reglab/statecodes huggingface dataset:
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 2 - ENVIRONMENTAL LEAD INTERVENTION SERVICES › Section 10:77-2.4 - Environmental lead intervention services

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All
				Medicaid/NJ FamilyCare-Plan A beneficiaries up to 72 months of age and older
				children who are considered as "high risk" for lead poisoning, shall be
				screened for such through venous or capillary blood tests.
1. Pursuant to
				N.J.A.C.
				8:44-2.11, clinical laboratories are required
				to report to the New Jersey Department of Health (DOH) the results of all lead
				screenings;
2. The DOH, in turn,
				will notify the appropriate local board of health of the need to conduct an
				environmental lead inspection service or hazard assessment of the child's
				primary residence;
3. The local
				board of health shall have a certified lead inspector/risk assessor conduct an
				environmental lead inspection service or hazard assessment of the Medicaid/NJ
				FamilyCare-Plan A beneficiary's primary residence in order to locate existing
				lead hazards.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 2 - ENVIRONMENTAL LEAD INTERVENTION SERVICES › Section 10:77-2.5 - Basis for reimbursement

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The
				reimbursement for rehabilitative service-environmental lead inspection or
				hazard assessment service shall be based on the provider's usual and customary
				charge or the maximum fee allowance at
				N.J.A.C.
				10:77-7.2(a), whichever is
				less.
(b) To be reimbursable as a
				rehabilitative service, the local board of health's environmental lead
				inspection or hazard assessment service shall meet the following conditions:
1. The service shall be provided by the local
				boards of health and performed by a DOH certified lead inspector/risk
				assessor;
2. The service shall be
				provided in the primary residences of Medicaid/NJ FamilyCare-Plan A
				beneficiaries who are children identified as having EBLLs. The purpose of the
				environmental lead inspection or hazard inspection is to identify the source(s)
				of lead contamination; and
3. The
				environmental lead inspection or hazard inspection shall include tests
				performed by the certified lead inspector/risk assessor designed to locate lead
				hazards.
i. Laboratory testing and analysis
				of substances, such as water and paint, shall not be included as reimbursable
				environmental lead inspection or hazard assessment
				services.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 2 - ENVIRONMENTAL LEAD INTERVENTION SERVICES › Section 10:77-2.6 - Recordkeeping

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All local boards of health shall keep
				such legible records as are necessary to fully disclose the specific services
				provided; as well as the necessity for such services; and the place, date, and
				time the services were provided; and all documentation required pursuant to
				N.J.A.C. 8:51.
(b) All required
				recordkeeping documents shall be made available, upon request, to the New
				Jersey Medicaid/NJ FamilyCare program or its agents.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 3 - RESIDENTIAL MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-3.1 - Scope of services

