New Jersey State Laws and Regulations - Summary
Frequently Asked Questions
Addiction Treatment Centers
Overview
- What types of chemical dependency services are offered in New Jersey?
- What does it mean to be "licensed," "certified," or "accredited" in this industry?
- What kind of licensure and certifications are required to operate a substance abuse treatment program in New Jersey?
- How can the licensing agency for substance abuse treatment facilities in New Jersey be reached?
- What is the process for substance abuse treatment facility to obtain a license?
- Under what circumstances will the Department issue a conditional license?
- How does a treatment facility renew, amend, or terminate its license?
- What kinds of inspections and surveys might there be for licensure determination?
- How can a facility prepare for inspections, on-site reviews, and surveys?
- What happens if the Department identifies problems during an inspection or survey?
- Under what circumstances will the Department deny, suspend, reduce, revoke, or terminate licensure?
- Under what circumstances will the Department seek an injunction against a facility?
- Under what circumstances will the Department issue financial penalties to a facility?
- What kinds of information must a licensed facility submit to the Department?
- What personnel policies must a licensed substance abuse facility maintain?
- What kinds of internal policies and procedures must a licensed substance abuse facility have?
- What special policies and procedures must be in place to address medical care provided by licensed facilities?
- What emergency protocols must be in place?
- What notices must a licensed substance abuse treatment facility post?
- What are the requirements for client records for licensed substance abuse facilities?
- What kind of governance must a licensed substance abuse facility have?
- What are the requirements for a treatment facility's quality assurance program?
- How must a licensed facility handle client transportation?
- How must a licensed facility handle infection prevention and control?
- What are the protections afforded to facilities and homes used for the purpose of substance abuse treatment?
- Are there any proximity restrictions regulating how close treatment centers may be to each other? Can an operator open a residential treatment center right next to one that is already there?
- What are the physical plant requirements for treatment facilities?
- What are the basic sanitation and safety requirements for treatment facilities?
- What procedures and standards must a facility develop for preadmission and admission?
- What information must be disclosed to the client during intake and what must a licensed facility put in its admissions agreement?
- How does a facility decide whether a client meets criteria for placement in a particular level of care?
- What staffing must be offered at each level of care?
- What are the requirements related to each type of staff member's qualifications and responsibilities?
- What training requirements are required for staff?
- What rules apply to volunteers at facilities?
- What services must be offered by residential programs?
- What services must be offered by outpatient programs?
- What are the requirements of a client assessment?
- What must be included in an individual treatment plan?
- What must be considered in continuum of care planning?
- What rights are guaranteed to clients?
- What policies and procedures must be in place to address client care at residential treatment facilities?
- What policies and procedures must be in place to address behavior management?
- What termination and discharge policies need to be in place?
- What grounds are needed in order to dismiss a client from a program?
- If a facility needs to discharge a client that relapsed, is the facility at risk if the client overdoses tonight? If so, how can the facility protect itself?
- What needs to be done if a client dies while in treatment?
- How must clients' privacy be protected?
- What rules govern medically-monitored detoxification programs in residential facilities?
- What rules govern medical services in outpatient facilities?
- What are the requirements to operate an opioid treatment facility?
- What special policies and procedures must be in place at an opioid treatment program?
- What assessments must be done for a client in an opioid treatment program?
- What services must be provided to clients of opioid treatment programs?
- What rules apply to take-home medication for opioid treatment program clients?
- How can an opioid treatment facility discharge a client?
- What payment policies must be in place at licensed facilities?
- How can a facility respond to clients who are unable to pay the required deductibles? Can the facility waive a program participant's financial responsibility?
- What are the key issues insurers raise to demand recoupment of fees from chemical dependency treatment programs?
- What marketing practices are prohibited?
- What are the limits of gift giving to potential referral sources?
- What kind of benefits can a facility offer existing or new clients?
- What are recovery residences?
- Is license or certification required to open recovery residences?
- How can recovery residences demonstrate their commitment to meeting minimum quality standards?
- What kind of services can recovery residences offer?
