New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 37A - LICENSED COMMUNITY RESIDENCES FOR ADULTS WITH MENTAL ILLNESSES
Subchapter 1 - GENERAL PROVISIONS
Section 10:37A-1.2 - Definitions

Current through Register Vol. 56, No. 18, September 16, 2024

The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise.

"Accrediting body recognized by DOH" means an organization that accredits mental health programs that is recognized by the Department for deemed status purposes. These organizations include, but are not limited to, the Joint Commission, the Council on Accreditation of Family Services Agencies (COA), the Council on Accreditation of Rehabilitation Facilities (CARF), and the National Commission on Quality Assurance (NCQA).

"Advance directive for mental health care" or "psychiatric advance directive" means a writing executed in accordance with the requirements of the New Jersey Advance Directives for Mental Health Care Act, N.J.S.A. 26:2H-107 et seq.

"Commissioner" means the Commissioner of the Department of Human Services.

"Conditional license" means a licensing action indicating that although certain prompt corrective actions in existing community residences are necessary before a full license can be issued, sufficient compliance exists to confer operational authority upon the licensed provider.

"Consumer " means a person diagnosed with a mental illness who is a resident of a licensed supervised housing unit or a shared supportive housing unit.

"Consumer service agreement" means a written agreement between the PA and consumer that includes responsibilities of both the PA and the consumer and that meets the requirements of N.J.A.C. 10:37A-4.2.

"Crisis intervention" means face-to-face, short-term interventions with a consumer who is experiencing increased distress and/or an active state of crisis. Crisis intervention also includes developing and implementing the consumer's crisis contingency plan and/or advance directive for mental health care.

"DCN&L" means the Division of Certificate of Need and Licensing within the Health Services Branch of the Department of Health.

"Deemed status" means that status granted to a supervised housing program that has received accreditation by an accrediting body recognized by DOH . In effect, DOH, through the granting of deemed status, substitutes the standards of the accrediting body for certain selected Department program standards.

"Department" means the New Jersey Department of Human Services.

"DOH" means the New Jersey Department of Health.

"Discharge" means, with reference to supervised residences in single detached homes, apartments, and family care homes, the process through which a consumer permanently vacates the physical premises and services to that consumer have ceased, for any of the reasons delineated at 10:37A-11.2. In the context of a shared supportive housing residence subject to a lease agreement, discharge means either:

"Division" or "DMHAS" means the Division of Mental Health and Addiction Services, in the Department, or a departmental unit or a contracted provider or other entity designated by the Division to perform administrative tasks; for example, an entity authorized to evaluate candidates for eligibility for rental subsidies, to certify that housing is habitable, or to pre-authorize the delivery of or payment for community mental health rehabilitation services.

"Dwelling unit" means a single unit providing complete, independent living facilities for one or more persons living as a single housekeeping unit, including permanent provisions for living, sleeping, eating, cooking and sanitation.

"Emergency response services" means the implementation of the PA's written emergency policies and procedures focusing on immediate consumer and staff safety. Examples include, but are not limited to, provision of behavior management techniques, request for outside assistance, and providing cardiopulmonary resuscitation (CPR) and first aid. Behavioral management techniques include positive and negative reinforcement, but exclude physical and chemical restraint, aversive conditioning, and punishment. Emergency response services shall be documented and shall be supported by such policies and procedures that require adequate responses to emergent situations.

"Exclusion" means the immediate and temporary removal of a consumer from a supervised residence, when, in the discretion of the PA, the individual's behavior presents a substantial, immediate threat to the physical safety or to the emotional or psychological wellness of other consumers. The consumer may be prevented from returning until the substantial, immediate threat has been obviated.

"Family care home" means a private home or apartment in which a home supervisor who is not an employee of the PA and is not related to any consumer living in the home who resides and provides housing and services to as many as three consumers who also reside in the home (except that residences where four consumers resided in the home prior to January 3, 2005, shall be considered family care homes). The PA provides or arranges for the provision of the level of services commensurate with residential settings also known as "Level D" to the consumer and consultation to the home supervisor pursuant to a services agreement.

"Health care monitoring and oversight services" means face-to-face visits in supervised housing by a registered nurse with each consumer every 90 days in the consumer's residence that provides an assessment of the consumer's health, a determination of medical services and medical referrals needed by the consumer, and direction to staff; assistance with scheduling, transportation, or monitoring of medical appointments and the treatment recommendations made by health care providers; and assistance with following treatment recommendations and coping with medical conditions. For example, for a consumer with diabetes, this assistance may include monitoring blood sugar levels on a daily basis and assisting the consumer with adjusting diet, activities, or medication when the glucose level is out of the acceptable range as determined by the physician or nurse supervising the treatment.

"Individualized rehabilitation plan" or "IRP" means a document that is developed in partnership with the consumer that sets forth goals and objectives that will lead to recovery and independence; identifies internal and external resources to support the consumer's recovery and independence; and identifies concrete skills the consumer will develop and actions the consumer will take to meet those goals, with the assistance of and participation in programs, interventions, and supports offered by licensed professionals, natural supports, or PAs, or a combination of these resources.

