New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 31 - SCREENING AND SCREENING OUTREACH PROGRAM
Subchapter 1 - GENERAL PROVISIONS
Section 10:31-1.3 - Definitions
The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise.
"Acute care" means community-based outpatient and inpatient psychiatric services designed to provide stabilization during the acute phase of psychiatric illness.
"Acute care system" means those services either contracted for or identified by the Division of Mental Health and Addiction Services, in consultation with the appropriate county mental health board, as part of a geographic area's acute care services. They may include, but are not limited to, the screening service, affiliated emergency services, short-term care facilities, inpatient psychiatric services, adult acute partial hospital services, partial hospital services, partial care services, crisis housing, integrated case management services (ICMS), programs of assertive community treatment (PACT), and peer support, self-help, and acute family support services.
"Adult acute partial hospital" means an intensive and time-limited acute psychiatric service for beneficiaries 18 years of age or older who are experiencing, or are at risk for, rapid decompensation. This mental health service is intended to minimize the need for hospitalization.
"Affiliated emergency service (AES)" means a mental health provider that is under contract with the Division of Mental Health and Addiction Services and has an affiliation agreement with the designated screening service in its geographic area and is responsible for the provision of services to people in psychiatric crisis. Emphasis is on stabilization, so that the consumer can actively participate in needs assessment and service planning.
"Assessment" means evaluation of the individual in psychiatric crisis in order to ascertain his or her current and previous level of functioning, psychosocial and medical history, potential for dangerousness, current psychiatric and medical condition factors contributing to the crisis and support systems that are available.
"Commissioner" means the Commissioner of the Department of Health.
"Commitment" means the procedure for authorizing admission to a treatment facility of an adult who is mentally ill, whose mental illness causes the person to be dangerous to self or dangerous to others or property, and who is unwilling to be admitted to a facility voluntarily for care, and who needs care at a short-term care facility, psychiatric facility or special psychiatric hospital because other services are not appropriate to meet the person's mental health care needs.
"Community referral source" means an individual, such as a police officer, religious leader, family member or other person, who may refer an individual for mental health services.
"Consensual admission" means a voluntary admission specifically to a short-term care facility from a screening service.
"Consumer" means an individual 18 years of age or older receiving assessment or treatment in a screening service or any ambulatory mental health service.
"Consumer protected health information (consumer PHI)" means all information, certificates, applications, records and reports that directly or indirectly identify a consumer currently or formerly receiving services, or for whom services were sought.
"Continuous quality improvement" means the ongoing objective and systematic monitoring and evaluation of a service's or system's components to ensure the quality, effectiveness and appropriateness of care and the pursuit of opportunities to further improve the care.
"Covered entity" means the professional staff of a community agency under contract with the Division of Mental Health Services, or of a screening service, short-term care or psychiatric facility as those facilities are defined in 30:4-27.2.
"Crisis housing" means a community-based crisis residential stabilization program providing an alternative setting for stabilization of individuals who are assessed by a screening service as being in acute psychiatric crisis, but who do not meet the standard for commitment.
"Crisis intervention counseling" means an attempt to facilitate crisis stabilization through the use of specific, time-limited counseling techniques. Crisis intervention counseling focuses on the present, providing pragmatic solutions to identified problems.
"Crisis intervention specialist" means an individual employed by a screening service or an affiliated emergency service who meets the educational and experiential requirements set forth in 10:31-3.4 and 4.3 and provides assessment, crisis stabilization services, hotline coverage, outreach and referral to people who are in crisis.
"Crisis outreach" means outreach provided by a screening service or an affiliated emergency service for the purpose of crisis stabilization. It does not include the screening process.
"Crisis stabilization" means intensive crisis intervention efforts toward or the result of a significant reduction of positive symptoms and some improvement in level of functioning, bringing the individual closer to the level of functioning demonstrated prior to the crisis.