- What are the protections afforded by federal law to small group homes used for the purpose of sustained recovery?
- Can local governments put special restrictions on recovery residences?
- What other aspects should an operator consider before choosing a location for a recovery residence?
- What are the obligations to residents for operators of recovery residences?
- What kind of agreement should recovery residences ask residents to sign?
- Can a recovery insist on drug tests and searches?
- Can recovery residences bill insurance for required and/or random drug testing?
- Can recovery residences make clients' obligations contractually enforceable?
- What kind of ownership and staffing structures are common with recovery residences?
- Are there any other organizations from which recovery residences operators could find more information?
In New Jersey, there are licensed residential and outpatient substance abuse treatment services, in addition to licensed general hospitals that may provide acute chemical dependency services.
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A license means that a facility or professional may operate or may deliver services with the advance and continuous authorization of a designated government agency, which is done to ensure protection of public health, safety, and welfare.
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Licensing & Certification
Facilities must be licensed to operate programs that provide substance abuse treatment services. In New Jersey, licenses must be obtained from the Department of Human Services, Offices of Licensing (the "Department") to operate a substance abuse treatment program.
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The Department is located at the following address:
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Any person, organization, or corporation planning to operate a residential or outpatient substance use disorders treatment facility must submit completed application forms with the appropriate fees...
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The Department issues conditional licenses in the following circumstances:
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Once issued, a license will be granted for a period of one year (12 consecutive months). The license is eligible for annual renewal on and up to 30 days following the license anniversary date upon submission of the appropriate licensing and inspection fees.
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The Department's agents may visit at any time with or without prior notice and inspect the facility, its staff, activities, and records to determine compliance with the licensing regulations and applicable state and federal laws.
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Facilities must ensure that staff are well-trained and ready to answer questions that may be asked of them by the Department, reflecting knowledge of compliance and operational requirements.
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Following an inspection or survey, the Department will provide findings of any deficiency observed.
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If a facility does not comply with the licensure process, licensing regulations, or other applicable laws, an initial license may be denied, an existing license may be suspended, revoked, or terminated, and/or a facility may face financial penalties.
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The Department may seek an injunction against the operation of a treatment facility or a component of the facility upon a finding of violations pertaining to the care of clients or hazardous or unsafe conditions of the physical structure...
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Financial penalties may be assessed for certain licensing violations. The Department may assess a penalty for violation of licensure rules according to the following standards:
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Operational Requirements
As a general rule, licensed facilities must submit any documentation or information requested by the Department. Facilities must also report monthly to all client admissions and discharges from the facility...
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New Jersey licensing regulations set forth specific requirements related to personnel requirements.
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Licensed facilities must have a set of written policies and procedures made available to staff, clients, Department inspectors, and the public.
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Both residential and outpatient facilities must have medical staff bylaws, along with written medical policies developed by the medical director in conjunction with the medical staff.
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Residential and outpatient facilities must maintain written emergency plans, policies, and procedures to be followed in case of hazards that necessitate an evacuation, ensuring that clients receive necessary services during the evacuation or other emergency.
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Facilities must conspicuously post a public notice that the following information is available in the facility during its normal business hours for clients and the public:
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Facilities must maintain separate records for each client in a secure and confidential manner, which is discussed in further detail in the Privacy Section below.
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Licensed facilities must have a governing body that is responsible for the policies and activities of the service. The governing body should consist of persons with expertise in management, finance, and substance abuse treatment.
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Residential and outpatient facilities must establish and implement an integrated comprehensive quality assurance program for client care, review the program at least annually, and revise the program as necessary.
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Facilities must develop a method of client transportation for services provided outside of the facility. Facilities must ensure the security of the client and his or her personal possessions, as well as transfer of client information to and from the provider of the services.
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Facility administrators must develop and implement an infection prevention and control program.
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Zoning and Land Use
The regulation of land use and zoning is traditionally reserved to state and local governments, except to the extent that it conflicts with requirements imposed by the Fair Housing Act, the protections of the ADA, or other federal laws.