Current through Register Vol. 56, No. 14, July 15, 2024
This subchapter sets forth the New Jersey Medicaid/NJ
				  FamilyCare programs provisions pertaining to mental health rehabilitation
				  services for children provided under the auspices of the Children's System of
				  Care within the Department of Children and Families. These services are
				  provided in psychiatric community residences for youth, children's group homes,
				  or residential childcare facilities.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 3 - RESIDENTIAL MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-3.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, as used in this subchapter,
				  shall have the following meanings, unless the context clearly indicates
				  otherwise:
"Children's group homes" means facilities licensed by the
				  Department of Children and Families and that meet the requirements at N.J.A.C.
				  3A:56, and provide mental health rehabilitation services.
"Contract pricing" means each facility shall have an
				  individual rate based on the rate in the contract negotiated by either the
				  Division of Mental Health and Addiction Services within the Department of Human
				  Services or the Division of Children's System of Care within the Department of
				  Children and Families.
"Discharged" means that the child, adolescent or young adult
				  receiving mental health rehabilitation services has been permanently discharged
				  home or to another treatment facility.
"Discharged" does not mean temporary absences from a
				  facility due to therapeutic or hospital leave.
"Hospital leave" means temporary absence from the facility
				  providing mental health rehabilitation services for the treatment of an acute
				  medical or mental health condition. "Mental health rehabilitation services"
				  means psychiatric and psychological services, including emotional and/or
				  behavioral treatment, drug and alcohol dependency treatment, psychiatric
				  treatment, psychotherapy and related nursing services.
"Psychiatric community residences for youth" means facilities
				  licensed by the Department of Children and Families in accordance with N.J.A.C.
				  3A:56 that provide mental health rehabilitation services.
"Regional area" means one of four possible geographic
				  provider groupings. Providers are assigned to a regional area depending on the
				  county in which the facility is located.
1. Northern: Bergen, Hudson, Morris, Passaic,
				Sussex and Warren
2. Metropolitan:
				Essex, Middlesex and Union
3.
				Central: Hunterdon, Mercer, Monmouth, Ocean and Somerset
4. Southern: Atlantic, Burlington, Camden,
				Cape May, Cumberland, Gloucester and Salem
"Residential child care facilities" means facilities licensed
				  by the Department of Children and Families in accordance with N.J.A.C. 3A:56
				  that provide mental health rehabilitation services.
"Temporary absence" means an absence from the facility of
				  more than 24 hours, starting and ending at midnight.
"Therapeutic leave" means the temporary absence, for
				  therapeutic reasons, of a resident from a facility providing mental health
				  rehabilitation services. Reasons for such absences may include, but are not
				  limited to, visits with parents or caregivers, attendance at a residential
				  camp, or residence in a temporary shelter.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 3 - RESIDENTIAL MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-3.3 - Provider participation requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Requirements
				for participation as a mental health rehabilitation provider shall be as
				follows:
1. An applicant shall be licensed by
				the Department of Children and Families in accordance with N.J.A.C. 3A:55 or
				3A:56 and shall provide mental health rehabilitation services.
2. A psychiatric community residence for
				youth or any other provider that is not enrolled as a provider of mental health
				personal care services by the Department of Children and Families in accordance
				with N.J.A.C. 3A:55 or 3A:56, shall enroll as a mental health rehabilitation
				provider.
3. All applicants shall
				complete and submit a provider application, including a copy of their license,
				to:
Division of Medical Assistance and Health Services
Office of Provider Enrollment, Mail Code #9
PO Box 712
Trenton, New Jersey 08625-0712
i. The applicant shall receive written
				notification of approval or disapproval of its provider status. If approved,
				the applicant shall be assigned a Provider Number, and shall receive a copy of
				this chapter.
ii. Upon approval as
				a Medicaid/NJ FamilyCare provider, the provider shall conform to all the
				provisions of N.J.A.C. 10:49, this chapter and any applicable rules of the
				Department of Children and Families.
4. A provider is required to enroll each site
				at which services are provided and obtain a separate provider number for each
				site.
5. In order to participate in
				the New Jersey Medicaid/NJ FamilyCare Program, a provider shall:
i. Have a valid National Provider Identifier
				(NPI) number obtained from the National Plan and Provider Enumeration System
				(NPPES);
ii. Have a valid taxonomy
				code obtained from the NPPES; and
iii. Remain a provider in good standing by
				successfully completing provider revalidation, when requested by
				DMAHS.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 3 - RESIDENTIAL MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-3.4 - Eligibility for services

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Division
				shall consider claims for children, youth, or young adults who are eligible for
				Medicaid/NJ FamilyCare, and children who are ineligible for Medicaid/NJ
				FamilyCare, but who are receiving mental/behavioral health services from
				DCF/CSOC. Children eligible as "medically needy" in accordance with N.J.A.C.
				10:71 shall not be eligible for mental health rehabilitation
				services.
(b) Children are eligible
				for services under this subchapter if the services have been determined
				clinically necessary using the criteria established by the Department of Human
				Services or Children and Families, or have been prior authorized by the
				Division of Medical Assistance and Health Services, or any contracted agent of
				the Department of Human Services or Children and Families used to authorize the
				clinical need for these services.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 3 - RESIDENTIAL MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-3.5 - Mental health rehabilitation services for youth

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Mental
				health rehabilitation services for youth shall include the psychiatric and
				psychological services, including emotional and/or behavioral treatment, drug
				and alcohol dependency treatment, psychiatric treatment, psychotherapy, and
				related nursing services, provided by the mental health rehabilitation
				provider.
1. All services shall meet the
				requirements specific to provider type as defined at N.J.A.C. 3A:55, Manual of
				Requirements for Residential Childcare Facilities, and 3A:56, Manual of
				Requirements for Children's Group Homes.
2. All providers shall also meet the
				requirements of N.J.A.C. 10:49, this chapter and any applicable rules of the
				Department of Children and Families.
3. All mental health rehabilitation services
				provided by psychiatric community residences for youth, group homes or
				residential child care facilities shall meet the referral requirements of their
				respective division.
4. All mental
				health rehabilitation services shall be provided directly by facility staff or
				under the direction or coordination of facility staff.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 3 - RESIDENTIAL MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-3.7 - Temporary absences from the facility

