New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 7 - ROLE OF THE COUNTY ADJUSTER › Subchapter 2 - DEFINITIONS › Section 10:7-2.1 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
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)