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• Waiver/Program TitleNH Acquired Brain Disorder Waiver

  State

  New Hampshire

  Waiver Type

  1915(c)

  Waiver Population

  Traumatic Brain Injury

  Waiver Age Group

  22 Years and Over

  Eligibility / Support Assessments

  • Bureau of Developmental Services Functional Screening Form
  • Scales of Independent Behavior-Revised (SIB-R)
  • Supports Intensity Scale (SIS)
  • Health Risk Screening Tool (HRST)

  Quality / Outcome Assessment

  National Core Indicators Adult Consumer Survey (NCI ACS)

• Waiver/Program TitleNH Choices for Independence

  State

  New Hampshire

  Waiver Type

  1915(c)

  Waiver Populations

  • Age Related Disability
  • Physical Disability

  Waiver Age Groups

  • 18-64 Years
  • 65 Years and Over

  Eligibility / Support Assessments

  • Medical Eligibility Assessment (MEA)
  • Minimum Data Set
  • Outcome and Assessment Information Set

• Waiver/Program TitleNH Developmental Disabilities Waiver

  State

  New Hampshire

  Waiver Type

  1915(c)

  Waiver Population

  Intellectual and Developmental Disability

  Waiver Age Group

  All Ages

  Eligibility / Support Assessments

  • ICF/IDD Level of Care Evaluation Form (AL LOC)
  • Scales of Independent Behavior-Revised (SIB-R)
  • Supports Intensity Scale (SIS)
  • Health Risk Screening Tool (HRST)

  Quality / Outcome Assessments

  • National Core Indicators Adult Consumer Survey (NCI ACS)
  • National Core Indicators (NCI) Family Guardian Survey (NCI FGS)

• Waiver/Program TitleNH In Home Supports for Children w/DD

  State

  New Hampshire

  Waiver Type

  1915(c)

  Waiver Populations

  • Intellectual and Developmental Disability
  • Autism Spectrum Disorder

  Waiver Age Group

  0-21 Years

  Eligibility / Support Assessments

  • Supports Intensity Scale (SIS)
  • Health Risk Screening Tool (HRST)
  • Bureau of Developmental Services Functional Screening Form
  • Scales of Independent Behavior-Revised (SIB-R)