NJAC 10:162 Rule ADOPTION draft Aug05



DEPARTMENT OF HUMAN SERVICES

DIVISION OF ADDICTION SERVICES

Intoxicated Driving Program:

Alcohol Treatment Programs Fund

Intoxicated Driver Resource Center Fee Increase

Proposed Readoption and Recodification with Amendments: to N.J.A.C. 8:66A, as 10:162

Adopted New Rules: N.J.A.C. 10:162-10 and 11 with Recodification at N.J.A.C. 10:162

Proposed: July 18, 2005 at 37 N.J.R. 2628(a).

Adopted: September 19, 2005 by Authorized by:

________________________________

James M. Davy,

Commissioner, of New Jersey Department of Human Services

Filed: September 22, 2005 as R.2005 d. 351, with substantive and technical changes not requiring additional public notice and comment (see N.J.A.C. 1:30-6.3).

Authority: N.J.S.A. 26:2B-9.2 et seq;, N.J.S.A. N.J.S.A. 39:4-50 et seq, especially especially 39:4-50(f); and Reorganization Plan 002-2004

Calendar Reference: See Summary below for explanation of exception to calendar requirement.

Proposal Number: PRN 2004—

Submit written comments by ___/____/___ to:

Michael Hanlon, Deputy Director

Office of Network Development

Division of Addiction Services

New Jersey Department of Human Services

120 South Stockton St., 3rd Floor

P.O. Box 362

Trenton, NJ 08625-0362

Effective Date: September 22, 2005, Readoption;

October 17, 2005, Amendments, New Rules and Recodification.

Expiration Date: September 22, 2010

The agency proposal follows:

Summary

Summary of Public Comments and Agency Responses:

COMMENT: The Monmouth County Division of Alcohol and Drug Services supports the proposed New Rules, and also suggests possible Intoxicated Driver Resource Center improvements and future rule revisions after readoption of these rules.

RESPONSE: The Division appreciates Monmouth County’s support and will consider the recommendations for future program improvements and possible future rule revisions.

COMMENT: The Alcohol and Drug Counselor Committee of the New Jersey Division of Consumer Affairs, State Board of Marriage and Family Therapy Examiners, requests that the definition of “Counselor” at N.J.A.C. 8:66-1.2 be revised to be consistent with the implementation of New Jersey counselor certification or licensing requirements at N.J.S.A. 45:2D, and new regulations at N.J.A.C. 13:34C, adopted March 15, 2004.

RESPONSE: The Division agrees with the recommendation of the Alcohol and Drug Counselor Committee, and has revised the definition of “Counselor” at N.J.A.C. 8:66-1.2 (recodified as N.J.A.C. 10:162-1.2) , to be consistent with, and as required by, the statute and new regulations governing the practice of alcohol and drug counselors in New Jersey. Under the former definition, “Counselor” means a person certified by the Alcohol and Drug Counselor Certification Board of New Jersey, Inc, or another state, or a person with five years of continuous experience in the treatment of alcohol or drug abusers. Under the new counselor statute and regulation, the authority of the former Counselor Certification Board is assumed and superceded by the New Jersey Division of Consumer Affairs, State Board of Marriage and Family Therapy Examiners, Alcohol and Drug Counselor Committee. Under the new counselor statute and regulation, alcohol and drug counselors licensed or certified in another state may continue to practice in New Jersey only after application to the Committee and recommendation to the Board by the Committee, pursuant to N.J.S.A. 45:2D-10, and N.J.A.C. 13:34C-1.9. Under the new counselor statute and regulation, those with five years experience before the enactment date of the statute have two years after the effective date of the regulation to apply to the Board to be licensed in New Jersey, pursuant to N.J.S.A. 45:2D-16(c.), and N.J.A.C. 13:34C-2.1(d). Alcohol and drug counselors in New Jersey have already been or are in the process of being licensed under the new counselor statute and regulation. It was an oversight by the Division of Addiction Services not to have amended the definition of “Counselor” in the Intoxicated Driving Program rule proposal at 37 N.J.R. 2628(a). The Division must conform its own regulations to the new counselor statute and regulation, and is doing so in this rule adoption notice. The amended definition of “Counselor” has otherwise no impact on these readopted rules and new rules for the operation of the Intoxicated Driving Program.

Pursuant to N.J.S.A. 26:2B-9.3, N.J.S.A. 39:4-50(f), and Reorganization Plan 002-2004, the Division of Addiction Services in the Department of Human Services, proposes to amend N.J.A.C. 8:66A relating to the Intoxicated Driving Program and to recodify the amended rule at N.J.A.C. 10: 162.

The proposed amendments include technical revisions to the existing rule made necessary by changes in organizational placement of the Division of Addiction Services within the Executive Branch and the formal change of the name of this Division from that indicated in N.J.A.C. 8:66A. As a result of Reorganization Plan 002-2004, entitled “A Plan For the Transfer, Consolidation and Reorganization of the Division of Addiction Services Into the Department of Human Services”, the functions, powers and duties of the Division of Addiction Services in the Department of Health and Senior Services, including, but not limited to, the functions, powers and duties under C. 39:4-50 of the Revised Statutes, were transferred along with necessary personnel to the Department of Human Services effective April 7, 2004. The reorganization plan specifically excluded smoking and tobacco related programs from this transfer. The reorganization plan also provided that “Whenever in any law, rule, regulation, order, contract, tariff, document, judicial or administrative proceeding or otherwise relating to the Division of Addiction Services reference is made to Department of Health and Senior Services or the Commissioner of Health and Senior Services, the same shall mean the Department of Human Services or the Commissioner of Human Services, respectively.”

N.J.S.A. 34:1B-21.12 and N.J.S.A. 26:2B-9.2 establish a special non-lapsing fund to be known as the Alcohol Treatment Programs Fund. This Fund is to be used exclusively for making grants to programs that provide treatment for alcoholism, alcohol abuse and other conditions related to the excessive consumption of alcoholic beverages among persons convicted of violating the State’s drunk driving laws and other substance abusing individuals. The Assistant Commissioner of Director of the Division of Addiction Services in the Department of Human Services, who functions as Director of the Division for purposes of these statutes, proposes amendments to N.J.A.C. 8:66A which include criteria for grantee eligibility, form and manner in which application for provider service contracts from the fund shall be made and treatment services and treatment recipients for which funds may be expended. The proposed amendments define the eligibility requirements of the grantees, the eligibility requirements of the persons convicted of alcohol related traffic offenses and the priorities according to which the funds will be disbursed.