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Temporary
				absence for the purpose of therapeutic or hospital leave shall be approved by
				the child, youth, or young adult's treatment team and included in the plan of
				care developed by the facility in accordance with N.J.A.C. 3A:55, Manual of
				Requirements for Residential Childcare Facilities, and 3A:56, Manual of
				Requirements for Children's Group Homes, this chapter, and any applicable rules
				of the Department of Children and Families.
(b) The dates and purpose of the temporary
				absence shall be recorded in the child, youth or young adult's record
				maintained by the facility.
(c) A
				provider may seek reimbursement for a child, youth or young adult's temporary
				absence from the facility due to a hospital or therapeutic leave for periods of
				up to 14 continuous days per episode. If the child, youth or young adult is
				present in the facility for any part of the day, beginning and ending at
				midnight, the HCPCS procedure codes for a day of service shall be used for that
				day. (See N.J.A.C.
				10:77-7.2(b)).
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 3 - RESIDENTIAL MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-3.8 - Conflict with personal care services

Current through Register Vol. 56, No. 14, July 15, 2024
A provider shall not claim reimbursement for mental health
				  personal care services and mental health rehabilitation services for the same
				  child, youth or young adult for the same day of service.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 3 - RESIDENTIAL MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-3.9 - Recordkeeping

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All community
				psychiatric residences for youth, residential child care facilities, and group
				homes shall keep such legible records as are necessary to fully disclose the
				kind and extent of services, as well as the medical necessity for such
				services, and the place, date, and the amount of time the services were
				provided.
(b) All recordkeeping
				documents required by (a) above shall be made available, upon request, to the
				Department of Human Services or Children and Families or authorized agents of
				either Department.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 3 - RESIDENTIAL MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-3.10 - Collaboration with mobile response agencies

Current through Register Vol. 56, No. 14, July 15, 2024
(a) As part
				of an individual crisis stabilization plan (see
				N.J.A.C.
				10:77-6) a mobile response agency may contact
				a non-Joint Commission accredited psychiatric community residence for youth,
				group home, or residential childcare facility to place a child, youth, or young
				adult receiving mobile response and/or stabilization management services for a
				period of up to seven days.
(b) The
				psychiatric community residence for youth, group home or residential childcare
				facility providing the crisis bed for the child may request reimbursement of a
				per diem fee, for up to seven days, to cover additional costs incurred by the
				facility during this period as included in a plan of care prepared by the
				mobile response agency and authorized by the Contracted Systems Administrator
				(CSA). This per diem fee shall be reimbursed in addition to their usual
				reimbursement using the HCPCS procedure code, H0018 TJ. (See
				N.J.A.C.
				10:77-7.2(b)).
(c) Effective for date of service on or after
				January 1, 2004 the Contracted Systems Administrator (CSA) will issue an
				authorization number for the facility providing the crisis bed to use when
				requesting reimbursement. The provider must enter this authorization number on
				the CMS-1500 claim form to ensure proper reimbursement is received.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 4 - BEHAVIORAL ASSISTANCE SERVICES › Section 10:77-4.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) This subchapter sets forth the manner in
				which behavioral assistance services shall be provided to eligible Medicaid/NJ
				FamilyCare and Children's System of Care beneficiaries under age 21.
(b) Behavioral assistance services shall be
				provided and administered in a manner consistent with Department of Human
				Services (DHS) and Department of Children and Families (DCF) rules and contract
				requirements. If a conflict arises between the contract requirements and any
				existing provider rules, the terms set forth in the DHS/DCF contract shall
				prevail.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 4 - BEHAVIORAL ASSISTANCE SERVICES › Section 10:77-4.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, when used in this subchapter,
				  shall have the following meanings, unless the context clearly indicates
				  otherwise.
"Behavioral assistance services" means concrete,
				  outcome-oriented interventions that are components of a written, detailed plan
				  of care prepared by a licensed behavioral healthcare practitioner, and
				  authorized by the CSA or other DHS or DCF-designated agency, which includes an
				  evaluation of the identified behavior(s), which includes recommendations for
				  specific interventions with definable outcomes and strategies with the goal of
				  restoring, rehabilitating or maintaining the child/youth or young adult's
				  capacity to successfully function in the community and diminish the need for a
				  more intensive level of care.
"Fingerprint-based criminal history record background check"
				  means a determination of whether a person has a criminal record by
				  cross-referencing that person's name and fingerprints with those on file with
				  the State Bureau of Identification in the New Jersey Division of State
				  Police.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 4 - BEHAVIORAL ASSISTANCE SERVICES › Section 10:77-4.3 - Provider participation

