title X Family Planning, and the Special Supplemental Food Program for Women, Infants and Children, and the Early Intervention Program. Such procedures shall include, to the extent permissible by federal law:
(a) A common application form;
(b) Medicaid eligibility technicians located at agencies providing these publicly-funded health care services; and
(c) The continuation and completion of rulemaking and other measures designed to make medicaid reimbursement available to these publicly funded health programs for medically necessary case management and care coordination services provided by these agencies to medicaid eligible pregnant women and children.

Source. 1993, 358:54. 1994, 409:1, 2. 1995, 190:8, eff. July 1, 1999; 310:122, 180, 182, eff. Nov. 1, 1995. 2015, 276:152, eff. July 1, 2015.

Section 167:68-a

    167:68-a Home Visiting Programs. – Home visiting programs for children and their families established pursuant to this subdivision shall be made available to all Medicaid eligible pregnant women, infants, and families with children up to age one, without restriction. The commissioner shall adopt rules, pursuant to RSA 541-A, relative to administering this section.

Source. 2019, 285:1, eff. Sept. 17, 2019. 2021, 91:418, eff. July 1, 2021.

Health Care Fund

Section 167:69 to 167:75

    167:69 to 167:75 Repealed by 2003, 319:145, I, eff. July 1, 2003. –

Section 167:76

    167:76 Repealed by 1995, 310:170, X, eff. Nov. 1, 1995. –

New Hampshire Employment Program and Family Assistance Program

Section 167:77

    167:77 Statement of Purpose. –
I. The purpose of this subdivision is to reform welfare through the vehicle made available by the federal government. To the extent permitted by federal law, it is the intent of the general court to operate the Temporary Assistance to Needy Families (TANF) program through 2 subprograms:
(a) The New Hampshire employment program which shall provide financial assistance for families with dependent children when the children are cared for by a parent or relative who is receiving assistance and is considered to be able-bodied for employment.
(b) The family assistance program which shall provide financial assistance for families with dependent children when the parent or other relative is considered unable to work due to a physical or mental disability or the children are cared for by a relative other than a parent who is not receiving assistance.
II. The New Hampshire employment program and the family assistance program are the financial assistance programs upon which Medicaid and Food Stamps are automatically granted.
III. Notwithstanding any other laws to the contrary, the New Hampshire employment program and family assistance program shall be covered by this subdivision and the rules adopted under the authority of this section. All statutory provisions within RSA 161 and 167 which are not inconsistent with the provisions of this subdivision shall remain in full force and effect and shall apply to the New Hampshire employment program and the family assistance program.
IV. The New Hampshire employment program shall promote economic independence and help maintain and strengthen family life by enabling able-bodied persons with dependent children to assume responsibility for their families through the dignity of work. Work shall be promoted by:
(a) Offering employment services, support services, and transitional financial assistance with the expectation that participants move quickly towards employment.
(b) Developing long-term employment skills that lead to self-sufficiency.
(c) Supporting job readiness, life skills, workforce training, and barrier resolution programs with proven records of success in ensuring that employment program clients are truly prepared for the workforce and able to maintain self-sufficiency regardless of whether those programs count towards the federal work participation rate.
(d) Recognizing the equal responsibility of both parents to provide economic support for their children.
V. The goals of the New Hampshire employment program shall be to:
(a) Eliminate or reduce the harmful effects of poverty on families and children by fostering employment and opportunity as a means to economic independence.
(b) Assist participants to gain employment as rapidly as possible, given due consideration to individual circumstances, labor market conditions, the needs of the dependent children for continuing care and protection, and the ultimate goal of long-term economic independence.
(c) Eliminate the stigma of welfare by promoting a philosophy and perception that the purpose of welfare is to eliminate or reduce the harmful effects of poverty on families and children by promoting work opportunities for all New Hampshire residents.
(d) Support and coordinate with activities that promote self-sufficiency and strengthen family life.
(e) Provide a comprehensive support service package that includes: medical assistance, food stamps, child care, transportation, child support, and other support services necessary to promote economic independence.
(f) Promote successful transition from public assistance through the provision of job readiness activities, training, and education activities concurrently with employment or seeking employment, family support skills, and follow-up services for problem resolution and job advancement.
(g) Develop partnerships with employers to create job opportunities and meet the needs of both employers and participants.
(h) Provide a program where it is more advantageous to work than not to work by rewarding self-sufficiency.
(i) Implement a program that is clear, focused, and simple to administer.
VI. The goals of the family assistance program shall be to:
(a) Eliminate or reduce the harmful effects of poverty on families and children by providing financial assistance and medical assistance only to families with children in a manner compatible with decency and health.
(b) Promote employment opportunities.

Source. 1995, 310:62. 2006, 325:1. 2007, 349:1, eff. Sept. 14, 2007.

Section 167:77-a

    167:77-a Work Participation Rates. –
The department shall make strong efforts to meet the work participation rate requirements of the federal TANF program, as amended by the Deficit Reduction Act of 2005.
I. Efforts may include the following actions:
(a) Using state funds not claimed as maintenance of effort for the federal TANF program to provide benefits for categories of families who are exempt from the state's work activity requirements or who have good cause reasons for not participating.
(b) Developing a diversion program for applicants for the employment program for up to 4 months to provide enhanced assessment and job placement services.
(c) Making a claim for additional caseload reduction credits based on state spending above the minimum to meet the federal TANF maintenance of effort requirement.
(d) Assigning participants into work activities that count toward the federal work participation rate where alternative activities are not better suited to assist the participant to enter, re-enter, and maintain employment and move toward self-sufficiency.
(e) Providing continuing assistance to participants who are meeting the hour requirements in an unsubsidized job, as specified in RSA 167:85, VIII.
II. The department shall submit a report to the oversight committee for health and human services, established in RSA 126-A:13, relative to actions taken to increase the work participation rate reported to the federal Department of Health and Human Services. The department also shall provide the oversight committee with an estimate of whether the state shall meet the federal requirements for each federal fiscal year by January 15 of that fiscal year.

Source. 2007, 349:2, eff. Sept. 14, 2007. 2015, 259:13, eff. July 1, 2015.

Section 167:77-b

    167:77-b Performance Measurement System. –
I. The department shall establish a performance measurement system designed to assist the department in meeting the goals of the TANF reauthorization program, including a mission statement identifying values that focus on qualitative outcomes. The measurement system shall be adopted on or before January 1, 2008. The system shall include: measurement and tracking of individual employee performance; tracking and analysis of programmatic outcomes; and tracking of other data or information otherwise useful in establishing success in moving clients into work participation, as defined by federal law. The department shall, for each indicator, develop performance and benchmark scores that reflect normal or expected performance. In developing these indicators, the department shall consult with the oversight committee on health and human services, established in RSA 126-A:13.
II. The department shall prepare an annual report that includes data and comparison with prior years and indicates normal or expected performance levels. Each annual report shall be submitted to the oversight committee on health and human services, the speaker of the house of representatives, the president of the senate, the governor, and the appropriate legislative policy committees. The first such report shall be submitted by December 15, 2007.

Source. 2007, 349:2, eff. Sept. 14, 2007.