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There is no statewide rule or regulation preventing multiple facilities from operating in close proximity. Notwithstanding the lack of legal or regulatory prohibitions for other types of treatment facilities...
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New Jersey licensing regulations set forth specific plant requirements for substance abuse treatment facilities.
Please note, the rules described below concern the physical plant and functional requirements for licensure purposes, and do not constitute all environmental requirements.
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Please note, these regulations concern the sanitation and safety requirements for licensure purposes, and do not constitute all environmental requirements.
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Care, Treatment, and Services
Admissions
There must be a preadmission or admission interview, which is documented in the client record. Facility staff must conduct a preadmission interview with all clients and, in the case of an adolescent, his or her family, guardian or legally authorized representative.
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Prior to admission, or in the case of an intoxicated client, as soon as stabilization occurs, basic information about treatment services and client rights must be provided, in simple, non-technical terms and in the client's primary language.
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To make a determination on whether the services offered by the facility are appropriate to meet the client's treatment needs, the facility must carry out an assessment of the client's treatment and rehabilitation needs and goals.
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Staffing Requirements
Substance abuse treatment facilities must meet the needs of admitted clients, as identified during the admission assessment process. Each facility type has unique requirements pertaining to the intensity and frequency of services provided.
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Facilities that are required to have the following types of staff members must ensure that they have the required qualifications and responsibilities set forth in the licensing regulations, as follows:
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Facilities must develop and implement a staff orientation plan and a staff education plan, which includes written plans for each service and designation of person(s) responsible for training.
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Facilities that use volunteers must provide education and training, limit the functions that volunteers serve, and establish written policies and procedures applicable to the use of volunteers.
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Requirements by Program Type
Residential treatment facilities must provide or arrange for the following types of services: (1) medical and nursing services (including assessment, diagnostic services, and treatment); (2) counseling; (3) case management; and (4) vocational, educational, and other supportive services.
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Outpatient treatment facilities must provide or arrange for the following types of services: (1) medical and nursing services (including assessment, diagnostic services, and treatment); (2) counseling; and (3) vocational, educational, and other supportive services.
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Treatment Planning
Both residential and outpatient facilities must perform a comprehensive biopsychosocial assessment of all clients, as described below. In addition, at the time of assessment, all clients must be screened for co-occurring disorders...
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For each client admitted, licensed facilities must complete an individual treatment plan based on the client's treatment, medical, psychiatric, and social histories.
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Both residential and outpatient treatment facilities must initiate continuum of care planning for each client upon admission. This plan should incorporate goals for discharge and address problems identified at admission and during treatment.
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Client Rights
Facilities must protect the legal and civil rights of each client at all times during treatment and discharge. Each licensed facility must adopt and maintain an updated set of rules, which set forth the responsibilities and the rights of clients regarding treatment and discharge.
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Every residential facility must develop, establish, and ensure the implementation and maintenance of client care policies and procedures. All client care policies and procedures must be sensitive to cultural, religious, ethnic, age, and gender issues.
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Facilities must establish and maintain written policies and procedures for managing disruptive behavior, including aggression, harm or threats of harm to self or others, destruction of property, and refusal to comply with program policies.
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Discharge
Licensed facilities must have written termination and discharge policies and procedures and make these available to prospective clients at the time of admission. Policies related to involuntary discharges should be provided to clients and signed by the client at intake.
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Generally, there are four types of discharge. First, successful completion of the program means that the client has met the goals of his or her recovery plan.
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The discharge of a client must be handled carefully given the risks if a client suffers negative health consequences in the aftermath of discharge.
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The facility must develop procedures to be followed in the event of the death of a client. These procedures must conform with laws governing the report of death to local authorities and the Department.
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Privacy
Client confidentiality is an important issue covered by both federal and state laws. These laws set forth specific requirements regarding how and when client information may be shared and the protections that must be in place to safeguard confidentiality.
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Medication-Assisted Treatment
In addition to the required policies, procedures, and services related to medication and medical services in residential facilities, which are described above, there are special rules that apply to medically monitored detoxification services in residential facilities.
