10:46B-1.1 Purpose; authority

10:46B-1.2 Scope

10:46B-1.3 Definitions

10:46B-2.1 General standards

10:46B-3.1 Availability of placements

10:46B-3.2 Waiting lists

10:46B-3.3 Emergency placements

10:46B-3.4 Placement of children

10:46B-4.1 General standards

10:46B-4.2 Placements into private institutions

10:46B-5.1 Placement appeals

The Division of Developmental Disabilities, Department of Human Services intends this chapter to establish standards and criteria for the placement of eligible persons, pursuant to N.J.S.A. 30:4-25.6.  This chapter provides guidelines for placement.  This chapter also includes the guidelines for those instances where the individual chooses in-home supports as an alternative to residential placement.  Each individual's abilities, needs and preferences are different.  Division staff shall consider the circumstances of each individual in light of his or her unique situation in making placement decisions.  Division staff shall exercise reasonable professional judgment in making such decisions.

10:46B-1.2 Scope

  The following words and terms, when used in this chapter, have the indicated meanings, unless the context clearly indicates otherwise.

   "Available" means the service may be offered within the limitations of funding in a given fiscal year. 

  "Basic needs" means food, shelter and personal safety.

   "Broker" means to arrange a service for an eligible individual without responsibility to fund that service.

  "Bureau of Guardianship" (BGS) means the unit within the Division of Developmental Disabilities which has the responsibility and authority to provide guardian of the person services to individuals in need of such services in accordance with N.J.A.C. 10:45.

   "Caregiver" means an individual other than a parent, spouse or child of an eligible person including, but not limited to, sibling, grandparent, step family member, aunt, uncle, cousin or legal guardian who, without monetary payment, cares for the eligible person in his or her own home.

   "Challenge grant" means funds provided to an agency which may be used in combination with other resources available to an individual which will meet the individual's needs sufficiently to allow that individual to be removed from the priority waiting list.

   "Child" means a person under 18 years of age.

   "Congregate setting" means a community residence as defined in N.J.A.C. 10:44A, developmental center, or a nursing home.

   "Director" means the Director of the Division of Developmental Disabilities.

   "Division" means the Division of Developmental Disabilities.

   "Emergency" means that the eligible person is homeless or in imminent peril.

   "Funded vacancy" means a residential placement opportunity with a provider agency that is presently funded through a contract with the Division which becomes available when an individual receiving services moves from that placement.

   "Homeless" means that the person has no place to live or the person's living arrangement will end on a date certain within 30 days and he or she has no other living arrangements after that date.

  "Imminent peril" means a situation which could reasonably be expected to cause serious risk to the health, safety or welfare of the individual receiving services or another person in the current living arrangement. Imminent peril does not exist if the Division can put supports into the living arrangement which eliminate the serious risk to the individual.

  "In-home supports" means the individual may choose to have the Division provide services in his or her home as an alternative to accepting a residential placement.

  "Individual habilitation plan" (IHP) means a written plan of intervention and action that is developed by the interdisciplinary team. (See N.J.A.C. 10:46B-2.1(j).)

  "Interdisciplinary team" (IDT) means an individually constituted group responsible for the development of a single, integrated IHP. (See N.J.A.C. 10:46B-2.1(k).)

  "Local education agency" (LEA) means a public board of education or other public authority having administrative control of schools in a city, township or other political subdivision of the State.

  "Long-term placement" means a placement which is anticipated to be of one year's duration or longer. 

  "Office of Education" means the component of the Department of Human Services which supervises the educational programs in all State facilities operated by, or under contract with, the Department.

  "Private institution" means a private residential facility for the developmentally disabled located in New Jersey which is licensed in accordance with N.J.A.C. 10:47, or any out-of-State institutional placements.

  "Private out-of-State placement" (POSP) means an out-of-State placement in a community setting, such as a group home or supervised apartment or other similar placement as defined in N.J.A.C. 10:44A, which is licensed or otherwise approved by the appropriate agency in the state in which it is located. A community program which is operated by an institution is a POSP.

  "Regional Assistant Director" means an employee of the Division with administrative authority over community programs and institutions within a specific geographic region of the State.

  "Regional Administrator" means an employee of the Division with administrative authority over community programs within a specific geographic region of the State.

   "Respite services" means a short term arrangement in which an entity licensed in accordance with N.J.A.C. 10:44A or N.J.A.C. 10:44B provides supports for a person with developmental disabilities when that person's parent, child, spouse or caregiver(s) is temporarily unable to provide care. Such arrangements are not placements.