Section 167:77-c

    167:77-c Outcome Measurement System. –
I. The oversight committee established by RSA 126-A:13 shall monitor changes to the state TANF program made as a result of the federal reauthorization of TANF in 2005 and shall provide informational meetings on such changes to the general court.
II. The department of health and human services shall provide the federal Administration for Children and Families with the data requested by that agency to calculate the national TANF high performance rankings regardless of whether financial bonuses are paid for performance.
III. Success of the TANF program shall be based on research and statistical analysis to determine if the goals of moving TANF clients towards long term economic independence set forth in RSA 167:77, IV and V are met.
IV. The department shall establish an outcome measurement system with the following areas of analysis:
(a) The number and percent of cash assistance recipients who close each month due to employment, the average hourly, weekly, and monthly wages, the average total weekly and monthly total income, the number and percent who return to cash assistance after 3, 6, and 12 months.
(b) Numbers and percentages of TANF families that leave TANF and ranking of their income compared to the federal poverty level and the New Hampshire living wage.
(c) Poverty and child poverty rates and out of wedlock births and the national ranking of New Hampshire.
(d) The reasons for caseload increases and decreases with analysis of numbers and reasons for openings, denials, and closings and the numbers and reasons for sanctions and denials due to noncompliance with program requirements.
V. The department shall develop and maintain the indicators for the program outcomes listed in paragraph IV, subject to review and approval by the oversight committee on health and human services. The department shall submit a report to the oversight committee each January.

Source. 2007, 349:2, eff. Sept. 14, 2007. 2015, 259:14, eff. July 1, 2015.

Section 167:77-d

    167:77-d TANF Pilot Diversion Program and Study. – The department shall perform a diversion program and study for a limited population of TANF applicants who receive an assessment and benefits prior to entry into the TANF program. The study shall assess the program's feasibility and effectiveness, as well as the impact of the diversion program on work participation rates. The department shall report its findings to the oversight committee on health and human services on December 31, 2007 and each December 31 thereafter, for the duration of the program.

Source. 2007, 349:2, eff. Sept. 14, 2007.

Section 167:77-e

    167:77-e Assistance Program for 2-Parent Families With Dependent Children. – Subject to available public and/or private funds, the department may establish a non-TANF financial assistance program for 2-parent needy families with dependent children in which one parent is underemployed or unemployed. With the exception of parental underemployment or unemployment, client eligibility and program requirements and administration shall be in accordance with this chapter and the rules adopted under this chapter.

Source. 2007, 349:2. 2010, Sp. Sess., 1:2. 2011, 224:286. 2013, 175:1, eff. Aug. 31, 2013. 2018, 204:3, eff. July 1, 2018.

Section 167:77-f

    167:77-f Career Ladder Initiatives. –
The commissioner shall work cooperatively with the Career One Stop Centers and the Workforce Investment Boards to develop career ladder initiatives for employment program clients and former employment program clients.
I. Career ladder initiatives shall:
(a) Promote both increased pay and increased benefits.
(b) Match the needs of the local economy.
(c) Focus on current in-demand occupations with the state.
(d) Explore self employment opportunities.
(e) Share TANF and WIA funding to the extent possible.
II. The department shall report its progress to the oversight committee on health and human services no later than January 1.

Source. 2007, 349:2, eff. Sept. 14, 2007. 2015, 259:15, eff. July 1, 2015.

Section 167:77-g

    167:77-g Adjustment of TANF Financial Assistance. – The maximum monthly cash benefit under this subdivision shall be equal to 60 percent of the federal poverty guidelines, based upon the applicable household size and composition, as determined annually by the United States Department of Health and Human Services.

Source. 2017, 156:83, eff. July 1, 2017.

Section 167:78

    167:78 Definitions. –
In this subdivision:
I. "Able-bodied" means a parent or specified relative who is under the age of 60 and who is not currently receiving supplemental security income, or social security disability insurance, or veteran's disability benefits of 80 percent or more, or state supplemental assistance (aid to the permanently and totally disabled, aid to the needy, blind, or old age assistance) and who does not have significant long-term employment related barriers.
II. "Applicant" means a person who has filed a written application for assistance.
III. "Caretaker relative" means a specified relative, other than a parent, who provides care and parental control to a dependent child.
IV. "Commissioner" means the commissioner of the department of health and human services.
V. "Department" means the department of health and human services.
VI. "Dependent child" means a child under the age of 18, or under the age of 20 if a full-time student in a secondary school or the equivalent, living in the home of a specified relative.
VII. "Earned income" means income in cash or the equivalent received by a person through the receipt of wages, salary, commissions, or profit from activities in which the person is self-employed or as an employee and before any deductions for taxes, except as provided in paragraph XX.
VIII. "Employment program" means the New Hampshire employment program.
IX. "Employment-related activities" mean activities that are designed to assist participants to enter, re-enter, or remain in the workforce. These activities include the activities described in RSA 167:85, the interim activities described in RSA 167:91, activities described in rules adopted pursuant to RSA 541-A, and, for the purposes of counting towards the federal work participation rate, the activities that meet the federally-defined work activities in The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), as amended by the Deficit Reduction Act (DRA), and federal regulations promulgated thereunder and further defined in rules adopted pursuant to RSA 541-A.
X. "Family assistance program" means the New Hampshire family assistance program.
XI. "Inmate of an institution" means a person who is living in a public or private institution. A person is not considered an inmate if:
(a) The person is in an educational or vocational training institution, for purposes of securing education or vocational training; or
(b) The person is in an institution for a temporary emergency period pending other arrangements appropriate to the person's needs.
XII. "Institution of higher education" means any institution determined by the United States Secretary of Education to meet:
(a) The definition of such term contained in either section 1201(a) or section 481(a) of the Higher Education Act of 1965 (20 U.S.C. 1001 et seq.) as amended; or
(b) The definitions of "proprietary institution of higher education" or "postsecondary vocational institution," as defined in sections 481(b) and (c) of such act.
XII-a. "Interim activities" mean those employment-related activities intended to address individual or family barriers to employment or to enhance long-term success in the workplace. These activities are not limited to federally countable work activities.
XIII. "Job search" means employment related activities that are outlined in the employment program.
XIV. "Making good progress" or "making satisfactory progress" means:
(a) While in training, that the participant is meeting a consistent standard of progress based upon a written policy developed by the training provider and approved by the commissioner.
(b) In an educational component, that the participant in any educational activity is meeting a consistent standard of progress based upon a written policy developed by the educational institution or program in which the person is enrolled and which is approved by the commissioner and the appropriate local education agency. Such standard includes both a qualitative measure of a participant's progress, such as a grade point average, and a quantitative measure, such as a reasonable time limit by which a student is expected to complete his or her studies.
XV. "Minor child" means a child less than the age of 18, or less than the age of 20 if a full-time student in a secondary school or the equivalent, living in the home of a specified relative.
XVI. "Minor parent" means a parent who is less than the age of 18.
XVII. "Net income" means the total gross income of the assistance group less allowable disregards and deductions.
XVIII. "On-the-job training" means employment-related activities provided to a person, employed by a private or public employer, that provides knowledge or skills essential to the full and adequate performance of that job.
XIX. "Participant" means a person who has been found eligible for assistance.
XX. "Self-employment" means the total profit from a business enterprise, farming, etc., resulting from a comparison of the gross receipts with the business expenses, i.e., expenses directly related to producing the goods or services and without which the goods or services could not be produced. However, items such as depreciation, personal business and entertainment expenses, and personal transportation are not business expenses.
XXI. "Economic independence" or "self-sufficiency" means that a participant household has obtained employment providing sufficient wages and other benefits to provide for the family's basic living needs in a manner compatible with decency and health with minimal or no reliance on any form of public assistance from federal, state, or local governments.
XXII. [Repealed.]
XXIII. "Specified relative" means a father, mother, grandfather, grandmother, brother, sister, stepfather, stepmother, stepbrother, stepsister, uncle, aunt, first cousin, nephew, or niece (including relatives of half-blood, relatives of preceding generations as denoted by the prefixes of grand, great, or great-great, adoptive parents and their relatives to the same degree as blood relatives, and spouses of the above relatives even after the marriage is terminated by death or divorce) who provides care and parental control to a dependent child.
XXIII-a. "Sponsor" means a private nonprofit employer, private charitable employer, private or public employer that provides a community or alternate work experience to a participant.
XXIV. "Temporary absence" means any assistance group member who is temporarily away from the home for, but not limited to, the following reasons: school attendance, vacation, illness, or work.

