New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 37F - PARTIAL CARE SERVICES STANDARDS › Subchapter 2 - PARTIAL CARE STANDARDS › Section 10:37F-2.5 - Services to be provided

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The PA shall
				provide, or arrange for, a range of services to effectively address the
				holistic needs of the consumer. Service provision shall be coordinated with
				other service providers. Services must not exceed a 1:15 staff-to-consumer
				ratio based upon the active daily census and direct care staff, except as
				indicated in (b)4 below.
(b) The PA
				shall directly provide the following core services:
1. Engagement strategies shall be designed to
				connect with consumers over time in order to develop a commitment on their part
				to enter into therapeutic relationships supportive of the individual'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;
2. Activities designed to assist a consumer
				to identify, achieve and retain personally meaningful 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;
3. An Illness Management and Recovery
				Program, which is comprised of a broad set of strategies and activities that
				help consumers collaborate with practitioners to identify and pursue personally
				meaningful recovery goals and which founded upon a core set of interventions
				that include: psycho education, social skills training, cognitive-behavioral
				therapy, motivational interviewing and behavioral tailoring, and relapse
				prevention techniques. This is accomplished by helping people to develop coping
				strategies and skills that reduce the individual's susceptibility to the
				illness, provide assistance and support to effectively manage symptoms to
				prevent relapse and rehospitalizations, and reduce distress to the point that
				the consumer 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 will be provided directly to consumers and
				in support of family members and/or other significant individuals important to
				the consumer. The services shall include, but are not limited to:
i. Coping skills, adaptive problem solving,
				and social skills training that teach individuals strategies to self-manage
				symptoms and personal stress and strengthen life skills and abilities to attain
				their recovery goals;
ii. Psycho
				education that provides factual information, recovery practices, including
				evidence-based models, concerning mental illness that instills hope and
				emphasizes the potential for recovery. Such services will be geared toward the
				consumer developing a sense of mastery over his or her illness and life, and
				shall also be effective in reducing relapse and rehospitalizations. It may also
				provide support to the consumer's family and other members of the consumer's
				social network to help them manage the symptoms and illness of the consumer and
				reduce the level of family and social stress associated with the
				illness;
iii. Development of a
				comprehensive relapse prevention plan that offers skills training and
				individualized support focused on self-management of mental illness and other
				aspects of recovery, including early recognition, identification and management
				of symptoms and positive coping strategies and development of supports to
				reduce the severity and distress of disturbing symptoms. Special attention
				shall be placed on understanding, recognizing and monitoring of stressors that
				have triggered return of persistent symptoms in the past and adaptive problem
				solving techniques shall be applied to avoid recurrences in the future. As this
				process of mastery over the illness evolves, the practitioner will explore and
				develop a new sense of personal identity with the consumer, and examine with
				him or her the potential for growth beyond the mental illness;
iv. Dual disorder education which provides
				basic information to consumers, family members or other significant individuals
				on the nature and impact of substance use and how it relates to the symptoms
				and experiences of mental illness and its treatment, as well as upon the
				attainment of one's personal recovery goals;
v. Medication education to be provided within
				the context of a collaborative and therapeutic relationship. Consumers will be
				provided with adequate information in an understandable format regarding
				medications' relative effectiveness and safety in order to make an informed
				decision. Interventions, such as medication self-management, behavioral
				tailoring, simplifying a consumer's medication regimen, and motivational
				interviewing assist and support consumers' in adhering to their medication
				regimens. Practitioners will specifically review with the consumer how
				medication management issues will impact their personal recovery goals and will
				be responsible for involving family members whenever possible; and
vi. Wellness activities that are consistent
				with the consumer have self-identified recovery goals. Wellness activities may
				address common physical health problems, such as tobacco dependency, alcohol
				use, sedentary lifestyle and lack of physical exercise, and overeating and/or
				poor nutrition. Other wellness services may address goals, such as constructive
				use of leisure time and fulfilled spirituality and creativity
				pursuits;
4. Skill
				development needed for consumer-chosen community environments, facilitating
				consumer-directed recovery and re-integration into valued community living,
				learning, working and social roles by developing critical competencies and
				skills. Skill development can be accomplished through either individual or
				group instruction; however, the direct staff-to-consumer ratio in such
				circumstances shall not exceed 1:12. Examples would include, but not be limited
				to:
i. Cognitive skills such as researching
				and recording information, decision making, identifying preferences and values,
				selecting clothing, interviewing, scheduling appointments, budgeting, personal
				nutrition planning, etc.;
ii.
