N.J. Admin. Code § 10:32-1.5

Current through Register Vol. 57, No. 1, January 6, 2025

Section 10:32-1.5 - Policies at psychiatric facilities

(a) Every psychiatric facility listed at N.J.S.A. 30:1-7 shall develop policies and procedures that require appropriate clinical staff to:

1. Inform current patients of:

i. The availability of advance directives for mental health; and

ii. The availability of the State's voluntary registry;

2. Assist patients in executing advance directives for mental health;

3. Make a routine inquiry of each patient admitted and the referring or committing physician or screening service, at the time of admission, or at such other times as are appropriate under the circumstances, concerning the existence and location of an advance directive for mental health care;

4.Provide appropriate informational materials concerning advance directives for mental health care, including standard forms approved by the Division of Mental Health and Addiction Services, located at N.J.S.A. 10:32 Appendix A, incorporated herein by reference, and information about the DMHAS Registry, established pursuant to N.J.A.C. 10:32-2.1, to all interested patients and their families and mental health care representatives;

5. Assist patients who express an interest in discussing and executing an advance directive for mental health care in doing so, as well as to encourage and enable patients to periodically review their advance directives for mental health care as needed and to consult with an advocate if they wish to do so;

6. Inform mental health care professionals of their rights and responsibilities under P.L. 2005, c. 233 (N.J.S.A. 26:2H-102 et seq.) and these rules, including the responsibility to defer to a patient's mental health care representative or advance directive unless doing so would:

i. Violate an accepted standard of mental health care or treatment under the circumstances of the patient's mental health condition, including past responses to requested or proposed treatments;

ii. Require the use of a form of care or treatment that is not available to the mental health care professional responsible for the provision of mental health services to the patient;

iii. Violate a court order or provision of statutory law; or

iv. Endanger the life or health of the patient or another person;

7. Inform staff that a mental health care professional who intentionally fails to act in accordance with the requirements of the Act is subject to discipline for professional misconduct pursuant to section 8 of P.L. 1978, c. 73 (N.J.S.A. 45:1-21);

8. Provide training for staff that includes a forum for discussion and consultation regarding the requirements of P.L. 2005, c. 233 (N.J.S.A. 26:2H-102 et seq.) and these rules for staff and clients, as well as a discussion of the criminal penalties that can be assessed for noncompliance with the Act;

9. Establish procedures that provide for staff consultation with an institutional ethics committee; designate a person to resolve disputes; and provide for referrals to the Attorney General in order to seek resolution by a court of competent jurisdiction in the event of disagreement among the patient, mental health care representative and responsible mental health care professional concerning the patient's decision-making capacity or the appropriate interpretation and application of the provisions of an advance directive for mental health care to the patient's course of treatment;

10. Prohibit any employee from acting as a mental health care representative for a current or former client of the hospital unless that designation is approved by the facility chief executive officer;

11. Establish procedures for gathering data required by N.J.A.C. 10:32-1.4;

12. Document in a patient's chart when the responsible mental health care professional and a corroborating mental health care professional determine that an individual lacks capacity to make a mental health decision and when the patient has been determined to have regained the capacity to make that decision;

13. Document the date, time, and nature of any decision about the patient's care that is made pursuant to an advance directive, whether through a mental health care representative or by operation of an instruction; and

14. Document any override of an advance directive and the reason therefor.

N.J. Admin. Code § 10:32-1.5

Amended by 47 N.J.R. 107(a), effective 1/5/2015