Bill Text: NJ S3797 | 2018-2019 | Regular Session | Introduced
Bill Title: Authorizes Assistant Commissioner of Division of Developmental Disabilities to establish exception rates, and programmatic and staffing requirements, for individuals with highly acute needs.
Spectrum: Slight Partisan Bill (Democrat 2-1)
Status: (Introduced - Dead) 2019-05-20 - Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee [S3797 Detail]
Download: New_Jersey-2018-S3797-Introduced.html
Sponsored by:
Senator STEPHEN M. SWEENEY
District 3 (Cumberland, Gloucester and Salem)
SYNOPSIS
Authorizes Assistant Commissioner of Division of Developmental Disabilities to establish exception rates, and programmatic and staffing requirements, for individuals with highly acute needs.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning individuals with highly acute developmental disabilities and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. The Assistant Commissioner of the Division of Developmental Disabilities in the Department of Human Services, or the Assistant Commissioner's designee, shall have the authority both to identify individuals who have highly acute needs, and to set exemption rates, within annually appropriated fiscal resources, for a provider agency to appropriately serve those individuals.
b. The setting of exception rates for individuals with highly acute needs shall be limited to the following services:
(1) individual supports;
(2) community-based supports;
(3) community inclusion;
(4) day habilitation; and
(5) behavioral supports.
c. As used in this section, "highly acute needs" means self-injurious or aggressive behaviors that are so extreme that the individual cannot be safely served within the current system without staffing ratios or clinical supports that are significantly higher than any assumed ratios and percentages in the current rate structure.
2. a. The Assistant Commissioner, or the designee thereof, shall establish corresponding programmatic requirements for each exception rate established under section 1 of this act. Programmatic requirements shall include, but need not be limited to, the following:
(1) mandated staffing ratios for all units of service under which the exception rate is being utilized;
(2) mandated minimum credentials and training for all staff performing units of service under which the exception rate is being utilized;
(3) the submission and implementation of a clear transition plan for the individual from their current service plan to the new proposed service plan;
(4) the inclusion of mandated planning regarding line of sight issues;
(5) the inclusion of established clinical requirements, such as applied behavior analysis, which are to be implemented by highly qualified clinical staff, such as board certified behavior analysts;
(6) the inclusion of initial and periodic clinical assessments, as applicable, to be performed by qualified professionals;
(7) mandated data reporting and review requirements;
(8) mandated medical oversight requirements; and
(9) a mandated plan to manage all physical environment issues.
b. Once a service provider is selected, the mandated programmatic requirements and corresponding exception rates shall be discussed with the service provider to ensure that the provider is willing, and has the capacity, to meet all programmatic requirements, and to make any needed clinical adjustments as agreed to by both the division and the provider.
3. This act shall take effect immediately.
STATEMENT
This bill would allow the Assistant Commissioner of the Division of Developmental Disabilities (DDD) in the Department of Human Services to create an exception rate for individuals who are identified thereby as having highly acute needs, and to mandate specific clinical and staffing requirements in association with that rate for each individual. The rate and programmatic requirements will be established on an individual basis, in order to ensure that funding is directly tied to true costs based on the programmatic requirements outlined in each case.
There is a small sub-population of individuals with developmental disabilities in New Jersey who are not able to be safely served in the current developmental disabilities system, due to inadequate staffing and clinical supports. This sub-population exhibits extremely intense self-injurious behavior, aggression towards others, or a combination of both, which significantly increases the risk of injury to these individuals, their families, facility staff, and anyone else around them.
The fee-for-service system recently implemented by the DDD does not account for this sub-population of individuals, and because these individuals represent such a small percentage of the overall population, and can be seen as outliers, the current rate structure was designed without these individuals in mind. As a result, even the highest rates do not account for the staffing ratios and clinical supports that are required to safely support these individuals.
The policies associated with the new fee-for-service system also do not ensure the safety of these individuals, as there are no requirements for mandated staffing ratios or specific clinical supports. This can lead to the dangerous placement of these individuals with service providers who are not clinically equipped to support someone with such intense needs. This bill would attempt to alleviate the system's shortcomings in this regard.
