- Administrative File for School Year:
- Credentials for all Qualified and waiver approved staff (All Covered Services)
- Evidence of supervision (or under the direction of) for all PTAs, COTAs, OTA/Ls, SLAs (All Covered Services)
- *School Calendar (Just one copy for each school district and applicable out of district placements)
- *Unexpected Closings List (Just one copy for district and any applicable out of district placements)
- * Hours in the regular school day
- Salary Information (For all service providers)
- Cost Information for Specialized Transportation
*While these items are not required by New Hampshire Medicaid policy, MSB recommends inclusion in the administrative file.
- Individual Student Files
|Documentation of Service Delivery||X||X||X||X||X||X||X||X||X||X||X|
|Additional LPHA Signature Required**||X||X||X||X|
|Parental Consent Form*||X||X||X||X||X||X||X||X||X||X||X|
|Annual Notification of Parental Consent Rights*||X||X||X||X||X||X||X||X||X||X||X|
*While these items are not required by New Hampshire Medicaid policy, MSB recommends inclusion in the student file. Parental consent/annual notification is a requirement of the IDEA.
**When speech, OT or PT is delivered by a licensed assistant, a second signature of a qualified LPHA is required within scope of practice