Here you can find information, downloadable forms, and links to organizations on the community, state, and national levels that provide specialized supports for individuals with developmental disabilities.
The Intake Coordinator at Monadnock Developmental Services can help determine eligibility for your family member.
You can also visit the DHHS website for information on eligibility requirements, which are prescribed by State (Bureau of Developmental Services) and Federal (Center for Medicaid Services) regulations.
They will enter the system through Early Supports & Services (ESS) and have a choice of using MDS Birth to Three or Rise for baby and family for their ESS services.
They will enter the system through Children’s Service Coordination (CSC). Please note that if an individual leaves school at age 18, they enter into the Adult System once out of school. Depending on what the diagnosis/situation is, they will be eligible for Service Coordination, Respite and, if necessary, In Home Supports. Children’s service coordination also provides Transition from youth to adult services.
When they turn 21, individuals enter into Adult Services and receive Adult Service Coordination (ASC). Service Coordinators act as case managers. Individuals and families can choose from a variety of service coordination options. Adult services available include residential, day, employment, respite, and others.
There are a variety of forms required to be used by individuals and their families, as well as nursing and MDS employees. Some of these forms are specific to MDS, while others are created and maintained by the Bureau of Developmental Services.
MDS forms include a wide range of forms that are used by many people. Some examples include incident reports, waiver requests and medication error reports.
Intake/Eligibility forms are used to determine an individual’s eligibility to receive services through MDS.
Self-Directed Services forms are used by families who design and manage services for their family member with a developmental disability or acquired brain disorder. The types of forms used for Self-Directed Services include supervision notes, expense reports, job description and job offer forms.
State forms include those pertaining to nursing and healthcare, as well as those that are maintained by Community Support Network, Inc. (CSNI). To ensure you are using the most current version, we provide a link to their website and a list of the forms you will find there.
Employee forms and links provide a variety of information about benefits, links to benefits providers’ websites, timesheets, expense reports and various MDS benefits.
MDS forms fall into three categories:
These forms will primarily be used by MDS staff and provider agency staff.
Safety Environmental. Lock.Key HRC Request Template
HRC Schedule Expectations FY-3. 2023
BDS Human Rights Reporting Procedure
Rights Reporting Staff Handout
Restraint Intervention Report EXAMPLE
Restraint Intervention Training Report-2023
Vendor Restraint Intervention Training Report
Intake/Eligibility forms are used to determine an individual’s eligibility to receive services through MDS. An MDS Intake Coordinator will help you fill these forms out. However, it can be useful to be familiar with the forms prior to meeting with an Intake Coordinator.
Self-Directed Services forms are used by families who design and manage services for their family member with a developmental disability or acquired brain disorder. The types of forms used for Self-Directed Services include supervision notes, expense reports, job description and job offer forms. If there is a form you need that you don’t see in this section, please look in the Employee Forms section.
In this section, you will find forms related to Healthcare and Nursing as well as a link to forms that are maintained by Community Support Network, Inc. (CSNI).
This site offers forms for:
HRC-Authorization Page_2016-09
HRC-Authorization Page- Directions_2016-09
Behavior Plan Requirements_2016-09
Nursing Medical Intervention Report
Weekly Service Notes
Monthly Progress Report
Medication Occurrence Form-Statewide Template_2017
Medication Occurrence Form-Directions_2017
Restraint Form- Directions_2017
Incident Report- 2020
Incident Report- 2020- Directions
Complaint Investigation Response-Template_2017-08
Complaint Investigation Response-Directions_2017-08
Fire Drill Form_2017-08
Fire Drill Form- Directions_2017-08
ITS Global Consent for Visitation
ITS Site Visit Sheet – Electronic Completion
ITS Site Visit Sheet – Handwritten Completion
Nursing Evaluation of Transition Form_2017
Nursing Evaluation of Transition-Directions_2018-05
SC 5 Day Visit Form_2017
SC 5 Day Visit Form-Directions_2018-04
Seizure Report- Template_2017-10
Seizure Report- Directions_2018-05
The Employee section contains information regarding employee benefits, forms employees need, such as timesheets as well as links to online resources.
Monadnock Developmental Services offers an ongoing series of educational opportunities for employees and families to gain the skills and knowledge that will help them better support people with developmental disabilities. Look here for our upcoming training schedule, and learn more about our training philosophy here.
Staff orientation provides MDS employees and Direct and family support professionals with the tools and information they will need to accomplish their work effectively. Employees may also be required to complete specific departmental and position orientation and ongoing training. We welcome and encourage individuals, family members and provider agency staff to attend training and events with us.
