N.J. Admin. Code § 10:52A-4.2

Current through Register Vol. 56, No. 19, October 7, 2024

Section 10:52A-4.2 - Conditions which shall be met for APH and PH services

(a) All of the following conditions shall be met for the provision of APH and PH services to each beneficiary:

1. Assigned staff shall complete an intake evaluation for each beneficiary within the identified timeframe established in 10:52A-4.7;

2. Assigned staff shall complete a comprehensive assessment for each beneficiary within the identified timeframe established in 10:52A-4.9;

3. The provider shall develop and maintain an Individualized Recovery Plan for each beneficiary, and shall update that Individualized Recovery Plan within the identified timeframe established in 10:52A-4.10;

4. Assigned staff shall record progress notes for each beneficiary within the identified timeframe established in 10:52A-4.11;

5. Assigned staff shall develop and maintain an applicable discharge plan for each beneficiary within the identified time frame established in 10:52A-4.12;

6. The provider shall monitor APH and PH services through a quality assurance, utilization review and outcome protocol;

7. Program hours of service:

i. APH and PH providers shall make services available to beneficiaries a minimum of five hours per day and a minimum of five days per week at the times most needed by the beneficiaries;

8. After conducting a treatment team evaluation, the treatment team shall certify that a beneficiary requires the services of APH or PH in strict accordance with the beneficiary eligibility requirements set forth in this chapter;

9. After the initial service plan required by 10:52A-4.7 has been developed, the treatment team shall examine the beneficiary to determine whether the beneficiary needs APH service. If so, the treatment team shall prepare a certification to that effect at least every 30 days to document that clinical evidence exists for continued stay. With respect to PH services, the treatment team shall examine the beneficiary and, if appropriate, prepare such a certification, every 60 days to document whether clinical evidence exists for continued stay; and

10. APH programs shall maintain affiliation agreements with local psychiatric community designated screening centers and inpatient hospital programs.

N.J. Admin. Code § 10:52A-4.2