Source. 1995, 310:62. 1998, 379:1. 2006, 325:2-6. 2007, 349:3, 4, 19, VI, eff. Sept. 14, 2007.

Section 167:79

    167:79 Employment Program; Eligibility. –
I. (a) For purposes of this subdivision, a person shall be eligible for financial assistance under the employment program who is a needy child deprived of parental support or care by reason of death, continued absence from the home, physical or mental incapacity, and who lives with a parent or an able-bodied specified relative. If the child is living with both parents, one parent shall be able-bodied. The parent or parents of the dependent child or the able-bodied caretaker relative may also be eligible for assistance.
(b) A needy child who is deprived of parental support or care by reason of unemployment or underemployment of a parent may receive assistance under TANF or under the state-funded assistance program in RSA 167:77-e.
II. The following persons shall be included in the assistance group, unless such person receives foster care or adoption assistance, if living in the same household or temporarily absent from the household: any dependent child and all minor blood-related, step, or adoptive brothers and sisters, and all natural, step, or adoptive parents of such children, including cohabitating adults who share a minor child. In the case of a minor parent, the assistance unit may also include all natural, step, or adoptive parents of the minor parent and all minor blood-related, step or adoptive brothers and sisters. If the parents are not residing together a child shall be considered residing with the parent who has physical custody of the child the majority of the time.
III. The following requirements and conditions shall be necessary to establish eligibility for the entire assistance group:
(a) The department has the authority to require appointments necessary for entry into the employment program, including but not limited to the initial orientation interview, as a condition of eligibility for TANF financial assistance in accordance with rules established pursuant to RSA 541-A. The department shall provide an opportunity for an orientation interview within 10 days of the date of application and shall offer referral assistance for child care and transportation.
(b) An applicant whose most recent case closure was the result of sanction for non-compliance in the employment program shall first participate fully in verifiable and approved employment-related activities for a period of 2 consecutive weeks.
(c) The parent or caretaker relative shall comply with the following with regard to any child for whom financial assistance is requested:
(1) Provide information and cooperate in all actions necessary to establish the child's paternity unless good cause exists.
(2) If the father is not identified, participate in an interview with a child support worker for the purpose of understanding the importance of establishing paternity and obtaining child support. Such interview shall be scheduled prior to any action to deny eligibility.
(3) Assign to the department the rights to any child or spousal support payments made by a person outside the assistance group to benefit any family member within the assistance group.
(4) In all other ways cooperate with efforts to obtain child or spousal support and identify and locate liable relatives, unless good cause exists. Good cause exists if the conditions defined in RSA 167:82, III(b) are met.
(d) An applicant who voluntarily quits or refuses a job without good cause, as defined in RSA 167:82, III(c), while receiving financial assistance shall first participate fully in verifiable and approved employment-related activities for a period of 2 consecutive weeks.
(e) The assistance group's net income shall be less than the payment standard for the assistance group size.
(f) The assistance group's countable resources shall be less than the allowable resource limit established by the department pursuant to RSA 167:81, II.
(g) A written application, signed under a penalty of perjury, shall be completed by the person applying for assistance.
(h) A person shall provide such person's social security number, or apply for a social security number if the person does not have one.
(i) The identity of all applicants for assistance shall be verified.
(j) A parent or caretaker relative shall appear for an interview.
(k) Each person in the assistance group shall develop all potential sources of income for which such person may be eligible. Each person shall apply for such income, cooperate in applying for such income, and accept the income if eligible.
(l) No person in the assistance group shall be on strike, unless the person establishes to the satisfaction of the commissioner that:
(1) The unemployment results solely from a lockout; or
(2) That to attempt to or to cross the picket line would place the person in physical danger.
(m) An unwed minor parent shall reside with such person's parent, legal guardian, other adult relative, or in another adult supervised supported arrangement, unless:
(1) The minor parent resided separately from such person's parent or legal guardian for a period of at least one year before either the birth of the dependent child or the parent's application for assistance;
(2) The physical or emotional health or safety of the minor parent or dependent child would be jeopardized; or
(3) There is otherwise good cause for the minor parent and dependent child to receive assistance while residing separate from the minor parent's parent, legal guardian, or other adult relative; or outside of an adult supervised living arrangement.
(n) Any other requirements established by the department by rules adopted pursuant to RSA 541-A as necessary to promote the purpose and goals of this subdivision.
IV. Failure to meet the following requirements shall result in that person being ineligible for assistance:
(a) A person shall be a current resident of the state of New Hampshire.
(b) A person shall not be an inmate of a public or private institution.
(c) A person shall be a United States citizen, or shall meet the citizenship requirements established in PRWORA, as amended.
(d) Any other requirements established by the department by rules adopted pursuant to RSA 541-A as necessary to promote the purpose and goals of this subdivision.
V. (a) The following persons are not eligible for assistance:
(1) A person who is not a United States citizen and does not meet the citizenship requirements established in PRWORA, as amended.
(2) A spouse of a caretaker relative.
(3) Other persons as determined by the department by rules adopted pursuant to RSA 541-A as necessary to promote the purpose and goals of this subdivision.
(b) The treatment of needs, income, and resources of such persons in the determination of eligibility and the amount of the financial assistance payment to other persons in the assistance group shall be determined by the department by rules adopted in accordance with RSA 541-A.
VI. Failure to meet the following requirements shall result in the imposition of sanctions and the reduction of benefits or case closure for the assistance group:
(a) A parent or caretaker relative shall comply with all of the following for any child for whom financial assistance is requested:
(1) Provide information and cooperate in all action necessary to establish the child's paternity unless good cause exists. If the father is not identified, the parent or caretaker shall participate in an interview with a child support worker for the purpose of understanding the importance of establishing paternity and obtaining child support. The interview shall take place prior to any action to reduce assistance.
(2) Assign to the department the rights to any child or spousal support payments made by a person outside the assistance group to benefit any family member within the assistance group.
(3) In all other ways cooperate with efforts to obtain child or spousal support and identify and locate liable relatives, unless good cause exists. Good cause exists if the conditions defined in RSA 167:82, III(b) are met.
(b) A parent or caretaker relative shall not voluntarily quit a job or refuse a job unless there is good cause as defined in RSA 167:82, III(c).
(c) A parent or caretaker relative and case members shall attend and cooperate with all required appointments and activities for entry into and participation in the employment program.
(d) Applicants and participants of the employment program shall participate in the development of an employment contract pursuant to RSA 167:88, shall agree to the terms of the employment contract, and shall cooperate fully with the steps established in the employment contract.
(e) Any other requirements established by the department by rules adopted pursuant to RSA 541-A as necessary to promote the purpose and goals of this subdivision.

