Bill Text: NJ A5139 | 2022-2023 | Regular Session | Introduced
Bill Title: Requires DOT to establish paratransit brokerage program to consolidate provisions of paratransit services under State Medicaid program and NJT Access Link.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2023-02-06 - Introduced, Referred to Assembly Transportation and Independent Authorities Committee [A5139 Detail]
Download: New_Jersey-2022-A5139-Introduced.html
Sponsored by:
Assemblyman DANIEL R. BENSON
District 14 (Mercer and Middlesex)
SYNOPSIS
Requires DOT to establish paratransit brokerage program to consolidate provision of paratransit services under State Medicaid program and NJT Access Link.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning the provision of paratransit services, supplementing Title 27 of the Revised Statutes, and revising various parts of the statutory law.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. (New section) As used in sections 1 through 7 of P.L. , c. (C. ) (pending before the Legislature as this bill):
"ADA paratransit service" means the paratransit service that the corporation is required to provide, whether directly or indirectly through contract, to comply with the requirements of the federal "Americans with Disabilities Act of 1990" (42 U.S.C. s.12101 et seq.).
"Community organization" means an organization that provides programs and services to persons with disabilities.
"Corporation" means the New Jersey Transit Corporation.
"County transit agency" means a transportation service organized under or in conjunction with a county government to provide trips to senior citizens and residents with disabilities under the "Senior Citizen and Disabled Resident Transportation Assistance Act," P.L.1983, c.578 (C.27:25-25 et seq.).
"Covered medical service" means a physical or behavioral health care service that is provided to a Medicaid beneficiary and is eligible for reimbursement under the Medicaid program.
"Livery vehicle" means a chauffeured vehicle, other than a mobility assistance vehicle, which is used to transport ambulatory Medicaid beneficiaries to and from health care providers to receive covered medical services. The term includes, but is not limited to, a clinic van, a paratransit van, or a wheelchair van.
"Medicaid program" or "Medicaid" means the State Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Medicaid transportation service" means the non-emergency medical transport of a beneficiary of the Medicaid program, which service is provided through the use of a mobility assistance vehicle or livery vehicle, is necessary for the beneficiary to receive covered medical services, and is provided in compliance with Title XIX of the federal Social Security Act (42 U.S.C. s.1396 et seq.), P.L.1968, c.413 (C.30:4D-1 et seq.), P.L.1981, c.134 (C.30:4D-6.2 et seq.), and any rules or regulations adopted thereunder.
"Mobility assistance vehicle" means a chauffeured vehicle that is staffed by certified trained personnel, and which is used to transport a non-ambulatory Medicaid beneficiary who is sick, has an infirmity, or has a disability, and is under the care and supervision of a physician, and whose medical condition is not of sufficient magnitude or gravity to require transportation by ambulance, but is of sufficient magnitude or gravity to require transportation from place to place for medical care, and whose use of an alternate form of transportation, such as a taxicab, bus, livery vehicle, private vehicle, or public conveyance might create a serious risk to the beneficiary's life or health.
"Paratransit brokerage program" or "program" means the program, established pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill), which is managed by a transportation broker that administers the provision of paratransit services, including Medicaid transportation services and ADA paratransit services, by paratransit providers in the State.
"Paratransit provider" or "provider" means any organization or entity that provides paratransit service, including, but not limited to, Medicaid transportation service and ADA paratransit service, subject to any applicable provisions of State or federal law or regulation.
"Paratransit service" means any transportation service other than fixed route transportation service, including, but not limited to, Medicaid transportation service and ADA paratransit service, except not including private or charter services provided by taxicabs, limousines, or transportation network companies.
"Transportation broker" or "broker" means the organization or entity that is contracted by the Department of Transportation pursuant to section 5 of P.L. , c. (C. ) (pending before the Legislature as this bill) to manage the paratransit brokerage program.
"Transportation brokerage contract" means the contract that is executed between the Department of Transportation and the transportation broker for the management of the paratransit brokerage program.
2. (New section) a. After the execution of the first transportation brokerage contract following the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), the Department of Transportation shall oversee the implementation of a paratransit brokerage program, through which a transportation broker shall manage the provision of paratransit service, including Medicaid transportation service and ADA paratransit service, by participating paratransit providers to eligible passengers, which services shall be requested and fulfilled through an interactive brokerage software.