"Level A+ Care" means, regarding licensed supervised residences in single dwelling units, homes, or apartments, services are available to consumers in the supervised residence or in a community setting 24 hours per day, seven days per week, and delivered by the PA licensed to operate the residence. This includes awake, overnight staff coverage. These services are provided on-site when a consumer is home. Services need not be available when no consumer is at home. In apartments, Level A+ care may be provided for a cluster of apartments by staff stationed in a nearby apartment, as opposed to having staff stationed in each apartment.

"Level A Care" means, regarding licensed supervised residences in single detached homes or apartments, community mental health rehabilitation services are available to consumers in the supervised residence or in a community setting for 12 or more hours per day (but less than 24 hours per day), seven days per week, delivered by the PA licensed to operate the residence. Services need not be available when no consumer is at home. In apartments, Level A care may be provided for a cluster of apartments by staff stationed in a nearby apartment, as opposed to stationed in each apartment.

"Level B Care" means, regarding licensed supervised residences in single detached homes or apartments, community mental health rehabilitation services are available to consumers in the supervised residence or in a community setting for at least four hours per day (but less than 12 hours per day), seven days per week.

"Level D Care" means, regarding licensed family care homes, community mental health rehabilitation services are available to consumers in the family care home 24 hours per day, pursuant to a Family Care contract with the Division.

"Protected health information" means any information, written, electronic, or verbal, that identifies an individual as a recipient of physical or mental health services, including information about program participation, diagnosis, treatment, or interventions offered or used by or known to the PA to assess, treat, or prevent an illness or condition.

"Provider agency" (PA) means a public or private organization that has a mental health service contract with the Division and has been licensed by DOH to provide shared supportive housing residences, supervised residences, and services required by this chapter to individuals 18 years of age and older.

"Registered professional nurse (RN)" means a person who is licensed by the State of New Jersey as a professional nurse pursuant to 45:11-26 et seq.

"Residential counseling" means verbal interventions provided to consumers and families to assist the consumer in accessing and utilizing all planned or needed services. It may include problem-solving, advice, encouragement, and emotional support to enhance stability in the living arrangement.

"Shared supportive housing residence " means any dwelling unit in which three or more individuals reside and whose occupancy is based on a diagnosis of serious mental illness and for which each consumer signs a lease or sublease, may sign a consumer service agreement and a consumer rental subsidy agreement, and may receive community mental health rehabilitation services from a PA. The consumer, not the PA, is responsible for mortgage/lease payments, safety, cleanliness, and property protection, and bears the responsibility for those aspects of residential living. The consumer has the key to the home and has control over access to it. No lease or residential agreement shall contain the provision of mandatory mental health program participation as a requirement for the consumer to maintain housing. The provisions of N.J.A.C. 10:37A-11 shall not apply to consumers in shared supportive housing residences; eviction shall only occur if it comports with the State landlord and tenant laws.

"Supervised residence" means any community residential facility that provides food, shelter, rehabilitation, and support under such level of care as required, to not more than 15 persons, 18 years of age or older, with mental illnesses who require assistance, temporarily or permanently, in order to live independently in the community. Consumers in supervised residences shall sign a consumer service agreement. Agencies operating supervised residences shall be licensed by DOH and shall have an approved purchase of service contract (or an affiliation agreement if the requirement for a contract is waived by the Division) pursuant to the Department's contract rules, N.J.A.C. 10:3-3, and this chapter. Supervised residences may take the form of a single detached home, an apartment, or a family care home. These residences are not considered health care facilities within the meaning of the Home Care Facilities Planning Act, P.L. 1971, c. 136 (N.J.S.A. 26:2H-1 et seq.) and are limited to Level A+, A, and B housing and family care homes ("Level D").

"Termination" means the discontinuation of supportive housing services.

"Valued life role" means an individually chosen adult role, desired by individuals and respected by society, such as worker, professional, employee, volunteer, student, spouse/partner, parent, or homemaker.

"Wellness and Recovery Action Plan (R) (WRAP (R))" means an evidence-based program that provides consumers with the tools to manage their own recovery. "Wellness and Recovery Action Plan" and "WRAP" are registered trademarks of Mary Ellen Copeland.

"Wellness and recovery support" means assistance in exploring valued life roles, and inspiring the consumer to work toward assuming a valued role by instilling hope and exposing him or her to possibilities and other consumers who have achieved success in various valued roles. It includes assisting the consumer in exploring and establishing goals that promote healthy lifestyles and wellness. It includes assisting the consumer in choosing a valued role that interests him or her and articulating the means of achieving success in that role through development and revision of the individual recovery plan. It also includes providing ongoing assessment and dynamic supports, as well as soliciting and coordinating varied supports from outside the residential service toward this end.