New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 31 - SCREENING AND SCREENING OUTREACH PROGRAM › Subchapter 1 - GENERAL PROVISIONS › Section 10:31-1.3 - 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.
"Acute care" means community-based outpatient and inpatient
				  psychiatric services designed to provide stabilization during the acute phase
				  of psychiatric illness.
"Acute care system" means those services either contracted
				  for or identified by the Division of Mental Health and Addiction Services, in
				  consultation with the appropriate county mental health board, as part of a
				  geographic area's acute care services. They may include, but are not limited
				  to, the screening service, affiliated emergency services, short-term care
				  facilities, inpatient psychiatric services, adult acute partial hospital
				  services, partial hospital services, partial care services, crisis housing,
				  integrated case management services (ICMS), programs of assertive community
				  treatment (PACT), and peer support, self-help, and acute family support
				  services.
"Adult acute partial hospital" means an intensive and
				  time-limited acute psychiatric service for beneficiaries 18 years of age or
				  older who are experiencing, or are at risk for, rapid decompensation. This
				  mental health service is intended to minimize the need for
				  hospitalization.
"Affiliated emergency service (AES)" means a mental health
				  provider that is under contract with the Division of Mental Health and
				  Addiction Services and has an affiliation agreement with the designated
				  screening service in its geographic area and is responsible for the provision
				  of services to people in psychiatric crisis. Emphasis is on stabilization, so
				  that the consumer can actively participate in needs assessment and service
				  planning.
"Assessment" means evaluation of the individual in
				  psychiatric crisis in order to ascertain his or her current and previous level
				  of functioning, psychosocial and medical history, potential for dangerousness,
				  current psychiatric and medical condition factors contributing to the crisis
				  and support systems that are available.
"Commissioner" means the Commissioner of the Department of
				  Health.
"Commitment" means the procedure for authorizing admission to
				  a treatment facility 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 other services are not appropriate to meet the
				  person's mental health care needs.
"Community referral source" means an individual, such as a
				  police officer, religious leader, family member or other person, who may refer
				  an individual for mental health services.
"Consensual admission" means a voluntary admission
				  specifically to a short-term care facility from a screening service.
"Consumer" means an individual 18 years of age or older
				  receiving assessment or treatment in a screening service or any ambulatory
				  mental health service.
"Consumer protected health information (consumer PHI)" means
				  all information, certificates, applications, records and reports that directly
				  or indirectly identify a consumer currently or formerly receiving services, or
				  for whom services were sought.
"Continuous quality improvement" means the ongoing objective
				  and systematic monitoring and evaluation of a service's or system's components
				  to ensure the quality, effectiveness and appropriateness of care and the
				  pursuit of opportunities to further improve the care.
"Covered entity" means the professional staff of a community
				  agency under contract with the Division of Mental Health Services, or of a
				  screening service, short-term care or psychiatric facility as those facilities
				  are defined in
				  30:4-27.2.
"Crisis housing" means a community-based crisis residential
				  stabilization program providing an alternative setting for stabilization of
				  individuals who are assessed by a screening service as being in acute
				  psychiatric crisis, but who do not meet the standard for commitment.
"Crisis intervention counseling" means an attempt to
				  facilitate crisis stabilization through the use of specific, time-limited
				  counseling techniques. Crisis intervention counseling focuses on the present,
				  providing pragmatic solutions to identified problems.
"Crisis intervention specialist" means an individual employed
				  by a screening service or an affiliated emergency service who meets the
				  educational and experiential requirements set forth in
				  10:31-3.4 and 4.3 and provides
				  assessment, crisis stabilization services, hotline coverage, outreach and
				  referral to people who are in crisis.
"Crisis outreach" means outreach provided by a screening
				  service or an affiliated emergency service for the purpose of crisis
				  stabilization. It does not include the screening process.
"Crisis stabilization" means intensive crisis intervention
				  efforts toward or the result of a significant reduction of positive symptoms
				  and some improvement in level of functioning, bringing the individual closer to
				  the level of functioning demonstrated prior to the crisis.
"Dangerous to others or property" means that, by reason of
				  mental illness, there is a substantial likelihood that the person will inflict
				  serious bodily harm upon another person or cause serious property damage within
				  the reasonably foreseeable future. This determination takes into account a
				  person's history, recent behavior and any recent act, threat, or serious
				  psychiatric deterioration.