b. The purpose of the paratransit brokerage program shall be to realize cost savings and operational efficiencies in the provision of paratransit services by enabling participating paratransit providers to voluntarily compete to fulfill each request for Medicaid transportation service and ADA paratransit service, respectively, scheduled by an eligible passenger of such service. To accomplish this purpose, the paratransit services provided under the program shall be facilitated through the use of an interactive brokerage software, as initially developed pursuant to section 4 of P.L. , c. (C. ) (pending before the Legislature as this bill), through which software:
(1) the recipients of ADA paratransit service and Medicaid transportation service may schedule regular or recurring requests for paratransit service, subject to any applicable restrictions of State or federal law or regulation;
(2) the participating providers of ADA paratransit service and Medicaid transportation service may compete, on a cost-efficient basis, to fulfill any scheduled requests for paratransit service, subject to any applicable restrictions of State or federal law or regulation;
(3) the recipients of ADA paratransit service and Medicaid transportation service may review and submit complaints concerning the quality of service received from any paratransit provider; and
(4) the transportation broker shall monitor, assess, and document the performance, reliability, responsiveness of each paratransit provider operating in the program and respond to passenger complaints.
c. In addition to any other terms and conditions that may be imposed by the Department of Transportation under the transportation brokerage contract, the responsibilities of the transportation broker in managing the paratransit brokerage program shall include:
(1) maintaining a paratransit provider network for ADA paratransit service and Medicaid transportation service, respectively, which networks shall have sufficient capacity to provide all required forms of paratransit service within all applicable service areas in the State;
(2) ensuring that each provider of ADA paratransit service is qualified to provide such service and complies with all applicable requirements of the federal "Americans with Disabilities Act of 1990" (42 U.S.C. s.12101 et seq.) and any other applicable provisions of State or federal law or regulation, including, but not limited to, any requirements concerning the type of vehicles used to provide such service;
(3) ensuring that each provider of Medicaid paratransit service is qualified to provide such service and complies with all applicable requirements of Title XIX of the federal Social Security Act (42 U.S.C. s.1396 et seq.), P.L.1968, c.413 (C.30:4D-1 et seq.), P.L.1981, c.134 (C.30:4D-6.2 et seq.), and any other applicable provisions of State or federal law or regulation, including, but not limited to, any requirements concerning the type of vehicles used to provide such service;
(4) ensuring that each recipient of ADA paratransit service or Medicaid paratransit service is eligible to receive the service;
(5) compensating each paratransit provider that operates in the program, which compensation shall be based exclusively on the requests for paratransit service that have been fulfilled by the provider, and which compensation shall be paid from the monies received by the transportation broker pursuant to subsection e. of this section;
(6) receiving and acting upon passenger complaints in accordance with the provisions of subsection f. of this section; and
(7) divesting from any ownership stake or equity interest in any entity or organization that operates as a paratransit provider under the program.
d. Except as otherwise provided in this subsection, beginning immediately after the implementation of the paratransit brokerage program, the program shall be limited to the provision of ADA paratransit service and Medicaid transportation service by paratransit providers other than county transit agencies and community organizations. Subject to the determination of the Department of Transportation pursuant to the study completed pursuant to section 6 of P.L. , c. (C. ) (pending before the Legislature as this bill) and the regulations adopted pursuant to subsection b. of section 7 of P.L. , c. (C. ) (pending before the Legislature as this bill), the program may be expanded to:
(1) incorporate the provision of other forms of paratransit service, including those services provided by the Department of Labor and Workforce Development pursuant to P.L.1987, c.455 (C.34:16-51 et seq.) and those services provided by counties under the "Senior Citizen and Disabled Resident Transportation Assistance Act," P.L.1983, c.578 (C.27:25-25 et seq.); and
(2) allow county transit agencies and community organizations to operate as paratransit providers under the program.
e. (1) Except as otherwise provided in paragraph (3) of this subsection, the operational and administrative costs of the paratransit brokerage program shall be defrayed by proportionate funding from the Department of Human Service and the corporation, which monies shall be transferred to the Department of Transportation and paid to the transportation broker in such intervals and amounts as may be prescribed in the transportation brokerage contract. The Department of Human Services shall be responsible for defraying all costs associated with the provision of Medicaid paratransit service under the program. The corporation shall be responsible for defraying all costs associated with the provision of ADA paratransit service under the program.
(2) From the monies paid to the transportation broker by the Department of Transportation, the broker shall compensate the paratransit providers operating in the program, which compensation shall be based exclusively on the requests for paratransit service that have been fulfilled by the provider. Of the remaining funds, the transportation broker shall retain such amounts as may be prescribed in the transportation brokerage contract to support the costs of managing the program.
