N.J. Admin. Code § 10:95-6.3

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

Section 10:95-6.3 - Mental restoration services

(a) Mental restoration services are designed to stabilize, correct or substantially modify, a mental condition. The Commission shall exclude from reimbursement those mental restoration services which:

1. Do not directly relate to the client's impediment to employment;

2. Do not directly relate to the client's vocational goal;

3. Involve in-patient mental restoration services; or

4. Involve primary treatment for alcohol or drug problems.

(b) Mental restoration services may be provided to a client who has been accepted for vocational rehabilitation services, has an individualized plan for employment and a vocational goal. The vocational rehabilitation counselor shall assure, on the individualized plan for employment, that the provision of specific mental restoration services are related to the client's vocational goal. Mental restoration services shall not be the only service provided. Counseling, guidance, and placement services are to be provided to the client in addition to mental restoration services.

(c) An individual who is undergoing an extended vocational rehabilitation evaluation pursuant to N.J.A.C. 10:95-3.3 may be provided with mental restoration services in order to assess the individual's rehabilitation potential.

(d) A financial needs test shall be applied to the provision of mental restoration services to clients who have been accepted for vocational rehabilitation services. The Commission's financial need standards for the provision of vocational rehabilitation services are set forth at N.J.A.C. 10:91-3.

(e) The client may choose his or her mental health professionals and mental health facilities as long as the professional or facility meets the agency's standards for providing the required services and is willing to accept the Commission's reimbursement fee schedule (see N.J.A.C. 10:91-7.1). All mental restoration services shall be approved by a Commission consultant. If the fee requested by the provider is higher than the fee schedule, the Commission consultant may authorize fee approval in writing.

(f) To qualify for Commission reimbursement, the mental restoration services must be provided by:

1. A licensed physician specializing in psychiatry or neuropsychiatry;

2. A licensed psychologist;

3. A social worker eligible for third party payment;

4. A clinic or hospital certified by the American Hospital Association to provide psychological, psychiatric or psychotherapeutic services; or

5. A professional or facility certified by the American Hospital Association to provide outpatient drug or alcohol treatment.

(g) The Commission's consultant shall have approved a client's mental restoration services treatment plan prior to the implementation of the plan.

(h) If a client has an acute or mental illness during the time the individual is already receiving planned rehabilitation services, services shall be provided if the acute condition or illness is such that it would complicate or delay the extended evaluation or the client's achievement of the vocational goal. If the acute condition or illness leads to changes in the client's condition, it may be necessary to re-evaluate the client, amend the program or close the case.

N.J. Admin. Code § 10:95-6.3

Amended by R.1999 d.375, effective 11/1/1999.
See: 31 New Jersey Register 2152(a), 31 New Jersey Register 3328(a).
In (b), substituted references to individualized plans for employment for references to individualized written rehabilitation programs throughout, and added the last sentence; and in (e) and (g), substituted references to the Commission consultant for references to the Commission psychiatric consultant.