 "Self-Determination Process" means a service delivery system which allows an individual with developmental disabilities, in conjunction with his or her legal guardian, if any, family and selected friends to identify appropriate services and supports and determine how an individual budget, as well as personal, family and community resources, can be used to develop a service plan.  The Self-Determination Process is based upon the principles of freedom to plan one's own life, authority to utilize and manage resources, build one's own support system and carries responsibility to contribute back to the community and the appropriate stewardship of public funds.

 "Supports" means those generic services other than residential services provided by the Division which will help the individual remain in his or her living situation.  While supports reflect a variety of service options, the term "in-home supports" means a specific decision concerning services as an alternative to residential placement.

SUBCHAPTER 2. ADMINISTRATION

  (b) Individual and family support shall be provided whenever possible to avoid long term out-of-home placements. Such support shall be provided to the family in accordance with N.J.A.C. 10:46A, subject to the availability of funding in a given fiscal year. 

  (c) The Division recognizes that, even with support, not all families or caregivers can provide the individual with a living arrangement. The Division further recognizes that even when the family or caregiver can support the individual, the family or caregiver should not be expected to provide support indefinitely.

   (d) Whenever possible, the individual shall be offered an available placement in a setting which is least restrictive of his or her personal liberty.

   (e) Because an individual's needs and abilities change, no out-of-home placement shall be considered permanent.

   (f) When placement is appropriate, every effort shall be made to place an individual within New Jersey.

   (g) The Division shall make every effort to return individuals placed out-of-State to an in-State residence as soon as possible, except where the conditions stipulated in N.J.A.C. 10:46B-4.3 have been satisfied.

   (h) The Division shall place an individual only in a licensed facility appropriate for that individual, as documented in his or her IHP.  (See (j) below.)   An individual may choose to live independently in an unlicensed facility and may continue to receive support services from the Division, in which case the provisions of this chapter shall not apply.

   (i) When funding from a source other than the Division is available to the individual, Division staff may broker a placement. In such an instance, the Division shall not be responsible to provide any funding for placement. If the Division brokers a placement, the person's current waiting list status shall continue.

   (j) The IHP specifies both the prioritized goals and objectives being pursued by each individual and the steps being taken to achieve them. The IHP may identify a continuum of skill development that outlines progressive steps and the anticipated outcomes of

services. The IHP is a single plan that encompasses all relevant components, such as an education plan, a program plan, a rehabilitation plan, a treatment plan and a health care plan. The complexity of the IHP will vary according to the needs, capabilities and desires of the person. For an individual who has been determined by an Interdisciplinary Team to require active treatment, the IHP shall address all needs identified. For an individual who makes only specific service requests, the IHP shall be a service plan which addresses only those specific requests.

 10:46B-3.2 Waiting lists

(a) If a placement is not immediately available, the individual shall be assigned to a waiting list category, in accordance with N.J.A.C. 10:46C. 

  (b) For any child residentially placed by a local education authority (LEA) in New Jersey, the Division of Developmental Disabilities shall assign that child to the priority category based on the date that the child was residentially placed by the LEA or no less than three years before the child's educational entitlement ends, whichever date is earlier.  The anticipated need for placement shall be reviewed annually at the time of the IHP.  The Division shall not assume responsibility for a residential placement until the child's educational entitlement ends. 

  (c) For any child residentially placed by the Division of Youth and Family Services, the Division of Developmental Disabilities shall assign that child to the priority category based on the date that the child was residentially placed by the Division of Youth and Family Services or no less than three years before the child reaches age 21, whichever date is earlier.  The anticipated need for placement shall be reviewed annually at the time of the IHP. 

  (d) If the individual is on the priority waiting list and agrees to accept in-home supports in lieu of a residential placement, the individual shall be placed on the "Priority Deferred" category of the waiting list in accordance with N.J.A.C. 10:46C-1.4(d)2.

1. An emergency need for placement shall be established when a long-term placement has been determined to be unavailable and the individual is homeless, or the Division cannot provide adequate alternate service in the existing situation to care for the individual safely.
2. When the Division determines that the need for an emergency placement exists, the individual shall be offered a placement which can meet his or her basic needs, as required by N.J.A.C. 10:46B-1.3.
3. When the Division determines that the need for an emergency placement exists, the development of an IHP is not required prior to placement.
4. An emergency placement shall not be considered permanent.
5. An IHP shall be developed within 30 days following an emergency placement to plan for an orderly transition to a more permanent placement, unless the IDT confirms the appropriateness of the emergency placement as a long term placement.

