New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 37 - COMMUNITY MENTAL HEALTH SERVICES ACT › Subchapter 6 - GENERAL ADMINISTRATIVE REQUIREMENTS FOR ALL STATE-FUNDED COMMUNITY MENTAL HEALTH PROGRAM ELEMENTS › Section 10:37-6.49 - Least restrictive setting

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Services shall
				be organized to meet the comprehensive needs of individual clients and shall be
				offered in the least restrictive environment possible, dependent on the
				client's functional level and emotional and psychiatric needs. Agencies shall:
1. Develop an intake procedure which, prior
				to the development of an Individual Service Plan (ISP), and after crisis
				stabilization, identifies a particular client's strengths and weaknesses, using
				a Level of Functioning and Companion Environmental/Natural Supports Assessment
				tool (see Division Service Dictionary for definitions);
2. Consider the range of services available
				within that Service Area and identify:
i. The
				service needs of that client; and
ii. The least restrictive setting available
				to meet those needs.
3.
				Consider alternatives in the following sequence:
i. Natural support systems: The client's
				living arrangement and the people who usually provide support to him/her in
				crisis. If no such people are readily identified, the staff may help the client
				to develop a natural support network with someone with whom there seems to be
				good potential for supportive contact.
(1) If
				the natural support system is unable to meet the client's needs in a timely
				manner, formal community services should be explored and used.
ii. Community services: These
				services should be explored and arranged as follows:
(1) Generic services/community supports:
				Income maintenance, housing, health, transportation, etc., shall be arranged
				when necessary, with the mental health Program Element acting as advocate and
				service procurer. In the cases of DYFS clients who are children, the primary
				advocate and service procurer/coordinator should be the DYFS worker.
(2) Mental health services: If the client's
				needs cannot be met by his/her natural environment or by the generic services
				available in the Service Area and client need dictates, the client shall be
				provided with local community mental health services, either by the intake
				agency, or through alternative arrangements with other mental health Program
				Element providers in the Service Area. The least restrictive alternative, i.e.,
				ambulatory Outpatient Program Elements, should be emphasized over more
				restrictive, i.e., inpatient alternatives, as appropriate.
iii. Division of Youth and Family Services
				(DYFS) residential network: Residential services provided directly and through
				contract by DYFS are appropriate for placement of children whose natural
				support setting is no longer sufficient to maintain a child in his/her home.
				Mental Health support services shall be provided, as needed, by mental health
				providers.
iv. Institutional:
				Local, inpatient units in general hospitals should be emphasized over less
				local settings, such as a county hospital. County psychiatric hospitals shall
				be the preferred setting, rather than a Regionalized State hospital, in Service
				Areas where General Hospital inpatient units are not available. The community
				mental health agency in that Service Area shall then work with the Hospital to
				maximize the therapeutic benefit of the IPU stay while also beginning discharge
				planning as quickly as possible.