Current through Register Vol. 56, No. 18, September 16, 2024
(a) As a recovery-oriented system, the STCF
program shall offer a high degree of accessibility with written procedures that
shall require the immediate admission of patients who meet the admission
criteria whenever an STCF bed is available.
(b) STCF policy and procedures shall specify
patient responsibility and expectations that include that, as a result of their
involvement with an STCF, patients will be better able to manage their illness
and improve the quality of their lives.
(c) All patients admitted to the STCF shall
be referred exclusively through a designated screening service. Prior to
admission, all patients shall receive a face-to-face assessment, as defined in
N.J.A.C. 10:31, by both a certified screener and a
psychiatrist formally affiliated with the screening service to confirm that the
patient is mentally ill, the mental illness causes the person to be dangerous
to self or dangerous to others or property and the patient needs care at an
STCF because other services are not appropriate or available to meet the
person's mental health care needs.
1. The
STCF shall maintain written policies and procedures that describe the referral
function of the designated screening service regarding transfers to the STCF
from other hospitals or from beds within the same hospital to assure that
patients meet the criteria noted at (c) above.
2. The STCF policies and procedures shall
specify that the psychiatrist who treats the patient in the STCF shall not also
have been the psychiatrist who completed the face-to-face screening evaluation
to determine commitability or who completed the screening certificate, unless
and only after reasonable but unsuccessful attempts were made to have another
psychiatrist conduct the evaluation and execute the certificate.
i. The STCF policies and procedures shall
stipulate that the "reasonable attempts" referred to in (a)2 above shall
include but shall not be limited to reassignment, scheduling changes, or any
other mechanism that may result in another psychiatrist treating the patient in
the STCF.
ii. The STCF policies and
procedures shall require the documentation of all reasonable but unsuccessful
attempts made to avoid the same psychiatrist completing both the screening and
clinical certificates.
(d) STCF staff shall develop and implement
written comprehensive affiliation agreements between the designated screening
service, State and county hospitals, and community mental health service
providers, to facilitate transfer, linkage, and access to appropriate aftercare
services for patients.
(e) All the
affiliation agreements shall be approved by the Division's Assistant Director ,
or his or her designee , biannually during the redesignation process.
Affiliation agreements between STCFs and State or county hospitals shall comply
with the requirements set forth at
N.J.A.C.
10:37G-2.4(d) and
(e).
(f) The affiliation agreement with the
designated screening service shall clearly delineate the STCF admission
criteria and the requirement that all referrals to the STCF emanate from the
designated screening service.
(g)
The STCF's written policies and procedures shall specify inclusionary and
exclusionary admission criteria that describe the diagnostic and patient
characteristics appropriate for the STCF.
1.
Admission criteria shall include the requirement that only individuals who meet
the statutory standard of dangerousness to self or others due to mental illness
(N.J.S.A. 30:4-27.2h, i and r) and who require intensive treatment shall be
admitted to the STCF.
2. Admission
criteria shall identify the geographic area or areas in which individuals must
reside in order to be considered appropriate for admission to that
STCF.
3. Pursuant to
Division-approved written agreements among designated screening services and
STCFs, an STCF shall also be contacted regarding a possible admission of a new
patient from outside its geographic area whenever all the STCF beds assigned to
that patient's county of residence are full or no STCF exists in the patient's
county of residence.
4. STCFs can
expect the designated screening service with the new admission to inquire
regarding the feasibility of such transfers and such approved out-of-county
placements and shall cooperate in avoiding clinically unnecessary State or
county hospital stays by making unused beds available to consumers from outside
their geographic area.
5.
Admission criteria shall include the requirement that patients with a
co-occurring disorder of substance abuse and psychiatric disorder shall be
admitted when they meet the other provisions of the admission
criteria.
6. Admission criteria
shall require that patients with a diagnosed organic condition or dementia
shall be admitted if their behavior symptoms pose a danger to self or others
and if those behavioral symptoms can be ameliorated by the short-term
psychiatric intervention available in a STCF.
7. Admission criteria shall adequately
address clinical and safety concerns and shall not permit the exclusion of a
patient for the sole reason of pending criminal charges indicated by a detainer
or a requirement that the patient register as a sex offender.
8. Admission criteria shall include a
provision that no individual otherwise eligible for admission shall be denied
admission due to inability to pay or type of insurance coverage.
9. Admission criteria shall include a
provision that no individual otherwise eligible for admission shall be denied
admission due to a medical condition unless the unresolved condition precludes
discharge from the screening service.
(h) When a new patient meets the admissions
criteria and all STCF beds are full, all current patients shall be reassessed
for possible transfer to the less restrictive acute unit, to nursing facilities
or intermediate care beds, or to State or county hospitals, as appropriate, to
allow the admission of the new patient.
(i) STCF staff shall comply with the
applicable provisions of
26:2H-102
et seq., the New Jersey Advance Directives for Mental Health Care Act, and its
implementing rules, N.J.A.C. 10:32, including the adoption of such policies and
practices as are necessary to provide for routine inquiry at the time of
admission and at such other times as are appropriate under the circumstances,
concerning the existence and location of an advance directive, pursuant to
26:2H-65(a)1.
