New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 44C - STANDARDS FOR COMMUNITY RESIDENCES FOR PERSONS WITH HEAD INJURIES
Subchapter 1 - GENERAL PROVISIONS
Section 10:44C-1.3 - Definitions

1. Personal advocacy: one-to-one advocacy to secure the rights of people with head injuries and their families;

2. Systems advocacy: seeking to change a policy or practice that affects people with head injuries;

3. Legislative advocacy as permitted by law: seeking legislative enactments that would enhance the rights and/or opportunities for people with disabilities or persons with head injuries;

4. Legal advocacy: using the judicial and quasi-judicial systems to protect the rights of persons with head injuries;

5. Self-advocacy: advocacy of a person served on his or her own behalf.

"Affirming rights" means respecting rights and providing the assistance persons served need to exercise those rights and to engage in self-advocacy.

"Affiliation" means a relationship, usually signified by a written agreement, between two organizations, under the terms of which one organization agrees to provide specified services and personnel to meet the needs of the other organization, usually on a scheduled basis.

"Agency" means the licensee and his or her staff responsible for the care and safety of the persons served in each community residence for persons with head injuries licensed under this chapter.

"Approved" means approved by the Office of Licensing.

"Assessment" means the process of identifying the strengths and needs of a person served, and the conditions that impede or promote development. There are two levels of assessment: screening and evaluation.

"Assistive device" means any implement or mechanism that enables a person with head injuries to increase, maintain, and/or improve his or her functioning capabilities.

"Assistive technology" means the use of commercial or custom-designed devices, modifications, and/or related technical services to increase, maintain, and/or improve the functional capabilities of persons with head injuries who have resulting disabilities.

"Audiology" means services provided by an audiologist who meets applicable legal requirements for the provision of audiology services and who meets the academic and work experience standards established by the American Speech-Language and Hearing Association for the Certificate of Clinical Competence in Audiology.

"Authorization to operate" means official correspondence issued by the Office of Licensing to permit a licensee to operate beyond the license expiration date, because of a delay in completing a licensing inspection.

"Behavior Support Plan" means a written, approved plan that employs techniques to decrease maladaptive behavior and increase adaptive behavior.

"Business manager" means the staff member charged with the responsibility of providing oversight of business practices, including budgets, purchasing, accounting and personnel practices.

"Capacity" means the maximum number of persons with head injuries who may reside in the licensed residence.

"Case manager" means the person responsible for the development, coordination, and overall management of the individual treatment plan for each person served, and who is employed by the licensee. There may also be an external case manager, such as one acting on behalf of an insurance company, managed care organization, or other payor source.

"Commensurate wage" means a wage that is proportionate to the prevailing wage paid to similarly experienced workers in the geographic vicinity of the person's place of employment for essentially the same type of work based on a comparison of the quantity of work produced by the worker with a head injury and a resulting disability with those of work produced by similarly experienced workers. This wage is to be determined by time studies as approved by the New Jersey Department of Labor.

"Community agency" means an agency licensed by the Department to provide services to persons with head injuries.

"Community agency head" means the person responsible for the overall operation of the agency under contract with or licensed by the Department. This may be the licensee, owner, or executive director.

"Community residence for persons with head injuries" means a community residential facility licensed pursuant to N.J.S.A. 30:11B-1 et seq., providing food, shelter, personal guidance, and integration with the community, under such supervision as required, to not more than 15 persons with head injuries, who require assistance, temporarily or permanently, in order to live in the community, and shall include, but not be limited to: group homes, halfway houses, supervised apartment living arrangements, and hostels. Such residences shall not be located on the grounds or immediately adjacent to public institutions serving a similar population. Such a residence shall not be considered a health care facility within the meaning of the "Health Care Facilities Planning Act," P.L. 1971, c. 136 (N.J.S.A. 26:2H-1 et seq.).

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

"Critical information" means information that must be communicated from shift to shift in order to ensure the health, safety, and welfare of the persons served, and includes, but is not limited to: unexpected behavioral outbursts, unexpected or unexplained mood swings on the part of persons served, the administration of PRN medication, problems with transportation, unexpected visits to the doctor or hospital, routine visits to the doctor requiring follow up for a reportable communicable disease, and missed medical appointments.

"Deficiency" means that an applicant or licensee has not complied with a rule contained in this chapter.

"Department" means the Department of Human Services.