The proposed amendments permit the establishment of a coordinating grantee or grantees. The coordinating grantee or grantees must be qualified to disburse funds as they become available in the Alcohol Programs Treatment Fund to sub-grantees. Funds disbursed will pay for the treatment of persons convicted of operating under the influence and related offenses following the date of the promulgation of the proposed amendments, and certain others whose meet program income requirements or lack sufficient resources to otherwise pay for treatment determined to be necessary. incomes are at a defined poverty level. Funds will be disbursed by the coordinating grantee or grantees upon presentation of documentation by the sub-grantees that clinically appropriate treatment services were, in fact, provided to eligible recipients. To receive payment, grantees and sub-grantees must indicate what portion of these services is being paid for by the Fund, which will be considered the payer of last resort. Sub-grantees will be alcohol and drug treatment providers licensed by the State of New Jersey or its authorized agent and affiliated with the Intoxicated Driver Resource Centers.

Based on needs assessment information made available by the Division of Addiction Services, payments will be authorized according to the following priorities: first, residential or combined residential and detoxification services, and clinically indicated continuing care treatment services, provided to eligible recipients who, at the time of admission, meet the Level III.7 or III.7-D criteria of the American Society of Addiction Medicine Patient Placement Criteria, Second Edition-Revised (ASAM PPC 2R) on or after the date of the adoption of these amended rules; second, intensive outpatient and clinically-indicated subsequent continuing care treatment services provided to eligible recipients who, at the time of admission, meet the Level II criteria of the ASAM PPC 2R, and who were referred to treatment on or after the date of the adoption of these amended rules; third, outpatient and other treatment services provided to eligible recipients who meet the Level I criteria of the ASAM PPC 2R , and who were referred to treatment on or after the date of the adoption of these amended rules. The Division of Addiction Services may authorize the coordinating grantee or grantees to disburse fFunds for provision of services tomay be disbursed on an annual basis by the coordinating grantee or grantees for other individuals who may qualify under the proposed amendments, but only when the treatment needs of the first group are met.

Pursuant to N.J.S.A. 39:4-50 (f), the proposed amendments establish criteria under which the Commissioner of Human Services may entertain and grant a request for a fee increase from the Division of Addiction Services, in coordination with the Directors of the Intoxicated Driver Resource Centers. On a showing that more than 50% of the Centers are in deficit or projecting a deficit at the time of the request to grant a fee increase, the Commissioner may take into account such factors as the rate of inflation since the previous increase, changes in client volume, increased workload, and the projected rate of inflation. No request for an additional fee increase may be made until one year from the date of the previous increase. No request for an additional fee increase may be made by an individual Intoxicated Driver Resource Center or by a group that includes only a portion of the Intoxicated Driver Resource Centers in the state. In order to be considered by the Commissioner, such a request must be submitted on behalf of all Intoxicated Driver Resource Centers in the state.

As the Department has provided a 60-day comment period for this notice of proposal, this notice is excepted from the rulemaking calendar requirements, pursuant to

N.J.A.C. 1:30-3.3(a)(5).

Social Impact

The Division of Addiction Services estimates that 53% of the approximately 22,000 persons annually convicted of alcohol-related traffic offenses may qualify as eligible persons based on financial status. The proposed amendments regarding the Alcohol Treatment Programs Fund may lower the barrier to appropriate treatment for up to 12,000 persons each year when the maximum funding authorized by the statute is released. The appropriate treatment of DUI offenders coupled with mandatory license suspension periods has been shown to significantly reduce the recidivism of convicted drunk drivers. Reduced DUI recidivism in this population will help continue to minimize the number of persons killed in DUI related crashes in New Jersey.

The proposed amendments regarding the granting of fee increases to Intoxicated Driver Resource Centers will permit the Centers to continue as self-supporting entities. Since the institution of the IDRC system, drunk driving deaths have fallen to historic lows in New Jersey.

Economic Impact

When it reaches its statutory maximum in SFY 20056, the Alcohol Treatment Programs Fund will make available an additional $7.5 million per year for treatment in New Jersey. The 5% per cent of funds reserved to the Department of Human Services for administration is sufficient for the Division of Addiction Services to provide oversight.

The Intoxicated Driver Resource Centers are supported largely through fees collected from their clients. Currently the per-diem fee for the 12-hour Centers is $75.00 (totaling $150.00 for a two-day program) and the per diem fee for the 48-hour Centers is $100.00 (totaling $200 for two days). In calendar year 2001, 15 Centers reported deficits, with IDRC income totaling $2,958,466 and expenditures totaling $3,261,339. Typically, counties provide supplementary funds for county-run Intoxicated Driver Resource Centers as needed. The Division of Highway Traffic Safety estimates that since 1981, the system of countermeasures for DUI, including the Intoxicated Driver Resource Centers, has saved well over 3,000 lives in New Jersey, with related savings of over $2 billion.

Federal Standards Statement

The proposed new rules are governed by N.J.S.A. 26:2B-9.2 et seq. and N.J.S.A. 39:4-50 et seq. The rules proposed for amendment are not subject to or required by any federal standards or requirements. The Intoxicated Driving Program, and Intoxicated Driver Resource Centers, under N.J.A.C. 10:162, are subject to, but do not exceed the requirements of 42 C.F.R. Part 2, Confidentiality of Alcohol and Drug Abuse Patient Records, authorized by 42 U.S.C. Sections 290dd-3, and 290ee-3. These Federal regulations prohibit unauthorized disclosure or use of patient records unless permitted in certain circumstances by the regulations. No other Federal standards are applicable to the subject matter of these rules. TTherefore, a federal standards statement analysis is not required.

Jobs Impact Statement

It is anticipated that the Alcohol Treatment Program Fund will have a small positive effect on the number of jobs available in the Alcohol and Drug Treatment field, as a result of increased treatment referrals and services required by these rules and increased funding for such services authorized by N.J.S.A. 34:1B-21.12 and N.J.S.A. 26:2B-9.2. The number of additional jobs cannot be determined at this time. It is anticipated that N.J.A.C. 8:66A-11 et seq. will have a neutral impact on the number of jobs existing in the Intoxicated Driver Resource Centers.

Agricultural Impact

This proposal is not anticipated to have an impact upon the agricultural industry in the state.

Regulatory Flexibility Statement

Virtually all of the approximately 300 businesses affected by the proposed amendments regarding the Alcohol Treatment Program Fund employ less than 100 full-time employees. The amount of record keeping, however, will not exceed that which these entities would normally be required to provide to any third-party payer to recover the costs of providing treatment. The coordinating grantee will be required to provide monthly, quarterly and annual financial reports to the Division of Addiction Services. These reports will be no more burdensome than those reporting requirements used in the oversight of any entity disbursing large sums of public funds.

Smart Growth Impact

This proposal is not anticipated to have an impact upon the achievement of smart growth and the implementation of the State Development and Redevelopment Plan.

