New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 47 - STANDARDS FOR PRIVATE LICENSED FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
Subchapter 1 - GENERAL PROVISIONS
Section 10:47-1.2 - Definitions
The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise.
"Abuse" means any act or omission that deprives an individual of his or her rights or which has the potential to cause or causes actual physical injury or emotional harm or distress. Examples of abuse include, but are not limited to: acts that cause pain, cuts, bruises, loss of body function, sexual abuse, temporary or permanent disfigurement, death; striking with a closed or open hand; pushing to the ground or shoving aggressively; twisting a limb; pulling hair; withholding food; forcing an individual to eat obnoxious substances; use of verbal or other communication to curse, vilify, degrade an individual or threaten with physical injury. Planned use of behavioral intervention techniques which are part of an approved behavior modification plan or Individual Habilitation Plan shall not be considered to be abuse or neglect.
"Advance practice nurse," also known as a nurse practitioner (see N.J.S.A. 45:11-46c), is defined in 45:11-23, and may, in addition to those tasks lawfully performed by a registered professional nurse, manage specific common deviations from wellness and stabilized long term care illnesses by initiating laboratory and other diagnostic tests and prescribing certain medications and devices. (See 45:11-49.)
"Age appropriate" means that aspect of normalization that reinforces recognition of an individual as a person of a certain chronological age. This includes, but is not limited to, an individual's dress, behavior, use of language, choice of leisure and recreation activities, personal possessions and self-perception.
"Assessment" means the process of identifying a person's developmental strengths and needs, and the conditions that impede and promote development. There are two levels of assessment: screening and evaluation.
"Aversive technique" means the presentation of stimuli or conditions to decrease the frequency, intensity or duration of maladaptive behavior by inducing distress, discomfort or pain, which may place the individual at some degree of risk of physical and/or psychological injury.
"Behavior disorder" means an abnormal action which may interfere with the individual's activities of daily living.
"Behavior Management Committee" means a representative body of individuals who have clinical expertise and individuals who have administrative authority within the Division component or provider agency who review behavior plans and who make a judgment as to whether or not the plans are clinically/technically appropriate. Other behavior management issues may be referred to this committee. The committee acts as an advisory body to the Chief Executive Officer.
"Behavior objective" means one of a series of short range steps which are developmentally sequenced and directed toward the achievement of an established goal. Each behavioral objective specifies a single, learned response to be exhibited by the individual and the criterion against which progress is measured. The objective is developed and based upon knowledge of assessed developmental strengths and needs.
"Chief executive officer" means the person having administrative authority over, and responsibility for, a private residential facility licensed under this chapter.
"Department" means the Department of Human Services.
"Developmental disability" means a severe, chronic disability of a person 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 before the age of 22 in three or more of the following areas of major life activity, that is, self-care, receptive and expressive language, learning, mobility, self-direction and capacity for independent living or 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 mental retardation, autism, cerebral palsy, epilepsy, spina bifida and other neurological impairments where the above criteria are met.
"Director" means the Director of the Division of Developmental Disabilities.
"Division" means the Division of Developmental Disabilities.
"Exploitation" means any unjust or improper use of an individual or his or her resources for one's profit, advantage, or gratification.
"Goal" means a long range outcome. Goals are generally expected to be achieved by an individual within one to five years; they are stated in measurable terms so that their attainment can be determined. Goals must be individually centered and written to reflect the intent and direction of the Individual Habilitation Plan. Goals are broad in nature, realistic, based upon assessed needs and capabilities and attained through the use of behavioral and/or service objectives.
"Habilitation" means the process of providing those comprehensive services that are deemed necessary to meet the needs of persons who are developmentally disabled in programs designed to achieve objectives of health, welfare and the realization of an individual's maximum physical, social, psychological and vocational potential for useful and productive activities. Habilitation services may include, but are not limited to, the following:
1. Developing socially appropriate behaviors including sexual behaviors and interpersonal skills, and eliminating maladaptive behaviors;
2. Developing cognitive skills including, but not limited to, recognizing personal danger, telling time, managing money, making change, recognizing street and other signs, solving problems, etc.;
3. Developing recreation and leisure time skills;
4. Orienting to the community and training for mobility and travel;
5. Developing or remediating communication skills;
6. Developing appropriate activities of daily living such as grooming, dressing and self-care habits, such as toileting, eating and shaving; and
7. Training in assertiveness, and advocacy in dealing with citizenship, legal, family and/or social needs.
"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 body to the CEO on issues directly or indirectly affecting the rights of individuals served.
