STATE OF NEW JERSEY
221st LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2024 SESSION
Sponsored by:
Assemblyman DONALD A. GUARDIAN
District 2 (Atlantic)
SYNOPSIS
Increases hourly limit of reimbursable personal care assistant services under NJ WorkAbility Program.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel.
An Act concerning the NJ WorkAbility Program and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Services provided to employed, permanently-disabled individuals through the NJ WorkAbility Program, established pursuant to P.L.2000, c.116, and in accordance with the federal "Ticket to Work and Work Incentives Improvement Act of 1999," Pub.L.106-170, shall be provided by health maintenance organizations and fee-for-service providers that have executed a contract with the Division of Medical Assistance and Health Services in the Department of Human Services to provide benefits through the State Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), except that reimbursable personal care assistant services shall be limited to a maximum of 112 hours per calendar work week.
2. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this act and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.
3. The Commissioner of Human Services shall adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to effectuate the purposes of this act.
4. This act shall take effect immediately, and shall apply to any contract executed on or after the effective date of this act between the Division of Medical Assistance and Health Services in the Department of Human Services and a health maintenance organization or a fee-for-service provider that provides benefits through the State Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
STATEMENT
This bill increases the hourly limit of reimbursable personal care assistant services under the NJ WorkAbility Program from 40 hours per calendar workweek to 112 hours per calendar workweek. The NJ WorkAbility Program provides full State Medicaid health coverage to individuals with disabilities who are working and whose earnings would otherwise make them ineligible for Medicaid. The regulations (N.J.A.C.10:72-9 et seq.) governing the Program provide that all services available through the NJ WorkAbility Program must be provided through existing Medicaid contracts held by the Division of Medical Assistance and Health Services (DMAHS) in the Department of Human Services. Currently, the reimbursement of personal care assistant services under such contracts is limited to 40 hours per calendar work week.
Individuals must meet the following guidelines in order to be eligible for the NJ WorkAbility Program: 1) be between the ages of 16 and 64; 2) work part time, full time, or be self-employed and have proof of employment; 3) have a permanent disability as determined by the United States Social Security Administration or the Disability Review Team in DMAHS; and 4) have an earned income below 250 percent, and an unearned income below 100 percent, of the federal poverty level. An individual participating in the program must pay a $25 monthly premium in order to receive full Medicaid coverage.