(3) If the paratransit brokerage program is expanded to include other forms of paratransit service, as permitted under subsection d. of this section, the costs of providing such services shall be defrayed as follows, which monies shall be transferred to the Department of Transportation in accordance with the provisions of paragraph (1) of this subsection:
(a) the Department of Labor and Workforce Development shall be responsible for defraying all costs associated with the provision of any paratransit services otherwise provided under P.L.1987, c.455 (C.34:16-51);
(b) the corporation shall be responsible for defraying all costs associated with the provision of any paratransit services otherwise provided by counties under the "Senior Citizen and Disabled Resident Transportation Assistance Act," P.L.1983, c.578 (C.27:25-25 et seq.), which costs shall be paid from the monies deposited into the Casino Revenue Fund pursuant to subsection b. of section 4 of P.L.1983, c.578 (C.27:25-28); and
(c) in the case of any other form of paratransit service, the administrative entity otherwise responsible for administering the service shall be responsible for defraying all costs associated with the provision of such service under the program.
f. The Department of Transportation, in consultation with the Department of Human Services and the corporation, shall prescribe procedures and methods by which the recipients of paratransit service may submit complaints through the interactive brokerage software. The transportation broker shall receive, process, and act upon each complaint in accordance with the procedures prescribed by the department, except that the broker shall respond to each complaint, in writing, within 21 days of the receipt of a complaint.
g. (1) After the implementation of the paratransit brokerage program, all Medicaid transportation services and ADA paratransit services shall be provided under the paratransit brokerage program, and the Department of Human Services and the corporation shall cease to provide, whether directly or indirectly through contract, such services. Before the implementation of the program, the Department of Human Services and the corporation, as applicable, shall submit such documentation as is necessary to the federal government to effectuate the implementation of the program, including, but not limited to, the application by the Department of Human Services for such State plan amendments or waivers as may be necessary to implement the provisions of P.L. , c. (C. ) (pending before the Legislature as this bill) and to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program. The Department of Human Services shall receive federal approval for such State plan amendments or waivers before the paratransit brokerage program may be fully implemented.
(2) After the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), but before the implementation of the paratransit brokerage program, the corporation shall not enter into any contract, or exercise any option to extend an existing contract, concerning the provision of ADA paratransit service under the Access Link service model unless the contract or option:
(a) is valid for not longer than one year; and
(b) permits the corporation to terminate the contract immediately upon the implementation of the paratransit brokerage program.
(3) After the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), but before the implementation of the paratransit brokerage program, the Department of Human Services shall not enter into any contract, or exercise any option to extend an existing contract, concerning the provision of Medicaid paratransit service under the State Medicaid program unless the contract or option:
(a) is valid for not longer than one year; and
(b) permits the department to terminate the contract immediately upon the implementation of the paratransit brokerage program.
3. (New section) a. Within six months following the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), the Department of Transportation, in consultation with the corporation and the Department of Human Services, shall develop standards for the provision of ADA paratransit service under the program. At a minimum, the standards shall prescribe minimum functionality requirements for the interactive brokerage software to ensure that the provision of ADA paratransit service complies with the purposes and responsibilities set forth in section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill), as well as any other applicable requirements of State or federal law or regulation. To the extent practicable, these standards shall be consistent with the standards developed by the Department of Human Services pursuant to subsection b. of this section.
b. Within six months following the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), the Department of Human Service, in consultation with the Department of Transportation, shall develop standards for the provision of Medicaid paratransit services under the program. At a minimum, the standards shall prescribe minimum functionality requirements for the interactive brokerage software to ensure that that the provision of Medicaid paratransit service complies with the purposes and responsibilities set forth in section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill), as well as any other applicable requirements of State or federal law or regulation. To the extent practicable, these standards shall be consistent with the standards developed by the Department of Transportation pursuant to subsection a. of this section.
4. (New section) a. Within nine months after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), the Department of Transportation, in consultation with the Department of Human Services and the corporation, shall issue a request for proposal for the development of an interactive brokerage software, which software shall facilitate the provision of paratransit services under the paratransit brokerage program. In addition to any other requirements that the Department of Transportation may deem appropriate, the request for proposal shall:
(1) incorporate the standards developed pursuant to section 3 of P.L. , c. (C. ) (pending before the Legislature as this bill); and
(2) require all bidders to demonstrate experience in the development of one or more software platforms that have facilitated the provision of any transportation service.
b. The Department of Transportation, in consultation with the Department of Human Services and the corporation, shall enter into a contract with the most qualified bidder for the development of the interactive brokerage software, except that the selected contractor shall have demonstrated experience in developing one or more software platforms that have facilitated the provision of any transportation service. In addition to any other terms and conditions that the Department of Transportation may deem appropriate, the contractor shall provide monthly updates, in writing, to the Department of Transportation documenting its progress in developing the interactive brokerage software.
c. Following the implementation of the paratransit brokerage program, if the Department of Transportation, in consultation with the transportation broker, determines that it is necessary to develop a new interactive brokerage software or update all or part of the existing software, the Department of Transportation may issue a request for proposal and enter into a contract to perform such work.