Full text of the readopted rules may be found in the New Jersey Administrative Code at N.J.A.C. 10:162

Full text of the proposed adopted amendments and new rules follows (additions to proposal indicted in boldface with asterisks *thus*; deletions from proposal indicated in brackets with asterisks *[thus]*)::

CHAPTER 162

INTOXICATED DRIVING PROGRAM

SUBCHAPTER 1. INTOXICATED DRIVING PROGRAM/ INTOXICATED DRIVER RESOURCE CENTER

Text that is new is underlined and bolded , text to be deleted from the original rules is in [brackets].

8:66A10:162-1.1 Purpose and scScope

The purpose of this chapter is to improve the driving behavior of individuals who have been identified as having some alcohol or drug involvement in connection with the operation of a motor vehicle or vessel. The chapter applies to all county Intoxicated Driver Resource Centers, all affiliated treatment programs, and the Department of [Health and Senior Services,] Human ServicesHuman Services, , and all individuals convicted in New Jersey or New Jersey licensees convicted in other States of a drug or alcohol offense related to the operation of a motor vehicle or vessel after May 25, 1977 and individuals subject to N.J.A.C. 13:20-31, adopted December 15, 1972.

8:66A10:162-1.2 Definitions

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

“Affiliated treatment agency” through “Alcohol Safety Institute” means an agency or practitioner affiliated with an Intoxicated Driver Resource Center with the approval of the Intoxicated Driving Program pursuant to 10:162-5.3 to provide alcohol and drug treatment services for the education, rehabilitation and treatment of clients.

[No change]

...

“Approved grantee” means an eligible applicant awarded a provider service contract or subcontract pursuant to N.J.A.C. 810:1662A-10.1 through 10.4.

“ASAM PPC 2R” means the publication of the American Society of Addiction Medicine, Inc., Chevy Chase, Maryland titled “ASAM Patient Placement Criteria for the Treatment of Substance-Related Disorders, Second Edition-Revised,” available from ASAM Publications Distribution, P.O. Box 101, Annapolis Junction, MD 20701-0101, Tel 1-800-844-8948, Fax 301-206-9789, , which is incorporated herein by reference.

…

“Cancellation” through “Client”

[No change]

“Coordinating grantee” means an entity authorized by the Division of Addiction Services to administer the distribution of funds to approved sub-grantees or to itself to provide services and receive payment pursuant to N.J.A.C. 810:1662A-6.13(c) throughand (d) and N.J.A.C. 810:1662A-10.1 through 10.4..

…

"Counselor" means a person certified *[for the State of New Jersey by the Alcohol and Drug Counselor Certification Board of New Jersey, Inc. or another state to counsel alcohol abusers or drug abusers, or a person with five years continuous experience in the treatment of alcohol or drug abusers]* * or licensed by the New Jersey Division of Consumer Affairs, State Board of Marriage and Family Therapy Examiners, Alcohol and Drug Counselor Committee, as required by N.J.S.A. 45:2D and N.J.A.C. 13:34C, or a counselor-intern pursuing certification or licensure pursuant to N.J.A.C. 13:34C-6.2.*

“Counselor” [No change]

“Covered treatment episode” means a course of alcohol or drug treatment, including intake evaluation conducted pursuant to N.J.A.C. 810:1662A-6.1, for which there is documentation of clinical necessity and which takes place as a result of a court order from a conviction for an alcohol or drug related offense as defined in N.J.A.C. 810:166A2-1.2, or a referral from the Intoxicated Driving Program or an Intoxicated Driver Resource Center pursuant to N.J.A.C. 810:166A2-2.3, or a course of alcohol or drug treatment, including intake, for others defined as eligible recipients.

“Detoxification”, for the purpose of these rules, “means services that are consistent with the definition of “Nnon-hospital based (medical) detoxification” included at N.J.A.C. 8:42A-1.3.

…

“Didactic” [No change]

“Director” means the Assistant Commissioner or successor official who serves as head of the Division of Addiction Services in the Department of Human Services.

“Driving Uunder the Iinfluence (DUI)” means any offense related to drunk driving, impaired driving, intoxicated driving, driving under the influence or driving while intoxicated, as defined in the applicable statute, or such other offenses as may require referral to an Intoxicated Driver Resource Center, and is interchangeable with the term “DWI” for the purpose of theseis ruleschapter.

…

“Drug abuser” [No change]

“Eligible applicant” means an entity qualified to administer the distribution of funds to approved sub-grantees for achieving the purpose of this chapter and/or an entity providing inpatient, intensive outpatient or outpatient treatment and licensed pursuant to N.J.S.A 26:2H-1 et seq., and N.J.A.C. 8:42A et seq. or N.J.A.C. 8:42B or N.J.A.C. 8:43A-26, et seq and affiliated in good standing with the Intoxicated Driver Resource centers pursuant to N.J.S.A. 39:4-50(f) and N.J.A.C. 8:66A 10:162-5.1 through 5.7., or licensed pursuant to N.J.S.A. 45:2D et seq and rules adopted for its implementation and affiliated in good standing with the Intoxicated Driver Resource Centers pursuant to N.J.S.A. 39:4-50(f) and N.J.A.C.

8:66A-5.1 through 5.7..

“Eligible recipient” means a person required to satisfy the requirements of the Intoxicated Driving Program and the Intoxicated Driver Resource Centers pursuant to N.J.S.A. 39:4-50 et seq and N.J.A.C. 8:66A10:162-2.1, or authorized to be referred to the Intoxicated Driving Program pursuant to N.J.A.C 8:66A10:162-2.3, and who meets the criteria of eligibility established in N.J.A.C. 8:66A10:162-6.16(c) and priorities established in N.J.A.C.

8:66A10:162-10.4(a) through (d);, or other person in need of alcohol or drug abuse treatment who meets the criteria of eligibility established in N.J.A.C. 8:66A10:162-6.16(c) and N.J.A.C. 8:66A-10.4(e).

...

“First offender” through “48-hour program” [No change]

“Fund” means monies deposited or accrued in the Alcohol Treatment Programs Fund pursuant to N.J.S.A. 26:2B-9.2 et seq. ..

…

“Incapacitated” through “Individual Provider”

[No change]

“Inpatient treatment” means treatment for alcohol and/or drug dependence within a residential alcohol or drug treatment facility licensed by the Department of [Health and Senior] Human Services, Division of Addiction Services.

“Intensive Oout Ppatient Ttreatment” means the type of treatment defined as Level II in the ASAM PPC 2R, consistent with the Standards for Licensure of Outpatient Substance Abuse Treatment Facilities (N.J.A.C. 8:43A-26 or any successor rules).