Source. 1995, 310:62. 1996, 170:1, 3, I. 2006, 325:7. 2007, 349:5-8. 2011, 224:287, eff. July 1, 2011; 272:2, eff. Jan. 13, 2012.

Section 167:80

    167:80 Eligibility; Income. –
I. Eligibility for assistance shall be based in part on the available countable earned and unearned income of the persons in the assistance group.
II. The department shall establish income limits for applicant and participant assistance groups by rules adopted pursuant to RSA 541-A.
III. All forms of earned and unearned income shall be counted unless specifically excluded pursuant to paragraph IV.
IV. The following types of income shall be excluded when determining eligibility for assistance:
(a) Advance earned income tax credit.
(b) Earned income from dependent children who are full-time students in primary or secondary school or equivalent.
(c) Payment in kind.
(d) Vendor payments.
(e) Interest and dividends from countable resources.
(f) Educational scholarships, grants, and loans.
(g) Any income that is not legally available to the assistance group.
(h) Federal, state, and local means-tested assistance other than means-tested assistance that is defined as included by the department by rules adopted pursuant to RSA 541-A.
(i) Any other type of income excluded by the department by rules adopted pursuant to RSA 541-A as necessary to promote the purpose and goals of this subdivision.
V. The treatment of non-recurring lump sum payments relative to eligibility shall be determined by rules adopted pursuant to RSA 541-A.

Source. 1995, 310:62. 1996, 170:2, eff. Aug. 2, 1996.

Section 167:81

    167:81 Eligibility; Resources. –
I. Eligibility for assistance shall be based in part on the equity value of all countable resources available to the assistance group.
II. The department shall establish resource limits for applicant and participant assistance groups by rules adopted pursuant to RSA 541-A.
III. All resources owned by any member of the assistance group shall be considered as countable unless specifically excluded by paragraph IV.
IV. The following resources shall be excluded when determining eligibility for assistance:
(a) The primary residence of the household.
(b) One vehicle per parent or caretaker relative.
(c) Resources belonging to and used solely by a business.
(d) All household possessions.
(e) Any resource that is not legally available to the assistance group.
(f) Farm equipment.
(g) Any other resource as determined by the department by rules adopted pursuant to RSA 541-A as necessary to promote the purpose and goals of this subdivision.
V. The treatment of non-recurring lump sum payments relative to eligibility shall be determined by rules adopted pursuant to RSA 541-A.

Source. 1995, 310:62, eff. Nov. 1, 1995.

Section 167:81-a

    167:81-a Eligibility; Individuals Exempt From Federal Law Which Denies Assistance and Benefits for Certain Drug-Related Felony Convictions. – Pursuant to the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, section 115(a)(1)-(2) of Public Law 104-19, all individuals domiciled in this state shall be exempt from the application of section 115(d)(1)(A) of Public Law 104-19 which makes any individual ineligible for certain state and federal assistance if that individual has been convicted under federal or state law of any offense which is classified as a felony by the law of the jurisdiction and which has as an element the possession, use, or distribution of a controlled substance as defined in section 102(6) of the Controlled Substances Act (21 U.S.C. 802(6)).

Source. 1997, 157:1, eff. Aug. 8, 1997.

