N.J. Admin. Code § 8:135-1.6

Current through Register Vol. 56, No. 23, December 2, 2024

Section 8:135-1.6 - Level II definition, criteria, and program structure

(a) A patient who warrants supervision at Level II:

1. Has begun to form a therapeutic alliance with staff;

2. Has shown signs of progress in self-management;

3. Exhibits improved mental status or reduction in symptoms;

4. Has improved behavioral controls and increased level of functioning; and

5. Continues to require supervision at most times, though not at the intensity present at Level I.

(b) A patient who is assigned to supervision Level II shall be provided programming and services both on-unit and off-unit (on or off hospital grounds).

1. Attendance and appropriate participation in on-unit activities are the primary responsibility of the patient.

2. While a patient who is assigned to supervision Level II requires less staff support and direct supervision than a patient assigned to supervision Level I, the patient shall receive such support and supervision, when necessary to promote the goals of the patient's treatment plan.

3. Staff escort is required for all off-unit activities provided on or off hospital grounds.

4. A patient who is assigned to supervision Level II may attend brief home visits, if risk level permits and the patient's family is capable and willing to provide direct supervision for the duration of the visit.

(c) In addition to the risk factors associated with Level I, factors to be considered in determining the appropriateness of assigning a patient to supervision Level II include, but are not limited to:

1. No longer on special observation or precautions for dangerous behavior such as suicide, arson, or assault risk;

2. Elopement or walkaway risk;

3. Medical risk;

4. Follows general directions and generally attends on-unit therapies and programs on a regular basis;

5. Psychotic symptoms or mood disturbances may be present but does not act in response to them in such a way as to create an imminent risk of harm;

6. Mildly confused and disoriented but able to adapt to unfamiliar surroundings;

7. Able to control impulses except when severely stressed; or

8. Risk of accidental injury.

(d) The demonstrated ability of a patient who is assigned to supervision Level II to participate in treatment activities by virtue of a greater degree of self-initiated responsible participation shall result in the patient's involvement in, and assignment to more off-unit activities and programs.

1. To maximize the probability of success in the change in the patient's treatment regimen, off-unit activities shall be structured and supportive with staff escort at all times.

2. On-unit therapies and activities shall use the patient's developing sense of responsibility and initiative as staff members provide less direct supervision and structure while they continue to frequently evaluate the patient's progress.

N.J. Admin. Code § 8:135-1.6

Amended by R.1993 d.58, effective 2/1/1993.
See: 24 New Jersey Register 4232(a), 25 New Jersey Register 583(b).
In (b): added "but are not limited to" to clarify listing of medical condition criteria.
Amended by R.1998 d.62, effective 1/20/1998.
See: 29 New Jersey Register 3763(b), 30 New Jersey Register 386(a).
Inserted new (c), and recodified existing (c) and (d) to (d) and (e).
Recodified from N.J.A.C. 10:36-1.5 and amended by R.2003 d.236, effective 7/7/2003.
See: 34 New Jersey Register 4290(a), 35 New Jersey Register 2903(a).
Rewrote the section. Former N.J.A.C. 10:36-1.6, Level III definition, criteria and program structure, recodified to N.J.A.C. 10:36-1.7.

Amended and recodified from 10:36-1.6 by 55 N.J.R. 2258(b), effective 11/9/2023