New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 46 - DETERMINATION OF ELIGIBILITY
Subchapter 1 - GENERAL PROVISIONS
Section 10:46-1.3 - Definitions
The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise.
"Application" means the form available at Division offices or on the Division website at: www.state.nj.us/humanservices/ddd/services/apply/index.html (see N.J.A.C. 10:46-3.2(a)). The term includes any supporting documentation deemed necessary by the Division to make an informed determination with regard to applicant eligibility, including medical information. Supporting documentation may include, but is not limited to, educational, psychiatric, psychological, vocational, rehabilitation, medical, and social service records.
"Assistant Commissioner" means the Assistant Commissioner of the Division of Developmental Disabilities.
"Benefits" means all current and future sources of cash and health assistance from Federal, State, or private entities including, but not limited to, Social Security, SSI, Medicare, Medicaid, State, and Federal funds and any third-party support pursuant to State rule, order, or by contract.
"Commissioner" means the Commissioner of the New Jersey Department of Human Services.
"Developmental disability" means a severe, chronic disability of an individual, which:
1. Is attributable to a mental or physical impairment or combination of mental or physical impairments;
2. Is manifest before age 22;
3. Is likely to continue indefinitely;
4. Results in substantial functional limitations in three or more of the following areas of major activities of daily living:
i. Self-care;
ii. Receptive and expressive language;
iii. Learning;
iv. Mobility;
v. Self-direction;
vi. Capacity for independent living; and
vii. Economic self-sufficiency; and
5. Reflects the need for a combination and sequence of special interdisciplinary or generic care, treatment, or other services, which are of lifelong or extended duration and are individually planned and coordinated
Developmental disability includes, but is not limited to, severe disabilities attributable to intellectual disability, autism, cerebral palsy, epilepsy, spina bifida, and other neurological impairments where the above criteria are met.
"Division" means the Division of Developmental Disabilities.
"Guardian" means a person or agency appointed by a court of competent jurisdiction to make decisions on behalf of an individual determined by the court to lack decision-making capacity in certain areas as set forth at N.J.S.A. 3B:12-24.1.
"Intake team" means at least two professionals, one of whom is the intake worker and one who is a psychologist, who are responsible for determining whether the eligibility criteria contained in this chapter have been met.
"Intake worker" means a professional employee of the Division or a contracted entity who completes an appropriate program of training as determined by the Division. The program of training, at a minimum, includes an orientation and instruction in the identification of developmental disabilities, the use of evaluation tools, and interaction techniques.
"Medical information" means reports that have been provided by licensed practitioners that demonstrate the existence of a developmental disability, as well as the individual's current physical condition and significant medical history.
"Mental illness" means a current substantial disturbance of thought, mood, perception, or orientation that significantly impairs judgment, behavior, or capacity to recognize reality but does not include simple alcohol intoxication, transitory reaction to drug ingestion, organic brain syndrome, or developmental disability. N.J.S.A. 30:4-27.2( P.L. 1987, c. 116.)
"Mental impairment" means impairment in cognitive, neurological, sensory, or cerebral functioning resulting from other than mental illness.
"Neurological Impairment (NI)" means a severe disorder of the central nervous system:
1. Evidenced by a medical diagnosis that is listed in the International Classification of Diseases, 10th revision, Clinical Modification (ICD-10- CM), incorporated herein by reference, as amended and supplemented. The ICD-10-CM is available by contacting the Center for Disease Control and Prevention, National Center for Health Services, 3311 Toledo Road, Hyattsville, MD, 20782, or at www.cdc.gov; and
2. Documented by the results from valid medical or neuropsychological testing.
"Physical impairment" means impairment in physical functioning that is substantial and results from neurological impairment, such as, but not limited to, cerebral palsy, spina bifida, spinal atrophies, and spinal cord injuries.
"Primary residence" means the dwelling where the individual usually lives. Second homes or privately made residential placements are not a primary residence.
"Resident" means a person who is a domiciliary of New Jersey for other than a temporary purpose and whose primary residence is in New Jersey.
"Transitional planning" means information and training provided to individuals between the ages of 16 and 21 to prepare for the transition from an individual's educational entitlement to adult life, with an emphasis on preparation for employment.
"Waiver" means a Medicaid waiver authorized by the Federal Centers for Medicare and Medicaid Services (CMS), pursuant to a program in which states request permission from CMS to provide a broad array of services, excluding room and board, that are not otherwise covered under the Medicaid program. These services are designed to support an individual in the individual's home and community, thereby preserving the individual's independence and bonds to family and friends, at a cost that is not higher than institutional care.
"Waiver services" means the services available in the authorized Medicaid waiver program in which an individual is enrolled.
