New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 46 - DETERMINATION OF ELIGIBILITY › Subchapter 1 - GENERAL PROVISIONS › Section 10:46-1.3 - 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.
"Application" means the form available at Division offices or
				  on the Division website at:
www.state.nj.us/humanservices/ddd/services/apply/index.html
(see N.J.A.C.
				  10:46-3.2(a)). The term
				  includes any supporting documentation deemed necessary by the Division to make
				  an informed determination with regard to applicant eligibility, including
				  medical information. Supporting documentation may include, but is not limited
				  to, educational, psychiatric, psychological, vocational, rehabilitation,
				  medical, and social service records.
"Assistant Commissioner" means the Assistant Commissioner of
				  the Division of Developmental Disabilities.
"Benefits" means all current and future sources of cash and
				  health assistance from Federal, State, or private entities including, but not
				  limited to, Social Security, SSI, Medicare, Medicaid, State, and Federal funds
				  and any third-party support pursuant to State rule, order, or by contract.
"Commissioner" means the Commissioner of the New Jersey
				  Department of Human Services.
"Developmental disability" means a severe, chronic
				  disability of an individual, which:
1. Is attributable to a mental or physical impairment or
				  combination of mental or physical impairments;
2. Is manifest before age 22;
3. Is likely to continue indefinitely;
4. Results in substantial functional limitations in three or
				  more of the following areas of major activities of daily living:
i. Self-care;
ii. Receptive and expressive language;
iii. Learning;
iv. Mobility;
v. Self-direction;
vi. Capacity for independent living; and
vii. Economic self-sufficiency; and
5. Reflects the need for a combination and sequence of
				  special interdisciplinary or generic care, treatment, or other services, which
				  are of lifelong or extended duration and are individually planned and
				  coordinated
Developmental disability includes, but is not limited to,
				  severe disabilities attributable to intellectual disability, autism, cerebral
				  palsy, epilepsy, spina bifida, and other neurological impairments where the
				  above criteria are met.
"Division" means the Division of Developmental Disabilities.
"Guardian" means a person or agency appointed by a court of
				  competent jurisdiction to make decisions on behalf of an individual determined
				  by the court to lack decision-making capacity in certain areas as set forth at
				  N.J.S.A.
				  3B:12-24.1.
"Intake team" means at least two professionals, one of whom
				  is the intake worker and one who is a psychologist, who are responsible for
				  determining whether the eligibility criteria contained in this chapter have
				  been met.
"Intake worker" means a professional employee of the
				  Division or a contracted entity who completes an appropriate program of
				  training as determined by the Division. The program of training, at a minimum,
				  includes an orientation and instruction in the identification of developmental
				  disabilities, the use of evaluation tools, and interaction techniques.
"Medical information" means reports that have been provided
				  by licensed practitioners that demonstrate the existence of a developmental
				  disability, as well as the individual's current physical condition and
				  significant medical history.
"Mental illness" means a current substantial disturbance of
				  thought, mood, perception, or orientation that significantly impairs judgment,
				  behavior, or capacity to recognize reality but does not include simple alcohol
				  intoxication, transitory reaction to drug ingestion, organic brain syndrome, or
				  developmental disability.
				  N.J.S.A.
				  30:4-27.2( P.L. 1987, c. 116.)
"Mental impairment" means impairment in cognitive,
				  neurological, sensory, or cerebral functioning resulting from other than mental
				  illness.
"Neurological Impairment (NI)" means a severe disorder of the
				  central nervous system:
1. Evidenced by a medical diagnosis that is listed in the
				  International Classification of Diseases, 10th revision, Clinical Modification
				  (ICD-10- CM), incorporated herein by reference, as amended and supplemented.
				  The ICD-10-CM is available by contacting the Center for Disease Control and
				  Prevention, National Center for Health Services, 3311 Toledo Road, Hyattsville,
				  MD, 20782, or at
www.cdc.gov
; and
2. Documented by the results from valid medical or
				  neuropsychological testing.
"Physical impairment" means impairment in physical
				  functioning that is substantial and results from neurological impairment, such
				  as, but not limited to, cerebral palsy, spina bifida, spinal atrophies, and
				  spinal cord injuries.
"Primary residence" means the dwelling where the individual
				  usually lives. Second homes or privately made residential placements are not a
				  primary residence.
"Resident" means a person who is a domiciliary of New Jersey
				  for other than a temporary purpose and whose primary residence is in New
				  Jersey.
"Transitional planning" means information and training
				  provided to individuals between the ages of 16 and 21 to prepare for the
				  transition from an individual's educational entitlement to adult life, with an
				  emphasis on preparation for employment.
"Waiver" means a Medicaid waiver authorized by the Federal
				  Centers for Medicare and Medicaid Services (CMS), pursuant to a program in
				  which states request permission from CMS to provide a broad array of services,
				  excluding room and board, that are not otherwise covered under the Medicaid
				  program. These services are designed to support an individual in the
				  individual's home and community, thereby preserving the individual's
				  independence and bonds to family and friends, at a cost that is not higher than
				  institutional care.
"Waiver services" means the services available in the
				  authorized Medicaid waiver program in which an individual is
				  enrolled.