NJAC 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 the 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) It shall be the responsibility of the IDRC Director initially to
evaluate each application for affiliation or renewal of affiliation of each
applicant after a site visit or providers meeting for compliance with (c) and
(d)1 and 2 below.
(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. Copies of valid State licenses or certifications, as applicable, required
by N.J.S.A. 26:2H-1 et seq. or 45:2D-1 et seq.;
3. A fee schedule, including any sliding fee schedule, and whether fees
can be paid by health insurance;
4. The address, telephone number, hours of operation and contact person
for each office location;
5. A written description of treatment philosophy, program requirements,
and treatment curriculum;
6. A list of proposed IDRC-affiliated program staff and their resumes;
and
7. Proof of commercial liability insurance, and individual or agency
professional liability insurance as appropriate.
(d) The Intoxicated Driver Resource Center shall attach a statement to
the agreement signed by the Center Director certifying that:
1. 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 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 approved by the
Division of Addiction Services as meeting rules adopted pursuant to N.J.S.A.
26:2H-1 et seq. if an outpatient agency or provider.
(e) 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.