"Dangerous to others or property" means that, by reason of mental illness, there is a substantial likelihood that the person will inflict serious bodily harm upon another person or cause serious property damage within the reasonably foreseeable future. This determination takes into account a person's history, recent behavior and any recent act, threat, or serious psychiatric deterioration.
"Dangerous to self" means that, by reason of mental illness, the person has threatened or attempted suicide or serious bodily harm, or has behaved in such a manner as to indicate that the person is unable to satisfy his or her need for nourishment, essential medical care or shelter, so that it is probable that substantial bodily injury, serious physical harm or death will result within the reasonably foreseeable future; however, no person shall be deemed to be unable to satisfy his or her need for nourishment, essential medical care, or shelter if he or she is able to satisfy such needs with the supervision and assistance of others who are willing and available. This determination shall take into account a person's history, recent behavior and any recent act, threat, or serious psychiatric deterioration.
"Division" means the Division of Mental Health Services, Department of Health.
"Enhanced screening service" means interventions that are made available to assist consumers who are hearing impaired to meaningfully access screening services. Enhanced screening services may also include consultative services for consumers who are developmentally disabled.
"Extended crisis evaluation bed (ECEB)" means a bed provided in a secure area where an individual can be held for up to 24 hours while being assessed and receiving intensive psychiatric supervision and medication monitoring.
"General hospital" means any hospital that maintains and operates organized facilities and services for the diagnosis, treatment or care of persons suffering from acute illness, injury or deformity and in which all diagnosis, treatment and care are administered by or performed under the direction of persons licensed to practice medicine or osteopathy in the State of New Jersey.
"Geographic area" means a geographically distinct area designated by the Commissioner to be served by one screening service. This area may be a county, portion of a county or a multi-county area.
"Hotline" means a telephone line answered directly by a clinical worker 24 hours per day for the purpose of providing telephone crisis intervention counseling, information and referral.
"In need of involuntary commitment" or "in need of involuntary commitment to treatment" means that an adult with mental illness, whose mental illness causes the person to be dangerous to self or dangerous to others or property and who is unwilling to accept appropriate treatment voluntarily after it has been offered, needs outpatient treatment, or inpatient care at a short-term care or psychiatric facility or special psychiatric hospital because other services are not appropriate or available to meet the person's mental health care needs.
"Integrated case management service (ICMS)" means personalized, collaborative and flexible outreach services, offered primarily off-site, designed to engage, support and integrate individuals with serious mental illness into the community of their choice, and facilitate their use of available resources and supports in order to maximize their independence.
"Least restrictive environment" means the available setting and form of treatment that appropriately addresses a person's need for care and the need to respond to dangers to the person, others, or property and respects, to the greatest extent practicable, the person's interests in freedom of movement and self-direction.
"Linkage" means referral to and voluntary enrollment in a mental health and/or ancillary program.
"Medical director" means the person who is designated by the director or chief executive officer of the screening center to provide medical leadership in a screening center. This may be a full or part-time position.
"Medication monitoring" means the provision of a variety of medication-related services which may include assessment for appropriateness of medication, titration of dosage, prescription, administration, evaluation and management of side effects and education related to psychotropic medication.
"Mental health board" means the county board appointed by each county board of freeholders or county executive or governing body, to review progress in the development of comprehensive community mental health services in the county.
"Mental health care representative" means the individual designated by a consumer pursuant to the proxy directive part of the consumer's advance directive for mental health care for the purpose of making mental health care decisions on the consumer's behalf, and includes an individual designated as an alternate mental health care representative who is acting as the consumer's mental health care representative in accordance with the terms and order of priority stated in an advance directive for mental health care.
"Mental illness" means a current, substantial disturbance of thought, mood, perception or orientation, which significantly impairs judgment, capacity to control behavior or capacity to recognize reality, but does not include simple alcohol intoxication, transitory reaction to drug ingestion, organic brain syndrome or developmental disability, unless it results in the severity of impairment as described in this definition. The term mental illness is not limited to "psychosis" or "active psychosis," but shall include all conditions that result in the severity of impairment as described in this definition.