5. (New section) a. After the interactive brokerage software has been developed pursuant to subsection b. of section 4 of P.L. , c. (C. ) (pending before the Legislature as this bill), and upon the expiration of each transportation brokerage contract, the Department of Transportation, in consultation with the Department of Human Services and the corporation, shall issue a request for proposal for the procurement of a transportation broker to manage the paratransit brokerage program. In addition to any other requirements that the Department of Transportation may deem appropriate, the request for proposal shall:
(1) incorporate all responsibilities of the broker under section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill) and the standards developed pursuant to section 3 of P.L. , c. (C. ) (pending before the Legislature as this bill); and
(2) require the bidder to demonstrate experience in the operation or management of one or more brokerage programs that have facilitated the provision of any transportation service.
b. The Department of Transportation, in consultation with the Department of Human Services and the corporation, shall enter into a transportation brokerage contract with the most qualified bidder for the procurement of the transportation broker, except that the broker shall have demonstrated experience in managing a similar brokerage program. Notwithstanding any provision of this section to the contrary, before the expiration of the transportation brokerage contract, the Department of Transportation may exercise an option to extend the existing contract without issuing the request for proposal otherwise required under subsection a. of this section.
6. (New section) a. Within no more than two years following the implementation of the paratransit brokerage program, and every five years thereafter, the Department of Transportation, in consultation with the Department of Human Services, the corporation, and the Department of Labor and Workforce Development, shall conduct a study to assess whether the program shall be expanded, which determination shall consider the cost savings realized and operational efficiencies realized from the operations of the program, and the capacity of the paratransit provider networks maintained by the transportation broker to fulfill the existing demand for paratransit services. In addition to any other considerations that may be deemed appropriate, the study shall:
(1) examine the performance of the existing paratransit provider networks for ADA paratransit service and Medicaid paratransit service, respectively, within each county in the State;
(2) examine the capacity of county transit agencies and community organizations to operate as providers of ADA paratransit service, Medicaid paratransit service, or both, under the program;
(3) determine whether the existing paratransit provider networks should be expanded to allow county transit agencies and community organizations to operate as providers of ADA paratransit service, Medicaid paratransit service, or both, under the program; and
(4) determine whether the program shall be expanded to include the provision of other forms of paratransit service, including those services provided by the Department of Labor and Workforce Development pursuant to P.L.1987, c.455 (C.34:16-51) and those services provided by counties under the "Senior Citizen and Disabled Resident Transportation Assistance Act," P.L.1983, c.578 (C.27:25-25 et seq.).
b. The transportation broker shall provide the Department of Transportation with such assistance as the department deems necessary to conduct the study, which assistance shall include, but shall not be limited to, the submission of all data retained by the broker concerning the performance, reliability, and responsiveness of all paratransit providers operating in the program.
7. (New section) a. The Department of Transportation, in consultation with the Department of Human Services and the New Jersey Transit Corporation, shall adopt, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), such rules and regulations as may be necessary to effectuate the purposes of P.L. , c. (C. ) (pending before the Legislature as this bill).
b. If the Department of Transportation determines to expand the paratransit brokerage program, as permitted under subsection d. of section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill), the Department of Transportation, in consultation with the Department of Human Services, the New Jersey Transit Corporation, and the Department of Labor and Workforce Development, as applicable, shall adopt, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), such rules and regulations as may be necessary to effectuate the expansion of the program, which expansion shall not take effect until the rules and regulations have been adopted.
8. Section 6 of P.L.1968, c.413 (C.30:4D-6) is amended to read as follows:
6. a. Subject to the requirements of Title XIX of the federal Social Security Act, the limitations imposed by this act and by the rules and regulations promulgated pursuant thereto, the department shall provide medical assistance to qualified applicants, including authorized services within each of the following classifications:
(1) Inpatient hospital services;
(2) Outpatient hospital services;
(3) Other laboratory and X-ray services;
(4) (a) Skilled nursing or intermediate care facility services;
(b) Early and periodic screening and diagnosis of individuals who are eligible under the program and are under age 21, to ascertain their physical or mental health status and the health care, treatment, and other measures to correct or ameliorate defects and chronic conditions discovered thereby, as may be provided in regulations of the Secretary of the federal Department of Health and Human Services and approved by the commissioner;
(5) Physician's services furnished in the office, the patient's home, a hospital, a skilled nursing, or intermediate care facility or elsewhere.
