N.J. Admin. Code § 10:77-5.7 - Program description: levels of service

Current through Register Vol. 54, No. 7, April 4, 2022

(a) The level of intensive in-community services provided shall be determined as part of the planning process of the individual service plan and shall be based on an assessment of need, a clinical evaluation and medical necessity. Such assessment shall determine the amount, duration and level and type of clinical intervention and professional support. There are three levels of intensive in-community services:
1. Supportive services (intensive in-community services that can be delivered by a bachelor's level direct care provider);
2. Professional services (intensive in-community services delivered by a master's level direct care provider); and
3. Clinical services (intensive in-community services delivered by a clinically licensed behavioral health care practitioner).
(b) Supportive services shall be delivered by individuals with a minimum of a bachelor's degree in a related field, including, but not limited to, social work, psychology, counseling or nursing and one year of relevant experience working with children and families with mental health needs. Supportive services shall be provided under the direct clinical supervision of a licensed behavioral health care practitioner, who within the scope of his or her practice, is licensed to provide, or supervise the provision of, services. The direct service provider shall receive a minimum of one hour of direct clinical supervision for every 40 hours of work. For those direct service providers who work less than 40 hours a month, one hour of face-to-face clinical supervision shall be provided a minimum of once a month.
1. Supportive services provide time-limited face-to-face behavioral stabilization and support interventions as an adjunct to support clinical professional services or as a stand-alone service as part of a step-down/discharge plan of care, including, but not limited to, one or more of the following:
i. Instruction in anger management skills;
ii. Parenting skill development;
iii. Instructions in stress reduction techniques;
iv. Problem solving skill development;
v. Psycho-educational services related to mental health including, but not limited to, improved decision-making skills to manage behavior and reduce risk behaviors; or
vi. Referral to other necessary services and supports.
2. Supportive level services are concrete, outcome-oriented, time-limited and are components of an approved, written, detailed plan of care that has been prepared by a clinically licensed behavioral health care practitioner.
3. Supportive level services shall be delivered on site in the community at locations appropriate for the specific intervention which are convenient for the child, youth or young adult and/or his or her family.
4. Bachelor's level direct care providers may not provide interventions requiring skills, experience, credentials and licensure other than those allowed under the appropriate licensing regulations.
(c) Professional services shall be delivered by individuals with a minimum of a master's degree in related field including, but not limited to, social work, psychology, counseling or nursing and one year of relevant experience working with children and families with mental health needs. Professional services shall be provided under the direct clinical supervision of a licensed behavioral health care practitioner, who, within the scope of his or her practice, is licensed to provide, or supervise the provision of, services. The direct service provider shall receive a minimum of one hour of clinical supervision for every 40 hours of work. For those direct service providers who work less than 40 hours a month, one hour of face-to-face clinical supervision shall be provided a minimum of once a month.
1. Professional services are time-limited, clinically supervised, face-to-face interventions focused on behavior modification and symptom reduction, including, but not limited to, one or more of the following:
i. Individual or family therapy;
ii. Allied behavioral therapies and modalities, including, but not limited to, play therapy, art therapy, drama therapy, and/or music therapy;
iii. Clinical consultation/evaluation;
iv. Psycho-educational instruction related to mental health; and
v. Counseling services.
2. Professional level services are concrete, outcome-oriented and are components of an approved, written, detailed plan of care that has been prepared by a clinically licensed behavioral health care practitioner.
3. Professional level direct care providers may not provide interventions requiring skills, experience, credentials and licensure other than those allowed under appropriate licensing regulations.
(d) Clinical services shall be delivered by a licensed clinical professional, including, but not limited to, a psychiatrist, a psychologist, an advanced practice nurse, a licensed clinical social worker or a mental health professional licensed in accordance with the Board of Marriage and Family Therapy Examiners (N.J.A.C. 13:34), who, within the scope of his or her practice, is authorized to provide or supervise the provision of mental health services. Clinical-level intensive in-community services may include, but are not limited to, all services described at (c) above, provided without additional clinical supervision. Clinical services shall be targeted to children and families requiring a more clinically intensive level of service provision, based upon clinical evaluation and determination of need. All services shall be provided by professionals with the appropriate licensure and/or specialty certification in accordance with all State rules and statutes.
(e) Services may be provided at any level by professionals whose credentials exceed the minimum requirements for that service level; however, increased reimbursement shall not be provided. More than one level of intensive in-community services may be provided to an individual child, youth or young adult and/or his or her family under the same approved plan of care if:
1. Each service is a distinct service with its own purpose, goal and expected outcome;
2. Each service is included in an approved, written, detailed plan of care developed by a licensed behavioral health care practitioner;
3. Each service is delivered under the direct clinical supervision of a clinically licensed behavioral health care professional as required; and
4. Each service is delivered at a separate time.
(f) Discrete interventions may be provided separately to the child/youth/young adult and the family caregiver at the same time, if they are clinically indicated and are included in the approved plan of care. For example, an approved family counseling session may be provided to the family/caregiver with the child/youth/young adult not present, while the child/youth/young adult is receiving a separate support intervention.

Notes

N.J. Admin. Code § 10:77-5.7

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