…

“Intoxicated” through “Out of State”

[No change]

“Outpatient treatment” means the type of [non-residential] the type of treatment defined as Level 1 in the ASAM PPC 2R, consistent with the Standards for Licensure of Outpatient Substance Abuse Treatment Facilities (N.J.A.C. 8:43A-26 or any successor rules).

…

“Recidivist” through “Self-help group”

[No change]

“Sub-grantee” means an entity licensed pursuant to N.J.S.A. 26:2H-1 et seq., and N.J.A.C. 8:42A, or N.J.A.C. 8:43A-26 or any successor rules governing the operation of substance abuse treatment facilities; or licensed pursuant to N.J.S.A. 45:2D-1 et seq and the rules adopted for its implementation, that provides direct treatment services as defined in this chapter to eligible recipients through a sub-contract with a coordinating grantee.

“Third and subsequent offenders” through “Z client”

[No change]

8:66A10:162-1.3 Establishment of an Intoxicated Driver Resource Center (IDRC)

[(No change in text.])

SUBCHAPTER 2. ACTIONS SUBSEQUENT TO CONVICTION FOR N.J.S.A. 39:4-50 et seq. OR 39:4-50.4(a) OR 39:4-50.14 OR 12:7-57 OR 12:7-34.19 OR 12:7-46 OR 39:3-10.24 OR 39:4-14.3g

8:66A10:162-2.1 Notification and evaluation

(a) [(No change.])

(b) The Intoxicated Driving Program shall schedule persons who have been convicted in (a) above, or referred, in accordance with N.J.A.C. 10:162-2.3 for attendance at an appropriate Intoxicated Driver Resouce Center.

10:162-2.2 and 2.3 8:66A-2.2 Report to court and the Division of Motor Vehicles following noncompliance through 8:66A-2.3 Authorized referrals to the Intoxicated Driving Program

[(No cchange in text.])

8:66A10:162-2.4 Fees

Fees shall be paid as provided for at N.J.S.A. 39:4-50, 39:4-50.4, 39:4-50.14, 39:4-14.3g, 12:7-57, 12:7-34.19, 12:7-46 and 39:3-10.24 or any amendment thereto and shall be payable as designated by the Division of [Alcoholism and Drug Abuse] Addiction Services from every person each time the person is convicted of a relevant alcohol or drug-related offense. These fees are owed and due upon conviction, pursuant to N.J.S.A. 39:4-50 if the conviction occurred on or after October 9, 1986, and upon referral or evaluation to the Intoxicated Driver Resource Center and the Intoxicated Driving Program if the conviction occurred prior to October 9, 1986.

8:66A10:162-2.5 Authorized license actions

[(No change in text.])

8:66A10:162-2.6 Conflict of interest

The county freeholders, through the county counsel or solicitor, shall be responsible for making an initial determination of whether a conflict of interest exists with respect to the management and staff of an Intoxicated Driver Resource Center. The county shall be responsible for eliminating such a conflict of interest, in accordance with N.J.S.A. 40A:9-22.1 et seq. and/or county conflict of interest standards. The county counsel or solicitor shall notify the Intoxicated Driving Program in writing that the Intoxicated Driver Resource Center treatment referral process is not in conflict of interest. Should there be a change in the treatment referral process, it shall be approved by the county counsel or solicitor and a new letter provided to the Intoxicated Driving Program prior to initiating the change. If an Intoxicated Driver Resource Center wishes to employ staff who are also working for an affiliated treatment program, a procedure to avoid conflict of interest shall be established by the Intoxicated Driver Resource Center and approved by the county counsel or solicitor. If, in its discretion, the Intoxicated Driving Program determines that a conflict of interest still exists after county review and action, it may refer the matter to the Commissioner of [Health and Senior Services] Human Services, to the Local Finance Board in the Department of Community Affairs or to the Attorney General for advice or action, as appropriate.

10:162-2.7 through 2.10 8:66A-2.7 Intoxicated Driver Resource Center Income and Expenditure Report through 8:66A-2.10 Data collection

[(No change in text.])

SUBCHAPTER 3. ATTENDANCE AND SCHEDULING AT AN INTOXICATED DRIVER RESOURCE CENTER

8:66A-3.1 Scheduling through 8:66A-3.7 Scheduling and monitoring of third and subsequent offenders10:162-3.1 through 3.6

[(No change in text.)

10:162-3.7 Scheduling and monitoring of third and subsequent offenders

Third and subsequent offenders shall be referred to the 12 hour Intoxicated Driver Resource Center for evaluation, referral to treatment and/or self-help group participation, pursuant to N.J.A.C. 10:162-4.2, and N.J.A.C. 10:162-4.5. Third and subsequent offenders shall be monitored by the Intoxicated Driver Resource Center for one full year from the time the client begins treatment.]

SUBCHAPTER 4. EVALUATION AND TREATMENT PROCEDURES

8:66A10:162-4.1 Evaluation procedures

(a) – (c) [(No change])

(b) [No change]

(c) [No change]

(d) The records release authorization form shall be filled out to allow information to be released to the court, Intoxicated Driving Program, and the Division of [Alcoholism and Drug Abuse] Addiction Services, the treatment program, the Division of Motor Vehicles, the Intoxicated Driver Resource Centers, and the client's attorney. In addition, the client may authorize any other persons to receive protected information by so indicating on the form.

8:66A10:162-4.2 (No change in text.)Criteria for client referral to treatment through 8:66A

10:162-4.63 Referral proceduresEvaluation approval

(a) (No change)

(b) If a counselor decides not to refer a client who meets any of the above criteria in N.J.A.C. 10:162-4.2(b), then documentation must be provided to support the nonreferral.

10:162-4.4 through 4.6 [(No change in text.])

SUBCHAPTER 5. TREATMENT PROGRAM AFFILIATION REQUIREMENTS

8:66A10:162-5.1 Affiliation and renewal-of-affiliation agreements

(a) [No change]

In order to treat Intoxicated Driver Resource Center/Intoxicated Driving Program clients, a treatment agency or provider shall sign a standard affiliation or renewal-of-affiliation agreement (see Appendices A and B). All affiliation and renewal-of-affiliation agreements are subject to approval by the Intoxicated Driving Program for compliance with the requirements of N.J.A.C. 10:162-5.3 and 5.6, as applicable (see Alternatives Counseling Center, Inc. v. New Jersey Department of Health and Senior Services, N.J. Super. Ct., App. Div. No. A-45-98T5, Oct. 8, 1999). All such affiliation and renewal-of-affiliation agreements shall expire at the end of the last day of June of the relevant calendar year

8:66A-5.2 Application for affiliation

(ab) – (c) [(No change.])