As used in this subsection, "laboratory and X-ray services" includes HIV drug resistance testing, including, but not limited to, genotype assays that have been cleared or approved by the federal Food and Drug Administration, laboratory developed genotype assays, phenotype assays, and other assays using phenotype prediction with genotype comparison, for persons diagnosed with HIV infection or AIDS.
b. Subject to the limitations imposed by federal law, by this act, and by the rules and regulations promulgated pursuant thereto, the medical assistance program may be expanded to include authorized services within each of the following classifications:
(1) Medical care not included in subsection a.(5) above, or any other type of remedial care recognized under State law, furnished by licensed practitioners within the scope of their practice, as defined by State law;
(2) Home health care services;
(3) Clinic services;
(4) Dental services;
(5) Physical therapy and related services;
(6) Prescribed drugs, dentures, and prosthetic devices; and eyeglasses prescribed by a physician skilled in diseases of the eye or by an optometrist, whichever the individual may select;
(7) Optometric services;
(8) Podiatric services;
(9) Chiropractic services;
(10) Psychological services;
(11) Inpatient psychiatric hospital services for individuals under 21 years of age, or under age 22 if they are receiving such services immediately before attaining age 21;
(12) Other diagnostic, screening, preventive, and rehabilitative services, and other remedial care;
(13) Inpatient hospital services, nursing facility services, and intermediate care facility services for individuals 65 years of age or over in an institution for mental diseases;
(14) Intermediate care facility services;
(15) Transportation services, including those services provided through the paratransit brokerage program established pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill);
(16) Services in connection with the inpatient or outpatient treatment or care of substance use disorder, when the treatment is prescribed by a physician and provided in a licensed hospital or in a narcotic and substance use disorder treatment center approved by the Department of Health pursuant to P.L.1970, c.334 (C.26:2G-21 et seq.) and whose staff includes a medical director, and limited to those services eligible for federal financial participation under Title XIX of the federal Social Security Act;
(17) Any other medical care and any other type of remedial care recognized under State law, specified by the Secretary of the federal Department of Health and Human Services, and approved by the commissioner;
(18) Comprehensive maternity care, which may include: the basic number of prenatal and postpartum visits recommended by the American College of Obstetricians and Gynecologists; additional prenatal and postpartum visits that are medically necessary; necessary laboratory, nutritional assessment and counseling, health education, personal counseling, managed care, outreach, and follow-up services; treatment of conditions which may complicate pregnancy; doula care and physician or certified nurse-midwife delivery services. For the purposes of this paragraph, "doula" means a trained professional who provides continuous physical, emotional, and informational support to a mother before, during, and shortly after childbirth, to help her to achieve the healthiest, most satisfying experience possible;
(19) Comprehensive pediatric care, which may include: ambulatory, preventive, and primary care health services. The preventive services shall include, at a minimum, the basic number of preventive visits recommended by the American Academy of Pediatrics;
(20) Services provided by a hospice which is participating in the Medicare program established pursuant to Title XVIII of the Social Security Act, Pub.L.89-97 (42 U.S.C. s.1395 et seq.). Hospice services shall be provided subject to approval of the Secretary of the federal Department of Health and Human Services for federal reimbursement;
(21) Mammograms, subject to approval of the Secretary of the federal Department of Health and Human Services for federal reimbursement, including one baseline mammogram for women who are at least 35 but less than 40 years of age; one mammogram examination every two years or more frequently, if recommended by a physician, for women who are at least 40 but less than 50 years of age; and one mammogram examination every year for women age 50 and over;
(22) Upon referral by a physician, advanced practice nurse, or physician assistant of a person who has been diagnosed with diabetes, gestational diabetes, or pre-diabetes, in accordance with standards adopted by the American Diabetes Association:
(a) Expenses for diabetes self-management education or training to ensure that a person with diabetes, gestational diabetes, or pre-diabetes can optimize metabolic control, prevent and manage complications, and maximize quality of life. Diabetes self-management education shall be provided by an in-State provider who is:
(i) a licensed, registered, or certified health care professional who is certified by the National Certification Board of Diabetes Educators as a Certified Diabetes Educator, or certified by the American Association of Diabetes Educators with a Board Certified-Advanced Diabetes Management credential, including, but not limited to: a physician, an advanced practice or registered nurse, a physician assistant, a pharmacist, a chiropractor, a dietitian registered by a nationally recognized professional association of dietitians, or a nutritionist holding a certified nutritionist specialist (CNS) credential from the Board for Certification of Nutrition Specialists; or
(ii) an entity meeting the National Standards for Diabetes Self-Management Education and Support, as evidenced by a recognition by the American Diabetes Association or accreditation by the American Association of Diabetes Educators;
(b) Expenses for medical nutrition therapy as an effective component of the person's overall treatment plan upon a: diagnosis of diabetes, gestational diabetes, or pre-diabetes; change in the beneficiary's medical condition, treatment, or diagnosis; or determination of a physician, advanced practice nurse, or physician assistant that reeducation or refresher education is necessary. Medical nutrition therapy shall be provided by an in-State provider who is a dietitian registered by a nationally-recognized professional association of dietitians, or a nutritionist holding a certified nutritionist specialist (CNS) credential from the Board for Certification of Nutrition Specialists, who is familiar with the components of diabetes medical nutrition therapy;
(c) For a person diagnosed with pre-diabetes, items and services furnished under an in-State diabetes prevention program that meets the standards of the National Diabetes Prevention Program, as established by the federal Centers for Disease Control and Prevention; and
(d) Expenses for any medically appropriate and necessary supplies and equipment recommended or prescribed by a physician, advanced practice nurse, or physician assistant for the management and treatment of diabetes, gestational diabetes, or pre-diabetes, including, but not limited to: equipment and supplies for self-management of blood glucose; insulin pens; insulin pumps and related supplies; and other insulin delivery devices;
(23) Expenses incurred for the provision of group prenatal care services to a pregnant woman, provided that:
(a) the provider of such services, which shall include, but not be limited to, a federally qualified health center or a community health center operating in the State :
(i) is a site accredited by the Centering Healthcare Institute, or is a site engaged in an active implementation contract with the Centering Healthcare Institute, that utilizes the Centering Pregnancy model; and
(ii) incorporates the applicable information outlined in any best practices manual for prenatal and postpartum maternal care developed by the Department of Health into the curriculum for each group prenatal visit;
(b) each group prenatal care visit is at least 1.5 hours in duration, with a minimum of two women and a maximum of 20 women in participation; and
(c) no more than 10 group prenatal care visits occur per pregnancy.
