New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 46C - COMMUNITY CARE PROGRAM WAITING LIST PROCEDURES
Subchapter 1 - GENERAL PROVISIONS
Section 10:46C-1.3 - Definitions
The words and terms in this chapter shall have the following meanings unless the context clearly indicates otherwise.
"Abuse" means wrongfully inflicting, or allowing to be inflicted, physical, sexual, verbal, or psychological abuse or mistreatment upon an individual with a developmental disability.
"Caregiver" means an individual who is not a parent of an eligible person including, but not limited to, a spouse, child, sibling, grandparent, step-family member, aunt, uncle, cousin, or legal guardian who, without monetary payment, cares for the eligible individual in the individual's home.
"Case management" means Division staff responsible for coordination of services across family, agency, and professional lines to develop and attain goals and objectives embodied in an individual's service plan. It involves monitoring of, and advocating for, the individual's needs with individual and family participation.
"Community Care Program" or "CCP" means a Division initiative, included in the Comprehensive Medicaid Waiver authorized by the Centers for Medicare and Medicaid Services under section 1115 of the Social Security Act, that funds community-based services and supports for adults with intellectual and developmental disabilities who meet the level of care for an Intermediate Care Facility for Individuals with Intellectual Disabilities.
"Community Care Waiver" or "CCW" means the Home and Community Based Services (HCBS) Waiver authorized by the Centers for Medicare and Medicaid Services (CMS) under section 1915(c) of the Social Security Act for people with developmental disabilities.
"Day program" means a community-based service, which addresses an individual's need for daytime activities as described in the individual's service plan.
"Division" or "DDD" means the Division of Developmental Disabilities in the Department of Human Services.
"Emergency" means an event in which an individual who is eligible for Division services is homeless or in imminent peril, as defined in N.J.A.C. 10:46B.
"Emergency placement" means that placement, as defined in N.J.A.C. 10:46B, which is made when the individual is homeless or in imminent peril and the Division cannot provide adequate alternate services in the existing situation or provide for the individual's personal safety, and the Division has determined that there is no long-term placement available.
"Essential lifestyle plan" or "ELP" means a specific type of service plan that is consistent with the requirements of 30:6D-10 through 12, developed by the interdisciplinary team (IDT). It is an outcome-based planning tool that, at a minimum, identifies each individualized program or service requested by and provided to the individual, for which the individual demonstrates a need. It identifies the person or agency responsible for its implementation. The complexity of the service plan will vary according to the individual's interests, preferences, and needs.
"Exploitation" means the act or process of using an individual with a developmental disability or the individual's resources for another person's profit or advantage.
"In-home services" means Division services rendered to an individual residing in the individual's family home.
"Individual habilitation plan" or "IHP" means a specific type of service plan of intervention and action that is developed by the interdisciplinary team. It specifies both the prioritized goals and objectives being pursued by each individual and the steps being taken to achieve them. It may identify a continuum of skill development that outlines progressive steps and the anticipated outcomes of services. The IHP is a single plan that encompasses all relevant components, such as an education plan, a program plan, a rehabilitation plan, a treatment plan, and a health care plan. The complexity of the IHP will vary according to the needs, capabilities, and desires of the person. For an individual who has been determined by an interdisciplinary team to require active treatment, the IHP shall address all needs identified. For an individual who makes only specific service requests, the IHP shall be a service plan, which addresses only those specific requests.
"Individualized service plan" or "ISP" means a standardized service planning document developed based on an individual's assessed needs that identifies an individual's outcomes and describes the services needed to assist the individual in attaining the outcomes identified in the plan. An approved ISP authorizes the provision of services and supports.
"Interdisciplinary team" or "IDT" means an individually constituted group responsible for the development of a single, integrated service plan. The team shall consist of the individual receiving services, the individual's parent or family member (if the adult desires that the parent or family member be present), legal guardian, those persons who work most directly with the individual served, and professionals and representatives of service areas relevant to the identification of the individual's needs and the design and evaluation of programs to meet those needs.
"Legal 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.
"Medical needs" means the individual has a documented chronic or acute medical condition, which requires regular care to be provided to the individual.
"Neglect" means any of the following acts on an individual with a developmental disability:
1. Willfully failing to provide proper and sufficient food, clothing, maintenance, medical care, or a clean and proper home; or
2. Failure to do, or permit to be done, any act necessary for the well-being of an individual with a developmental disability.
"Out-of-home services" means Division services rendered to an individual residing in a community setting other than the individual's family home (for example, group home, supervised apartment, community care residence, etc.).
"Qualified provider" means a service provider who has met all qualifications for providing Division services through the CCP.
"Regional offices" means that component of the Division, which provides intake, referral, and an array of community-based day and residential services. DDD regional offices serve four geographical areas of the State, which are: northern, upper central, lower central, and southern. Regional offices are sometimes referred to as Community Services Regional Offices.
"Support coordinator" means the professional responsible for developing and maintaining the individualized service plan with the individual, his or her family, as applicable, and other interdisciplinary team members; linking the individual to needed services; and monitoring the provision of services included in the individualized service plan.
"Supports program" or "SP" means a Division initiative, included in the Comprehensive Medicaid Waiver authorized by the Centers for Medicare and Medicaid Services under section 1115 of the Social Security Act, that funds community-based services and supports for adults with intellectual and developmental disabilities.
"Service plan" means a written, individualized plan, consistent with the requirements of 30:6D-10 through 12, developed by the IDT. It is an outcome-based planning tool that, at a minimum, identifies each individualized program, support, or service requested by and provided to the individual, for which the individual demonstrates a need. It identifies the person or agency responsible for its implementation. The complexity of the service plan will vary according to the individual's interests, preferences, and needs. The service plan format must be Division-approved but can be chosen from various types of plans, as determined by the requirements of the specific program, service, or support and can include, but is not limited to, the following types of plans: individual habilitation plan or essential lifestyle plan.
"Supports" means those services, other than residential services provided by the Division, which will help the individual remain in the individual's living situation.
"Waiting list" means a roster of individuals who are eligible for functional services from the Division and who have expressed a general service need.
"Waiting list coordinator" means a Division staff member who maintains and amends the waiver waiting list.
"Waiver review team" or "WRT" means a group of five members responsible for the review of requests for assignment to the Priority Waiting List category. At least one member of the group shall be an advocate or family member of an individual with a developmental disability, except where an advocate or family member cannot be readily identified or is unavailable to participate. If there is no readily available advocate or family member, the WRT shall operate without them.
