N.J. Admin. Code § Tit. 12, ch. 45, subch. 2, app A

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

Appendix A - TRANSPORTATION SURVEY

Instructions for completion of client lists for transportation survey

The enclosed client list is that which we have for your facility at the present time. We may have overlooked some data that we received from you, so please check the list carefully. If any clients have been placed or dropped out and are not to receive a check, please draw a single line through the entry. Please do this lightly so that we can read the information sufficiently to remove it from our system.

The critical items that we need reviewed and adjusted on this document are:

1. The daily cost to the client is to be adjusted in the column "Daily Client Out of Pocket Costs."

2. The number of days the client attended during this period should be indicated under "Number of Days in Attendance."

3. Accurate distance is critical in those instances where the client is transported by personal auto and is to be paid mileage up to a maximum of $ 0.25 per mile.

4. Please verify the mode of transportation on all clients in extended employment using the following codes as appropriate:

NJ	=	New Jersey Transit
CT	=	County Transportation System
PC	=	Private contractor
FC	=	Facility operated
PF	=	Private Contractor arranged by facility
DD	=	Division of Developmental Disabilities
MU	=	Municipal transportation system
AU	=	Client/Parent own auto
PA	=	PATH (northeast) or PATCO (south).

After verifying the accompanying list, please use the blank form to list any clients that must be added. Please fill in all the requested information: Client name, address, zip code, social security number, mode of transportation, distance from the facility, daily client out of pocket cost, and the actual number of days the individual attended the program.

Please return this material to the attention of your community rehabilitation program specialist by........................................................

N.J. Admin. Code Tit. 12, ch. 45, subch. 2, app A