As used in this paragraph, "group prenatal care services" means a series of prenatal care visits provided in a group setting which are based upon the Centering Pregnancy model developed by the Centering Healthcare Institute and which include health assessments, social and clinical support, and educational activities;
(24) Expenses incurred for the provision of pasteurized donated human breast milk, which shall include human milk fortifiers if indicated in a medical order provided by a licensed medical practitioner, to an infant under the age of six months; provided that the milk is obtained from a human milk bank that meets quality guidelines established by the Department of Health and a licensed medical practitioner has issued a medical order for the infant under at least one of the following circumstances:
(a) the infant is medically or physically unable to receive maternal breast milk or participate in breast feeding, or the infant's mother is medically or physically unable to produce maternal breast milk in sufficient quantities or participate in breast feeding despite optimal lactation support; or
(b) the infant meets any of the following conditions:
(i) a body weight below healthy levels, as determined by the licensed medical practitioner issuing the medical order for the infant;
(ii) the infant has a congenital or acquired condition that places the infant at a high risk for development of necrotizing enterocolitis; or
(iii) the infant has a congenital or acquired condition that may benefit from the use of donor breast milk and human milk fortifiers, as determined by the Department of Health; and
(25) Comprehensive tobacco cessation benefits to an individual who is 18 years of age or older, or who is pregnant. Coverage shall include: brief and high intensity individual counseling, brief and high intensity group counseling, and telemedicine as defined by section 1 of P.L.2017, c.117 (C.45:1-61); all medications approved for tobacco cessation by the U.S. Food and Drug Administration; and other tobacco cessation counseling recommended by the Treating Tobacco Use and Dependence Clinical Practice Guideline issued by the U.S. Public Health Service. Notwithstanding the provisions of any other law, rule, or regulation to the contrary, and except as otherwise provided in this section:
(a) Information regarding the availability of the tobacco cessation services described in this paragraph shall be provided to all individuals authorized to receive the tobacco cessation services pursuant to this paragraph at the following times: no later than 90 days after the effective date of P.L.2019, c.473; upon the establishment of an individual's eligibility for medical assistance; and upon the redetermination of an individual's eligibility for medical assistance;
(b) The following conditions shall not be imposed on any tobacco cessation services provided pursuant to this paragraph: copayments or any other forms of cost-sharing, including deductibles; counseling requirements for medication; stepped care therapy or similar restrictions requiring the use of one service prior to another; limits on the duration of services; or annual or lifetime limits on the amount, frequency, or cost of services, including, but not limited to, annual or lifetime limits on the number of covered attempts to quit; and
(c) Prior authorization requirements shall not be imposed on any tobacco cessation services provided pursuant to this paragraph except in the following circumstances where prior authorization may be required: for a treatment that exceeds the duration recommended by the most recently published United States Public Health Service clinical practice guidelines on treating tobacco use and dependence; or for services associated with more than two attempts to quit within a 12-month period.
c. Payments for the foregoing services, goods, and supplies furnished pursuant to this act shall be made to the extent authorized by this act, the rules and regulations promulgated pursuant thereto and, where applicable, subject to the agreement of insurance provided for under this act. The payments shall constitute payment in full to the provider on behalf of the recipient. Every provider making a claim for payment pursuant to this act shall certify in writing on the claim submitted that no additional amount will be charged to the recipient, the recipient's family, the recipient's representative or others on the recipient's behalf for the services, goods, and supplies furnished pursuant to this act.
