NJAC 10:162-6.16. Treatment costs
(a) The Division of Addiction Services shall not be responsible for any
treatment costs for any treatment or treatment agency evaluation costs for a
client 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 is an eligible recipient and meets the criteria set forth in (c)
and (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, subject to
the provisions of (d) below regarding nominal co-payments. 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 Intoxicated Driver Resource Center/Intoxicated Driving Program
clients.
(c)
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 exceeds these
Federal Poverty Guidelines, but due to reduced income or necessary medical,
legal, legally-mandated, or educational expenses, still lacks sufficient
resources to pay for treatment determined to be clinically necessary pursuant
to N.J.A.C. 10:162-6.1 through 6.4.
(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.
10:162-6.1(d). Proof of eligibility does not relieve the client of the
responsibility to pay the 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.