"Individual Habilitation Plan (IHP)" means a written 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 behavior modification 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. In most instances, the IHP shall address all major needs identified. The major needs shall be prioritized. For an individual who makes only specific service requests, the IHP shall be a service plan which addresses only those specific requests.
"Imminent danger" means a situation which could reasonably be expected to cause a serious risk to the health, safety or welfare of an individual receiving services.
"Individual with developmental disabilities" (individual, person served) means that person with developmental disabilities residing in a licensed private facility for the developmentally disabled.
"Informed consent" means a formal expression, oral or written, of agreement with a proposed course of action by an individual who has the capacity, the information and the ability to render voluntary agreement on his or her own behalf or on behalf of another.
"Interdisciplinary Team (IDT)" means an individually constituted group responsible for the development of a single, integrated IHP. The team shall consist of the person receiving services, the legal guardian, the parents or family member (if the adult desires that the parent or family member be present), those persons who work most directly with the individual served, and professionals and representatives of the service areas who are relevant to the identification of the individual's needs and the design and evaluation of programs to meet them.
"Investigation" means the systematic inquiry into the factors which have contributed to an incident, allegation or complaint. An investigation may range from a brief examination of records and statements to a comprehensive collection and analysis of all pertinent evidence.
"Least restrictive" means a principle whereby the interventions in the lives of persons with developmental disabilities are carried out with a minimum of limitation, intrusion, disruption, or departure from commonly accepted patterns of living.
"License" means the authorization issued by the New Jersey Department of Human Services for a period of one year, to the legally responsible person or entity in the facility providing residential services to persons with developmental disabilities.
"Measurable" means there are established criteria which are observable and can be quantified via a data collection system.
"Neglect" means the failure of the facility staff to provide for or maintain the care and safety of individuals under his or her supervision, including, but not limited to, failure to provide and maintain proper and sufficient food, clothing, health care, shelter and/or supervision.
"Normalization" means a principle of making available to the persons receiving services the commonly accepted patterns and conditions of everyday life.
"Physical restraint" means physical contact with an individual, initiated by one or more staff members, which restricts freedom of movement either partially or totally. Physical restraint as herein defined may be implemented as:
1. A procedure intended to protect an individual from inflicting injury upon himself or herself, staff or other individuals; or
2. As a behavior reduction procedure intended to reduce the frequency of a maladaptive behavior including, but not limited to, self injurious or otherwise aggressive behavior.
"Pica" means the maladaptive behavior of ingesting inedible substances or objects, including, but not limited to, soil, toys, or paint chips.
"Psychoactive medication" means those chemical substances which exert a direct effect upon the central nervous system and which are utilized as part of a treatment plan to address psychiatric disorders, symptoms of psychiatric disorders or to influence and modify behavior. Specifically, the generic classes of psychoactive medication include, but are not limited to:
1. Neuroleptics, such as chlorpromazine;
2. Anti-depressants, such as imipramine;
3. Agents for control of mania and depression, such as lithium;
4. Sedatives, hypnotics to promote sleep, such as flurazepam hydrochloride;
5. Psychomotor stimulants, such as methylphenidate hydrochloride; and
6. Anti-convulsants, such as Carbamazepine.
"Regulated medical waste" means any solid waste generated in the diagnosis, treatment, immunization of human beings or animals, research pertaining thereto, or in the production or testing of biologicals listed in the following: cultures or stocks; pathological wastes; human blood and blood products; sharps; animal waste; isolation wastes; and unused sharps, in accordance with N.J.A.C. 7:26-3A.
"Service objective" means a significant desired outcome that cannot be achieved as a result of learning or training. It includes quantifiable but non-behavioral outcomes such as seizure reduction or maintenance of blood pressure within a stated range, and quality of life outcomes such as developing and maintaining social networks. It also includes outcomes dependent on the behavior of staff, such as provision of adaptive or mobility equipment, obtaining specialized assessments, or referral for alternative placement.
"Severe medical problem" means any acute or long term condition which warrants frequent nursing care or monitoring, including, but not limited to, nasogastric tube feedings, gastrostomy, colostomy, tracheostomy, intravenous therapy, decubitus ulcer, quadriplegia and poorly controlled diabetes.
"Unusual incident" means an event involving an individual served by the Department 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 individuals served and/or employees; or a newsworthy incident.
"Vehicle operator" means a facility staff person utilizing a facility owned or leased vehicle to transport individuals.
"Volunteer" means an unpaid person who supports and supplements daily programs and services. A person may volunteer individually, or as a member of an organized group.