Section 167:82

    167:82 Employment Program Characteristics. –
I. The program shall provide financial assistance to assistance groups who meet and comply with all the eligibility and employment program participation requirements under RSA 167:79, 167:80, and 167:81.
II. The following persons shall be temporarily exempt from participation in employment-related activities:
(a) Dependent children under the age of 16.
(b) Dependent children age 16 or older who are full-time students in an elementary, secondary, vocational/technical school, or the equivalent.
(c) A parent or caretaker relative who is personally providing care for a child under one year of age, subject to a maximum exemption period for an individual of 12 months over their lifetime. A parent or caretaker relative who has exhausted the maximum allowable exemption and who subsequently gives birth to a child for whom financial assistance is requested, shall be permitted exemption immediately following the child's birth for a maximum period of 12 weeks.
(d) A parent or caretaker relative who is 60 years of age or older.
(e) A pregnant woman who is deemed medically unable to participate, as certified by a licensed physician. The physician shall certify, on a form provided by the department, the duration and limitations of the disability.
(f) A person who is temporarily unable to participate in program requirements due to illness or incapacity as certified by a licensed physician or board certified psychologist. The physician or psychologist shall certify, on a form provided by the department, the duration and limitations of the disability.
(g) A parent or caretaker relative required to be in the home to care for another relative or assistance group member who resides in the same household due to that member's illness, or incapacity or disability; and there are no other household members to provide the care; and required care is considered necessary by a licensed physician or board certified psychologist. The physician or psychologist shall certify, on a form provided by the department, the duration that care is required. The household shall meet participation and verification requirements in PRWORA, as amended by the DRA, and federal regulations promulgated thereunder.
(h) Temporary exemptions shall remain in effect until the individual enters his or her 40th month of receipt of TANF financial assistance.
(i) A person with significant employment-related barriers, as determined by the department by rules adopted pursuant to RSA 541-A, that prevent the person from accepting immediate employment.
(j) Any other person as determined by the department by rules adopted pursuant to RSA 541-A as necessary to promote the purpose and goals of this subdivision.
III. Financial assistance for an assistance group shall be reduced and can lead to case closure subject to the sanction policy as established under RSA 167:79, VI, 167:82, III, and 167:82, IV and by rules adopted pursuant to RSA 541-A, if a parent or caretaker relative of the assistance group:
(a) Fails to assign child support rights to the department.
(b) Fails to cooperate with child support requirements without good cause. A parent or caretaker relative shall have good cause for noncooperation with child support requirements when efforts to establish paternity or secure support are against the best interests of the child or parent or caretaker relative or when efforts to establish paternity or secure support can reasonably be anticipated to result in physical or emotional harm to the child or parent or caretaker relative. A parent or caretaker relative shall also have good cause for noncooperation with child support requirements when at least one of the following conditions exists:
(1) The child for whom support is sought was conceived as a result of incest or forcible rape;
(2) Proceedings for adoption of the child are pending in a court; or
(3) A social service agency is helping the parent or caretaker relative decide whether to relinquish the child for adoption, and the discussions have not occurred for more than 3 months.
(c) Voluntarily quits a job consisting of at least 20 hours of work per week without good cause 60 days or less prior to the date of application for financial assistance, and such parent or caretaker relative has not become reemployed at a level consisting of at least 20 hours of work per week. Good cause for leaving employment shall include any of the following:
(1) Discrimination by an employer based on age, race, sex, color, physical or mental disability, religious belief, national origin, or political beliefs;
(2) Work demands or conditions that render continued employment unreasonable, including but not limited to, employment in which the degree of risk to health or safety is unreasonable or employment yielding weekly earnings of less than the state or federal hourly minimum wage;
(3) Resignation by a person under the age of 60 which is recognized by the employer as retirement;
(4) Employment which becomes or is revealed to be unsuitable following acceptance of such employment, including, but not limited to, employment which the parent or caretaker relative is physically or mentally unfit to perform, or employment in which the distance from the parent or caretaker relative's home to the place of employment is unreasonable considering the wage and the time and cost of commuting;
(5) Acceptance by the parent or caretaker relative of new employment or enrollment at least half time in a training or education program, that requires the parent or caretaker relative to leave current employment, provided that the training or education program meets the requirements in RSA 167:85, IV(h) or (i);
(6) Leaving a job in order to accept a bona-fide job offer which job offer, because of subsequent circumstances beyond the control of the applicant, is withdrawn or results in employment of fewer than 20 hours per week or weekly earnings of less than the state or federal hourly minimum wage;
(7) Leaving a job in connection with patterns of employment in which workers frequently move from one employer to another, such as migrant farm labor or construction work, even though employment at the new site has not actually begun;
(8) Leaving a job because of circumstances beyond the control of the parent or caretaker relative which render continued employment impracticable, including but not limited to, lack of transportation or child care, or illness, incapacity or disability of the parent or caretaker relative, or illness, incapacity or disability of another household member serious enough to require the presence in the home of the parent or caretaker relative, net loss of cash income, required court appearance, or mandated appointments; or
(9) Other good cause.
(d) Voluntarily quits or refuses a job without good cause as defined in RSA 167:82, III(c) while receiving financial assistance. A parent or caretaker relative shall be considered to have voluntarily quit a job while receiving financial assistance if such person fails to report for work without good cause as defined in RSA 167:82, III(c), resulting in the termination of the parent or caretaker relative's employment while receiving assistance. A parent or caretaker relative who is fired or resigns from a job at the request of the employer due to such person's inability to maintain the employer's normal work productivity standard shall not be considered to have voluntarily quit the job.
(e) Fails to comply without good cause with ongoing participation requirements in RSA 167:85, 167:88, 167:90, or 167:91. Good cause shall exist when circumstances are beyond the participant's control, including, but not limited to, lack of transportation or child care, or illness, incapacity or disability of the participant, or illness, incapacity or disability of another household member serious enough to require the presence in the home of the participant, net loss of cash income, required court appearance, mandated appointments, or unreasonable risk to the health or safety of any household member. The participant shall be allowed 7 business days from the date of notification of non-compliance to present verifiable information supporting good cause.
(f) Fails to comply with other eligibility requirements as determined by the department by rules adopted pursuant to RSA 541-A as necessary to promote the purpose and goals of this subdivision.
(g) Fails to provide verification of their participation in required activities or other verification as established by PRWORA, as amended by DRA, and federal regulations promulgated thereunder.
IV. Financial assistance for an assistance group shall be reduced if a non-deferred dependent child of the assistance group:
(a) Fails to comply without good cause with ongoing participation requirements as required by RSA 167:85, 167:88, 167:90, or 167:91. Good cause shall exist when circumstances are beyond the participant's control, including, but not limited to, lack of transportation or child care, or illness, incapacity or disability of the participant, or illness, incapacity or disability of another household member serious enough to require the presence in the home of the participant, net loss of cash income, required court appearance, mandated appointments, or unreasonable risk to the health or safety of any household member.
(b) Failure to comply with other eligibility requirements as determined by the department by rules adopted pursuant to RSA 541-A as necessary to promote the purpose and goals of this subdivision.
V. The department shall establish a sanction policy for participants who are non-compliant with program requirements. The goal of the sanction policy shall be to obtain compliance with the work requirements and move the client towards self-sufficiency. The sanction policy shall establish the timing and occurrence of benefit reduction and termination of the TANF financial assistance case for non-compliance as provided in this paragraph. No reduction shall be imposed which disregards the needs of the children when the parent or caretaker relative who is out of compliance lacks the means necessary to immediately come into compliance. The following progression of sanctions shall apply:
(a) The initial sanction shall consist of reduction of financial assistance benefits representing the needs of the individual who is out of compliance. The second level of sanction shall consist of reduction of 1/3 of the adjusted payment standard for the assistance group. The third level of the sanction shall consist of reduction of 2/3 of the adjusted payment standard for the assistance group. The initial sanction shall apply for a 2-week period. The second and third levels of sanction shall each apply for a 4-week period, at the end of which the TANF financial assistance case shall close if the participant remains in noncompliance. Progressive sanctions shall apply unless and until the participant demonstrates full compliance. Termination of assistance shall not occur until reasonable efforts for a home visit have been made to ensure that the client was competent to understand the requirement and had the means to come into compliance.
(b) For non-compliance in the employment program or for voluntarily quitting a job as defined in RSA 167:82, III(c), full compliance is demonstrated by completion of verifiable participation in approved employment-related activities for 2 consecutive weeks.
(c) For non-compliance in paternity identification or assignment of support, full compliance is demonstrated by fully cooperating in all action necessary to identify and establish paternity or to identify, locate, assign and obtain support.
(d) For non-compliance by a non-deferred dependent child in participation requirements, the initial sanction shall consist of reduction of financial assistance in the amount established to meet the needs of the dependent child. The benefit reduction shall continue for the duration of the non-compliance.
(e) For all sanctions, the reduction period shall apply to the period immediately following the determination of non-compliance. A determination of non-compliance shall be made within 10 business days of an act of non-compliance, barring a finding of good cause. The participant shall be allowed 2 weeks from the date of benefit reduction to demonstrate full compliance. No sanction shall be imposed on a household unless the participant who is out of compliance has received prior written notice of the reason for the reduction of assistance and the specific actions which must be taken in order to reinstate full assistance.
(f) A participant, other than a non-deferred dependent child, who is in sanction status for a cumulative period of 3 months over a 12-month period shall have his or her TANF case closed.
(g) For a TANF financial assistance case that closes in sanction status, in the event of reapplication for financial assistance at a later time, the participant shall demonstrate full compliance before the TANF financial assistance case may be processed.
VI. Participants shall be eligible for medical assistance as categorically needy provided they receive financial assistance under this subdivision, or are otherwise eligible to receive such assistance but do not. An assistance group that becomes ineligible due to new or increased earnings shall remain eligible for medical assistance for 12 months from when the assistance group became ineligible pursuant to rules adopted under RSA 541-A.
VII. (a) Financial assistance payments shall be based on the characteristics of the assistance group under this section and the standard of need and payment standard as authorized in RSA 167:7, II. The financial assistance grant is the difference between the assistance group's net income and the payment standard. The financial assistance payments may be contingent on the performance of program activities and may be made after the performance of such program activities. The following disregards and deductions shall be allowed in determining net income:
(1) An applicant earned income disregard.
(2) A participant earned income disregard.
(3) A deduction for all amounts actually paid by the assistance group for court-ordered payments.
(4) A deduction for amounts actually paid for child care expenses not to exceed the applicable rate as determined by the department by rules adopted pursuant to RSA 541-A.
(5) [Repealed.]
(6) Any other disregard or deduction established by the department by rules adopted pursuant to RSA 541-A as necessary to promote the purpose and goals of this subdivision.
(b) The department may establish the amount of the earned income disregard or any other disregard or deduction by rules adopted pursuant to RSA 541-A.
VIII. When the department has made a final determination that a parent or caretaker relative, without good cause, has failed to comply with employment program work requirements under RSA 167:85, and assistance to the household has been reduced or closed pursuant to RSA 167:82, III(c)-(e) or IV(a), the amount of reduction shall be a qualified state assistance reduction. The reduction or closure shall remain a qualified state assistance reduction for so long as the parent or caretaker relative is a New Hampshire employment program recipient and maintains the present ability to cure the reduction by complying with employment program work requirements. The department shall provide advance notice to the parent or caretaker relative of the amount and effective date of the qualified state assistance reduction or closure and that a city or town may consider the amount as deemed income for purposes of calculating eligibility for and the amount of general assistance. Upon request, the department, in a timely manner, shall make available to the welfare administrator of any city or town information as to the existence and amount of any qualified state assistance reduction or closure or denial that has been imposed on any person applying for assistance from that municipality. Such reporting shall be in accordance with a confidentiality agreement executed between the department and the New Hampshire Local Welfare Administrators Association and in a manner sufficient to enable the tracking of any additional municipal cost which may result from the qualified assistance reduction, closure, or denial.