1. The placement of children shall conform to the requirements of N.J.A.C. 10:17.
2. When a child cannot be maintained with his or her immediate or extended family, he or she shall be placed in a family setting, such as a community care home, as defined in N.J.A.C. 10:44B.
3. A child may be placed in a congregate setting only when the Assistant Director certifies that no other placement exists.

SUBCHAPTER 4. PLACEMENT DECISIONS

  (a) Appropriations for placements received by the Division may be targeted to specific populations. The budget language may identify the persons eligible for consideration for placement. If no such language is provided, the Division shall be guided by (d) below. 

  (b) Placements are offered to persons in need of emergency residential services as defined in N.J.A.C. 10:46B-3.3. 

  (c) When a person has been placed outside the State of New Jersey by the Division, a caregiver, family member, legal guardian or another state or county entity, the Division shall make every effort to return him or her to the State of New Jersey as soon as possible unless the conditions of N.J.A.C. 10:46B-4.3 have been met.  The Division shall not be responsible to return the individual to New Jersey until such time as the individual has been found eligible for services and the Division has assumed responsibility for funding. 

  (d) When a vacancy occurs in an existing program or an appropriation is targeted for a specific population, Division staff shall identify individuals to be placed, using the following criteria and considering any other information pertinent to the needs of the specific individual.  No specific weight or priority shall be given to the 10 categories listed below:

   1. The age, sex and functioning level of the individual and the geographic proximity of the proposed placement to interested family and/or friends;

   2. The present needs of the individual as well as anticipated future needs;

   3. Preferences including where the individual wishes to live, with whom the individual wishes to live and how geographically close to family and friends the individual wishes to live; 

  4. The ability of the placement to meet the individual's needs;

   5. The likelihood of the success of the placement, including a review of past clinical or diagnostic history; 

  6. The stability of the individual's present placement, including how well the placement meets the behavior and/or medical needs of the individual;

  7. The availability of a caregiver or parent to continue to provide care;

   8. The availability of continued funding of a current placement by a party other than the Division;

   9. The potential that the placement will be long term; and

  10. Acceptance of the individual by the service provider.

   (e) In the instance that a placement is equally appropriate for more than one individual, the placement shall be offered to the individual placed in the Priority Waiting List Category the longest, unless exceptional circumstances warrant otherwise based on each individual's circumstances and need for such services at the time placement becomes available.

   (f) Information concerning the individual shall be provided to the individual(s) or agency(s) offering placement. The release of these records to further the individual's habilitation goals is consistent with the requirements of N.J.A.C. 10:41-2.13. Specific authorization from the competent individual or legal guardian shall not be required.

  (g) When a placement is offered, the individual, legal guardian and/or family shall be notified by telephone and in writing in accordance with N.J.A.C. 10:46C-1.7. The written notification shall ask that the individual who is competent to make decisions concerning his or her living arrangement or legal guardian respond in writing within 14 calendar days of receipt, whether the offer is accepted or rejected.  When the Division agrees that the individual is in need of guardianship services and a family member or the Bureau of Guardianship is pursuing guardianship, the Division shall recognize the proposed guardian as the decision-maker.

  (h) When a placement is offered, the individual, legal guardian and/or family shall be given an opportunity to tour the placement and the site of any day programs to be provided.

  (i) In the case of residential placements, it is expected in most cases that an overnight visit will occur. The overnight visit may be waived or additional visits required upon mutual agreement of the individual or legal guardian, the Division and the prospective provider.

  (j) If a placement is offered and rejected, the Division shall follow the requirements of N.J.A.C. 10:46C-1.7(f). 

  (k) An IHP shall be developed by the IDT at least 30 days prior to the projected date of placement, except in an emergency.

Family members may attend the IHP meeting unless there is an objection by the competent individual or legal guardian.

  1. The IHP shall indicate the habilitation goals to be achieved by the placement, and the services needed during the transition.

SUBCHAPTER 5. APPEALS

a. Placement decisions may be appealed in accordance with N.J.A.C. 10:48.

2. Specific offers of placement shall be considered contested cases.
3. Recommendations of placement changes, where no specific offers of placement have been made, shall be considered non-contested.
4. Except in emergencies, a placement may be deferred pending the exhaustion of the administrative appeal if the appeal is received verbally or in writing 30 calendar days before the proposed placement and the appellant can demonstrate that there may be irreparable harm to the individual as the result of the placement. The Division Director shall decide whether or not to defer the placement. If the Division Director agrees to defer the placement, the Division shall not be responsible to fund the placement except where the Division was funding the placement prior to the request to defer.