New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 46C - COMMUNITY CARE PROGRAM WAITING LIST PROCEDURES › Subchapter 1 - GENERAL PROVISIONS › Section 10:46C-1.3 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The words and terms in this chapter shall have the following
				  meanings unless the context clearly indicates otherwise.
"Abuse" means wrongfully inflicting, or allowing to be
				  inflicted, physical, sexual, verbal, or psychological abuse or mistreatment
				  upon an individual with a developmental disability.
"Caregiver" means an individual who is not a parent of an
				  eligible person including, but not limited to, a spouse, child, sibling,
				  grandparent, step-family member, aunt, uncle, cousin, or legal guardian who,
				  without monetary payment, cares for the eligible individual in the individual's
				  home.
"Case management" means Division staff responsible for
				  coordination of services across family, agency, and professional lines to
				  develop and attain goals and objectives embodied in an individual's service
				  plan. It involves monitoring of, and advocating for, the individual's needs
				  with individual and family participation.
"Community Care Program" or "CCP" means a Division
				  initiative, included in the Comprehensive Medicaid Waiver authorized by the
				  Centers for Medicare and Medicaid Services under section 1115 of the Social
				  Security Act, that funds community-based services and supports for adults with
				  intellectual and developmental disabilities who meet the level of care for an
				  Intermediate Care Facility for Individuals with Intellectual
				  Disabilities.
"Community Care Waiver" or "CCW" means the Home and Community
				  Based Services (HCBS) Waiver authorized by the Centers for Medicare and
				  Medicaid Services (CMS) under section 1915(c) of the Social Security Act for
				  people with developmental disabilities.
"Day program" means a community-based service, which
				  addresses an individual's need for daytime activities as described in the
				  individual's service plan.
"Division" or "DDD" means the Division of Developmental
				  Disabilities in the Department of Human Services.
"Emergency" means an event in which an individual who is
				  eligible for Division services is homeless or in imminent peril, as defined in
				  N.J.A.C. 10:46B.
"Emergency placement" means that placement, as defined in
				  N.J.A.C. 10:46B, which is made when the individual is homeless or in imminent
				  peril and the Division cannot provide adequate alternate services in the
				  existing situation or provide for the individual's personal safety, and the
				  Division has determined that there is no long-term placement available.
"Essential lifestyle plan" or "ELP" means a specific type of
				  service plan that is consistent with the requirements of 30:6D-10 through 12,
				  developed by the interdisciplinary team (IDT). It is an outcome-based planning
				  tool that, at a minimum, identifies each individualized program or service
				  requested by and provided to the individual, for which the individual
				  demonstrates a need. It identifies the person or agency responsible for its
				  implementation. The complexity of the service plan will vary according to the
				  individual's interests, preferences, and needs.
"Exploitation" means the act or process of using an
				  individual with a developmental disability or the individual's resources for
				  another person's profit or advantage.
"In-home services" means Division services rendered to an
				  individual residing in the individual's family home.
"Individual habilitation plan" or "IHP" means a specific type
				  of service plan of intervention and action that is developed by the
				  interdisciplinary team. It specifies both the prioritized goals and objectives
				  being pursued by each individual and the steps being taken to achieve them. It
				  may identify a continuum of skill development that outlines progressive steps
				  and the anticipated outcomes of services. The IHP is a single plan that
				  encompasses all relevant components, such as an education plan, a program plan,
				  a rehabilitation plan, a treatment plan, and a health care plan. The complexity
				  of the IHP will vary according to the needs, capabilities, and desires of the
				  person. For an individual who has been determined by an interdisciplinary team
				  to require active treatment, the IHP shall address all needs identified. For an
				  individual who makes only specific service requests, the IHP shall be a service
				  plan, which addresses only those specific requests.
"Individualized service plan" or "ISP" means a standardized
				  service planning document developed based on an individual's assessed needs
				  that identifies an individual's outcomes and describes the services needed to
				  assist the individual in attaining the outcomes identified in the plan. An
				  approved ISP authorizes the provision of services and supports.
"Interdisciplinary team" or "IDT" means an individually
				  constituted group responsible for the development of a single, integrated
				  service plan. The team shall consist of the individual receiving services, the
				  individual's parent or family member (if the adult desires that the parent or
				  family member be present), legal guardian, those persons who work most directly
				  with the individual served, and professionals and representatives of service
				  areas relevant to the identification of the individual's needs and the design
				  and evaluation of programs to meet those needs.
"Legal 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.
"Medical needs" means the individual has a documented chronic
				  or acute medical condition, which requires regular care to be provided to the
				  individual.
"Neglect" means any of the following acts on an individual
				  with a developmental disability:
1. Willfully failing to provide proper and sufficient food,
				  clothing, maintenance, medical care, or a clean and proper home; or
2. Failure to do, or permit to be done, any act necessary for
				  the well-being of an individual with a developmental disability.
"Out-of-home services" means Division services rendered to an
				  individual residing in a community setting other than the individual's family
				  home (for example, group home, supervised apartment, community care residence,
				  etc.).
"Qualified provider" means a service provider who has met all
				  qualifications for providing Division services through the CCP.
"Regional offices" means that component of the Division,
				  which provides intake, referral, and an array of community-based day and
				  residential services. DDD regional offices serve four geographical areas of the
				  State, which are: northern, upper central, lower central, and southern.
				  Regional offices are sometimes referred to as Community Services Regional
				  Offices.
"Support coordinator" means the professional responsible for
				  developing and maintaining the individualized service plan with the individual,
				  his or her family, as applicable, and other interdisciplinary team members;
				  linking the individual to needed services; and monitoring the provision of
				  services included in the individualized service plan.
"Supports program" or "SP" means a Division initiative,
				  included in the Comprehensive Medicaid Waiver authorized by the Centers for
				  Medicare and Medicaid Services under section 1115 of the Social Security Act,
				  that funds community-based services and supports for adults with intellectual
				  and developmental disabilities.
"Service plan" means a written, individualized plan,
				  consistent with the requirements of 30:6D-10 through 12, developed by the IDT.
				  It is an outcome-based planning tool that, at a minimum, identifies each
				  individualized program, support, or service requested by and provided to the
				  individual, for which the individual demonstrates a need. It identifies the
				  person or agency responsible for its implementation. The complexity of the
				  service plan will vary according to the individual's interests, preferences,
				  and needs. The service plan format must be Division-approved but can be chosen
				  from various types of plans, as determined by the requirements of the specific
				  program, service, or support and can include, but is not limited to, the
				  following types of plans: individual habilitation plan or essential lifestyle
				  plan.
"Supports" means those services, other than residential
				  services provided by the Division, which will help the individual remain in the
				  individual's living situation.
"Waiting list" means a roster of individuals who are eligible
				  for functional services from the Division and who have expressed a general
				  service need.
"Waiting list coordinator" means a Division staff member who
				  maintains and amends the waiver waiting list.
"Waiver review team" or "WRT" means a group of five members
				  responsible for the review of requests for assignment to the Priority Waiting
				  List category. At least one member of the group shall be an advocate or family
				  member of an individual with a developmental disability, except where an
				  advocate or family member cannot be readily identified or is unavailable to
				  participate. If there is no readily available advocate or family member, the
				  WRT shall operate without them.