10:162-5.2 Application for affiliation

(a) An applicant for affiliation may contact the Intoxicated Driving Program, PO Box 365, Trenton, NJ 08625-9365, (609) 588-3547, which shall provide the applicant with a list of IDRCs. The applicant shall make request for affiliation to the IDRC. Upon receipt of a request for affiliation from an applicant, an IDRC shall provide the applicant with a standard affiliation agreement as specified in N.J.A.C. 10:162-5.1, which shall serve as the application form. The IDRC shall include as part of the application a current statement of IDRC needs regarding client volume, modalities of service, geographic requirements, cultural needs of the population served, and client accessibility. A copy of this statement shall be filed with the IDP and kept current by the IDRC.

(b) (No change.)

(c) Every treatment program and individual provider shall conform to N.J.S.A. 39:4-50 et seq., 45:2D-1 et seq., 26:2H-1 et seq. and 40A:9- 22.1 et seq., N.J.A.C. 10:162, as appropriate, and shall submit the following information to the IDP and to the IDRC:

1. A statement that the program or provider conforms to and will abide by N.J.S.A. 39:4-50 et seq., 45:2D-1 et seq., 26:2H-1 et seq. and 40A:9-22.1 et seq., N.J.A.C. 10:162, as amended and supplemented and any rules adopted pursuant thereto;

2.- 7. (No change.)

(b) [No change]

(c) [No change]

(d) The Intoxicated Driver Resource Center shall attach a statement to the agreement signed by the Center Director certifying that:

1. (No change.)The facility (outpatient facilities only) is accessible to its clients, in that it is convenient to public transportation or reachable by motor vehicle within 30 minutes of normal drive time; and

2. The facility is suitable as a place of treatment in that it is licensed by the Department of [Health and Senior] Human Services to provide alcohol and drug treatment services if a residential facility, or that it is physically inspected by the Intoxicated Driver Resource Center and [certified] approved by the Division of [Alcoholism and Drug Abuse] Addiction Services as meeting rules adopted pursuant to N.J.S.A. 26:2H-1 et seq. if an outpatient agency or provider.

(e) [No change] The Chief of the IDP, after receipt and review of a signed affiliation or renewal of affiliation agreement, using the criteria found at N.J.A.C. 10:162-5.3 and 5.6, as applicable, shall indicate approval by signing the agreement. Copies of the agreement shall be distributed to all parties to it.

8:66A10:162-5.3 Treatment program affiliation criteria through 8:66A-5.7 Revocation of affiliation

[No change]

(a) The Chief of the IDP shall determine that an agency or provider is appropriate for affiliation or renewal of affiliation if it:

1. Conforms to the requirements of N.J.A.C. 10:162-5.2(c) and (d);

2. Meets the needs of an Intoxicated Driver Resource Center as set forth in the statement of IDRC needs described in N.J.A.C. 10:162-5.2(a); and

3. Is deemed suitable to accomplish the purposes of the program as defined in N.J.A.C. 10:162-1.1

10:162-5.4 (No change in text.)

10:162-5.5 Renewal of affiliation agreements

The Director of the Intoxicated Driver Resource Center shall be responsible for initiating the process of renewal of affiliation agreements after conducting an annual site visit and/or providers meeting. Each agency renewing its affiliation will complete a standard renewal of affiliation agreement (see appendix B). The Director of the Intoxicated Driver Resource Center shall attach a certification to the renewal agreement as specified in N.J.A.C. 10:162-5.2(d) and forward the package to the Intoxicated Driving Program for approval pursuant to N.J.A.C. 10:162-5.3.

10:162-5.6 Criteria for renewal

All affiliated agencies or providers in order to be eligible for renewal shall meet the criteria established in N.J.A.C. 10:162-5.3.

10:162-5.7 (No change in text.)

SUBCHAPTER 6. TREATMENT PROGRAM OPERATIONAL REQUIREMENTS

8:66A10:162-6.1 Intake evaluation

(a). Each Intoxicated Driver Resource Center client or DUI offender sentenced by a court to treatment in place of jail shall receive an individual intake evaluation, preferably with his or her counselor of record. The purpose of the intake is to make an independent evaluation of the client’s needs in treatment, and, if the provider is an approved grantee, to determine if the client is an eligible recipient.

(b). The treatment program shall conduct an independent evaluation of the client’s need for treatment, using an instrument approved by the Division of Addiction Services. Any testing tool utilized must be noted in the evaluation. The information packet received from the Intoxicated Driving Program shall also be utilized. The treatment program shall inform the client of his or her specific responsibility under the treatment plan. If a client is determined by the treatment program to need treatment, a treatment plan shall be developed and a copy of the plan shall be provided to the client. Clients shall be advised that failure to participate in treatment will result in license suspension and a minimum two -day jail sentence, or if he or she has been sentenced to treatment in place of jail, imposition of the applicable jail sentence. The treatment agency shall establish a written, signed contract with the client regarding the treatment plan. The client shall sign a records release authorization during the intake process. The form shall be completed to allow the court, the Intoxicated Driver Resource Center, the Intoxicated Driving Program, the [Division of Alcoholism and Drug Abuse] Division of Addiction Services, [and] the Division of Motor Vehicles Commission, the client’s attorney, and the treatment program/approved grantee and coordinating grantee as appropriate to exchange information.

(c). (nNo change.)

(d). When determining whether a client is an eligible recipient, an approved grantee shall require proof of income and, when applicable, documentation of medical indigency status pursuant to N.J.A.C. 810:1626A-6.16(c) in the form of the prior year’s tax returns, pay stubs or other documentation deemed suitable by the Division of Addiction Services.

10:162-6.2 through 6.6 8:66A-6.2 Client intake form through 8:66A-6.12 Client transfers from one treatment program to another

[(No change in text.])

10:162-6.7 Determining number of self help group meetings per week

(a) (No change.)

(b) Required self help attendance as an adjunct to treatment shall be determined on an individual basis pursuant to N.J.A.C. 10:162-4.2 and 4.5.

10:162-6.8 through 6.12 (No change in text.)

8:66A10:162-6.13 Final client treatment release [and], evaluation, and request for payment

(a). – (b) (nNo change.)

(b). no change

(c). An approved sub-grantee shall present suitable documentation to a coordinating grantee designated by the Division of Addiction Services for payment for a covered treatment episode, indicating the date or dates on which services were provided, the number of units of service provided, the modality or modalities of service provided and proof that the client was an eligible recipient.

(d). The Division of Addiction Services may authorize provider service sub-contracts in the form of payments by a coordinating grantee to approved grantees based on the documentation provided pursuant to N.J.A.C. 8:66A10:162-6.13(c) and N.J.A.C. 8:66A-10.4(a)- through (c).