				Physical skills such as showering, grooming, cooking, cleaning personal space,
				shopping, taking public transportation, parenting, etc.; and
iii. Emotional skills such as negotiating,
				communicating, asking for help, avoiding risks to sobriety, greeting others,
				conversing, identifying psychiatric cues, planning for psychiatric emergencies,
				etc.;
5. Prevocational
				services, which are an array of strategies and interventions that assist in
				acquiring general work behaviors, attitudes and skills in response to the
				interests and needs of consumers who are thinking about and/or intending to
				take on the role of worker and which may be used in other life domains.
i. Prevocational intervention or strategies
				selected are based upon an assessment of consumer interest, needs, skills and
				supports and reflected in the consumer's individualized recovery
				plan.
ii. Prevocational activities
				might include, but not be limited to:
(1)
				Understanding and choosing work settings;
(2) Gathering and researching job
				information;
(3) Clarifying
				occupational values and interests;
(4) Defining work preferences;
(5) Identifying personal work
				criteria;
(6) Exploring barriers to
				working;
(7) Identifying and
				defining critical work skills;
(8)
				Researching personal work supports and resources;
(9) Identifying psychiatric illness
				management strategies related to working;
(10) Simulated work activities such as work
				units to address work hardening, concentration, attending and other skills;
				and
(11) Learning methods to
				respond to criticism, negotiating for needs, dealing with interpersonal issues,
				and adherence to medication requirements.
iii. Therapeutic subcontract work may be
				provided within the context of partial care as prevocational therapy if already
				provided.
(1) Therapeutic subcontract work
				activity is the production, assembly and/or packing tasks for compensation
				obtained by the organization under a contract with a vendor for which
				individuals with disabilities performing the tasks are paid under a wage and
				hour certificate, typically less than minimum wage.
(2) The consumer's individual service plan
				shall stipulate that the therapeutic subcontract work is a form of intervention
				intended to address the individual as identified in the consumer's
				assessment.
(3) The therapeutic
				subcontract work shall be facilitated by a qualified mental health services
				worker.
(4) The therapeutic
				subcontract work activity shall be performed within the line of sight of the
				qualified mental health service worker.
(5) The staff-to-consumer ratio shall not
				exceed a ratio of 1:12 qualified mental health services worker to
				consumer;
6.
				Medication-related services, as needed, which include the following:
i. Medication counseling and education, as
				defined in
				10:37-6.53 and 6.54;
ii. Knowledge and documentation of each
				consumer's current medication treatment/therapies;
iii. Providing a mechanism for staff to share
				clinical information regarding medication utilization; and
iv. Educating beneficiaries, staff and other
				caregivers regarding adverse drug reactions, potential side effects and
				established procedures for responding to crisis situations;
7. 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 for engaging, motivating, stabilizing and the related effects on
				role functioning including consumers 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;
8. Age-appropriate
				learning activities which are directly tied to the learning of daily living or
				other community integration competencies such as financial literacy, learning
				basic computer literacy, recognition of directions and safety warnings. Such
				basic computing, reading or writing skills are considered incidental and not
				student education;
9.
				Social/leisure services, which include independent living skills training,
				interpersonal skills such as greeting, talking about impersonal topics,
				conversing, learning about available community social and recreational
				opportunities, planning for leisure time, practicing social interaction,
				recreational, spiritual and cultural activities;
10. Psychiatric services, which include
				assessment and ongoing treatment supervision; and
11. Other planning activities may include the
				development of an advance directive, that meets 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
				(WRAP).