New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 7 - ROLE OF THE COUNTY ADJUSTER
Subchapter 2 - DEFINITIONS
Section 10:7-2.1 - Definitions
The following words and terms, when used in this chapter, shall have the following meanings unless the context clearly indicates otherwise.
"Agency" means a Division, institution, facility, or organizational unit within the DHS.
"Amended order" means a superior court order changing the terms of a court order.
"Charitable institution" means, for purposes of these rules, a facility which receives public funds to support the individuals it serves, such as a county nursing home. It does not include, for example, privately owned/operated nursing homes, residential healthcare facilities, or boarding homes.
"Charity care fee scale" means the progressive scale, which incorporates specific asset and income eligibility standards, as described as 10:7-4.2, specifically 10:7-4.2(c), to determine a client's or a legally responsible relative's percentage of payment responsibility for a specific hospitalization.
"Chief executive officer" means the highest ranking official in a State agency or county psychiatric facility.
"Client" means an individual receiving services from the DHS or the county psychiatric facilities.
"Commissioner" means, unless otherwise specified, the Commissioner of the DHS.
"Compromise" means a decision made by the Office of the Commissioner as authorized by 30:4-77, 30:4-80.6 and P.L. 2005, c. 55, to: satisfy any debt due to a State agency or county psychiatric facility, as appropriate, by accepting less than the amount owed; or release all or part of the assets subject to a lien claim for the use or benefit of the client or his or her dependents, heirs or assignees. A compromise is not necessary for the release of a lien claim if a partial payment is made that constitutes the final distributive share to a creditor (the Department or county) from the estate of a deceased client. (30:4-80.6)
"Compromise offer" means a written offer by or on behalf of a client or former client to: satisfy any debt due to a State agency or county psychiatric facility by offering less than the amount owed; or release all or part of the assets subject to a lien claim for the use or benefit of the client or his/her dependents, heirs, or assignees. Compromise offers can also be made by or on behalf of legally responsible relatives (LRR) to satisfy any unpaid debts the LRR is obligated to pay, as substantiated by a court order, for the care and maintenance of a client or former client, in accordance with 30:4-80.6 and 10:7-6.2.
"County adjuster" means the county official charged with the responsibility for determining the psychiatric client's financial ability to pay the DHS psychiatric agency and/or the county psychiatric facility for the cost of care and maintenance. The individual is also responsible for filing a petition with the court to determine the client's legal settlement and provision for payment of the client's expense for care and treatment. This petition shall be accompanied by a report stating the results of the county adjuster's investigation and recommendations on this matter, as required by R. 4:74-7(i). The use of this term in these rules shall mean the county adjuster or county designee.
"County bills" means the monthly State charges to the counties for their share of care and maintenance costs for services provided by the various DHS agencies to county chargeable clients.
"County of admission/commitment" means the county where the client was admitted/committed from to a short-term care facility, psychiatric facility or special psychiatric hospital or where a voluntary client is admitted to a facility for treatment, including DDD clients.
"County per diem rate" means the daily per capita rate established for each State agency, set annually by the State House Commission, and used to charge counties for their share of the cost of care and maintenance for clients with county settlement in State operated facilities, in accordance with 30:4-78.
"County psychiatric facility" means a county operated psychiatric facility which participates in the State Aid Program of the New Jersey Division of Mental Health and Addiction Services (DMHAS).
"Court order" means a legal document issued by the superior court that authorizes the admission/commitment/discharge of a client and specifies financial liability and/or legal settlement of the client.
"Crime victim" is a person who suffers personal, physical or psychological injury or death or incurs loss or injury to personal or real property as a result of a crime committed against that person. Victim also includes the nearest relative of the victim of a homicide. (52:4B-37)
"Crime victim exemption status" is the status assigned to a crime victim as defined above who qualifies under P.L. 2001, c. 208 as eligible for an exemption from the financial assessment process as a legally responsible relative for the client's cost of care and maintenance.