8:66A10:162-6.14 Client treatment procedures

(a) The Intoxicated Driver Resource Center or Intoxicated Driving Program, as appropriate, and the treatment program must conclude that the client is appropriate for treatment before treatment commences. If the treatment program, after performing a proper evaluation under this chapter, indicates the client is not appropriate for treatment or needs an alternate treatment referral, the client shall be referred back to the Intoxicated Driver Resource Center for appropriate action. The Intoxicated Driver Resource Center or Intoxicated Driving Program will close the case unless it is determined that the criteria used, in accordance with N.J.A.C. 10:162-4.2, justify treatment. A client refusing to participate in treatment after two findings that treatment is appropriate shall be referred to the sentencing court as non-compliant, in accordance with N.J.A.C. 10:162-8.

(b) – (e) (No change.)

10:162-6.15 (No change in text.)

through 8:66A-6.15 Unauthorized use of intoxicated driving program cards

[No change]

8:66A10:162-6.16 Treatment costs

(a). [The Intoxicated Driver Resource Center or Intoxicated Driving Program] The Division of Addiction Services shall not be responsible for any treatment costs for any treatment or treatment agency evaluation costs for a client[s] unless the client provides proof that he or she is an eligible recipient, and the grantee or sub-grantee providing such services indicates what percentage of the costs have been or will be paid from other sources. The Division of Addiction Services may then make payments from the Fund on a sliding scale up to 100% percent of the costs.

(b). If a client [claims indigency] is an eligible recipient and meets the [indigency] criteria [for the county wherein the client has been assigned to an Intoxicated Driver Resource Center] set forth in N.J.A.C.

8:66A-6.16(c) throughand (d) below, treatment shall be provided by an approved grantee to the client at no cost to the client when monies from the Fund are available, notwithstandingsubject to the provisions of N.J.A.C. 8:66A-6.16(d) below regarding nominal co-payments [or on a sliding scale basis]. [Approved treatment] When monies from the Fund are not available, affiliated treatment programs and approved grantees shall provide treatment on a sliding scale basis or at no cost for up to 10 percent of their [treatment at no cost for indigent] Intoxicated Driver Resource Center/Intoxicated Driving Program clients.

(c). Income e Recipients for this program will be required to meet eligibility criteria that consider income, resources, Federal Poverty Guidelines, and medical indigency status. Eligibility for this program will be based on Federal Poverty Guidelines as published annually in the Federal Register by the Secretary of Health and Human Services, with an applicable income threshold of 350 percent for applicants seeking residential treatment, and 250 percent for applicants seeking other levels of treatment. For the purpose of this section, medical indigency is defined to include circumstances where an applicant who does not otherwise exceeds these meet Federal Poverty Guidelines, but due to reduced income or necessary medical, legal, legally-mandated, or educational expenses,program income requirements still lacks sufficient resources to pay for treatment that is determined to be clinically necessary pursuant to N.J.A.C. 810:1662A-6.1 through 6.4.. will be tied to the federal poverty level, with the specific Specific eligibility criteria to will be published annually in the Department of Human Services Directory of Contracted Services or through a Public Notice in such form as may be used by the Department of Human Services for announcing other funding initiatives, as described in N.J.A.C. 8:66A-10.1.

(d). A client who claims to be an eligible recipient shall provide proof of income and, when applicable, documentation of medical indigency status including, but not limited to, garnishments, alimony, child support and legal fines, to an approved grantee pursuant to N.J.A.C. 810:1662A-6.1(d) . Proof of eligibility does not relieve the client of the responsibility to pay the applicable Intoxicated Driving Program and Intoxicated Driver Resource Center fees required pursuant to N.J.A.C. 10:162-2.4, and 8.1, and any nominal co-payment charged by an approved grantee for therapeutic purposes, as approved by the Division of Addiction Services.

8:66A-6.17 Treatment programs through 8:66A-6.18 Treatment after arrest10:162-6.17 and 6.18

[(No change in text.])

SUBCHAPTER 7. CLIENT CONDUCT

10:162-7.1 and 7.2 (No change in text.)

SUBCHAPTER 8. CLIENT NON-COMPLIANCE PROCEDURES

10:162-8.1

[(No change in text.])

10:162-8.2 Failure to contact treatment facility

When the Intoxicated Driver Resource Center/Intoxicated Driving Program has been notified that a client has not contacted the treatment facility by the contact date, the Intoxicated Driver Resource Center/Intoxicated Driving Program shall follow the procedures of N.J.A.C. 10:162-8.1(a) through (c) and shall, for new law clients, in addition to the other documents, mail a copy of the treatment agreement to the court of conviction.

10:162-8.3 Failure to comply with the treatment program

Upon receipt of a Client Treatment Release form indicating that the client did not comply with the treatment program requirements, the Intoxicated Driver Resource Center/Intoxicated Driving Program shall follow the procedures in N.J.A.C. 10:162-8.1(a) 1 through 3 and shall, for new law clients, in addition to the other documents, mail a copy of the treatment agreement to the court of conviction.

10:162-8.4 Other noncompliance

If the client is found to be in noncompliance for any reason, the Intoxicated Driver Resource Center/Intoxicated Driving Program will follow the procedures in N.J.A.C. 10:162 -8.1(a)1 through 3, and shall, for new law clients, mail any necessary documents to the court of conviction.

10:162-8.5 through 8.8 (No change in text.)

SUBCHAPTER 9. MISCELLANEOUS OFFENDERS

10:162-9.1 through 9.5

[(No change in text.])

SUBCHAPTER 10. ALCOHOL TREATMENT PROGRAM FUND GRANTS

810:1662A-10.1 Form and manner in which application for provider service contracts the fund shall be made.

(a). The Division of Addiction Services shall annually publish specific application procedures, qualifications and requirements for award of funding to a coordinating service agency and approved sub-contracted providers in the Department of Human Services Directory of Contracted Services or through a Ppublic Nnotice in such form as may be used by the Department of Human Services for announcing other funding initiatives, based upon the availability of funding., consistent with this subchapter.

(b). Eligible applicants may apply to the Division of Addiction Services for funding pursuant to the procedures and requirements indicated in N.J.A.C. 810:1662A-10.1(a), and upon execution of a provider service contract or sub-contract will be considered approved grantees.

Applicant programs shall apply to:

Division of Addiction Services

New Jersey Department of Human Services

P.O. Box 362

Trenton, NJ 08625-0362

810:1662A-10.2 Length of provider service contracts

Subject to the availability of funds, the Division of Addiction Services may contract with the coordinating grantee or grantees for a time period that is appropriate and consistent with Department of Human Services policies and procedures for the administration of provider service contracts.