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Providers of
				behavioral assistance services shall be providers that are licensed in New
				Jersey to provide medical/mental health services, a medical/mental health
				practice, or other service provider that includes the appropriate licensed
				practitioners who can provide, or supervise the provision of, services.
				Examples of provider agencies include, but are not limited to, acute care or
				psychiatric hospitals, Joint Commission-accredited residential treatment
				centers, licensed group homes, or child care residential providers, psychiatric
				community residences for youth, home health agencies, mental health clinics, or
				any other licensed clinic, Federally Qualified Health Centers, or other
				entities licensed by a New Jersey government agency to provide physical or
				mental/behavioral health services in New Jersey.
(b) Individual group practices or other
				individual service provider entities rendering behavioral assistance services
				shall employ at least one of the following licensed practitioners who can
				provide the services directly or supervise the provision of services:
1. Psychiatrist (N.J.A.C. 13:35);
2. Psychologist (N.J.A.C. 13:42);
3. Advance Practice Nurse (mental health)
				(N.J.A.C. 13:37);
4. Licensed
				Clinical Social Worker (N.J.A.C. 13:44G); or
5. A professional licensed in accordance with
				the Board of Marriage and Family Therapy Examiners (N.J.A.C. 13:34) including,
				but not limited to:
i. A Licensed Marriage
				and Family Therapist (N.J.A.C.
				13:34-4);
ii. A Licensed Professional Counselor
				(N.J.A.C.
				13:34-11 or 12);
iii. A Clinical Mental Health Counselor
				(N.J.A.C.
				13:34-14); or
iv. A Rehabilitation Counselor (N.J.A.C.
				13:34-21).
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 4 - BEHAVIORAL ASSISTANCE SERVICES › Section 10:77-4.4 - Beneficiary eligibility

Current through Register Vol. 56, No. 14, July 15, 2024
(a)
				Children/youth/young adults shall be eligible to receive behavioral assistance
				services if they are Medicaid/NJ FamilyCare beneficiaries or are ineligible for
				Medicaid/NJ FamilyCare but are receiving mental health rehabilitation services
				under DCF/CSOC.
(b) Children/youth
				and young adults shall be eligible for behavioral assistance services if the
				services have been determined clinically necessary by the Division of Mental
				Health and Addiction Services DMHAS, the Division of Child Protection and
				Permanency (DCP&P), the Division of Medical Assistance and Health Services
				(DMAHS), the contract systems administrator (CSA), or any contracted and
				authorized agent of the Department of Human Services or the Department of
				Children and Families, which authorizes the clinical need for these
				services.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 4 - BEHAVIORAL ASSISTANCE SERVICES › Section 10:77-4.5 - Beneficiary rights

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Any provider
				entity providing behavioral assistance shall demonstrate regard for the rights
				of the child, youth or young adult, their families and/or caregivers to
				exercise choice and to receive culturally appropriate, integrated, coordinated
				and carefully monitored services in the least restrictive setting appropriate
				to their individual needs.
(b) The
				provider entity shall deliver services in a manner that includes the
				beneficiary, primary caregiver, legal guardian and family support organization
				(FSO) representative in service planning and permits the maximum freedom of
				choice by the beneficiary in all areas of their lives, where possible,
				including, but not limited to:
1. Fully
				informing the child/youth or young adult and his or her parent/caregiver of all
				service options, and the benefits of these options; and
2. Allowing the child/youth or young adult
				and/or his or her parent/caregiver to make all possible decisions with regard
				to their lives, being appropriately advised of the expected benefits and
				possible consequences of those decisions.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 4 - BEHAVIORAL ASSISTANCE SERVICES › Section 10:77-4.6 - Program description