1. Providing a person served with new and untried experiences;

2. Assisting the person served when he/she chooses among possible courses of action in trying new experiences;

3. Assisting the person served in determining the risks and consequences;

4. Assessing the risks and consequences on behalf of the person served;

5. Assuring that the person served and the legal guardian (if any) understand such risks and consequences; and

6. Defining, documenting and providing the means of support necessary to establish the allowable limits of the risk, assuring thereby that the person served is as safe as possible at all times.

"Direct support professional" means any licensee and any full time, part time, temporary employment services, or contract employee at a community residence for persons with head injuries present in the living or program area who work directly with the person served. For the purpose of this definition, this term does not include housekeepers, food service workers, maintenance workers, clerical staff, or volunteers.

"Division" means the Division of Developmental Disabilities.

"Evaluation" means an assessment process performed by qualified professionals according to procedures that incorporate the use, when possible, of standardized tests and measures.

"Eviction" means the legal process of officially removing a tenant from the premises.

"Executive leadership" means the person or persons to whom the licensee may delegate administrative authority over the licensee's community based programs regulated or under contract with the Department. A person who functions as executive leadership may also be referred to as an executive director.

"Exploitation" means the act or process of a caregiver using a person served or his or her resources for another person's profit or advantage. (See N.J.S.A. 30:6D-73 et seq. and N.J.A.C. 10:44D)

"Falsification" means intentionally making a record or a document false, giving a false appearance to a record or a document, tampering with a record or a document.

"Fiduciary capacity" means that the licensee acts with a high degree of good faith when handling money entrusted to the licensee by persons served.

"Fire official" means a person certified by the Commissioner of the Department of Community Affairs, and appointed or designated by the appointing authority of a local enforcing agency to direct the enforcement of the Uniform Fire Safety Act, and any certified fire inspector working under the direction of the fire official.

"Full license" means the authorization to operate based upon substantial compliance with this chapter. A full license shall be effective for up to one year.

"Functional literacy" means the ability to read, comprehend, and assimilate the oral and written language and numerical information required to function in a specific work or community environment, with or without accommodation strategies. Accommodation strategies may include, but are not limited to, picture instructions or calculators, computers and/or audiovisual tapes.

"Group homes" means living arrangements operated in residences leased or owned by the licensee, which provide the opportunity for persons served to live together in a home, sharing in chores and the overall management of the residence. Staff in a group home provide supervision, training, and/or assistance in a variety of forms and intensity as required to assist the persons served as they move toward independence and integration with the community.

"Guardian" means a person or agency appointed by a court of competent jurisdiction who is otherwise legally authorized and responsible to act on behalf of a minor or incompetent adult to assure provision for the health, safety, and welfare of the person and to protect his or her rights.

"Head injury" means, for the purposes of this chapter, traumatic brain injury.

"Human Rights Committee" means a group comprised of professionals, individuals served, advocates, and/or interested persons from the community at large who function as an advisory group to the CEO or executive director on issues directly or indirectly affecting the rights of individuals served.

"Imminent danger" means a situation that could be expected to cause a serious risk to the health, safety or welfare of a person served.

"Individual treatment plan" (ITP) means a written plan of intervention and action developed by the transdisciplinary team in a person-centered planning process. It describes the methodologies, strategies, and programs that will be employed and monitored to provide habilitation or rehabilitation to enable persons served to acquire or restore functional skills to the highest possible level of performance, within a reasonable time period. The ITP shall also document barriers to implementation and goal achievement. The ITP shall be reviewed and modified on a regular and as-needed basis, but no less than annually. For a person who makes only specific services requests, the ITP is a service plan that addresses only those specific requests. The ITP may be appealed in accordance with licensee procedure.

"Informed consent" means a formal expression, oral or written, of agreement with a proposed course of action by someone who has the capacity, the information and the ability to render voluntary agreement.

"Integration" means participation in the mainstream of community life, that persons served maintain social relationships with family members, peers, and others in the community who do not have head injuries. In addition, integration means that persons served have equal access to and full participation in community resources and activities available to the general public.

"Interferon Gamma Release Assay" (IGRA) means a blood test to identify or rule out infection with M. tuberculosis. Only FDA-approved IGRAs, such as QuantiFERON-TB Gold or T-Spot.TB are acceptable.

"License" means the authorization issued by the Department of Human Services to operate a community residence providing services to persons with head injuries.

"Licensee" means the person, partnership, or corporation responsible for providing services associated with the operation of a community residence(s).

"Maladaptive behavior" means behavior that is injurious or destructive to self, others, or the environment, that demonstrates a reduction in or lack of ability that is necessary to adjust to environmental demands.