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Medical services must be provided in outpatient substance use disorder treatment programs as follows:
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Opioid programs are subject to extensive regulations under federal and state law. Operators considering opioid treatment programs may wish to consult with experienced legal counsel to review the applicable rules and make sure their program is in compliance with all relevant requirements.
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In addition to the policy and procedure requirements for outpatient facilities generally, opioid treatment programs must also establish special written policies and procedures. Opioid treatment programs' policies and procedures must include the following:
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All persons admitted to an opioid treatment program must meet the admission criteria outlined in the federal standards set by accrediting agencies and be diagnosed with opioid dependence consistent with DSM-5.
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All opioid treatment programs must provide counseling services, drug screenings, and education.
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As an initial matter, in determining eligibility for take-home medication, programs must refer to federal standards set by accrediting agencies...
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Discharge depends on the circumstances. Clients who are undergoing medically supervised withdrawal as a planned goal in a maintenance program may request a blind dosage reduction...
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Payment
As described above, New Jersey licensing regulations sets forth specific requirements related to the payment policies of substance abuse treatment facilities.
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Clients seeking drug and alcohol rehabilitative services often face financial difficulties, whether because of the consequences of their addiction or the expense of multiple, prior failed treatment programs.
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Insurers may demand recoupment of fees based on any defect in the billing claim or supporting documentation and/or based on any noncompliance with federal or state laws.
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Marketing
In the addiction treatment industry in general, the most widespread prohibited marketing practices appear to revolve around inappropriate inducements and inaccurate marketing claims.
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Federal and state laws prohibit the exchange of items of value to induce referrals for health-related services. As a result, the exchange of any item of value, whether it is cash or in kind, must be carefully monitored.
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Providers must avoid giving a patient or prospective client anything of value or benefit. For example, facilities must avoid giving gifts to clients or referral sources because these may violate anti-kickback laws and rules against inducements and patient brokering.
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Recovery Residences
Overview
Recovery residences, also known as sober living facilities, are transitional alcohol and drug free residential settings with rules, peer-led groups, activities and/or other structured operations.
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Recovery residences are not licensed substance abuse treatment facilities. Recovery residences can offer sober housing with rules, peer-led groups, staff activities, and/or other structured operations, and are for persons in early recovery...
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Sober homes may devise their own quality standards. The National Association of Recovery Residences ("NARR") provides a Code of Ethics that is used by sober homes in many states and is available here:
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Recovery residences provide a structured alcohol and drug free environment for congregate living that may offer regularly scheduled peer-led or community gatherings (house meetings and self-help groups, etc.).
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Zoning and Land Use
Federal law, including the ADA and Fair Housing Act, provide protections for recovery residences to operate in residential communities.
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This area of law is complex and evolving, especially in the State of New Jersey. It is well settled that state and federal law prohibit local governments from discriminating against or treating the residents of sober living homes...
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In siting recovery residences, attention should be paid to potential hostility from neighbors. While federal and state law generally protect the right to operate sober living residences of six or fewer people in any residential community...
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Residents' Rights and Responsibilities
In general, operators of sober living houses should agree to the following: (1) to enforce that the premises remain safe and free of intoxicant use; (2)...
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As a general matter, the housing agreement should include: (1) a pledge from the client to live by the house rules, including to abstain from drug and alcohol use...
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Recovery residences do not have the right to impose testing or searches without consent.
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Recovery residences sometimes rely on the drug screening that takes place when the resident attends outpatient services, although they may make use of drug testing equipment that can be used on-site.
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Yes, as long as the obligations are enforceable under New Jersey law in general and any applicable laws relating to landlord and tenants. Operators should consult legal counsel regarding specific obligations and whether those obligations are legally enforceable under applicable laws.
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Governance and Staffing
Recovery residences are traditionally structured as a nonprofit corporation, a for-profit corporation, limited liability company, partnership, or a sole owner arrangement. Recovery residences may also consist of individuals...
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Substance Abuse and Mental Health Services Administration
http://www.samhsa.gov/
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