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Behavioral assistance shall be delivered
				in accordance with a plan of care approved by the Department of Human Services,
				Children and Families, or a designated agent of either Department, which has
				been prepared by the responsible case management function, including, but not
				limited to, the care management organization, the contracted system
				administrator, and mobile response agencies.
(b) Behavioral assistance is a dynamic
				process of intervention and ongoing evaluation resulting in effective
				modification of the identified behavior(s). Behavioral assistance shall be
				delivered in accordance with an individualized behavioral intervention plan
				that is based upon an evaluation of the identified behavior(s), which includes
				recommendations for specific interventions with definable outcomes and
				strategies and, developed in accordance with 10:77-4.7 and any applicable rules
				of the Department of Children and Families.
(c) Behavioral assistance services shall
				include applying positive behavioral principles within community and culturally
				based norms to reduce undesirable behaviors and build appropriate behaviors
				that are rehabilitative and restorative in nature, resulting in durable and
				sustainable positive behavioral changes and improvement in functionality and
				quality of life. Behavioral assistance focuses on creating and sustaining
				environments that improve lifestyle changes by making problem behavior less
				effective and less relevant and the desired behavior more effective and
				relevant.
(d) Behavioral assistance
				services shall also include interaction and instruction, provided individually
				or in a group setting, with the child/youth or young adult's family and
				caregiver(s) to enable them to provide the necessary support to the child/youth
				or young adult to attain the goals of the service plan and sustain the positive
				behavioral changes and improvement in functionality and quality of life.
1. Behavioral assistance services provided in
				a group setting may be provided to the family member(s) and/or caregiver(s) of
				up to three children/youth or young adults in one session.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 4 - BEHAVIORAL ASSISTANCE SERVICES › Section 10:77-4.8 - Authorization for services

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Behavioral
				assistance services shall be provided only in conjunction with other treatment,
				rehabilitative and social support services as part of a coordinated and
				authorized plan of care as described in
				10:77-4.7.
(b) Effective for dates of service on or
				after January 1, 2004, behavioral assistance services shall be prior authorized
				by the CSA.
(c) Service utilization
				and continuing care criteria shall be determined by the CSA or other agent(s)
				designated by the Department to review the progress of the child/youth or young
				adult toward achieving the goals as defined in the individual behavioral
				assistance services plan.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 4 - BEHAVIORAL ASSISTANCE SERVICES › Section 10:77-4.10 - Staff responsibilities

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The provider
				shall be responsible for supervising the overall daily management of all facets
				of the program, including, but not limited to, ensuring:
1. That all provider policies and procedures
				appropriately reflect the needs of the individuals being served, are
				implemented according to the service model as described in this subchapter, and
				are adhered to and revised when necessary;
2. That provider policies and procedures are
				in place regarding the safety and well being of the individual receiving
				services when the transportation and care of the individual outside of the
				individual's place of residence is necessary;
3. That all services are provided within the
				context of the service description and the individualized behavioral assistance
				service plan;
4. That all service
				delivery hours are designed to meet the flexible needs of the families
				served;
5. That the clinical
				supervisor maintains a system of clinical recordkeeping and a monitoring system
				that includes, at a minimum, the provision for periodic case reviews with all
				relevant staff, sign-off on progress notes, incident reports, and case plans
				and goals;
6. That monitoring of
				the completion and quality of progress notes for each case contact was done by
				all staff;
7. That the
				confidentiality of all records is maintained;
8. That the documentation of periodic
				performance reviews for all staff is in place;
9. That there is access to supervision of
				staff 24 hours a day, seven days per week by a licensed or credentialed mental
				health clinician;
10. That there is
				delivery of, and staff participation in, ongoing training programs, including
				staff development, that address the needs of the staff and of the children and
				families being served;
11. That the
				provider meets all MIS, Quality Assurance and outcome specifications for
				provider reimbursement, as provided by the DHS or the CSA; and
12. That fingerprint-based criminal history
				background checks are successfully completed in accordance with
				N.J.A.C.
				10:77-4.15 on any employee who may provide
				in-person services directly to beneficiaries.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 4 - BEHAVIORAL ASSISTANCE SERVICES › Section 10:77-4.11 - Reimbursement