"Dangerous to self" means that, by reason of mental illness,
				  the person has threatened or attempted suicide or serious bodily harm, or has
				  behaved in such a manner as to indicate that the person is unable to satisfy
				  his or her need for nourishment, essential medical care or shelter, so that it
				  is probable that substantial bodily injury, serious physical harm or death will
				  result within the reasonably foreseeable future; however, no person shall be
				  deemed to be unable to satisfy his or her need for nourishment, essential
				  medical care, or shelter if he or she is able to satisfy such needs with the
				  supervision and assistance of others who are willing and available. This
				  determination shall take into account a person's history, recent behavior and
				  any recent act, threat, or serious psychiatric deterioration.
"Division" means the Division of Mental Health Services,
				  Department of Health.
"Enhanced screening service" means interventions that are
				  made available to assist consumers who are hearing impaired to meaningfully
				  access screening services. Enhanced screening services may also include
				  consultative services for consumers who are developmentally disabled.
"Extended crisis evaluation bed (ECEB)" means a bed provided
				  in a secure area where an individual can be held for up to 24 hours while being
				  assessed and receiving intensive psychiatric supervision and medication
				  monitoring.
"General hospital" means any hospital that maintains and
				  operates organized facilities and services for the diagnosis, treatment or care
				  of persons suffering from acute illness, injury or deformity and in which all
				  diagnosis, treatment and care are administered by or performed under the
				  direction of persons licensed to practice medicine or osteopathy in the State
				  of New Jersey.
"Geographic area" means a geographically distinct area
				  designated by the Commissioner to be served by one screening service. This area
				  may be a county, portion of a county or a multi-county area.
"Hotline" means a telephone line answered directly by a
				  clinical worker 24 hours per day for the purpose of providing telephone crisis
				  intervention counseling, information and referral.
"In need of involuntary commitment" or "in need of
				  involuntary commitment to treatment" means that an adult with mental illness,
				  whose mental illness causes the person to be dangerous to self or dangerous to
				  others or property and who is unwilling to accept appropriate treatment
				  voluntarily after it has been offered, needs outpatient treatment, or inpatient
				  care at a short-term care or psychiatric facility or special psychiatric
				  hospital because other services are not appropriate or available to meet the
				  person's mental health care needs.
"Integrated case management service (ICMS)" means
				  personalized, collaborative and flexible outreach services, offered primarily
				  off-site, designed to engage, support and integrate individuals with serious
				  mental illness into the community of their choice, and facilitate their use of
				  available resources and supports in order to maximize their
				  independence.
"Least restrictive environment" means the available setting
				  and form of treatment that appropriately addresses a person's need for care and
				  the need to respond to dangers to the person, others, or property and respects,
				  to the greatest extent practicable, the person's interests in freedom of
				  movement and self-direction.
"Linkage" means referral to and voluntary enrollment in a
				  mental health and/or ancillary program.
"Medical director" means the person who is designated by the
				  director or chief executive officer of the screening center to provide medical
				  leadership in a screening center. This may be a full or part-time
				  position.
"Medication monitoring" means the provision of a variety of
				  medication-related services which may include assessment for appropriateness of
				  medication, titration of dosage, prescription, administration, evaluation and
				  management of side effects and education related to psychotropic
				  medication.
"Mental health board" means the county board appointed by
				  each county board of freeholders or county executive or governing body, to
				  review progress in the development of comprehensive community mental health
				  services in the county.
"Mental health care representative" means the individual
				  designated by a consumer pursuant to the proxy directive part of the consumer's
				  advance directive for mental health care for the purpose of making mental
				  health care decisions on the consumer's behalf, and includes an individual
				  designated as an alternate mental health care representative who is acting as
				  the consumer's mental health care representative in accordance with the terms
				  and order of priority stated in an advance directive for mental health
				  care.
"Mental illness" means a current, substantial disturbance of
				  thought, mood, perception or orientation, which significantly impairs judgment,
				  capacity to control behavior or capacity to recognize reality, but does not
				  include simple alcohol intoxication, transitory reaction to drug ingestion,
				  organic brain syndrome or developmental disability, unless it results in the
				  severity of impairment as described in this definition. The term mental illness
				  is not limited to "psychosis" or "active psychosis," but shall include all
				  conditions that result in the severity of impairment as described in this
				  definition.