To ensure compliance with State and Federal regulations, all employees/support positions are required to complete basic online learning topics on the Relias training platform. In addition to this, all Direct Support Professionals and Participant Directed Managed Services (PDMS) and Family Support Staff must complete additional training in the Relias system, as determined by their position. All direct service & direct support positions will be required to attend two in-person orientation sessions, Rights, HCBS & Reporting and Introduction to Gentle Teaching. These sessions are posted on the MDS training calendar and tentatively take place each month.
MDS and Family Managed employees will be provided with accounts in the Relias training system by the MDS HR team. All employees are responsible for completing their required training, and are encouraged to work with their supervisors to ensure that they can do so. Please contact the Quality & Training Department (as noted above) with specific training and Relias system questions.
For 1201 Medication Administration Training, the nursing staff at MDS collaborate with state nurse trainers to arrange and/or provide the He-M 1201 medication administration training. This includes the initial Medication Training course, recertification, med administration observations and oversight. Please contact the nursing office at 603-352-1304×221 to inquire.
Additional MDS training opportunities and Initiatives are listed below. You can also find them on the MDS Training Calendar.
Pre-registration is required as sessions may require a minimum or maximum number of participants to be held. Please register at least four days in advance.
To register for a class, please provide the following information via email training@mds-nh.org or by calling 603-352-1304×221.
Changes in schedule will be posted on the Training Calendar.
The Training Calendar lists the most current scheduled training and learning opportunities. Check back frequently for updates. New opportunities and cancelations will be posted as they occur. For additional information and to register for an upcoming training, please email the Training Department or call 603-352-1304×221.
MDS Staff – if you have completed training that the Training Department does not know about, please fill out Training Attestation Form and submit it to the Training Department.
Benefits for people with disabilities are administered through the NH Department of Health and Human Services (DHHS) and the Social Security Administration (SSA). You must apply to both agencies to become eligible and begin receiving benefits. Eligibility, procedure and maintenance can be complicated, so it’s best to work with your Service Coordinator for help in understanding and accessing appropriate funding.
In December 2013, New Hampshire transitioned to a Managed Care system for Medicaid healthcare services and acute medical care (not for disabilities or long-term care).
Click here to find out more about Medicaid Care Management at the DHHS website.
For Medicare and Medicaid information, visit the Center for Medicaid Services (CMS) website.
The NH Department of Health and Human Services administers certain programs including:
For information on NH programs, visit the DHHS website.
If you have any questions about benefits for you or your family member, please contact your Service Coordinator who can help you better understand and access appropriate resources.
The Social Security Administration handles:
Don’t do it alone. Ask for help!
You must apply with two agencies, the federal Social Security Administration (SSA) and NH Department of Health and Human Services.
It is important that you work with your Service Coordinator to fully access and understand these benefits.
Specific changes can occur at age 18, 19, 21, 23, 26, 62 and 65. Click here to read a very helpful guide: Benefit Changes As You Age.
No, you will not lose your benefits if you go to work!
American Association of Intellectual and Developmental Disabilities (AAIDD)
American Network of Community Options and Resources (ANCOR)
Association of Developmental Disabilities Providers (ADDP)
Center for Parent Information & Resources
Human Services Research Institute (HSRI)
National Association of Councils on Developmental Disabilities (NACDD)
National Core Indicators (NCI)
National Council on Independent Living (NCIL)
National Down Syndrome Society
National Organization on Disability
Social Role Valorization Implementation Project
The State of the States in Intellectual and Developmental Disabilities Project
In New Hampshire, there are ten area agencies that provide service coordination and direct services to people with developmental disabilities and acquired brain disorders. Each area agency has a Legislative Liaison who communicates between our state and local legislators, the area agency and the people and families who receive supports through the area agency.
The information your Legislative Liaison provides can help us all become legislative advocates. Legislative advocacy is simply engaging with legislators to express your public support for a specific cause or policy. You can express your support by attending a meeting, writing a letter to an elected official or testifying at a legislative hearing or school board meeting. Legislative advocacy can also be as easy as telling your friends and family about policies that are important to you!
121 Railroad Street
Keene, NH
603-352-1304
12 Depot Street, Suite 2A
Peterborough, NH
603-924-4203
Monadnock Development Services (MDS) is an Equal Opportunity Employer
©2023 Monadnock Development Services, Inc.
