N.J. Admin. Code § 10:164B-1.4

Current through Register Vol. 56, No. 19, October 7, 2024
Section 10:164B-1.4 - Definitions

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

"Adult day health services facility" means a facility or a distinct part of a facility, which is licensed by the Department of Health pursuant to N.J.A.C. 8:43F to provide preventive, diagnostic, therapeutic and rehabilitative services under medical and nursing supervision to meet the needs of functionally impaired adult participants, who are not related to the members of the governing authority by marriage, blood or adoption, for a period that does not exceed 12 hours during any calendar day.

"Adult family care" means a 24-hour per day living arrangement for persons who, because of age or physical disability, need assistance with activities of daily living and for whom services are rendered in the homes of trained caregivers who are employed by Department of Health licensed adult family care sponsor agencies.

"Applicant" means a functionally impaired person 18 years of age or older who would be at risk of long-term institutional placement if his or her regular caregiver could not continue in that role without the assistance of temporary home and community support services, including respite care.

"Assisted living" means a coordinated array of supportive personal and health services provided by a facility licensed by the Department of Health pursuant to N.J.A.C. 8:36, which are available 24 hours per day, to residents who have been assessed as needing these services, including residents who require formal long-term care.

"Campership" means a day or overnight accredited camp program for functionally impaired adults.

"Caregiver" means a spouse, parent, child, relative or other person who:

1. Is 18 years of age or older;

2. Has the primary responsibility of providing daily care for the eligible person; and

3. Does not receive financial remuneration for the care.

"Commissioner" means the Commissioner of the Department, or his or her designee.

"Co-payment" means financial participation in service costs by the eligible person according to a sliding fee scale established at 10:164B-6.2.

"Companion or sitter services" means a non-medical, basic supervision service, which is provided for the eligible person in his or her home on a short-term, intermittent basis.

1. Companion or sitter services are intended for those eligible persons who do not require any personal care assistance, medical assistance or housekeeping services during the time when respite care services are provided.

"Department" means the New Jersey Department of Human Services.

"Eligible person" means an applicant who meets the eligibility criteria as set forth in this chapter.

"Eligible veteran" means a person with a functional impairment arising out of service in the active military or naval service of the United States in any war or conflict on or after September 11, 2001, who has been honorably discharged or released from that service under conditions other than dishonorable, and meets the requirements for total disability ratings for compensation based upon unemployability of the individual as determined by the United States Department of Veterans Affairs.

"Emergency" means providing respite care in the case of a sudden or unexpected event that impairs the ability of the caregiver to continue in that role.

1. Emergencies include, but are not limited to, sudden illness of a caregiver, the caregiver's spouse or children; a natural disaster; a death in the family of the caregiver; or an accident affecting the caregiver, the caregiver's spouse or the caregiver's children.

"Functionally impaired" means the presence of a chronic physical or mental disease, illness, or disability, as certified by the physician, physician assistant, advanced practice nurse or a sponsor-provided assessment team, which causes physical dependence on others, and which leaves a person unable to attend to his or her basic daily needs without the substantial assistance or continuous supervision of a caregiver.

"Homemaker/home health aide services" means services which include personal care, household tasks, and activities provided to eligible persons in their homes.

"Homemaker services" means services which include household tasks and activities provided to recipients in their homes, but shall not include personal care.

"Liquid resources" means any checking accounts, savings accounts, individual retirement accounts, certificates of deposits, stocks, or bonds, that can be converted into cash within 20 working days.

"Nursing facility" means a long-term care facility licensed by the Department of Health under N.J.A.C. 8:39 that provides health related care and services on a 24-hour basis.

"Peer support" means the provision of mutual support services for caregivers involved in the Statewide Respite Care Program.

"Personal care" means services provided by a certified home health aide in assisting a person to attend to his or her bodily needs or functions, including, but not limited to, hygiene, grooming, eating, drinking, bed mobility, ambulation, and toileting.

"Private duty nursing" means hourly service delivered by nursing personnel, licensed in accordance with N.J.A.C. 13:37-5, in the eligible person's home.

"Provider" means a person, public agency, private nonprofit agency, or proprietary agency which is licensed or certified or otherwise approved by the Commissioner to supply any service or combination of services described under "respite" as defined below.

"Residential health care" means short-term placement in a facility, licensed pursuant to N.J.A.C. 8:43-2, which provides food, shelter, supervised health care and related services to four or more persons, 18 years of age or older who are unrelated to the owner or administrator.

"Respite" or "respite care" means the provision of temporary, short-term care for, or the supervision of, an eligible person on behalf of the caregiver in emergencies or on an intermittent basis to relieve the daily stress and demands of caring for the functionally impaired adult.

1. Respite may be provided hourly, daily, overnight or on weekends and may be provided by paid or volunteer staff.

2. The term includes, but is not limited to, companion or sitter services; homemaker services; personal care services; homemaker/home health aide services; adult day health services; short-term inpatient care in a licensed nursing facility, residential health care facility or assisted living residence; adult family care arrangement or overnight camp program; private duty nursing; and peer support and training for caregivers.

"Service plan" means a written document agreed upon by the eligible person, the caregiver and the sponsor, which specifies the type(s), frequency and duration of services to be provided and takes into account other services available to the eligible person and his or her caregiver.

"Social adult day services" means comprehensive social and therapeutic recreational activities in a group setting, with some health monitoring.

1. Clients attending social adult day services programs may not need medical attention during the day, but may require supervision for safety and activities of daily living.

"Sponsor or sponsor agency" means a county or regional agency, either public or private non-profit, which contracts with the Department to administer the local program and arranges for services for eligible persons.

N.J. Admin. Code § 10:164B-1.4

Amended by R.1988 d.505, effective 11/7/1988.
See: 20 N.J.R. 105(a), 20 N.J.R. 2774(a).
Added "liquid resources".
Amended by R.1993 d.256, effective 6/7/1993.
See: 25 N.J.R. 876(a), 25 N.J.R. 2557(b).
Amended by R.1998 d.274, effective 6/1/1998.
See: 30 N.J.R. 624(a), 30 N.J.R. 2001(a).
Amended by R.2004 d.241, effective 7/6/2004.
See: 35 N.J.R. 2633(a), 36 N.J.R. 3278(a).
Amended by R.2010 d.022, effective 1/19/2010.
See: 41 N.J.R. 2874(a), 42 N.J.R. 478(a).
Amended by 49 N.J.R. 1419(a), effective 6/5/2017