"Department" (DHS) means the Department of Human Services or one of its agencies.
"Discharge of lien" means the legal document through which a lien is removed from county or State Superior Court records.
"Division of Developmental Disabilities" (DDD) means a division of the DHS which administers the State developmental centers, provides special residential facilities, and supplies social services for the developmentally disabled.
"Division" or "DMHAS" means the Division of Mental Health and Addiction Services within the Department of Human Services which establishes Statewide policy and coordination regarding the delivery of mental health services, operates the State psychiatric hospitals, and contracts with community-based mental health providers for direct services.
"DMAHS" means the Division of Medical Assistance and Health Services, the division within the Department of Human Services which administers the State Medicaid program.
"Incompetent to stand trial" (IST), or pending such status, means a client who has been adjudicated incompetent to stand trial or is being examined for competency to stand trial.
"Involuntary commitment--adult" means a commitment of an adult who is mentally ill, whose mental illness causes the person to be dangerous to self or dangerous to others or property and who is unwilling to be admitted to a facility voluntarily for care, and who needs care at a short term care facility, psychiatric facility or special psychiatric hospital because services are not appropriate or available to meet the person's mental health care needs. (N.J.S.A. 30:4-27.2m)
"Involuntary commitment--minor" means a commitment of a minor in need of intensive psychiatric therapy which cannot practically or feasibly be rendered in the home or in the community or on an outpatient basis. (Civil Practice Rules 4:74-7A)
"Legal settlement" means the client's legal residence, as defined by 30:4-49 et seq., which is used to determine whether the State and/or a specific county is responsible for the cost of care and maintenance of the client if he/she is unable to pay the full private rate.
"Legally responsible relative (LRR)" means a mother or father who is statutorily responsible for the cost of care and maintenance of a child under 18 years of age. (30:4-66)
"Lien" means a legal encumbrance against the assets of a client or LRR precluding disposition until settlement with the State and/or county for services. Settlements in this context can take many forms, for example, payment, compromise, etc. Liens are filed by the chief executive officer (or equivalent) or a duly constituted agent, for example, county adjuster or supervisor of patient's accounts (SPA). (30:4-80.1, 80.2 and 80.3 et seq.)
"Lien subordination" means a lien claim for the cost of care and maintenance on a client/LRR which is placed in subordinate position to another debt.
"Maintenance bill" means a billing, by year, reflecting the number of days a client was present at the agency, multiplied by the State Board of Human Services daily rate for those years, and from which charge all payments and recoveries realized from the client and/or LRR are deducted.
"No settlement" means that a client does not have State or county settlement and is charged to the State pending his or her removal to the place where he or she has legal settlement, if any. (30:4-52)
"Not guilty by reason of insanity (NGRI)" or "Krol client" means a client who has been found not guilty of a criminal offense by reason of insanity. (See also State v. Krol, 69 N.J. 236 (1975).)
"Notice of Commitment Hearing" means a written document giving the time and place of the commitment hearing which is a notice served upon the client and his or her counsel or guardian ad litem which includes a copy of the temporary court order, a statement of the client's rights at the hearing and the screening or clinical certificates and supporting documents. (Civil Practice Rules 4:74-7(c)(4) and 4:74-7A)
"Order of Commitment" means a document signed by either a municipal court judge or a superior court judge which orders a client to be detained in or transferred to a short-term care facility, a psychiatric facility, or a special psychiatric hospital and contains all the terms mandated in the Civil Practice Rules 4:74-7(c)(4) and 4:74-7A.
"Order of Settlement and Support" means a superior court order establishing legal settlement and financial obligations for institutional care. The order determines the extent of county, State, client and LRR liability.
"Petition for Settlement and Maintenance" means a document by which the county adjuster petitions the court for the designation of the client's legal settlement and provision for payment of the expenses of the client's care and treatment, which is accompanied by a report stating the results of the county adjuster's investigation and his or her recommendations. (Civil Practice Rules 4:74-7(i)(1) and 4:74-7A)
"Power of attorney" means a legal document authorizing an individual to represent another.
