922.01 Required Verification for a Mental Health or Substance Misuse Treatment Program for Recipient of NHEP or FAP] (FAM)

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Form 2691, Verification for Participation in a Mental Health or Substance Misuse Treatment Program is the only allowable verification for participation in a mental health or substance misuse treatment program.

Section 1 and 2 of Form 2691, Verification for Participation in a Mental Health or Substance Misuse Treatment Program, must be completed, signed, and dated to verify the parent is participating in an approved Mental Health or Substance Misuse Treatment Program.

  A new Form 2691, Verification for Participation in a Mental Health or Substance Misuse Treatment Program, must be submitted at redetermination.

Form 2691 is allowable at initial application or redetermination if the licensed professional has signed and dated the form within the past 90 days.

References: He-C 6910.07, He-C 6910.09 (y), He-C 6910.10(o)(1)-(4), He-C 6910.16(b)(c), RSA 161:2,XII; RSA 167:58,IV, RSA 167:83,I(b), RSA 167:83,II(c) and (o), RSA 167:83,II, 45 CFR 98.20