Bill Text: NJ A374 | 2024-2025 | Regular Session | Introduced
Bill Title: Requires Medicaid coverage of social day care services for senior citizens.
Spectrum: Partisan Bill (Democrat 4-0)
Status: (Introduced) 2024-01-09 - Introduced, Referred to Assembly Aging and Human Services Committee [A374 Detail]
Download: New_Jersey-2024-A374-Introduced.html
STATE OF NEW JERSEY
221st LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2024 SESSION
Sponsored by:
Assemblyman STERLEY S. STANLEY
District 18 (Middlesex)
Assemblyman REGINALD W. ATKINS
District 20 (Union)
SYNOPSIS
Requires Medicaid coverage of social day care services for senior citizens.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel.
An Act requiring Medicaid coverage of social day care services and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. As used in this section:
"Managed Long Term Services and Supports program" means the Medicaid program that provides coordinated, long-term services and supports to Medicaid beneficiaries who reside in the community, but require a nursing home level of care.
"Social adult day care services" means a community-based group program designed to meet the non-medical needs of senior citizens with functional impairments through an individualized plan of care; social adult day care services are provided in a protective setting during the day when participants' caregivers are at work or are otherwise unavailable.
b. The Division of Medical Assistance and Health Services in the Department of Human Services shall provide coverage for social adult day care services for Medicaid beneficiaries, regardless of whether the beneficiaries are enrolled in the Medicaid Managed Long Term Services and Supports program.
c. Eligibility for Medicaid coverage of social adult day care services, provided pursuant to paragraph b. of this section, is limited to beneficiaries who are aged 60 years or older, and who also meet the clinical, income, and asset requirements established for the Managed Long Term Services and Supports program by the Commissioner of Human Services.
2. The Commissioner of Human Services shall apply for such State plan waivers or amendments 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 implement the purposes of this act.
4. This act shall take
effect immediately, but shall remain inoperable until the Commissioner of Human
Services receives federal approval of any necessary State plan waivers or
amendments, pursuant to section 2 of this act.
STATEMENT
This bill requires the Division of Medical Assistance and Health Services in the Department of Human Services to provide social adult day care services for Medicaid beneficiaries, regardless of whether the beneficiaries are enrolled in the State's Medicaid Managed Long Term Services and Supports (MLTSS) program. This benefit, however, would be limited to those Medicaid beneficiaries who are aged 60 years or older and who also meet the clinical, income, and asset requirements established for the MLTSS program by the Commissioner of Human Services.
The bill defines social adult day care services as a community-based group program designed to meet the non-medical needs of senior citizens with functional impairments through an individualized plan of care. Social adult day care services are provided in a protective setting when participants' caregivers are at work or are otherwise unavailable.
Pursuant to the bill, the Commissioner of Human Services is to apply for any federal Medicaid waivers or State plan amendments necessary to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program. The bill additionally stipulates that the provisions therein are to remain inoperable until the Commissioner of Human Services receives federal approval of the requisite federal Medicaid waivers or State plan amendments.
Under current law, only Medicaid beneficiaries enrolled in the MLTSS program are eligible for social adult day care or medical day care services. Beneficiaries enrolled in a medical day care program receive preventive, diagnostic, therapeutic and rehabilitative services under medical and nursing supervision in order to support their ability to live in the community. To qualify for the MLTSS program, individuals must be enrolled in the State Medicaid program, reside in the community, require a nursing home level of care, and meet the program's income and asset limits.