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Reimbursement for behavioral assistance
				services shall be fee-for-service.
(b) All reimbursements shall be restricted to
				approved Medicaid/NJ FamilyCare providers and shall be subject to Medicaid/NJ
				FamilyCare regulations.
1. Behavioral
				assistance services rendered in a location which does not meet Title XIX (
				42 U.S.C. §
											1396a ) requirements as a reimbursable
				service site shall be reimbursed if it is a part of the approved treatment plan
				of the child/youth or young adult using the HCPCS code S5125. See
				10:77-7.2(c).
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 4 - BEHAVIORAL ASSISTANCE SERVICES › Section 10:77-4.12 - Required records for each beneficiary

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Each provider
				entity shall maintain all records in accordance with Departmental contract
				rules (see N.J.A.C. 10:3) and in compliance with appropriate Federal and State
				laws, regulations and rules, including, but not limited to,
				10:49-9.8.
(b) Providers shall keep
				such individual and legible records as are necessary to fully disclose the
				nature and extent of the services provided in accordance with the Health
				Insurance Portability and Accountability Act of 1996 (HIPAA),
				P.L.
				104-191, August 1996.
(c) Providers shall maintain any information
				required by the Department of Human Services, Children and Families, the
				designee of either Department, the contracted system administrator, or the care
				management organization for services rendered to a child receiving DCF
				services, including, but not limited to, the outcome measures listed at
				N.J.A.C.
				10:77-4.10.
(d) Providers shall maintain the following
				data in support of all behavioral assistance services claims:
1. The name and address of the
				beneficiary;
2. The name and title
				of the individual providing the service;
3. The exact date(s), location(s) and time(s)
				of service;
4. The type of
				activity/service provided in accordance with the goals of the service plan;
				and
5. The length of face-to-face
				contact, excluding travel time to or from the location of the beneficiary
				contact.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 4 - BEHAVIORAL ASSISTANCE SERVICES › Section 10:77-4.13 - System outcomes

