N.J. Admin. Code § 10:140-3.6

Current through Register Vol. 56, No. 11, June 3, 2024

Section 10:140-3.6 - Exceptions to service standards

(a) Exceptions to the service standards in 10:140-3.5(a), (b)2 and 3 shall be:

1. Initiated by the applicant or consumer;

2. Reviewed on a case-by-case basis by the Division; and

3. Consumers have the right to appeal decisions regarding denials of the exception to the service standards. Appeals shall be challenges to the material facts of the case, and shall be made to the Division Director or designee, who shall be the ultimate authority to render a decision.

(b) Exceptions to the service standards in 10:140-3.5(c) and (d) shall be:

1. Initiated by the applicant or consumer;

2. Reviewed on a case-by-case basis by the county designated agency. The county designated agency shall make a recommendation to the State Program Administrator as to whether an exception should be allowed; and

3. The State Program Administrator shall notify the county designated agency of the determination. Upon receipt of the determination, the county designated agency shall then notify the applicant or consumer regarding the results of the decision rendered by the State Program Administrator.

(c) In making the recommendations and determinations on exception requests, the county designated agency and State Program Administrator shall:

1. Give consideration to the request presented by the applicant or consumer;

2. Require a showing of unusual or emergent circumstances;

3. Give consideration based on funding available;

4. Give consideration to other services received by the consumer or applicant through other funding sources; and

5. Give consideration to the facts presented on a case-by-case basis.

(d) For the purposes of granting exceptions to 10:140-3.5(c), the following standards apply:

1. Personal assistance services in the form of maintaining essential communications, advocacy, household, and home maintenance services shall be continued on a limited basis only when other relatives or informal caregivers are not available.

2. Personal care services shall not be provided under the Personal Assistance Services Program during a period of hospitalization.

3. In granting an exception, a temporary modification of the consumer plan of service shall be made with the county designated agency to reflect current needs.

N.J. Admin. Code § 10:140-3.6

Amended by R.2012 d.079, effective 4/16/2012.
See: 43 N.J.R. 2551(a), 44 N.J.R. 1262(b).
In the introductory paragraph of (a), substituted "(b)2 and 3" for "(b)3 and (b)4"; in (a)2, substituted "Division" for "county designated agency"; and rewrote (a)3.