No provider whose claim for payment pursuant to this act has been denied because the services, goods, or supplies were determined to be medically unnecessary shall seek reimbursement from the recipient, his family, his representative or others on his behalf for such services, goods, and supplies provided pursuant to this act; provided, however, a provider may seek reimbursement from a recipient for services, goods, or supplies not authorized by this act, if the recipient elected to receive the services, goods or supplies with the knowledge that they were not authorized.
d. Any individual eligible for medical assistance (including drugs) may obtain such assistance from any person qualified to perform the service or services required (including an organization which provides such services, or arranges for their availability on a prepayment basis), who undertakes to provide the individual such services.
No copayment or other form of cost-sharing shall be imposed on any individual eligible for medical assistance, except as mandated by federal law as a condition of federal financial participation.
e. Anything in this act to the contrary notwithstanding, no payments for medical assistance shall be made under this act with respect to care or services for any individual who:
(1) Is an inmate of a public institution (except as a patient in a medical institution); provided, however, that an individual who is otherwise eligible may continue to receive services for the month in which he becomes an inmate, should the commissioner determine to expand the scope of Medicaid eligibility to include such an individual, subject to the limitations imposed by federal law and regulations, or
(2) Has not attained 65 years of age and who is a patient in an institution for mental diseases, or
(3) Is over 21 years of age and who is receiving inpatient psychiatric hospital services in a psychiatric facility; provided, however, that an individual who was receiving such services immediately prior to attaining age 21 may continue to receive such services until the individual reaches age 22. Nothing in this subsection shall prohibit the commissioner from extending medical assistance to all eligible persons receiving inpatient psychiatric services; provided that there is federal financial participation available.
f. (1) A third party as defined in section 3 of P.L.1968, c.413 (C.30:4D-3) shall not consider a person's eligibility for Medicaid in this or another state when determining the person's eligibility for enrollment or the provision of benefits by that third party.
(2) In addition, any provision in a contract of insurance, health benefits plan, or other health care coverage document, will, trust, agreement, court order, or other instrument which reduces or excludes coverage or payment for health care-related goods and services to or for an individual because of that individual's actual or potential eligibility for or receipt of Medicaid benefits shall be null and void, and no payments shall be made under this act as a result of any such provision.
(3) Notwithstanding any provision of law to the contrary, the provisions of paragraph (2) of this subsection shall not apply to a trust agreement that is established pursuant to 42 U.S.C. s.1396p(d)(4)(A) or (C) to supplement and augment assistance provided by government entities to a person who is disabled as defined in section 1614(a)(3) of the federal Social Security Act (42 U.S.C. s.1382c (a)(3)).
g. The following services shall be provided to eligible medically needy individuals as follows:
(1) Pregnant women shall be provided prenatal care and delivery services and postpartum care, including the services cited in subsection a.(1), (3), and (5) of this section and subsection b.(1)-(10), (12), (15), and (17) of this section, and nursing facility services cited in subsection b.(13) of this section.
(2) Dependent children shall be provided with services cited in subsections a.(3) and (5) of this section and subsections b.(1), (2), (3), (4), (5), (6), (7), (10), (12), (15), and (17) of this section, and nursing facility services cited in subsection b.(13) of this section.
(3) Individuals who are 65 years of age or older shall be provided with services cited in subsections a.(3) and (5) of this section and subsections b.(1)-(5), (6) excluding prescribed drugs, (7), (8), (10), (12), (15), and (17) of this section, and nursing facility services cited in subsection b.(13) of this section.
(4) Individuals who are blind or disabled shall be provided with services cited in subsections a.(3) and (5) of this section and subsections b.(1)-(5), (6) excluding prescribed drugs, (7), (8), (10), (12), (15), and (17) of this section, and nursing facility services cited in subsection b.(13) of this section.
(5) (a) Inpatient hospital services, subsection a.(1) of this section, shall only be provided to eligible medically needy individuals, other than pregnant women, if the federal Department of Health and Human Services discontinues the State's waiver to establish inpatient hospital reimbursement rates for the Medicare and Medicaid programs under the authority of section 601(c)(3) of the Social Security Act Amendments of 1983, Pub.L.98-21 (42 U.S.C. s.1395ww(c)(5)). Inpatient hospital services may be extended to other eligible medically needy individuals if the federal Department of Health and Human Services directs that these services be included.
