New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 73 - CASE MANAGEMENT SERVICES
Subchapter 2 - ADULT CASE MANAGEMENT PROGRAM/MENTAL HEALTH (CMP/MH)
Section 10:73-2.1 - Definitions

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context indicates otherwise:

"Adult" means any individual over age 21, or an individual over age 18 who did not receive services from the Department of Children and Families' child-serving systems, including, but not limited to, the Children's System of Care, prior to their 18th birthday.

"Clinical case management" means the provision of face-to-face individualized clinical support services to adult Medicaid/NJ FamilyCare beneficiaries, in accordance with 10:73-2.11, for a beneficiary who needs consistent contact to ensure that the beneficiary remains:

1. Engaged with the case manager;

2. Stable in his or her individual situation; and

3. Linked to needed services.

"Ongoing support services" means the provision of face-to-face individualized clinical support services for a beneficiary who needs such contact, as determined in accordance with 10:73-2.4(a)5.

"Risk category" means the three levels of clinical case management involvement, based upon assessed risk of hospitalization, functional level and willingness and/or ability to access needed services. The three risk categories are: high-risk, or intensive case management; at-risk, or supportive case management; and low-risk, or maintenance level case management.

"Service provider monitoring" means the process of routine follow-up by a case manager or by the Division of Mental Health and Addiction Services with the beneficiary's service providers to assess whether services have been provided as planned and whether such services meet the beneficiary's needs, in accordance with N.J.A.C. 10:73-2.4(a)4.

"Targeted case management" under Case Management Program/Mental Health (CMP/MH) means the provision of services targeted to adults with serious mental illness who are at high risk of hospitalization or deterioration in their functioning and who require an assertive community outreach service to meet their needs. Targeted case management services include, but are not limited to: assessment, service planning, services linkage, ongoing monitoring, ongoing clinical support and advocacy.

"Unit of service," for the purposes of this subchapter, means a continuous face-to-face contact with an enrolled beneficiary, or on behalf of an enrolled beneficiary, which lasts 15 minutes, not including travel time.