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The Bureau of Mental Health Services will provide approval decisions for only those rules for which they have oversight responsibility, there is a waiver provision in the rule, and as designated by the Commissioner. Laws and statutes cannot be waived and entire rule or “global” waivers are outside of the scope of the BMHS to approve.

BMHS rules and the specific waiver provisions are: He-M 401 and 401.15 ; He-M 402 and 402.10; He-M 403 and 403.16; He-M 405 and 405.17; He-M 406 and 406.10; He-M 408 and 408.14; He-M 426 and 426.24; and He-M 1202 and 1202.12.

The following rules and the specific waiver provisions require additional review and approval from the Office of Licensing and Certification: He-M 1002 and 1002.18; He-M 1007 and 1007.13; He-P 830 and 830.10.

Supporting Documents

Additional documentation submitted with the waiver request in order to substantiate and support the approval decision includes:

Supporting Documents for Client Waivers:

  1. Eligibility determination form. (required)
  2. Individual Services Plan/Treatment Plan. (required)
  3. Case Management Plan and Area Agency ISP (for dual TCM waivers only)
  4. Quarterly Reviews

Supporting Documents for Staff Waivers:

  1. Resume of staff employment, education, and relevant experience or signed employment application.
  2. For initial criminal history waivers, State of NH criminal records & Bureau of Elderly and Adult Services (BEAS) checks completed within 90 days of the waiver request.
  3. Staff waivers must also include the supervision the staff will be receiving on the request form.

Prior Authorization

A Prior Authorization (PA) is required in order for the provider to exceed the service limits identified in rule 426.12 (p):

Additional Information required for PA waivers:

  1. Current treatment plan must include updates service frequencies to identify services needing overages
  2. Procedure Codes and units needed for each code must be included on the request form.
    Allowable codes:
    i. H2010: Comprehensive Medication Support
    ii. H2019: Therapeutic Behavioral Support (TBS)
    iii. H2019 HQ: Group TBS
    iv. H0034: Medication Training and Support
    v. T1027: Family Training and Support
    vi. H2015: Any combination of above codes (total units for all codes)
  3. Unexpected overages of service limits should be submitted as soon as possible prior to billing and will be reviewed on a case by case basis


  1. Incomplete waivers will not be processed and the agency will receive notification of this. It will be the agency’s responsibility to review the waiver and submit a complete version.
  2. Timelines for Processing:
    a. Waiver requests should be submitted a minimum of 30 days prior to the requested start date
    b. The bureau will process all waiver requests within 45 days of receipt, but strive to process within 1 week. If a request needs to be expedited please indicate this when submitting
    Staff waiver requests will be processed within 48 business hours of receipt
    c. Waivers that require DHHS legal consultation or review/consultation with another DHHS department may exceed 45 days for approval decision.
  3. Duration of Waivers
    a. The bureau may approve waivers up to 5 years maximum. Below are some guidelines for common types of requests:
    i. Staff Education waivers: Up to 5 years or if in school; through anticipated graduation
    ii. Eligibility waivers: up to 2 years or until eligibility assessment expires
    iii. Prior Authorizations: Up to 1 year or until ISP/TP expires
    iv. Dual CM waivers: Up to 1 year or until CM plan expires
    v. Staff Training waivers: Up to 1 year or until next available training
  4. All requests are initiated by a single point of contact from the CMHC or agency. All follow-up communication will occur between the Bureau and the Agency contact.
  5. It is preferred that the completed Waiver Request Form Microsoft Word Symbol and supporting documentation be sent via secure e-mail.
    a. Subject line is: “WAIVER from [agency name] to BMHS on [mmddyy]”
    b. E-mail to BMHS Program Planner:
    c. Requests may be faxed to 603-271-5040
    d. Or mailed to:
    New Hampshire Department of Health and Human Services
    Division for Behavioral Health
    Bureau of Mental Health Services
    105 Pleasant Street
    Concord, New Hampshire 03301
  6. Agencies will be formally notified of decision by letter from BMHS via an encrypted email.
  7. If you have not heard back with an approval decision from the Bureau within 30 days please contact the BMHS Program Planner for a status update.
    8. If you receive an automated e-mail that the Program Planner is out for more than two days please forward your request to the Administrator of CMHP Kerri Swenson at

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New Hampshire Department of Health and Human Services
129 Pleasant Street | Concord, NH | 03301-3852

copyright 2016. State of New Hampshire