"Natural support system" means the consumer's family, friends, neighbors, or significant others who are willing and able to provide emotional, financial, or other help.
"Outpatient treatment" means clinically appropriate care, based on proven or promising treatments directed to wellness and recovery, provided by a member of the patient's treatment team to a person not in need of inpatient treatment.
Outpatient treatment may include, but shall not be limited to, day treatment services, case management, residential services, outpatient counseling and psychotherapy, and medication treatment.
"Outpatient treatment provider" means a community-based provider, designated as an outpatient treatment provider pursuant to N.J.S.A. 30:4-27.8, that provides or coordinates the provision of outpatient treatment to persons in need of involuntary commitment to treatment.
"Partial care" means an individualized, outcome-oriented mental health service, which provides a comprehensive, structured, non-residential, interdisciplinary treatment and psychiatric rehabilitation program in a community setting to assist consumers who have serious mental illness in increasing or maximizing independence and community living skills and enhancing the quality of their lives. Partial care services are offered to an individual age 18 or older with a primary psychiatric disorder that is accompanied by an impaired ability to perform living, learning, working, or social roles. Partial care services support consumer stabilization and community integration and are alternatives to more intensive acute interventions. Partial care services provide active treatment and psychiatric rehabilitation for consumers who do not require inpatient hospitalization, but require support and structured programming.
"Partial hospital" means an individualized, outcome-oriented psychiatric service which provides a comprehensive, structured, non-residential, interdisciplinary treatment and psychiatric rehabilitation program to assist beneficiaries who have a serious mental illness in increasing or maximizing independence and community living skills and enhancing the quality of their lives.
"Peer advocate" means a person who works for a screening service and is or has a family member who is a consumer of mental health services. The responsibilities of a peer advocate are to raise awareness, provide education and serve as a resource to other consumers and family members on issues related to the effective management of mental illness in areas, such as symptom reduction, relapse prevention, stress management, social skills, depression, anxiety and healthy relationships. The peer advocate may resolve conflicts, and document and refer consumer concerns and complaints to professional staff, where appropriate. Peer advocates also serve as positive role models and demonstrate positive decision-making skills in both their personal and professional lives.
"Personal contact" means either face-to-face or telephone contact.
"Physician" means a person who is licensed to practice medicine in the State of New Jersey.
"Plan of outpatient treatment" means a plan for recovery from mental illness approved by a court pursuant to N.J.S.A. 30:4-27.15.a that is to be carried out in an outpatient setting and is prepared by an outpatient treatment provider for a patient who has a history of responding to treatment. The plan may include medication as a component of the plan; however, medication shall not be involuntarily administered in an outpatient setting.
"Program" means a set of related organizations, resources and/or services directed to the accomplishment of a defined set of objectives or missions for a specific target group(s). A program may include the activities of more than one agency, program element, division or department.
"Programs of assertive community treatment (PACT)" means the community mental health program that provides comprehensive, integrated rehabilitation, treatment and support services to individuals with serious and persistent mental illness, who have had repeated psychiatric hospitalizations, and who are at serious risk for psychiatric hospitalization. PACT, provided in vivo by a multi-disciplinary service delivery team, is the most intensive program element in the continuum of ambulatory community mental health care. Services to an individual may vary in type and intensity.
"Psychiatric facility" means a State psychiatric hospital listed in 30:1-7, a county psychiatric hospital, or a psychiatric unit of a county hospital.
"Psychiatric unit of a general hospital" means an inpatient unit of a general hospital that restricts its services to the care and treatment of persons with mental illness who are admitted on a voluntary basis.
"Psychiatrist" means a physician licensed to practice medicine in the State of New Jersey who has completed the training requirements of the American Board of Psychiatry and Neurology or the American Osteopathic Board of Neurology and Psychiatry.
"Psycho-education" means information dissemination, professional guidance and consultation and skill development to families of consumers and consumers themselves, aimed at assisting families and consumers in becoming essential contributors and participants in the rehabilitation process.