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A provider
				entity providing behavioral assistance services shall deliver those services in
				accordance with the child/youth or young adult's plan of care and shall
				participate in studies related to consumer satisfaction developed by the
				Department of Human Services, Children and Families, or the contracted system
				administrator.
(b) This information
				s hall be made available on a regular basis to the Department of Human
				Services, Children and Families, and/or the contracted system
				administrator.
(c) At a minimum,
				the provider entity shall maintain a record of the following information for
				each beneficiary for whom services are provided in a manner prescribed by the
				Department of Human Services, Children and Families, or the designated contract
				agent of either Department:
1. A complete
				service record as described in
				10:77-4.12(e);
2. A record of services required other than
				behavioral assistance services;
3.
				Frequency of staff changes for each beneficiary;
4. Level of beneficiary satisfaction for each
				service; and
5. Degree of
				improvement in the beneficiary's ability to function at home, in school, in the
				community and/or on the job, as applicable.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 4 - BEHAVIORAL ASSISTANCE SERVICES › Section 10:77-4.14 - General provider recordkeeping requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) To
				qualify for Medicaid/NJ FamilyCare reimbursement, approved Medicaid/NJ
				FamilyCare enrolled behavioral assistance providers shall retain, in a secure
				location, and in compliance with all applicable laws and regulations,
				confidential information related to the individuals providing or supervising
				the provision of behavioral assistance services and shall produce the
				information for the Department of Human Services, Children and Families or any
				authorized agents of either Department, in an orderly fashion on
				demand.
(b) For licensed clinical
				staff members of the agency, the following information shall be maintained:
1. Verified written documentation of the
				supervising licensed behavioral healthcare practitioner's credentials and any
				other adjunct staff involved with the direct administration and/or delivery of
				this service as appropriate, including, at a minimum:
i. His or her current and valid license
				number authorizing him or her to practice in New Jersey and the state where
				services are delivered; and
ii.
				Verified written documentation of his or her experience working with children;
				and
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 5 - INTENSIVE IN-COMMUNITY MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-5.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) This subchapter sets forth the manner in
				which intensive in-community mental health rehabilitation services (intensive
				in-community services) shall be provided, through community-based provider
				entities, to eligible Medicaid/NJ FamilyCare and Department of Children and
				Families' (DCF) Children's System of Care beneficiaries under age 21.
(b) This subchapter describes intensive
				in-community services as one component of the continuum of mental health care
				services provided through the Children's System of Care. Intensive in-community
				services are provided as part of an integrated service plan, addressing the
				unique needs of the child, youth, or young adult and his or her
				family/caregiver with the goal of stabilizing and maintaining the child, youth,
				or young adult in the community and averting the need for more intensive
				services, including, but not limited to, treatment in residential or other
				inpatient settings.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 5 - INTENSIVE IN-COMMUNITY MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-5.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, when used in this subchapter,
				  shall have the following meanings, unless the context clearly indicates
				  otherwise:
"Fingerprint-based criminal history background check" means
				  determination of whether a person has a criminal record by cross-referencing
				  that person's name and fingerprints with those on file with the State Bureau of
				  Identification in the New Jersey Division of State Police.
"Intensive in-community mental health rehabilitation
				  services" means an array of mental health rehabilitation services delivered in
				  community-based settings, not in provider offices or office settings, which
				  address symptom reduction, and are restorative and preventative in nature.
				  These services target problem solving and strengthening adaptive and coping
				  skills that restore or maintain the child, youth or young adult's ability to
				  function in the community. These services are provided as part of an approved
				  plan of care and encompass a variety of mental health services, including, but
				  not limited to, group, individual or family therapy, allied behavioral
				  therapies and modalities, clinical consultation/evaluation, instruction in
				  anger management, parenting skills, problem solving and stress reduction
				  techniques, psycho-educational services and counseling.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 5 - INTENSIVE IN-COMMUNITY MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-5.3 - Provider participation requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Providers of
				intensive in-community mental health rehabilitation services shall be providers
				that are licensed in New Jersey to provide medical/mental health services or a
				medical/mental health practice or other agency that includes the appropriate
				licensed practitioners who can provide, or supervise the provision of,
				services. Examples of appropriate provider agencies, include, but are not
				limited to:
1. Acute care or psychiatric
				hospitals;
2. Joint
				Commission-accredited residential treatment centers (see
				N.J.A.C.
				10:77-5.6(f));
3. Licensed group homes or childcare
				residential providers;
4.
				Psychiatric community residences for youth;
5. Home health agencies;
6. Mental health clinics or any other
				licensed clinics;
7. Federally
				qualified health centers; or
8.
				Other entities licensed by a State of New Jersey governmental agency to provide
				physical or mental health services in New Jersey.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 5 - INTENSIVE IN-COMMUNITY MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-5.4 - Beneficiary eligibility

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Eligible
				children, youth, or young adults shall be:
1.
				Enrolled in Medicaid/NJ FamilyCare; or
2. Children, youth, or young adults who are
				ineligible for Medicaid/NJ FamilyCare but who are receiving services from DCF's
				Children's System of Care.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 5 - INTENSIVE IN-COMMUNITY MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-5.5 - Beneficiary rights

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Any provider
				entity providing intensive in-community mental health rehabilitation services
				shall demonstrate regard for the rights of the child, youth or young adult and
				their families/caregivers to exercise choice of provider. Service providers
				shall communicate with the child, youth or young adult in a language or format
				that is understood by all parties. Services shall be culturally sensitive,
				integrated, coordinated and provided in the least restrictive setting
				appropriate to the child's individual needs.
(b) The provider shall deliver services in a
				manner that includes the child, youth or young adult, primary caregiver,
				parent/legal guardian and Family Support Organization (FSO) representative in
				service planning and permits the maximum freedom of choice by the beneficiary
				in all areas of their lives, including, but not limited to:
1. Fully informing the child, youth or young
				adult and his or her parent/legal guardian or caregiver of all service options,
				and the benefits of those options; and
2. Allowing the child, youth or young adult
				and/or his or her parent/legal guardian or caregiver to participate in all
				decision-making processes about the services they receive, and to be
				appropriately advised of the expected benefits and possible consequences of
				those decisions.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 5 - INTENSIVE IN-COMMUNITY MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-5.6 - General program description

