New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 75 - PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY SERVICES FOR INDIVIDUALS UNDER AGE 21
Subchapter 2 - PROGRAM REQUIREMENTS
Section 10:75-2.2 - Certification of need for PRTF services
Universal Citation: NJ Admin Code 10:75-2.2
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Prior to admission to the facility, PRTF services shall be certified in writing to be necessary, in accordance with 42 CFR 441.152. Certification of the need for services shall be made by an interdisciplinary team, composed of DCF/DCSOC, Care Management Organization (CMO), or the State's Contracted Systems Administrator (CSA) staff, who have knowledge of the child/youth/young adult's situation, are competent in the diagnosis and treatment of mental/behavioral health challenges, preferably in child psychiatry and include a physician.
1. For a beneficiary enrolled in the
Medicaid/NJ FamilyCare/DCF/DCSOC program before the admission to the PRTF, the
certification of need may be completed up to 45 days before admission. The form
must be received by the facility prior to the admission of the
child/youth/young adult.
2. For
children/youth/young adults receiving services coordinated by the DCF/DCSOC,
this certification may be completed by the child's CMO or the CSA, if the teams
assembled by the CMO or the CSA meet the requirements of
42 CFR 441.152.
(b) The interdisciplinary team shall certify, in writing, that:
1. Ambulatory care resources available in the
community do not meet the treatment needs of the child/youth/young
adult;
2. Proper treatment of the
child/youth/young adult's psychiatric condition requires services on an
inpatient basis under the direction of a physician; and
3. Treatment provided in a PRTF can
reasonably be expected to improve the child/youth/young adult's condition, or
prevent further regression, so that inpatient services would no longer be
needed.
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