Care Management Organization (CMO) – An independent, community-based organization that combines advocacy, service planning and delivery, and care coordination into a single, integrated, cross system process, in order to assess, design, implement and manage child-centered and family-focused individual service plans for children, youth and young adults whose needs require intensive care management techniques that cross multiple service systems.
Care Manager – An employee of a Care Management Organization (CMO) responsible for facilitating the process of Individual Service Plan design and implementation at the local level.
Center for Medicare and Medicaid Services (CMS) – The entity within the Federal Department of Health and Human Services that funds the State Medicaid and NJ FamilyCare Programs.
Child Welfare System – The child welfare system is a group of services designed to promote the well-being of children by ensuring safety, achieving permanency, and strengthening families to successfully care for their children.
The child welfare system varies from State to State, but it generally includes public agencies such as departments of social services or family and children’s services. These State agencies often work with private child welfare agencies to provide services for families and children. Caseworkers at these agencies are required by law to ensure the safety, well-being, and permanent living arrangements of children. Their responsibilities include investigating reports of child abuse and neglect and arranging for services for children and families.
Children’s Crisis Intervention Services (CCIS) – An acute closed child/youth inpatient psychiatric unit located in a community hospital or a free-standing facility, designated by DCBHS and licensed by the Department of Health and Senior Services. These are short-term units with a typical length of stay of less than two weeks that provides screening, stabilization, assessment and short term intensive treatment.
Children’s Health Care Coverage Program – A health insurance program for targeted, low-income children as established by the federal government under Title XXI, known as NJ FamilyCare Program. Also referred to as the federal “S-CHIP” program.
Clinically Licensed Practitioner – An individual licensed as a psychiatrist (N.J.A.C. 13:35); a psychologist (N.J.A.C. 13:42); an advance practice nurse, mental health (N.J.A.C. 13:37-7); a licensed clinical social worker (N.J.A.C. 13:44G); or professional licensed in accordance with the Board of Marriage and Family Therapy Examiners (N.J.A.C. 13:34) including, but not limited to, a licensed marriage and family therapist (N.J.A.C. 13:34-4); a licensed professional counselor (N.J.A.C. 13:34-11 or 12); a clinical mental health counselor (N.J.A.C. 13:34-14); a rehabilitation counselor (N.J.A.C. 13:34-21 or 22). (Source: N.J.A.C. 10:97-4.3(b)).
Contracted System Administrator (CSA, contractor) – An administrative organization contracted by the Division of Child Behavioral Health Services to provide utilization management, care coordination, quality management and information management for the Children’s System of Care that provides mental and/or behavioral health services and supports to eligible children, youth, and young adults.
Contracted System Administrator Care Coordinator (CSA CC) – A licensed clinician at the contractor who provides telephonic access, management and coordination of the assessment process for children, youth, and young adults with emotional and/or behavioral healthcare challenges and needs.
Coordination of Benefits – The process whereby other health insurance coverage is first accessed and used to fund the mental health services covered under the Division of Child Behavioral Health Services Service Delivery Network.
Crisis Residential Services – Treatment, including assessment and stabilization provided in temporary housing for persons in immediate need of protection, supervision, and care in emergency situations caused by serious emotional challenges.
DAS – Division of Addiction Services in the Department of Human Services. The Division is responsible for providing effective treatment and prevention for alcoholism and drug abuse and for enhancing public awareness of the dangers of such substances.
DCBHS– Division of Child Behavioral Health Services – The Division within the Department of Children and Families that provides a comprehensive approach to the provision of mental and behavioral health services to eligible children, youth and young adults.
DCF – Department of Children and Families.
DDD – Division of Developmental Disabilities – The Division within the Department of Human Service, coordinates and provides services for people with autism, mental retardation, cerebral palsy, spina bifida and traumatic brain injuries. DDD provides evaluation, functional, and guardianship services to eligible persons. Services include residential services, family support, contracted day programs, work opportunities, social supervision, and guardianship and referral services.
Developmental Disability – A physical or mental impairment that substantially limits one or more of the major life activities.
DHHS or HHS – Department of Health and Human Services of the Federal government, which administers the Medicaid and NJ FamilyCare programs at the federal level through the Center for Medicare and Medicaid Services (CMS).