"Psychotherapy notes" means notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint or family counseling session and that are separated from the rest of the of the individual's medical record. Psychotherapy notes excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis and progress to date ( 45 CFR 164.501) .
"Reasonably foreseeable future" means a time frame that may be beyond the immediate or imminent, but not longer than a time frame as to which reasonably certain judgments about a person's likely behavior can be reached.
"Referral" means services, which are voluntary in nature, that direct, guide, and link a consumer with appropriate services, which promote the achievement of the goals of wellness and recovery and which include diversion from hospitalization, as clinically appropriate.
"Screener" means an individual who has fulfilled the requirements set forth in N.J.A.C. 10:31-3.3 and has been certified by the Division to assess a consumer's need for involuntary commitment to treatment.
"Screening" means the process for determining whether an individual is in need of involuntary commitment to treatment.
"Screening center coordinator" means an individual who is employed by a designated screening center, who meets the educational and experiential requirements set forth in 10:31-3.2(a) and fulfills the duties set forth in 10:31-3.2(b).
"Screening certificate" means a form developed by the Division and approved by the Administrative Office of the Courts that is executed by a psychiatrist or other physician affiliated with a screening service who has examined the consumer and which states that the consumer designated therein is in need of involuntary commitment to treatment. The form shall also state the specific facts upon which the examining physician has based his or her conclusion and shall be certified in accordance with the Rules of Court. The certificate may not be executed by a person who is a relative, by blood or marriage, of the person who is being screened.
"Screening coordinator" means an individual who is employed by a screening service, who meets the educational and experiential requirements set forth in 10:31-3.2(a) and fulfills the duties set forth in 10:31-3.2(b).
"Screening document" means a form developed by the Division and completed and signed by a screener after that screener has assessed the consumer. The screening document serves as the first step of the involuntary commitment process.
"Screening outreach" means an evaluation provided by a certified screener, wherever the person to be screened may be located, when clinically relevant information indicates the person may need involuntary commitment to treatment and is unable or unwilling to come to a screening service.
"Screening psychiatrist" means a psychiatrist employed by a screening service or a psychiatrist affiliated through a written agreement with a screening service. The written agreement shall minimally outline a supervisory procedure consistent with N.J.A.C. 10:31-3.6.
"Screening service" means a public or private ambulatory care service with mobile capacity designated by the Commissioner, which provides mental health services, as specified in N.J.A.C. 10:31-2.1.
"Short-term care facility (STCF)" means a closed acute care adult psychiatric unit in a general hospital for short-term admission of individuals who meet the legal standard for commitment and require intensive treatment. The STCF shall be designated by the Division to serve residents of specific geographic areas within the State. All admissions to short-term care facilities shall be referred through a designated screening service.
"Special psychiatric hospital" means a public or private hospital licensed by the Department of Health to provide voluntary and involuntary mental health services, including assessment, care, supervision, treatment, and rehabilitation services to persons with mental illness.
"Stabilization options" means treatment modalities or means of support used to remediate a crisis. They may include, but are not limited to, early intervention programs, crisis intervention counseling, acute partial hospital services, adult partial hospital services, partial care services, crisis housing, acute in-home services, extended crisis evaluation bed with medication monitoring, or emergency stabilization regimes, admission on a voluntary basis to a psychiatric unit in a general hospital, referral to other 24-hour treatment facilities, referral and linkage to other community resources, and use of natural support system.
"Treatment facility" means a legal entity, public or private, providing mental health, developmental disability, nursing, rehabilitative and/or drug and alcohol services.
"Voluntary admission" means that an adult with mental illness, whose mental illness causes the person to be dangerous to self or dangerous to others or property and is willing to be admitted to a facility voluntarily for care, needs care at a short-term care or psychiatric facility because other facilities or services are not appropriate or available to meet the person's mental health needs. A person may also be voluntarily admitted to a psychiatric facility if his or her mental illness presents a substantial likelihood of rapid deterioration in functioning in the near future, there are no appropriate community alternatives available, and the psychiatric facility can admit the person and remain within its rated capacity.