810:1662A-10.3 Criteria for approved sub-grantee eligibility

Eligible applicants for subcontracts shall be licensed by the Department of Human Services pursuant to N.J.S.A. 26:2H-1 and N.J.A.C. 8:42A, 8:43A-26, or any successor rules governing the operation of substance abuse treatment facilities; or licensed pursuant to N.J.S.A. 45:2D-1 et seq and rules adopted for its implementation; and shall be affiliated with the Intoxicated Driver Resource Centers pursuant to N.J.S.A. 39:4-50(f) and N.J.A.C. 810:166A2-5.1 through 5.7.

810:1662A-10.4 Funding priorities

(a). The Division of Addiction Services may make funding available to a coordinating grantee or grantees and approved sub-grantees for certain populations pursuant to N.J.A.C. 8:66A-10.4(b) through (e) below .

(b). First priority is for residential or combined residential and detoxification services, and clinically indicated continuing care treatment services, provided to eligible recipients who, at the time of admission, meet the Level III.7 or III.7-D criteria of the ASAM PPC 2R on or after * [the effective date of the adoption of these amended rules]* *October 17, 2005*.

(c). Second priority is for intensive outpatient and clinically-indicated subsequent continuing care treatment services provided to eligible recipients who, at the time of admission, meet the Level II criteria of the ASAM PPC-2R, and who were referred to treatment on or after * [the effective date of the adoption of these amended rules]* *October 17, 2005*.

(d). Third priority is for outpatient and other treatment services provided to eligible recipients who meet the Level I criteria of the ASAM PPC-2R , and who were referred to treatment on or after * [the effective date of the adoption of these amended rules]* *October 17, 2005*.

(e). The Division of Addiction Services may disburse funds or authorize the disbursement of any funds for others who have been convicted of an offense under N.J.S.A. 39:4-50 et seq., or N.J.S.A. 39:4-50.4(a), or N.J.S.A. 39:4-50.14, or N.J.S.A. 12:7-46, or N.J.S.A. 12:7-57, or N.J.S.A. 39:3-10.24 or N.J.S.A. 39:4-14.3g no more than five years prior to *[the adoptioneffective date of these rules]* *October 17, 2005,*, and who meet the ASAM criteria referenced in N.J.A.C. 8:66A-10.4(b) through (d) above, as long as its estimates of need permit it to do so and funding is available.

SUBCHAPTER 11. INTOXICATED DRIVER RESOURCE CENTER PER DIEM FEE INCREASES

810:1662A-11.1 Criteria for Intoxicated Driver Resource Center per diem fee increases

(a). The Commissioner of Human Services, in consultation with the Governor’s Council on Alcoholism and Drug Abuse, may entertain and grant a request from the Division of Addiction Services, in coordination with the Directors of the Intoxicated Driver Resource Centers, for a per diem fee increase for all Intoxicated Driver Resource Centers, when it has been determined by the Director, of the Division of Addiction Services that more than 50% percent of the Intoxicated Driver Resource Centers are operating in deficit, based upon the annual income and expenditure reports submitted pursuant to N.J.A.C 810:1662A-2.7.

(b). In calculating an appropriate fee increase, the Commissioner may take into account such factors as the rate of inflation since the previous fee increase, changes in client volume of the Intoxicated Driver Resource Centers, increased work load as the result of legislation and rule making, and the estimated projected rate of inflation, and the intent that Intoxicated Driver Resource Centers be self-supporting. The Commissioner may also require an independent review of the income and expenditure reports and/or documentation of an independent audit consistent with Department of Human Services standards.

(c.) Any Intoxicated Driver Resource Center not incurring a deficit at the time of a fee increase may use any excess revenues generated by the fee increase for assessment or treatment enhancement or shall place any such revenues into a special reserve to cover the costs of future deficits or variations in client volume.

810:1662A-11.2 Minimum Iinterval between requests

A request for a fee increase shall not be entertained by the Commissioner until one full year after the date a previous fee increase has become effective.

810:1662A-11.3 Individual or group requests prohibited

The Commissioner shall not entertain or grant a request for a fee increase by an individual Intoxicated Driver Resource Center or by a group that includes only a portion of the Intoxicated Driver Resource Centers in the sState. In order to be considered by the Commissioner, such a request must be submitted on behalf of all Intoxicated Driver Resource Centers in the sState.

APPENDIX A

INTOXICATED DRIVER RESOURCE CENTER

TREATMENT AGENCY/PROVIDER

AFFILIATION AGREEMENT

 IDRC _________________________________________________________________

 

 Treatment Agency/Provider ________________________________________________

 

 Date ____________________

 

It is agreed that the above named treatment agency or provider will accept referrals from the _______ County Intoxicated Driver Resource Center (IDRC) or the Intoxicated Driving or the Intoxicated Driving Program (IDP) of the N.J. Department of [Health] Human Services, Division of Addiction Services ffor the purpose of alcohol and/or drug abuse treatment. The initial determination of 

treatment appropriateness will be made through the screening process and evaluation

done by the IDRC or IDP.

 ….

 "Treatment appropriate" refers to those IDRC or IDP clients who may be in need

   of a structured intervention into their drinking and/or drug use; or care for

   alcohol, drug abuse or related problems.

 

 A treatment referral will be made by the IDRC or IDP. If from the IDRC, the

   Agency/Provider will communicate with the IDRC and will send the entire

   required forms etc. to the IDRC. If the referral is from IDP, then the

   Agency/Provider will send all forms etc. to the IDP.

 

 The Agency/Provider will be notified of the referral via the Treatment Referral

   Form. Clients referred to the program will be given an Agreement to

   Participate in Treatment Form by the IDRC or IDP, and they will contact the

   program for an intake interview by the agreed contact date.

 

 The Agency/Provider agrees to schedule the client for the intake interview

    within 30 days of the client's contact of the program.

 

 If the client fails to make contact or appear for his appointment, the

   Agency/Provider will immediately inform the IDRC or IDP, as appropriate, via

   the Client Treatment Release Form.

 

 When the client appears, the Agency/Provider will make a determination as to

   the client's appropriateness for the program. If the client is found not

   appropriate, the Agency/Provider agrees to immediately inform the IDRC or

   IDP, as appropriate, via the Client Treatment Release Form, with supporting

   explanation.

 

 If the client is treatment appropriate and is accepted for treatment with the

   Agency/Provider, the IDRC or IDP as appropriate, will be informed via the

   Client Intake Form. The agency agrees to make an independent evaluation of

   the client's needs in treatment. A copy of the evaluation and recommendations

   must be sent with the Client Intake Form. The information packet received

   from the IDRC shall be utilized. The Client Intake Form and evaluation by the

   treatment program shall be sent to the IDRC or IDP, as appropriate, within

   seven (7) working days after the intake with the Records Release

   Authorization. The IDRC or IDP, as appropriate, must concur with the

    treatment plan prior to the start of treatment.