"Mental health program" means a service designed to develop, support, and maximize the quality of life and functional abilities of persons served with severe and/or persistent and diagnosed psychiatric disabilities, as a result of, or in addition to the head injury.

"Mini-team review" means a modified version of a complete transdisciplinary team, the composition of which shall always include the person served, and/or his or her guardian, and/or personal representative; the case manager; and the individual in the discipline(s) knowledgeable in the issues for review.

"Negative licensing action" means an action, which imposes a restriction on a licensee and may include suspension of admissions, issuance of a provisional license, a reduction in the licensed capacity, a denial of the license, a non-renewal of the license, a suspension of the license, or a revocation of the license.

"Neglect" means any of the following acts by a caregiver on a person served: willfully failing to provide proper and sufficient food, clothing, maintenance, medical care, or a clean and proper home; or failure to do, or permit to be done, any act necessary for the well-being of a person served. (See N.J.S.A. 30:6D-73 et seq. and N.J.A.C. 10:44D)

"Non-ambulatory person" means a person served not capable of independent ambulation.

"Occupant" means any person lawfully occupying or sharing occupancy of a unit of dwelling space on a regular basis or for more than 30 consecutive days.

"Office of Investigations (OI)" means that component of the Department responsible to investigate serious unusual incidents in community programs licensed, contracted, or regulated by the Department.

"Office of Licensing" means the licensing agency, that component of the Department responsible to inspect and license programs under this chapter.

"Owner" means the person, corporation or association who must comply with 30:11B-1 et seq. and this chapter. The owner may be responsible for day-to-day operations or may employ an executive leadership, if so desired or if required by the qualifications associated with the executive leadership title.

"Payment authority" means a person, a private corporation (usually an insurance company) or public agency (local, State or Federal government) that provides funding of the residential placement and related services for care of the person served.

"Person served" means a person with head injury receiving services in a community residence for persons with head injuries.

"Person with head injury" means a person with traumatic brain injury.

"Personal advocate" means a person selected by a person served to provide assistance or act on his or her behalf in non-legal matters.

1. Bathing, hair care, skin care, shaving, nail care, and oral hygiene;

2. Alimentary procedures to assist one with eating and bowel and bladder management;

3. Positioning;

4. Care of adaptive personal care devices; and

5. Feminine hygiene.

"Personal guidance" means the assistance provided to a person with head injury in activities of daily living and/or personal care because he or she routinely requires help completing such activities of daily living and/or cannot direct someone to complete such activities when physical disabilities prevent self-completion; or there is a documented health or mental health problem requiring supervision of the person for the protection of the person or others.

"Placing agency" means the person or payment authority that is responsible for selecting and/or funding a program.

"Plan of correction" means a written response outlining actions taken or to be taken to address deficiencies cited in a licensing inspection report.

"Power of attorney (POA)" means a written document that grants a person (other than the individual granting the permission), the authority to act as an agent for the grantor, within the parameters of duties and powers specified in the document.

"Process" means activities that are systematically and intentionally linked in order to produce a service.

"Program description" means a document submitted to obtain a license from the Department. A program description includes a detailed description of services provided to persons with head injuries and staff coverage, and is reviewed as part of the licensing inspection process. The program description shall be amended to reflect major changes in the provision of services.

"Protecting rights" means ensuring that the rights of a person served are not ignored or infringed upon. This affirmation and protection is reflected in all aspects of the service process, from service initiation to discharge and follow up.

"Provisional license" is a negative licensing action issued to prompt corrective actions in existing community residences. A provisional license shall be effective for less than one year.

1. Rehabilitation services are necessary when the person with a head injury is in need of assistance in order to reacquire skills and it is beyond the person's personal capacities and resources to achieve his or her maximum potential for personal, cognitive, social, and economic adjustment and beyond the services available in the person's usual daily experience.

2. Habilitation is closely related to and is conceptually and programmatically a part of rehabilitation. The range of functional goals is the same as the range of services that shall be provided for the person to attain the goals. The chief difference is the condition or nature of the person served. Habilitation refers to the process that involves persons served who need to acquire particular skills and/or functional abilities they did not possess previously, such as independent living skills or vocational skills, while rehabilitation refers to the process that involves persons served who need to re-acquire or maximize lost skills and/or functional abilities.