"Private rate" means the full per capita rate as set by the State Board of Human Services for State agencies and the county governing body or a county-designated committee thereof, for the county psychiatric facilities.
"Psychiatric facility" means a State psychiatric hospital (30:1-7), a county psychiatric hospital, or a psychiatric unit of a county hospital (N.J.S.A. 30:4-27.2u) and, for the purposes of these rules, the inpatient psychiatric services provided by the University of Medicine and Dentistry of New Jersey through the Community Mental Health Center at Piscataway.
"Recovery" means any money received on behalf of a specific client to offset accumulated maintenance charges for care and treatment in a State or county facility or community program. Sources of recoveries may include: regularly recurring income such as wages, pensions, interest, annuity benefits and Social Security benefits; inheritances; judgments; voluntary contributions; LRR contributions; and Medicare and other third-party insurance coverage.
"Release of property from lien" means to preserve a lien on a client/LRR while removing certain property from its effect. (30:4-80.4)
"Representative payee" means an individual or agency receiving Federal annuity benefits for another person. A representative payee is necessary whenever a client is incapable of managing funds.
"Short-term care facility" means an inpatient, community based mental health treatment facility which provides acute care and assessment services to a person with a mental illness whose mental illness causes the person to be dangerous to self or dangerous to others or property. A short-term care facility is so designated by the Commissioner and is authorized by the Commissioner to serve persons from a specified geographic area. A short-term care facility may be a part of a general hospital or other appropriate health care facility and meets certificate of need, licensing, and inspection requirements of the Department of Health pursuant to P.L. 1971, c. 136 (N.J.S.A. 26:2H-1 et seq.), and in accordance with standards developed jointly with the Commissioner of Human Services. (N.J.S.A. 30:4-27.2bb)
"Special psychiatric hospital" means a public or private hospital licensed by the Department of Health to provide voluntary and involuntary mental health services, including assessment, care, supervision, treatment, and rehabilitation services to persons who are mentally ill. (N.J.S.A. 30:4-27.2cc)
"State House Commission" means the commission empowered by the State Legislature to establish the yearly per capita rates to the State for client maintenance in county psychiatric facilities and to the counties for client care and maintenance in specific State funded agencies and programs.
"State settlement" means when there is no continuous residency in any county for a period of five years or more immediately preceding the date of admission/commitment and there is continuous residence in the State for one year. There are no county charges. (30:4-51)
"Treasury formula" means the method of determining the financial ability to pay for care and maintenance by a client and/or LRR(s). (30:4-60)
"Voluntary admission--adult" means an admission of an adult who is mentally ill, whose mental illness causes the person to be dangerous to self or dangerous to others or property, and is willing to be admitted to a facility voluntarily for care, needs care at a short-term care or psychiatric facility because other facilities or services are not appropriate or available to meet the person's mental health care needs. A person may also be voluntarily admitted to a psychiatric facility if his or her mental illness presents a substantial likelihood of rapid deterioration in functioning in the near future, there are no appropriate community alternatives available and the psychiatric facility can admit the person and remain within its rated capacity. (N.J.S.A. 30:4-27.2ee)
"Voluntary admission--minor" means any minor 14 years of age or over, who has requested his or her admission to an institution for psychiatric treatment, provided the court, on a finding that the minor's request is voluntary, enters an order approving the admission. If an order approving a voluntary admission of a minor is entered, the minor may discharge himself or herself from the institution in the same manner as an adult who has voluntarily admitted himself or herself. (Civil Practice Rules 4:74-7A(c))
"Warrant to Enter Satisfaction" means the legal document by which the satisfaction of liens are authorized. They are signed by the chief executive officer or equivalent at the State agency or county psychiatric facility making the claim. (30:4-80.6)