"Natural support system" means the consumer's family,
				  friends, neighbors, or significant others who are willing and able to provide
				  emotional, financial, or other help.
"Outpatient treatment" means clinically appropriate care,
				  based on proven or promising treatments directed to wellness and recovery,
				  provided by a member of the patient's treatment team to a person not in need of
				  inpatient treatment.
Outpatient treatment may include, but shall not be limited
				  to, day treatment services, case management, residential services, outpatient
				  counseling and psychotherapy, and medication treatment.
"Outpatient treatment provider" means a community-based
				  provider, designated as an outpatient treatment provider pursuant to
N.J.S.A. 30:4-27
.8, that provides or coordinates the provision
				  of outpatient treatment to persons in need of involuntary commitment to
				  treatment.
"Partial care" means an individualized, outcome-oriented
				  mental health service, which provides a comprehensive, structured,
				  non-residential, interdisciplinary treatment and psychiatric rehabilitation
				  program in a community setting to assist consumers who have serious mental
				  illness in increasing or maximizing independence and community living skills
				  and enhancing the quality of their lives. Partial care services are offered to
				  an individual age 18 or older with a primary psychiatric disorder that is
				  accompanied by an impaired ability to perform living, learning, working, or
				  social roles. Partial care services support consumer stabilization and
				  community integration and are alternatives to more intensive acute
				  interventions. Partial care services provide active treatment and psychiatric
				  rehabilitation for consumers who do not require inpatient hospitalization, but
				  require support and structured programming.
"Partial hospital" means an individualized, outcome-oriented
				  psychiatric service which provides a comprehensive, structured,
				  non-residential, interdisciplinary treatment and psychiatric rehabilitation
				  program to assist beneficiaries who have a serious mental illness in increasing
				  or maximizing independence and community living skills and enhancing the
				  quality of their lives.
"Peer advocate" means a person who works for a screening
				  service and is or has a family member who is a consumer of mental health
				  services. The responsibilities of a peer advocate are to raise awareness,
				  provide education and serve as a resource to other consumers and family members
				  on issues related to the effective management of mental illness in areas, such
				  as symptom reduction, relapse prevention, stress management, social skills,
				  depression, anxiety and healthy relationships. The peer advocate may resolve
				  conflicts, and document and refer consumer concerns and complaints to
				  professional staff, where appropriate. Peer advocates also serve as positive
				  role models and demonstrate positive decision-making skills in both their
				  personal and professional lives.
"Personal contact" means either face-to-face or telephone
				  contact.
"Physician" means a person who is licensed to practice
				  medicine in the State of New Jersey.
"Plan of outpatient treatment" means a plan for recovery from
				  mental illness approved by a court pursuant to
N.J.S.A.
				  30:4-27
.15.a that is to be carried out in an outpatient setting and is
				  prepared by an outpatient treatment provider for a patient who has a history of
				  responding to treatment. The plan may include medication as a component of the
				  plan; however, medication shall not be involuntarily administered in an
				  outpatient setting.
"Program" means a set of related organizations, resources
				  and/or services directed to the accomplishment of a defined set of objectives
				  or missions for a specific target group(s). A program may include the
				  activities of more than one agency, program element, division or
				  department.
"Programs of assertive community treatment (PACT)" means the
				  community mental health program that provides comprehensive, integrated
				  rehabilitation, treatment and support services to individuals with serious and
				  persistent mental illness, who have had repeated psychiatric hospitalizations,
				  and who are at serious risk for psychiatric hospitalization. PACT, provided
in vivo
by a multi-disciplinary service delivery team, is the
				  most intensive program element in the continuum of ambulatory community mental
				  health care. Services to an individual may vary in type and intensity.
"Psychiatric facility" means a State psychiatric hospital
				  listed in 30:1-7, a county psychiatric
				  hospital, or a psychiatric unit of a county hospital.
"Psychiatric unit of a general hospital" means an inpatient
				  unit of a general hospital that restricts its services to the care and
				  treatment of persons with mental illness who are admitted on a voluntary
				  basis.
"Psychiatrist" means a physician licensed to practice
				  medicine in the State of New Jersey who has completed the training requirements
				  of the American Board of Psychiatry and Neurology or the American Osteopathic
				  Board of Neurology and Psychiatry.
"Psycho-education" means information dissemination,
				  professional guidance and consultation and skill development to families of
				  consumers and consumers themselves, aimed at assisting families and consumers
				  in becoming essential contributors and participants in the rehabilitation
				  process.