DHS – Department of Human Services.
DHSS – Department of Health and Senior Services in the Executive branch of New Jersey State government.
DMAHS – Division of Medical Assistance and Health Services – The Division within the New Jersey Department of Human Services, who has the authority to administer the New Jersey Medicaid and the NJ FamilyCare programs.
DMHS – Division of Mental Health Services within the Department of Human Services (DHS). DMHS is responsible for the administration of the State’s mental health programs, primarily for adults.
DPCP – Division of Prevention and Community Partnership.
DCP&P – Division of Child Protection and Permanency –The Division within the New Jersey Department of Children and Families, which provides comprehensive social services for children, youth and young adults and their family/caregivers, and child protective services referred to as the DCP&P System.
Emergency/Crisis Intervention Services – Crisis and protective interventions and supports necessary to prevent serious psychiatric or medical consequences to children, youth and young adults who are experiencing acute mental health or substance abuse problems. In order to protect children, youth and young adults, relieve their distress and help restore their levels of functioning, these services must be available twenty-four (24) hours a day on an immediate basis and wherever the need presents.
Family – Child or children and biological parent(s), legal guardian(s), adoptive parent(s), foster parent(s), or resource family or person acting in the place of a parent such as the person with whom the child or children legally resides and/or a person legally responsible for the child’s welfare.
Family Crisis Intervention Unit (FCIU) – The County based organizational entity that provides services to stabilize juvenile family crises on a 24-hour-a-day basis.
Family Support Organization (FSO) – An independent community-based organization under contract with DCBHS comprised of family members who are involved or who have been involved in the system of mental health/behavioral health care and who provide direct peer support and advocacy to children, youth, young adults and their family/caregivers receiving Care Management Organization (CMO), Youth Case Management (YCM) services, as well as provide advocacy and support for other children, youth, young adults and their family/caregivers in the community who may need services under DCBHS.
Grievance – Any formally registered complaint that is submitted in writing or that is orally communicated and cannot be resolved within the timeframes established for complaint resolution.
Group Home – A residential facility licensed in accordance with N.J.A.C. 20:128 to provide board, lodging, and treatment services on a 24- hour basis for generally 12 or fewer children, youth and young adults in a community based setting. The level of the mental health treatment and the average length of stay may vary depending on the program design and funding source.
High Level of Need – Children, youth or young adults who have been determined by the DCP&P, or its designated contracted system administrator (CSA), to require an intense level of care coordination services due to any one or any combination of the following: (N.J.A.C. 10:73-35(a)(2) 30
- Serious emotional or behavioral health challenges resulting in significant functional impairment which adversely affects the child, youth or young adult’s ability to function in the community;
- The child, youth or young adult’s DCBHS assessment indicates a need for the intensive level of care management services;
- The child, youth or young adult is involved with one or more agencies or systems, including, but not limited to:
- Division of Mental Health Services (DMHS);
- Crisis/emergency service providers;
- Department of Human Services or Department of Children and Families provider agencies;
- Juvenile Justice Commission (JJC); or
- The court system;
- A risk of disruption of a current therapeutic treatment setting exists;
- Risk of a psychiatric re-hospitalization exists, or;
- A risk of admission into an OOH residential treatment setting exists.
Individual Crisis Plan (ICP) – A crisis stabilization plan that identifies target behaviors, develops desired outcomes and strategies and implements necessary mental health/behavioral health services, for the mobile response service period and, if necessary, for a period of up to eight weeks, to stabilize the presenting crisis situation. The ICP includes linking the children, youth, young adults and their family/caregivers with ongoing formal and informal mental health/behavioral health services and other services in the community after the presenting situation has been stabilized.
Individual Service Plan (ISP) – The plan developed by the Child/Family Team that incorporates formal and informal services and supports into a comprehensive, integrated plan that, using the identified strengths of the child, youth and young adult and their family/caregivers, addresses the needs of the child, youth and young adult and family/caregivers across life domains in order to support the child, youth and young adult and their family/caregivers to remain in or return to the community, in school and out of trouble.