"Rehabilitation nurse" means a person who meets legal requirements as a registered nurse and who has training and experience in dealing with the unique needs of those persons served who need rehabilitation. Rehabilitation nursing is a specialty practice within the profession. Rehabilitation nurses diagnose and treat the human responses of persons and groups to actual or potential disabilities that interrupt or alter their functioning and life satisfaction. The goal of rehabilitation nursing is to assist the person or group in the restoration and maintenance of maximal health and improve the person's quality of life. One mechanism of ascertaining the knowledge of rehabilitation nursing is through certification as a certified rehabilitation nurse (C.R.R.N.).

1. The provision of a range of choices, with personal preference, self-determination and dignity of risk receiving full respect and consideration;

2. A variety of social interactions that promote community integration;

3. An environment of peer support and mentorship;

4. Professional team involvement and competence; and

5. A physical environment conducive to enhancing the functional abilities of the persons served.

"Relocate" means providing accommodations which enable a person to evacuate the premises within three minutes, if prior accommodations could not be evacuated by the person within three minutes.

"Residence" means a community residence for persons with head injuries.

"Roommate" means the person with whom one shares a bedroom.

"Self-advocacy group" means a group of persons with head injuries who meet on a regular basis (such as at house meetings) to discuss common goals, issues, needs, and wishes. With the assistance of a facilitator, if needed, a self-advocacy group can serve as a united voice for persons with head injuries.

1. The violation by an owner, applicant, licensee, or executive leadership of the laws of the State of New Jersey pertaining to or governing community residences for persons with head injuries;

2. One or more licensing requirements have been left unmet and the unmet licensing requirements directly endanger the health, safety, or well-being of a person served;

3. The owner, applicant, licensee or executive leadership refuses to cooperate with Department personnel in gaining admission to a residence or in conducting an investigation or inspection;

4. The owner, applicant, licensee or executive leadership has failed to adhere to the approved program description;

5. The owner, applicant, licensee or executive leadership has falsified any information in order to obtain a license;

6. The owner, applicant, licensee or executive leadership has refused to furnish the Department with files, reports, or records as required by this chapter; or

7. The owner, applicant, licensee or executive leadership has failed to act in a fiduciary capacity in order to protect the funds of persons served.

"Supervised apartments" means apartments that are occupied by persons served and leased or owned by the licensee. Staff provide supervision, guidance, and training, as needed, in activities of daily living as defined by the needs and targeted future goals of the person served, in accordance with the requirements of this chapter. Up to four persons served may reside in a single apartment.

"Support" means activities, materials, equipment or other services designed and implemented to assist the person served. Examples include, but are not limited to, instruction, training, assistive technology, and/or removal of architectural barriers. Support also includes positive interactions between the person served and person(s) significant to the person served.

"Transdisciplinary Team" (TDT) means a group that shall be comprised of the person served and all personnel directly involved in the person-centered planning process of defining the person's capabilities and needs, in refining and meeting all of the person's goals and objectives, and in the provision of care or supervision. The team shall also include, as needed, other significant persons such as employers and those disciplines and persons involved in the provision of care or supervision. Team membership shall represent a variety of disciplines, to the extent possible. The team members shall share their knowledge and expertise in order to facilitate the assessment, planning, and implementation of the person's program. There shall be interaction and integration among the team members to ensure that the achievement of the individual's goals is facilitated. Family members, peers, and advocates shall participate at the discretion of the person served or his or her legal guardian.

"Traumatic brain injury" means an acquired injury to the brain. Such term does not include brain dysfunction caused by congenital or degenerative disorders, nor birth trauma, but may include brain injuries caused by anoxia due to trauma.

"Uniform Construction Code" means 52:27D-119 et seq. and N.J.A.C. 5:23.

"Uniform Fire Safety Act" means 52:27D-192 et seq., and the related codes adopted pursuant thereto.

"Unusual incident" means an event involving a person served or employee involving indications or allegations of criminal actions, injury, negligence, exploitation, abuse, clinical mismanagement or medical malpractice, a major unforeseen event, for example, serious fire, explosion, power failure that presents a significant danger to the safety or well being of persons served, and/or employees; or a newsworthy incident.

"Variance" means written recognition by the Department that the licensee has complied with the intent of a standard in a Department-approved alternative manner, in accordance with 10:44C-1.10.

"Volunteer" means an unpaid person who supports and supplements programs and services. A volunteer may be an individual, or a member of an organized group.

"Waiver" means the temporary suspension of a standard that is granted in writing by the Office of Licensing.

"Willful non-compliance" means that action or non-action of an applicant or licensee who has knowledge of the violations of licensing rules and/or terms of the license, has been advised of the consequences of not achieving compliance and has not achieved compliance after being given an adequate opportunity to do so.