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Intensive
				in-community mental health rehabilitation services are intensive
				community-based and family-centered mental health services delivered as a
				defined set of interventions, within the context of an approved plan of care
				and are restorative or preventative in nature. These services are geared toward
				improving or stabilizing the child, youth or young adult's level of functioning
				within the home and community in order to prevent, decrease or eliminate
				behaviors or conditions that may lead to or that may place the child, youth or
				young adult at increased clinical risk, or that may impact on the ability of
				the child, youth or young adult to function in their home, school or community.
				These services encompass a variety of mental health rehabilitative services
				including, but not limited to, group, individual or family therapy, allied
				behavioral therapies and modalities, clinical consultation, evaluation and
				counseling.
(b) Intensive
				in-community services shall be provided either individually or in a group of up
				to three children/youth or young adults, as appropriate to the needs of the
				child.
(c) Intensive in-community
				services shall also include interaction and instruction, provided individually
				or in a small group setting, to the child, youth or young adult's family and
				caregiver(s) to enable them to provide the necessary support to the child,
				youth or young adult to attain the goals of the service plan and sustain the
				positive behavioral changes and improvement in functionality and quality of
				life.
1. Intensive in-community services
				provided in a group setting may be provided to the family member(s) and/or
				caregiver(s) of up to three children/youth or young adults in one
				session.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 5 - INTENSIVE IN-COMMUNITY MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-5.7 - Program description: levels of service

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The level of
				intensive in-community services provided shall be determined as part of the
				planning process of the individual service plan and shall be based on an
				assessment of need, a clinical evaluation and medical necessity. Such
				assessment shall determine the amount, duration and level and type of clinical
				intervention and professional support. There are three levels of intensive
				in-community services:
1. Supportive services
				(intensive in-community services that can be delivered by a bachelor's level
				direct care provider);
2.
				Professional services (intensive in-community services delivered by a master's
				level direct care provider); and
3.
				Clinical services (intensive in-community services delivered by a clinically
				licensed behavioral health care practitioner).
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 5 - INTENSIVE IN-COMMUNITY MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-5.8 - Individual intensive in-community service plan

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Each child,
				youth, or young adult receiving intensive in-community mental health
				rehabilitation services shall have an approved, documented individual plan of
				care addressing the services. The plan shall be individually tailored to
				address identified behavior(s) that impact on the child/youth/young adult's
				ability to function at home, school or in the community, and shall incorporate
				generally accepted professional interventions. The plan of care shall be
				authorized by the Department of Children and Families, the contracted system
				administrator, or other authorized DCF designated agent(s).
1. For those children, youth and young adults
				receiving care management organization (CMO) services, this plan shall be
				included as part of the child's CMO individual service plan (ISP) prepared by
				the Child/Family Team.
2. For all
				other Children's System of Care-enrolled children, youth, or young adults
				receiving intensive in-community mental health rehabilitation services, this
				plan of care shall be included in the comprehensive plan of care as coordinated
				and/or authorized by the CSA or other agent designated by the Department of
				Human Services, prior to implementation.
New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 77 - REHABILITATIVE SERVICES FOR CHILDREN › Subchapter 5 - INTENSIVE IN-COMMUNITY MENTAL HEALTH REHABILITATION SERVICES › Section 10:77-5.9 - Staff requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The individual(s) responsible for
				administrative oversight of the program shall have, at a minimum, a master's
				degree in social work or in a relevant discipline including, but not limited
				to, counseling, psychology or psychiatric nursing, and a minimum of three years
				of post-graduate experience in the delivery of mental health services to
				families and children. The administrative oversight duties and the clinical
				supervision described in (b) above may be provided by the same individual. At a
				minimum, administrative oversight responsibilities shall include:
1. The overall daily management of all facets
				of the program, including, but not limited to, the referral process, staffing,
				supervision of caseloads, case consultation and quality assurance;
2. Ensuring that all work hours are designed
				to meet the flexible needs of the families served and that access to services
				are provided 24 hours a day, seven days per week;
3. Ensuring clinical supervision of all
				appropriate service staff;
4.
				Ensuring that the individual(s) responsible for providing clinical supervision
				maintain a system of clinical recordkeeping and a monitoring system that
				includes, at a minimum, the provision for case reviews and a sign-off on
				progress notes;
5. Ensuring access
				to supervisory staff 24 hours a day, seven days per week; and
6. Ensuring that all information required or
				requested by the Department of Human Services or other authorized contract
				agent, including, but not limited to, Management Information Systems, Quality
				Assurance and system outcome data are provided in the manner required or
				requested.