New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 52A - PSYCHIATRIC ADULT ACUTE PARTIAL HOSPITAL AND PARTIAL HOSPITAL SERVICES
Subchapter 4 - PROGRAM REQUIREMENTS
Section 10:52A-4.3 - Reimbursable and non-reimbursable APH and PH services

1. Psychiatric services in APH:

2. Treatment services and interventions which assist a beneficiary to resolve an immediate crisis and attain stabilization in order to remain in the community through the support of a less intensive service, which include the following:

3. Medication-related services, as needed, which include the following:

4. Integrated treatment for co-occurring mental health and substance use disorders, which is a distinct clinical approach combining mental health and addiction into a unified, comprehensive and blended philosophy which provides prevention, intervention and treatment techniques which simultaneously address the beneficiary's needs;

5. Assessment and regular monitoring of co-occurring physical health needs to include procurement of medically necessary treatment(s) and services;

6. Beneficiary outreach to facilitate continued participation in the APH program;

7. Integrating the support of family and significant others into a beneficiary's treatment plan;

8. Other planning activities, which may include the development of an advance directive, meeting the requirements of P.L. 2005, c. 233, with specific instructions on what steps need to be taken in the event of a relapse and the development of a personal wellness and recovery action plan;

9. Environmental and safety procedures, which conform with 10:37D-2.5 and 10:37F-2.7;

10. Referral procedures for crisis intervention in the event the beneficiary experiences exacerbation of medical or psychiatric symptoms; and

11. An illness management and recovery program, comprised of a broad set of strategies and activities, which help a beneficiary collaborate with practitioners to identify and pursue personally meaningful recovery goals founded upon a core set of interventions that include: psychoeducation, social skills training, cognitive-behavioral therapy, motivational interviewing and behavioral tailoring and relapse prevention techniques. This is accomplished by helping each beneficiary to develop coping strategies and skills which reduce the beneficiary's susceptibility to the illness, provide assistance and support to effectively manage symptoms to prevent relapse and rehospitalizations and reduce distress to the point where the beneficiary is able to enjoy an improved quality of life. The interventions are intended to be both didactic and practical in nature and can be provided in both group and individual settings. Such services shall be provided directly to beneficiaries and in support of family members or other significant individuals important to the beneficiaries. The services shall include, but are not limited to:

1. Psychiatric services in PH, which include assessment and ongoing treatment supervision.

2. Counseling and case management services, which include evaluation, service planning and personal intervention;

3. Psychoeducational services for beneficiaries and families, which include mental health and medication education;

4. Prevocational services, as appropriate, directed toward maximizing vocational potential, including work readiness, prevocational experiences, prevocational training and counseling, prevocational assessment and planning. Prevocational services are an array of strategies and interventions that assist the beneficiary in acquiring general work behaviors, attitudes and skills in response to the interests and needs of beneficiaries who are considering, or intending to take on, roles which may be used in other life domains.

5. Community integration services, such as independent living skills training and goal-oriented cultural activities;

6. Engagement strategy services designed to connect with a beneficiary over time in order to develop a commitment on the beneficiary's part to enter into therapeutic relationships supportive of the beneficiary's recovery. This service may include, but is not limited to, activities, such as initial contacts with potential program participants, as well as continued efforts to engage individuals to participate in program services;

7. Activities designed to assist a beneficiary to identify, achieve and retain personally meaningful life goals over time which help the person resume normal functioning in valued life roles in self-chosen community environments. Examples of such goals include, but are not limited to, returning to work or school, returning to adult care-giving or parenting roles, resuming roles as a spouse or significant other, becoming a member of a religious community or becoming a neighbor;

8. An illness management and recovery program, comprised of a broad set of strategies and activities which help a beneficiary collaborate with practitioners to identify and pursue personally meaningful recovery goals founded upon a core set of interventions which include: psycho-education, social skills training, cognitive-behavioral therapy, motivational interviewing and behavioral tailoring, and relapse prevention techniques. This is accomplished by helping each beneficiary to develop coping strategies and skills which reduce the beneficiary's susceptibility to the illness, provide assistance and support to effectively manage symptoms to prevent relapse and rehospitalizations and reduce distress to the point where the beneficiary is able to enjoy an improved quality of life. They are intended to be both didactic and practical in nature and can be provided in both group and individual settings. Such services shall be provided directly to beneficiaries and in support of family members or other significant individuals important to the beneficiaries. The services shall include, but are not limited to:

9. Skill development needed for beneficiary-chosen community environments, facilitating beneficiary-directed recovery and re-integration into community living, learning, working and social roles by developing critical competencies and skills. Skill development may be accomplished through either individual or group instruction; however, the direct staff-to-beneficiary ratio in group activities shall not exceed 1:12. Examples include, but are not limited to, developing:

10. Medication-related services, as needed, which include the following:

11. Goal-oriented verbal counseling, which may include individual, group and family modalities to address the emotional, cognitive and behavioral symptoms of mental health illness or to engage, motivate, stabilize and address related effects on role functioning including beneficiaries with a co-occurring mental health and substance use disorder. Goal-oriented verbal counseling may also include motivational interviewing, connecting skills and cognitive behavioral therapy;

12. Age-appropriate learning activities, which are directly tied to the learning of daily living or other community-integration competencies such as financial literacy, basic computer literacy and recognition of directions and safety warnings. Such basic computing, reading or writing skills are considered incidental and not student education;

13. Community integration services, which include independent living skills training, interpersonal skills such as greeting, talking about impersonal topics, conversing, learning about available community cultural opportunities, practicing social interaction, and spiritual and cultural activities;

14. Psychiatric services, which include assessment and ongoing treatment supervision;

15. Other planning activities including the development of an advance directive, which meets the requirements of P.L. 2005, c. 233, with specific instructions on the steps to be taken in the event of a relapse and the development of a personal wellness and recovery action plan (WRAP); and

16. Integrated treatment for co-occurring mental health and substance use disorders, which is a distinct clinical approach combining mental health and addiction into a unified, comprehensive and blended philosophy which provides prevention, intervention and treatment techniques which simultaneously address the beneficiary's needs.

1. Vocational services, such as technical occupational skills training, college preparation, individualized job development and marketing to employers;

2. Student education, including preparation of school-assigned class work or homework;

3. Off-site services and activities, unless conducted in accordance with the provisions of this chapter;

4. Transportation, which is not a component of active programming; and

5. Breaks or mealtimes.