Individualized Education Plan (IEP) – A written plan which sets forth present levels of academic achievement and functional performance, measurable annual goals and short-term objectives or benchmarks and describes an integrated, sequential program of individually designed instructional activities and related services necessary to achieve the stated goals and objectives. This plan shall establish the rationale for the student’s educational placement, serve as the basis for program implementation and comply with the mandates set forth in this chapter.
Source: NJAC 6A:14-1.3
Individualized Service Planning – A process that wraps services and supports around the child, youth and young adult and their family life domains and provides access to the services they need, delivered in the communities where they live, work and attend school. Plans are holistic in nature and address areas of everyday living beyond the treatment of emotional or behavioral health challenges. Plans are family-friendly, child-focused, culturally competent, and are developed based on the individual strengths and needs of the child, youth and family/caregivers.
Informal services or resources – Services delivered under an individualized service plan by family/caregivers, community residents, and/ or community organizations not reimbursable under Medicaid or other DCP&P/DCBHS provider contracts.
Intensive In-Community Mental Health Rehabilitation Services – An array of mental health rehabilitation services delivered face-to-face as a defined set of interventions by a clinically licensed practitioner in the child, youth or young adult’s home and/or in community-based settings, not in provider offices or office settings, which address symptom reduction and are restorative and preventative in nature. These services are provided as part of an approved intensive in-community service plan and encompass a variety of mental health services, including, but not limited to, group, individual or family therapy, allied behavioral therapies and modalities, clinical consultation/evaluation, instruction in anger management, parenting skills, problem solving and stress reduction techniques, psycho-educational services and counseling.
Intensive Residential Treatment Services (IRTS) – A non-inpatient secure intensive treatment provided to children, youth and young adults who require 24/7 care in a safe, secure environment with constant line-of-sight supervision, medication management and a concentrated individualized treatment protocol.
Intermediate Children’s Unit (CIU) – A sub-acute inpatient psychiatric unit licensed as a closed child/adolescent inpatient facility by the Department of Health and Senior Services and located in a community hospital. These units serve children, youth and young adults who require additional inpatient treatment following stabilization in a CCIS with a typical length of stay of up to 60 days.
Mobile Response and Stabilization Services (MRSS) – A system of time-limited, clinically based interventions delivered 24/7/365, across DYFS, mental health and juvenile justice systems, for children, youth and young adults exhibiting emotional and/or behavioral challenges that threaten their current living arrangements. The initial interventions are delivered at the site of the crisis and may last up to 72 hours. Follow-up mobile response stabilization management services, which include appropriate service implementation, may last up to 8 weeks.
Mobile Response and Stabilization Services Agency – A DCBHS contracted entity responsible for the administration, coordination, delivery, management, and monitoring of a system of mobile response and stabilization management services for children, youth and young adults within a designated area.
Mobile Response and Stabilization Services/Family Crisis Intervention Units (MRSS/FCIUs) – These combined units are located within those counties that chose to integrate the FCIU with MRSS and who are responsible to meet all MRSS and all FCIU requirements.
Mobile Response Service Period – The time that mobile response services can be provided. Generally described as the 72 hour period from the initial dispatch to the MRSS entity by the contractor. The 72 hour period means up to midnight of the fourth day of the initial dispatch. If the 72-hour episode would expire at 5 pm on the fourth day, the MRSS entity shall provide services up to midnight of that day.
Mobile Response Stabilization Services Network – A network of providers developed to deliver time-limited services to meet the needs of children, youth, young adults and their family/caregivers involved with a Mobile Response and Stabilization Services Agency. They are delivered in accordance with the Individualized Crisis Plan and monitored by the Mobile Response and Stabilization Services Agency.
Out-of-Home (OOH) Treatment – A residential facility (public or private) that provides 24/7 care and treatment for children, youth and young adults with needs such that they are unable to function appropriately in their home, community or school.
Outpatient Treatment – Clinical services including individual, group, or family therapy and other counseling as well as medication prescription administration and review provided in a non residential setting.
Partial Care – A continuum of day treatment that includes intensive treatment within a structured therapeutic setting designed to serve as an alternative to hospital care as well as programs that offer an integrated set of treatment and family interventions on a longer-term basis. Children’s partial care programs are licensed in accordance with N.J.A.C. 10:191.
