N.J. Admin. Code § 8:135-1.7

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

Section 8:135-1.7 - Level III definition, criteria, and program structure

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

1. Is generally able to control dangerous impulses; and

2. Requires less staff supervision than a patient who is assigned to supervision Level II.

(b) A patient who is assigned to supervision Level III shall be provided programming and services on-unit and off-unit (on or off hospital grounds) with an increasing emphasis on off-unit programming.

1. The treatment team shall determine the frequency, duration, and types of unescorted off-unit activities, in which a patient who is assigned to supervision Level III is to participate.

2. The treatment team shall determine whether a patient who is assigned to supervision Level II is to participate in a scheduled off-unit program on hospital grounds based on time accountability and the clinical relevance of the program.

3. The treatment team shall implement incrementally the participation of a patient who is assigned to supervision Level III in unescorted off-unit activities.

4. A patient who is assigned to supervision Level III may participate in staff-escorted community activities.

5. A patient who is assigned to supervision Level III may attend brief home visits if the patient's family is capable and willing to provide the level of supervision that the treatment team determines to be necessary in consideration of the patient's clinical needs.

(c) In addition to the risk factors associated with supervision Levels I and II, factors that the treatment team is to consider in determining the appropriateness of assigning a patient to supervision Level III include, but are not limited to:

1. Minimal psychotic or mood disordered symptoms, or if chronic residual symptoms are still present, does not act in response to them;

2. Oriented and aware of surroundings;

3. Cooperative with established plan and schedule of activities;

4. Appropriate on and off-unit behavior resulting in no precautions for a certain number of days or weeks (to be set by treatment team);

5. Minimal elopement/walkaway risk;

6. Able to control impulses except when severely stressed;

7. If recent history and behavior indicates substance abuse risk, or risk of other dangerous behavior, cooperation with search and/or other procedures that the treatment team determines necessary and documents in the patient's treatment plan;

8. History of anti-social behavior;

9. History of sexually inappropriate behavior;

10. History of elopement or walkaway risk;

11. History of criminal behavior;

12. History of violent behavior directed toward others;

13. Ambulatory patients and non-ambulatory patients who have demonstrated an ability to safely use their adaptive equipment; or

14. Medical problems requiring only intermittent evaluation by unit staff.

(d) The patient's responsible and cooperative participation in activities while on-unit, off-unit but on hospital grounds, and off hospital grounds with staff escort, is expected to result in the treatment team encouraging a patient who is assigned to supervision Level III to participate in more independent activity by gradually increasing the number of unescorted off-unit programs.

1. These programs and activities generally include centralized (off-unit) social and rehabilitative programs and activities.

2. Staff shall monitor a patient who is assigned to supervision Level III to ensure that the patient participates in the programs.

N.J. Admin. Code § 8:135-1.7

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. 10:36-1.6 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. 10:36-1.7, Level IV definition, criteria and program structure, recodified to N.J.A.C. 10:36-1.8.

Amended and recodified from 10:36-1.7 by 55 N.J.R. 2258(b), effective 11/9/2023