Source. 1995, 310:62. 1996, 170:3, II; 175:4. 2006, 325:8. 2007, 349:9-12, eff. Sept. 14, 2007.

Section 167:82-a

    167:82-a Infringement on Rights of Other Employees Prohibited; Limited Employee Status. –
I. The employment program shall not require individuals to participate in the employment program in any way contrary to federal law under section 407(f) of the Social Security Act.
II. No participant in the employment program shall be required to work in subsidized employment for more hours than would be needed to produce an equivalent compensation if the participant were paid at the federal minimum wage level, unless a greater number of hours is necessary for the participant to meet federal work participation requirements.
III. Participants in the employment program shall receive the protections regarding sexual harassment and work conditions, not related to compensation and benefits, which are available to regular employees in that workplace such as safe environment, non-discrimination, and adequate rest and meal periods.

Source. 1997, 279:1. 2006, 325:9, eff. Oct. 1, 2006.

Section 167:83

    167:83 Administration; Duties; Rulemaking. –
I. The commissioner shall provide:
(a) Cash benefits to needy families with dependent children.
(b) Assistance to parents and caretaker relatives of children in such families for employment searches, and other work preparation activities, work experience, and support services that the state considers appropriate to enable such families to achieve self-sufficiency.
(c) Special needs, emergency assistance, and other support and preventive services to parents and caretaker relatives of children in such families under RSA 167:7, V.
II. The commissioner shall adopt rules under RSA 541-A relative to:
(a) A system of hearings for filing a complaint or an appeal.
(b) Notification of case decisions which affect the type or amount of benefits, the level of eligibility, or changes in participation requirements.
(c) Verification of eligibility and program requirements.
(d) Redetermination of an assistance group's eligibility.
(e) The budgeting method for determining or estimating income and family circumstances for the period of the financial assistance payment.
(f) The frequency and distribution of financial assistance payments.
(g) Procedures for voluntary vendor payments.
(h) Assignment of protective payees.
(i) Procedures for reconciling incorrect payments.
(j) Performance standards and a quality control system.
(k) Fraud disqualification, including the treatment of needs, income, and resources of disqualified individuals.
(l) Requirements for proof of good cause claims.
(m) Procedures for counting income and resources of ineligible assistance group members.
(n) Child support payments made to the department directly by the participant.
(o) Operation of the employment program and employment-related activities as required by PRWORA, as amended by DRA, and federal regulations promulgated thereunder.
(p) [Repealed.]
(q) Modification of the work requirement for the child care scholarship program to include participation in an approved mental health or substance use disorder or substance misuse treatment program verified by a licensed physician, an advanced practice registered nurse (APRN), a licensed behavioral health professional, a licensed physician assistant, a licensed alcohol and drug counselor (LADC), a certified recovery support worker (CRSW), or a board-certified psychologist.
III. The department shall advise persons of the following rights:
(a) To apply for assistance and have a timely decision made on the application.
(b) To choose any person to assist them in any aspect of the eligibility process.
(c) To be notified of the decision relative to eligibility, benefit amounts, and of any changes which affect the benefit amount, the level of eligibility, or changes in participation requirements.
(d) To receive written information and be notified of the lump sum policy provisions at the time of application, redetermination, and report of lump sum income.
(e) To not be discriminated against because of gender, race, creed, color, sex, gender identity, sexual orientation, age, disability, political affiliation or beliefs, religion, or national origin.
(f) To request an administrative review or a fair hearing when they are dissatisfied with any action or inaction by the department which affects participation in the employment program, or benefit level or amount of assistance.
(g) To have all information concerning the person held confidential. Use or disclosure of information in case files shall be limited to persons directly involved in administration or enforcement of the employment program, or as otherwise permitted by policy or federal or state laws, or as provided in RSA 167:30.
(h) To be notified of eligibility requirements and actions the department shall take if the person does not comply with eligibility requirements.
(i) To unrestricted use of financial assistance.
(j) To any other rights as defined by the department by rules adopted pursuant to RSA 541-A as necessary to promote the purpose and goals of this subdivision.
IV. The department has the right to pursue and collect any child or spousal support payments made by a person not in the assistance group to benefit any family member of such person in the assistance group.
V. The commissioner may enter into an agreement or contract with the commissioner of the department of employment security to carry out the employment program and may delegate authority and duties for the employment program to the commissioner of the department of employment security and other state agencies. The commissioner shall adopt rules for the employment program.

Source. 1995, 310:62. 2006, 325:10-12. 2007, 349:13. 2010, Sp. Sess., 1:1. 2012, 171:26, X, eff. Aug. 10, 2012. 2018, 334:1, eff. June 30, 2019. 2019, 332:13, eff. Oct. 15, 2019.

Section 167:84

    167:84 Family Assistance Program. –
I. The family assistance program shall provide financial assistance for dependent children who:
(a) Are deprived of parental support or care by reason of death, continued absence from the home, physical or mental incapacity of a parent; and
(b) Reside with either their nonable-bodied specified relative or a caretaker relative who is not included in the assistance group. Financial assistance shall be provided to the parents of the dependent child for the benefit of the child. Financial assistance may be provided to the nonable-bodied caretaker relative for the benefit of the child.
II. An applicant shall meet all eligibility requirements under RSA 167:79, II, III, IV, V, VI(a), RSA 167:80 and RSA 167:81 to be eligible for financial assistance under this section, and shall be subject to applicable sanctions,including case closure, under RSA 167:82, III(a), III(b), and III(f).
III. Persons eligible for financial assistance under this section shall be eligible for medical assistance as categorically needy pursuant to RSA 167:82, VI.
IV. Financial assistance payments shall be pursuant to RSA 167:82, VII.
V. Administration of the family assistance program shall be pursuant to RSA 167:83, I(a), I(c), II, III, and IV.

Source. 1995, 310:62. 2006, 325:13, eff. Oct. 1, 2006.