"Psychotherapy notes" means notes recorded (in any medium) by
				  a health care provider who is a mental health professional documenting or
				  analyzing the contents of conversation during a private counseling session or a
				  group, joint or family counseling session and that are separated from the rest
				  of the of the individual's medical record. Psychotherapy notes excludes
				  medication prescription and monitoring, counseling session start and stop
				  times, the modalities and frequencies of treatment furnished, results of
				  clinical tests and any summary of the following items: diagnosis, functional
				  status, the treatment plan, symptoms, prognosis and progress to date (
				  45
				  CFR 164.501 ).
"Reasonably foreseeable future" means a time frame that may
				  be beyond the immediate or imminent, but not longer than a time frame as to
				  which reasonably certain judgments about a person's likely behavior can be
				  reached.
"Referral" means services, which are voluntary in nature,
				  that direct, guide, and link a consumer with appropriate services, which
				  promote the achievement of the goals of wellness and recovery and which include
				  diversion from hospitalization, as clinically appropriate.
"Screener" means an individual who has fulfilled the
				  requirements set forth in
N.J.A.C.
				  10:31-3.3
and has been certified by
				  the Division to assess a consumer's need for involuntary commitment to
				  treatment.
"Screening" means the process for determining whether an
				  individual is in need of involuntary commitment to treatment.
"Screening center coordinator" means an individual who is
				  employed by a designated screening center, who meets the educational and
				  experiential requirements set forth in
				  10:31-3.2(a)  and
				  fulfills the duties set forth in
				  10:31-3.2(b).
"Screening certificate" means a form developed by the
				  Division and approved by the Administrative Office of the Courts that is
				  executed by a psychiatrist or other physician affiliated with a screening
				  service who has examined the consumer and which states that the consumer
				  designated therein is in need of involuntary commitment to treatment. The form
				  shall also state the specific facts upon which the examining physician has
				  based his or her conclusion and shall be certified in accordance with the Rules
				  of Court. The certificate may not be executed by a person who is a relative, by
				  blood or marriage, of the person who is being screened.
"Screening coordinator" means an individual who is employed
				  by a screening service, who meets the educational and experiential requirements
				  set forth in
				  10:31-3.2(a)  and
				  fulfills the duties set forth in
				  10:31-3.2(b).
"Screening document" means a form developed by the Division
				  and completed and signed by a screener after that screener has assessed the
				  consumer. The screening document serves as the first step of the involuntary
				  commitment process.
"Screening outreach" means an evaluation provided by a
				  certified screener, wherever the person to be screened may be located, when
				  clinically relevant information indicates the person may need involuntary
				  commitment to treatment and is unable or unwilling to come to a screening
				  service.
"Screening psychiatrist" means a psychiatrist employed by a
				  screening service or a psychiatrist affiliated through a written agreement with
				  a screening service. The written agreement shall minimally outline a
				  supervisory procedure consistent with
N.J.A.C.
				  10:31-3.6
.
"Screening service" means a public or private ambulatory care
				  service with mobile capacity designated by the Commissioner, which provides
				  mental health services, as specified in
N.J.A.C.
				  10:31-2.1
.
"Short-term care facility (STCF)" means a closed acute care
				  adult psychiatric unit in a general hospital for short-term admission of
				  individuals who meet the legal standard for commitment and require intensive
				  treatment. The STCF shall be designated by the Division to serve residents of
				  specific geographic areas within the State. All admissions to short-term care
				  facilities shall be referred through a designated screening service.
"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 with mental illness.
"Stabilization options" means treatment modalities or means
				  of support used to remediate a crisis. They may include, but are not limited
				  to, early intervention programs, crisis intervention counseling, acute partial
				  hospital services, adult partial hospital services, partial care services,
				  crisis housing, acute in-home services, extended crisis evaluation bed with
				  medication monitoring, or emergency stabilization regimes, admission on a
				  voluntary basis to a psychiatric unit in a general hospital, referral to other
				  24-hour treatment facilities, referral and linkage to other community
				  resources, and use of natural support system.
"Treatment facility" means a legal entity, public or private,
				  providing mental health, developmental disability, nursing, rehabilitative
				  and/or drug and alcohol services.
"Voluntary admission" means that an adult with mental
				  illness, 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 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.