 

 The Agency/Provider agrees to inform the client of his/her specific

   responsibility under the treatment plan and to provide a written copy of the

   plan to the client.

 

 The Agency/Provider agrees to establish a contract with the client regarding

   the treatment plan.

 

 The client shall sign a Records Release Authorization during the intake

   process. The form shall be completed to allow the Intoxicated Driver Resource

   Center, all New Jersey courts, the Intoxicated Driving Program, the Division

   of Addiction Services, the Division of Motor Vehicle Services, the client's

   attorney, and the treatment program to exchange information. A copy shall be

   sent to the IDRC or IDP, as appropriate.

 

 The Agency/Provider will inform the IDRC or IDP, as appropriate, of the

   client's participation in treatment on a monthly basis for the duration of

   treatment. Verification of active treatment participation will be by use of

   the monthly roster and Client Treatment Progress form to be filed by the

   fifteenth (15) day of each month.

 

 When the client is released from treatment, with approval, or if the client

   refuses to complete treatment, the Agency/Provider agrees to inform the IDRC

   or IDP, as appropriate, via the Client Treatment Release Form within seven

   (7) days. All forms will be supplied by the IDRC or IDP, as appropriate.

 

 The Agency/Provider may apply whatever treatment plan is deemed necessary for

   each client. If the treatment plan is acceptable to the IDRC or IDP, as

   appropriate, the referral agency will require the client to complete that

   treatment. The program may also charge the client applicable fees for

   treatment services rendered. The IDRC or IDP will not be responsible for the

   client's treatment fees.

 

 The undersigned hereby agrees to the terms described in this document and to

   the Division of Addiction Services rules and regulations found in N.J.A.C.

   8:66A10:162 et seq., and N.J.S.A. 39:4-50.

 

 The Agency/Provider agrees that all treatment will be performed or supervised

   by a Certified Alcoholism or Drug Abuse Counselor (CADC), who meets the criteria

   established in N.J.S.A. 45:2D et seq. and any rules adopted pursuant thereto.

 

  The Agency/Provider agrees to notify the IDRC or IDP, as appropriate,

   immediately of any changes in its fee schedule, including sliding fee

   schedule, and information on fee payment by health insurance and other

   information required by N.J.A.C. 8:66A 10:162.

 

 The Agency/Provider agrees to adhere to professional standards of care and

   ethics and any applicable State and Federal laws and regulations. Further,

   the Agency/Provider certifies with this agreement that no principal or

   employee of the treatment program is in a conflict of interest situation with

   this County IDRC or any other County IDRC.

 …

 The Agency/Provider agrees to accept and provide free treatment for up to 10

   percent of its IDRC or IDP clients. These clients will first have been

   determined to be indigent by their county of residence.

 

This agreement shall expire on the last day of June of each year, and shall not survive that date without prior written IDRC or IDP approval. The IDRC or IDP may terminate this agreement for violation of this agreement or violation of any policy, procedure, rule or regulation as prescribed in N.J.A.C. 10:162.

….

_________________________________

James M. Davy, Commissioner

Department of Human Services

_________________________________

Date

[END 09.16.05]

 The Agency/Provider agrees to provide the IDP and the IDRC with a written

   description of treatment philosophy, program requirements, and treatment

   curriculum.

 

 The Agency/Provider agrees to provide the IDRC and IDP with a statement

   regarding its use of chemical testing as a requirement of treatment or

    evaluation.

 

 The Agency/Provider warrants that there are no real or potential conflicts of

   interest with respect to the IDRC or IDP and services provided.

 

 The Agency/Provider warrants that its facilities comply with all zoning, fire,

   building, health, and/or other applicable regulations.

 

 The Agency/Provider shall furnish the IDRC and IDP with copies of malpractice

   and general liability insurance and will hold the IDRC and IDP harmless from

   and against all claims, personal injury, or death sustained in connection

   with the delivery of services by the Agency/Provider and which result

   directly from any wrongful acts or omissions, including negligence or

   malpractice, of any of its officers, directors, employees, agents, servants

   or independent contractors. The provisions of this paragraph shall continue

   after the termination of this Agreement with respect to any liability, loss,

   expense or damage resulting from acts occurring prior to termination.

 

 If the client is in need of a different treatment plan, the Agency/ Provider

   will notify the IDRC or IDP, as appropriate. The IDRC or IDP will decide the

   appropriate course of action.

 

 This agreement shall expire on the last day of June of each year, and shall not

   survive that date without prior written IDRC or IDP approval. The IDRC or IDP

   may terminate this agreement for violation of this agreement or violation of

   any policy, procedure, rule or regulation as prescribed in N.J.A.C. 8:66A.

 

 The Agency/Provider may terminate this agreement by providing the IDRC, IDP

   with at least four months written notice.

 

 Agency/Provider: ________________________________________________________

 

 M.I.S. Provider Code: ____________________________________________________

 

 Location of Program:         __________________________________________________

 (if more than one location,

 list on reverse side)        __________________________________________________

 

 Mailing Address:             __________________________________________________

                               __________________________________________________

 

 Phone Number:                __________________________________________________

 

 Hours of Program:            __________________________________________________

 

 Days of Week:                __________________________________________________

 

 Contact Person:              __________________________________________________

 

 Cost:                        __________________________________________________

 

 Sliding Fee Scale                  _______ Yes                _______ No

   Available:

 

 Third Party Payment                _______ Yes                _______ No

   Available:

 

 Alcohol and/or Drug                _______ Yes                _______ No

   Testing:

   (may be required)

 

 List of Program Counselors with certifications/degrees, or experience, and

   foreign languages: (Use back of page if necessary)

  ________________________________________________________________________

 _______________________________________________________________________

 _______________________________________________________________________

 _______________________________________________________________________

 

 Name and qualifications of person providing clinical supervision of counselors

   conducting DUI groups.

 _______________________________________________________________________

 _______________________________________________________________________

 _______________________________________________________________________________

 

 How often are DUI groups conducted ________________________________________

 

 ***********************************************************************

 

 Signing for the IDRC         __________________________________________________

                              Director, IDRC

 

                              __________________________________________________

                                                     Date

 

  Signing for the              __________________________________________________

   Agency/Provider

 

 Name and Title (please       __________________________________________________

   print)

                              __________________________________________________

                                                     Date

 

 SIGNING FOR THE IDP          __________________________________________________

                              Chief, IDP

 

                              __________________________________________________

                                                     Date

 

APPENDIX B INTOXICATED DRIVER RESOURCE CENTER TREATMENT AGENCY/PROVIDER AFFILIATION AGREEMENT RENEWAL

[No change]

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