Section 167:85

    167:85 Employment Program Work Component; Employment-Related Activities. –
The primary purpose of assignment to activities is to prepare the client for work and towards the long term ability to achieve self sufficiency. All applicants and participants in the employment program shall attend and participate in required appointments, employment contract development, and employment-related activities for eligibility into, and while participating in, the program unless temporarily exempt from participation as authorized by RSA 167:82, II. Noncompliance with employment-related activities without good cause shall be subject to financial assistance reductions and case closure pursuant to RSA 167:82, III and IV.
I. The commissioner shall determine the priority of assignment to employment activities and interim activities and the hours of participation in order to promote and provide the skills and training to meet the requirements of long term economic independence in RSA 167:77, IV and V.
II. The commissioner shall make strong efforts to meet the federal work participation rate requirements while assigning employment-related activities that meet the goals stated in the introductory paragraph.
III. An individual is participating in work and work activities for a month in a fiscal year if the individual is participating in work activities for a minimum of 30 hours per week, except as provided in paragraphs V and VI.
IV. Activities may include:
(a) Unsubsidized employment.
(b) Subsidized private sector employment.
(c) Subsidized public sector employment.
(d) Work experience if sufficient private sector employment is not available.
(e) On-the-job training. A participant shall make satisfactory progress in the employment placement to continue to qualify as an employment-related activity under the employment program.
(f) Job search, where participants are required to contact employers and participate in other appropriate job-seeking activities directed toward obtaining full-time, unsubsidized employment and job readiness assistance and life skills including parenting skills.
(g) Community service programs.
(h) Vocational educational training, provided that:
(1) All training shall emphasize vocational skills training for participants in a specific occupational area with priority given to the needs of New Hampshire employers.
(2) The commissioner shall require an assessment for referral to training programs to determine the appropriateness of the training in accordance with employer needs and the criteria established by the commissioner by rules adopted pursuant to RSA 541-A.
(3) Final approval of the training program shall be the responsibility of the commissioner. To the extent possible, Workforce Investment Act funds shall be used.
(4) An extension beyond the federal limitation may be granted if deemed necessary in order to provide for successful transition to employment and long term economic independence.
(i) Postsecondary educational activities. The commissioner may refer a participant to postsecondary education if it appears that postsecondary education will contribute to the family's ability to achieve long-term economic independence. All postsecondary education shall emphasize vocational skills training for participants in a specific occupational area with priority given to the needs of New Hampshire employers. The commissioner shall conduct an assessment for referral to postsecondary educational programs to determine the appropriateness of the post secondary education in accordance with the criteria established by the commissioner by rules adopted pursuant to RSA 541-A. Final approval of the postsecondary educational program shall be the responsibility of the commissioner. An extension beyond the federal limitation may be granted if deemed necessary in order to provide a successful transition to employment and long term economic independence.
(j) The provision of child care services to an individual who is participating in a community service program.
(k) Job skills training directly related to employment.
(l) Education directly related to employment, in the case of a recipient who has not received a high school diploma or a certificate of high school equivalency.
(m) Satisfactory attendance at secondary school or in a course of study leading to a certificate of general equivalence, in the case of a recipient who has not completed secondary school or received such a certificate.
(n) Interim activities described in RSA 167:91.
V. A recipient who is married or is a single head of household and has not attained 20 years of age shall be required to maintain satisfactory attendance at secondary school or the equivalent during the month or participate in education directly related to employment for at least 20 hours per week pursuant to federal regulations.
VI. A single parent with a child under 6 years of age shall be deemed to be meeting work participation requirements if participating in work activities for 20 hours per week.
VII. A person temporarily exempted under RSA 167:82, II may participate in the employment program on a voluntary basis to the extent that the program is available and funding and resources are sufficient as determined by the commissioner. If such a person participating in the employment program does not meet the requirements of this section without good cause pursuant to RSA 167:82, the person shall not re-enroll for 3 months.
VIII. Recipients who are working at least 30 hours per week in paid employment shall not be subject to time limit requirements or be required to attend any meetings that interfere with their work schedule or require them to lose pay.
IX. The commissioner shall waive requirements under this section if funding, resources, and support services are not available to administer this section.

Source. 1995, 310:62. 2006, 325:14. 2007, 349:14, eff. Sept. 14, 2007.

Section 167:86

    167:86 Support Services. – The commissioner shall reimburse persons for necessary travel, child care, and other support service expenses incurred while conducting employment program activities. The amount shall be determined by the commissioner by rules pursuant to RSA 541-A. Child care shall be appropriate and safe. The lack of such care shall be considered good cause for deferral from participation.

Source. 1995, 310:62, eff. Nov. 1, 1995.

Section 167:87

    167:87 Commissioner's Duty to Provide Information. –
The commissioner shall inform applicants and participants in writing and, if appropriate, orally, of available program activities and support services. Information concerning the employment program and participant responsibilities shall be provided, including:
I. The rights, responsibilities, requirements, and obligations of applicants and participants including, but not limited to, the grounds for deferral from participation and the consequences of refusing or failing to cooperate and fully participate.
II. The rights, responsibilities, requirements, and obligations of the department.

Source. 1995, 310:62, eff. Nov. 1, 1995.

Section 167:88

    167:88 Employment Assessment; Employment Contract. –
I. The commissioner shall assess a participant's ability for employment based on:
(a) Such person's work experience, skills, training, education, physical abilities, local labor market area conditions, and if appropriate, aptitude and vocational interests.
(b) Such person's child care, transportation, and other support service needs.
(c) Any other factors that the employment program considers relevant in accordance with rules adopted pursuant to RSA 541-A.
II. The commissioner may make the assessment in paragraph I through various methods, including, but not limited to, interviews, testing, counseling sessions, and self-assessment instruments. Participants identified as needing additional services not provided by the commissioner may be referred to community agencies, resources, and services.
III. Assessments and analysis of outcomes shall be used to determine the activities to which an individual is mandated to participate and such assessment criteria and the resulting assignment shall be described in rules adopted pursuant to RSA 541-A.
IV. The commissioner shall develop an employment contract in conjunction with the participant. To the extent that it is feasible and consistent with the purpose and goals of this subdivision, the employment contract shall reflect the preferences of the participant with respect to goals for employment, training, or education. The employment contract shall:
(a) Indicate employment goals for achieving long-term economic independence, including goals for immediate employment in the labor market.
(b) Outline a planned series of action steps necessary to achieve employment goals.
(c) Include mandatory participation in any employment-related activities as assigned by the employment program.
(d) Describe the services to be provided by the employment program.
(e) Identify the support service needs of the participant and indicate how those needs are being addressed.
V. The commissioner shall make the final approval of the employment contract.

Source. 1995, 310:62. 2006, 325:15. 2007, 349:15, eff. Sept. 14, 2007.

Section 167:89

    167:89 Case Management. – The commissioner may assign a case manager to a participant, as needed.

Source. 1995, 310:62, eff. Nov. 1, 1995.

Section 167:90

    167:90 Job Search Programs. – The commissioner shall provide appropriate employment services, as funding and resources permit, including job referrals, job development, workshops, counseling, labor market information, vocational assessment and testing, and referral to appropriate community agencies and resources. The commissioner shall operate structured job search activities, referred to as Job Club, in all employment program offices. Job Club shall be staffed by positions funded from the TANF reserve of 100 percent federal funds. These positions shall be in addition to the staffing of the employment program office.

Source. 1995, 310:62. 2006, 325:21. 2007, 349:16, eff. Sept. 14, 2007.