Psychiatric Community Residence (PCR) – A psychiatric community residence for children, youth and young adults licensed by the Department of Children and Families under N.J.A.C. 10:192 that provides mental health rehabilitation services 24/7 in an OOH treatment setting.
Psychiatric Emergency Service – Emergency response to a crisis situation requiring immediate attention to children, youth, young adults and their family/caregivers.
Rehabilitative Service – A Medicaid reimbursable service that a state may define to include (pursuant to 42 C.F.R. 440.130) medical or remedial services recommended by a physician or other licensed practitioner within the scope of practice under State law, for maximum reduction of physical or mental disability and restoration of an individual to his or her best possible functional level.
Residential Child Care Facility – Providers of children’s mental health rehabilitative services that are licensed by the Department of Children and Families under N.J.A.C. 10:128 and who are under contract with the Division of Child Behavioral Health Services to provide 24/7 OOH treatment services.
Residential Treatment Center (RTC) – An RTC provides room, board, and care and treatment services for 13 or more children, youth or young adults on a 24 hour a day basis. These include facilities providing educational services on or off grounds as well as programs that provide adventure-based treatment. Facilities may be certified by DYFS or DMHS or are JCAHO accredited to provide voluntary inpatient psychiatric care to children, youth and young adults 21 years of age and under. DCP&P/DCBHS contracts with residential treatment centers in New Jersey and out-of-state. RTCs are licensed in accordance with N.J.A.C. 10:127.
Respite Services – Temporary supervision including crisis stabilization and temporary residential services, provided to individuals living with family members, family care providers or significant others, when short-term relief is needed. Respite care can be provided in-home or OOH during the day, evening, and/or overnight.
Service Authorization – Authorization granted by the contractor after appropriate review by an appropriate qualified mental health, behavioral health staff, a Care Coordinator or physician based on an assessment of need.
Short Term Care Facility (STCF) – An inpatient community based mental health treatment facility designated, by the Commissioner of Children and Families or the Commissioner of Human Services, to provide involuntary care to children, youth and young adults who have been screened by State-designated Psychiatric Commitment Screening and Assessment Centers. It provides assessment, acute care and stabilization services to mentally ill persons whose mental illness causes the person to be dangerous to self, others, or property.
Stabilization Management Services – The development, coordination and monitoring of an individual crisis plan for up to 8 weeks subsequent to the mobile response period, to ensure the stabilization of the presenting situation.
Therapeutic Foster Care/Treatment Homes – A licensed provider in accordance with N.J.A.C. 10:128 that provides out of home treatment to children, youth and young adults with emotional/behavioral health challenges and needs in the homes of trained families within the community. Treatment parents are seen as the primary therapeutic agents and are specially trained, licensed and clinically supervised. Clinical, supportive and case management services are provided to each child, youth and young adult and treatment family/caregivers.
Treatment Planning – Ongoing delineation of goals, objectives, and therapeutic interventions regarding the appropriate level of care based on the uniqueness of each child, youth or young adult, which considers the perspectives of the child, youth and young adult, their clinician(s), treatment team, family/caregivers and/or significant others. Treatment planning builds on the child, youth or young adult’s strengths and incorporates a discharge focus.
Urgent Care – Clinically necessary treatment of a condition that requires immediate attention in order to prevent deterioration or harm to a child, youth, young adults or their family/caregivers, but is not life threatening.
Wraparound Services – A term used to describe a model of community-based care that literally wraps individualized services around a specific child to maintain that child in a community setting. Wrap-around services reflect a philosophy of care that advocates doing whatever it takes to stabilize a child in all domains of functioning (home, school and community) and to prevent placement in more intensive levels of care, such as psychiatric hospitals and residential treatment centers.
Youth Services Commission (YSC) – The county-based planning body under the jurisdiction of the Juvenile Justice Commission that consolidates, within a single community agency, the planning, implementation, monitoring, and evaluation of the juvenile justice system, that oversees the implementation of community-based services for adjudicated juveniles, as well as oversees the implementation of delinquency prevention programs, including FCIUs.