N.J. Admin. Code § 10:37-5.59

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:37-5.59 - Service approaches

(a) Inpatient Treatment/Service Approaches

1. IPU programs shall include a wide range of services and treatment modalities. These shall include medical psychiatric services, such as individual and group therapies, neuroleptics, etc. and various psychological interventions, such as behavioral modification and structured group processes, as defined within the context of psychosocial therapeutic milieu.

2. Appropriate interdisciplinary staff shall be an ongoing part of treatment and service planning for each client. Selected staff members from other community mental health program elements (for example: Partial Care, Outpatient, etc.) should also become a part of the treatment team, as needed, for continuity of care purposes.

3. IPU Individual Service Plans (ISPs) shall be designed to relieve the client from present discomfort and to provide the client with the coping skills necessary to function in the community. The treatment/service plan shall be explicit in describing how/why the client could not cope in the community and what will be done, during the stay, to help the client to function more adequately upon discharge. (See N.J.A.C. 10:37-6, Article VIII.)

4. When appropriate, families and/or other support system members shall be encouraged to participate in goal setting, treatment planning, program services, and discharge planning.

5. When clients known to DYFS are admitted, the IPU shall notify and involve DYFS in program and discharge planning, as soon as possible.

6. Upon completion of needs assessments, if a client under the age of 18 is in need of DYFS services, referral to the appropriate District Office of DYFS should be completed.

7. The services of the various professional disciplines shall be integrated through regular staff conferences initiated for the purpose of needs assessment, services and discharge planning, and ongoing involvement of clients.

8. A daily schedule of group and individual program/service options shall be made available to each client and shall be developed with client participation whenever possible.

9. For clients who are discharged within 48 hours of admission, emphasis shall be on reinforcing the client's natural support system, where appropriate, and on treatment and discharge planning, described in (a)3 above.

(b) Records: IPU programs shall comply with the requirements for medical/service records as specified by the Joint Commission on the Accreditation of Hospitals and the Division. (See N.J.A.C. 10:37-6, Article XIII.)

(c) Client involvement:

1. Each client shall be involved in determining service goals, modalities of treatment and timetables, to the extent that his or her condition permits. Participation should be documented by having the client's signature on the plan. (See N.J.A.C. 10:37-6, Article VIII.) Client involvement shall include the development, modification, execution, and registration of an advance directive for mental health treatment if the consumer, after receiving complete information about such directives, wishes to designate either a mental health representative or to execute an instruction directive.

2. Client participation in community-based activities (for example: Partial Care, vocational programs, or visits to a future residence), shall be encouraged and facilitated. Clients shall also be given opportunities to reorient themselves to their home community while still an inpatient.

3. See N.J.A.C. 10:37-4.

(d) Discharge planning:

1. Unified Services requirements applicable to State and County psychiatric hospitals shall also apply to community-based IPU programs. (See N.J.A.C. 10:37-6, Article XVIII.)

2. Discharge planning shall begin as soon after admission as feasible.

3. An Individual Service Plan (ISP) shall include linkages with appropriate community mental health and related social services. The ISP shall identify comprehensive service needs. (See N.J.A.C. 10:37-6, Article VIII.)

4. A review of the client's condition should be made after 24 hours in order to certify/justify the initial stay. A treatment plan shall be developed within 72 hours and be reviewed after one week. Each client's treatment plan should be updated as often as possible. A formal review of a client's treatment plan after the first week should minimally be made on the 14th and 28th day of enrollment. Subsequently the Individual Service Plan shall be reviewed and updated every two weeks up to three months, and every three months thereafter. In each review, justification for continued hospitalization, if necessary, should be recorded.

5. If a client is readmitted, the Unit should ascertain and document where a breakdown in the individual's community and natural support systems, his/her personal adaptive capabilities, and/or emotional or physical condition occurred, so as to avoid subsequent breakdowns.

N.J. Admin. Code § 10:37-5.59

Amended by R.2007 d.187, effective 6/18/2007.
See: 38 N.J.R. 3407(a), 39 N.J.R. 2346(a).
In (c)1, substituted "his or her" for "his/her" and inserted the last sentence.