N.J. Admin. Code § 10:37-6.49

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

Section 10:37-6.49 - Least restrictive setting

(a) Services shall be organized to meet the comprehensive needs of individual clients and shall be offered in the least restrictive environment possible, dependent on the client's functional level and emotional and psychiatric needs. Agencies shall:

1. Develop an intake procedure which, prior to the development of an Individual Service Plan (ISP), and after crisis stabilization, identifies a particular client's strengths and weaknesses, using a Level of Functioning and Companion Environmental/Natural Supports Assessment tool (see Division Service Dictionary for definitions);

2. Consider the range of services available within that Service Area and identify:

i. The service needs of that client; and

ii. The least restrictive setting available to meet those needs.

3. Consider alternatives in the following sequence:

i. Natural support systems: The client's living arrangement and the people who usually provide support to him/her in crisis. If no such people are readily identified, the staff may help the client to develop a natural support network with someone with whom there seems to be good potential for supportive contact.

(1) If the natural support system is unable to meet the client's needs in a timely manner, formal community services should be explored and used.

ii. Community services: These services should be explored and arranged as follows:

(1) Generic services/community supports: Income maintenance, housing, health, transportation, etc., shall be arranged when necessary, with the mental health Program Element acting as advocate and service procurer. In the cases of DYFS clients who are children, the primary advocate and service procurer/coordinator should be the DYFS worker.

(2) Mental health services: If the client's needs cannot be met by his/her natural environment or by the generic services available in the Service Area and client need dictates, the client shall be provided with local community mental health services, either by the intake agency, or through alternative arrangements with other mental health Program Element providers in the Service Area. The least restrictive alternative, i.e., ambulatory Outpatient Program Elements, should be emphasized over more restrictive, i.e., inpatient alternatives, as appropriate.

iii. Division of Youth and Family Services (DYFS) residential network: Residential services provided directly and through contract by DYFS are appropriate for placement of children whose natural support setting is no longer sufficient to maintain a child in his/her home. Mental Health support services shall be provided, as needed, by mental health providers.

iv. Institutional: Local, inpatient units in general hospitals should be emphasized over less local settings, such as a county hospital. County psychiatric hospitals shall be the preferred setting, rather than a Regionalized State hospital, in Service Areas where General Hospital inpatient units are not available. The community mental health agency in that Service Area shall then work with the Hospital to maximize the therapeutic benefit of the IPU stay while also beginning discharge planning as quickly as possible.

N.J. Admin. Code § 10:37-6.49