Section 167:91

    167:91 Interim Activities. –
The following describes interim activities and associated participant requirements:
I. (a) Each participant less than 20 years of age, who is not enrolled in school and who does not have a general education diploma (GED) or a high school diploma (HSD) shall:
(1) Actively pursue an education designed to prepare such person to qualify for a high school equivalency diploma; or
(2) Enroll in school to pursue a high school diploma.
(b) Each participant required to pursue an education under subparagraph I(a) and who is unable to obtain a GED or HSD in a specified period of time may participate in activities intended to enhance basic literacy and work skills.
(c) A participant shall be permitted to volunteer to participate under paragraphs I and II as funding and resources permit.
II. A participant shall be exempt from the requirements of paragraph I if:
(a) The participant is unable to successfully complete educational activities and is willing and able to participate in employment-related activities; or
(b) The participant's involvement in educational activities is inappropriate, based on assessment and the employment goals established in the employment contract, and such goals do not require a high school diploma or equivalent.
III. An individual may participate in interim activities when the activity has been determined to be reasonable and necessary for his or her entrance into or success in the work force. Participation in an interim activity may not count as an approved activity under PRWORA, as amended by the DRA and federal regulations promulgated thereunder. Interim activities include but are not limited to:
(a) Mental health counseling services.
(b) Homelessness services.
(c) Substance abuse services.
(d) Domestic violence services.
(e) DCYF services.
(f) Vocational educational training beyond that countable as an employment-related activity under PRWORA, as amended by DRA.
(g) Post-secondary education and vocational educational training beyond that countable as an employment-related activity under PRWORA, as amended by DRA.
(h) English as a second language services.
(i) Job search and job readiness beyond that which is countable as employment-related under PRWORA, as amended by DRA.
III-a. (a) A person in good standing in a postsecondary educational program or training program at the time of application to the department may continue to attend if the following requirements are met:
(1) The training or postsecondary education emphasizes vocational skills training in a specific occupation.
(2) The participant is making satisfactory progress in the course of study and the training or postsecondary education is reasonable for entry into the workforce.
(b) Self-initiated education shall not be approved beyond the associates degree level unless the participant is completing a bachelors degree program within a limited period of time to be determined by the department by rules adopted pursuant to RSA 541-A.
(c) Participants in self-initiated training or postsecondary education may be assigned additional activities in order to meet a required number of participation hours.
(d) The applicant is considered appropriate for the training or postsecondary education based on the assessment described in RSA 167:85, IV(h) or (i).
IV. The department shall be the payor of last resort for all expenses involved in any training and postsecondary educational activity, and participants shall be required to apply for any other available assistance, prior to receiving financial assistance from the department. Financial assistance for training and educational programs shall have monetary limits established by the department by rules adopted by the commissioner pursuant to RSA 541-A.
V. The duration of services under this section shall be determined by the commissioner by rules adopted pursuant to RSA 541-A as necessary to promote the purpose and goals of this subdivision.

Source. 1995, 310:62. 2006, 325:16. 2007, 349:17, 18, eff. Sept. 14, 2007.

Section 167:91-a

    167:91-a Infringement on Rights of Other Employees Prohibited. –
I. The work experience and community service program shall not permit individuals in the employment program to participate in any way contrary to federal law under section 407(f) of the Social Security Act.
II. No participant in the work experience and community service program shall be required to work for more hours than would be needed to produce an equivalent compensation if the participant were paid at the federal minimum wage level, unless a greater number of hours is necessary for the participant to meet federal work participation requirements.
III. Participants in the work experience and community service program shall receive the protections regarding sexual harassment and work conditions, not related to compensation and benefits, which are available to regular employees in that workplace such as safe environment, non-discrimination, and adequate rest and meal periods.
IV. Participants in the work experience and community service program administered by the state shall be considered employees of both the state and the sponsor for workers' compensation purposes only, and any claims for workers' compensation thereunder shall be charged to the temporary assistance to needy families program. The state and the sponsor shall both be entitled to the exclusivity of remedy provisions of RSA 281-A:8. For purposes other than workers' compensation, the state shall not be vicariously liable for the actions or omissions of the sponsor and the sponsor shall not be vicariously liable for the actions or omissions of the state. Nothing in this section shall prohibit any direct contractual liability between the state and the sponsor.

Source. 1997, 279:2. 1998, 379:2. 2006, 325:17, eff. Oct. 1, 2006.

Section 167:91-b

    167:91-b Work Experience and Community Service Program Participants; Workers' Compensation Eligibility. –
I. For the purposes of RSA 281-A, an employment program participant is an employee of both the state and the sponsor. In the event that it is determined that the participant has been subject to an injury or occupational disease producing a disability arising out of and in the course of participation in the employment program, the program shall not provide compensation pursuant to RSA 281-A:28, 281-A:28-a, 281-A:31, and 281-A:31-a, but the participant shall receive benefits from the employment program while otherwise eligible, or compensation equivalent to those benefits if the participant becomes ineligible for benefits under RSA 167. When determining the amount of compensation provided pursuant to RSA 281-A:32 for a scheduled permanent impairment award, the amount of compensation shall be calculated by using the minimum wage at the time of injury multiplied by the average number of hours worked per week or the number of hours agreed to by the program and the participant, whichever is higher.
II. The department of health and human services may provide this benefit by appropriate means including purchasing and serving as the master policyholder for any insurance, by self-insurance or by administrative services contract. Except as otherwise provided in this section, all other provisions of RSA 281-A apply.

Source. 1998, 379:3. 2006, 325:17, eff. Oct. 1, 2006.

Section 167:92

    167:92 Suitable Employment. –
The commissioner, in determining whether or not any work is suitable for an individual, shall consider the following:
I. The degree of risk involved to a participant's health, safety, and morals.
II. A participant's physical fitness.
III. A participant's prior training and experience.
IV. A participant's prospects for securing, in the local labor market area, work in his or her customary occupation.
V. The distance of the available work from a participant's residence, provided that such distance shall not be substantially greater than that distance to all those places to which others living in the same town or city travel for work which utilizes similar or related skills or services, and also to where a participant acquired previous annual earnings.
VI. A participant's prior earnings and length of unemployment. Prior earnings may be given more weight initially in the first 26 weeks of the job search program than their length of unemployment.

Source. 1995, 310:62, eff. Nov. 1, 1995.

Section 167:93

    167:93 Administrative Fines. – The commissioner of health and human services, after notice and hearing pursuant to RSA 541-A, may impose an administrative fine pursuant to 42 C.F.R. 488.438 for each offense upon any person who violates any provision of RSA 167 or any rule adopted pursuant to such chapter relative to nursing home enforcement. Rehearings and appeals under this section shall be in accordance with RSA 541. Any administrative fine imposed under this section shall not preclude the imposition of further penalties under this chapter. The commissioner shall adopt rules, under RSA 541-A, relative to the enforcement of this section.

Source. 1996, 163:1, eff. Jan. 1, 1997.

Section 167:93-a

    167:93-a Repealed by 2007, 349:19, I, eff. Sept. 14, 2007. –

Section 167:93-b

    167:93-b Repealed by 2007, 349:19, II, eff. Sept. 14, 2007. –

Section 167:93-c

    167:93-c Repealed by 2007, 349:19, III, eff. Sept. 14, 2007. –

Section 167:93-d

    167:93-d Repealed by 2007, 349:19, IV, eff. Sept. 14, 2007. –

Long-Term Care Assistance Fund

Section 167:94

    167:94 Repealed by 2017, 195:10, eff. Sept. 3, 2017. –

Section 167:95

    167:95 Purposes of the Fund. – The principal assets and interest earnings from the fund shall be used exclusively by the department of health and human services for the development of the community-based infrastructure needed to implement the community initiatives contained in the department's long-term care plan. No expenditures may be made for the purposes of political or legislative advocacy.

Source. 1998, 388:11, eff. Nov. 25, 1998.

Section 167:96

    167:96 Available Assets. – Commencing with the fiscal year ending June 30, 2000, the state treasurer shall annually, on or before October 1, certify an amount to the commissioner which shall be the sum of the market value of the principal assets and interest earnings held in the fund available to be expended under RSA 167:95. Notwithstanding any other provision of law, the funds authorized for expenditure shall not be reduced by any funds made available from other sources.

Source. 1998, 388:11, eff. Nov. 25, 1998.

Section 167:97

    167:97 Restrictions on Support. – In developing the community-based infrastructure pursuant to RSA 169:95 or in any other program, the department shall act as a single state agency on aging and shall not establish or provide support to area agencies on aging.

Source. 1998, 388:11, eff. Nov. 25, 1998.