(b) Outpatient hospital services, subsection a.(2) of this section, shall only be provided to eligible medically needy individuals if the federal Department of Health and Human Services discontinues the State's waiver to establish outpatient hospital reimbursement rates for the Medicare and Medicaid programs under the authority of section 601(c)(3) of the Social Security Amendments of 1983, Pub.L.98-21 (42 U.S.C. s.1395ww(c)(5)). Outpatient hospital services may be extended to all or to certain medically needy individuals if the federal Department of Health and Human Services directs that these services be included. However, the use of outpatient hospital services shall be limited to clinic services and to emergency room services for injuries and significant acute medical conditions.
(c) The division shall monitor the use of inpatient and outpatient hospital services by medically needy persons.
h. In the case of a qualified disabled and working individual pursuant to section 6408 of Pub.L.101-239 (42 U.S.C. s.1396d), the only medical assistance provided under this act shall be the payment of premiums for Medicare part A under 42 U.S.C. ss.1395i-2 and 1395r.
i. In the case of a specified low-income Medicare beneficiary pursuant to 42 U.S.C. s.1396a(a)10(E)iii, the only medical assistance provided under this act shall be the payment of premiums for Medicare part B under 42 U.S.C. s.1395r as provided for in 42 U.S.C. s.1396d(p)(3)(A)(ii).
j. In the case of a qualified individual pursuant to 42 U.S.C. s.1396a(aa), the only medical assistance provided under this act shall be payment for authorized services provided during the period in which the individual requires treatment for breast or cervical cancer, in accordance with criteria established by the commissioner.
k. In the case of a qualified individual pursuant to 42 U.S.C. s.1396a(ii), the only medical assistance provided under this act shall be payment for family planning services and supplies as described at 42 U.S.C. s.1396d(a)(4)(C), including medical diagnosis and treatment services that are provided pursuant to a family planning service in a family planning setting.
(cf: P.L.2019, c.473, s.1).
9. Section 3 of P.L.2020, c.114 (C.27:25-37) is amended to read as follows:
3. For the purposes of P.L.2020, c.114 (C.27:25-35 et seq.):
["Community organization" means an organization that provides programs and services to persons with disabilities.]
"Corporation" means the New Jersey Transit Corporation.
["Corporation paratransit service" means the paratransit service that is managed, administered, or provided directly through the New Jersey Transit Corporation's operating budget, as a part of the Access Link program or any successor program to meet the requirements of the "Americans with Disabilities Act of 1990" (42 U.S.C. s.12101 et seq.), and does not include services directly provided by county transit agencies.
"County transit agency" means a transportation service organized under or in conjunction with a county government to provide trips to senior citizens and residents with disabilities under the "Senior Citizen and Disabled Resident Transportation Assistance Act," P.L.1983, c.578 (C.27:25-25 et seq.).]
"Department" means, unless another meaning clearly applies, the Department of Human Services.
"Paratransit brokerage program" means the program established pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
"Paratransit provider" means any organization or entity that provides paratransit services, including State and local transit agencies, directly or through contract service, and community organizations that provide transportation trips, either directly or through a third party, funded by the Department of Human Services or the Division of Vocational Rehabilitation Services within the Department of Labor and Workforce Development.
"Paratransit service" means and includes any transportation service other than fixed route transportation service, except that "paratransit service" does not include private or charter services provided by taxicabs, limousines, or transportation network companies.
"Transportation broker" means the same as the term is defined in section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
(cf: P.L.2020, c.114, s.3)
10. Section 6 of P.L.2020, c.114 (C.27:25-40) is amended to read as follows:
6. a. There are hereby established six separate regional paratransit coordinating councils in furtherance of the purposes of P.L.2020, c.114 (C.27:25-35 et seq.) and P.L. , c. (C. ) (pending before the Legislature as this bill). The regional paratransit coordinating councils shall be organized as follows:
(1) one council shall cover the counties of Atlantic, Cape May, Cumberland, Gloucester, and Salem;
(2) one council shall cover the counties of Burlington, Camden, and Ocean;
(3) one council shall cover the counties of Mercer, Middlesex, and Monmouth;
(4) one council shall cover the counties of Hunterdon, Sussex, and Warren;
(5) one council shall cover the counties of Essex, Morris, Somerset, and Union; and
(6) one council shall cover the counties of Bergen, Hudson, and Passaic.
b. Each regional paratransit coordinating council shall have the following members:
(1) one designee of the Director of the Division of Developmental Disabilities in the Department of Human Services;
(2) one designee of the New Jersey Transit Corporation who works on [the Access Link program or] the Senior Citizen and Disabled Resident Transportation Assistance Program;
(3) one representative of [any company or entity that has contracted with the New Jersey Transit Corporation to provide Access Link paratransit service within the region] the transportation broker that manages the paratransit brokerage program established pursuant to P.L. , c. (C. ) (pending before the Legislature as this bill);
(4) one representative of each county office of aging within the respective region to be chosen by the county executive director or by the board of freeholders, as applicable;
(5) one representative of each county transportation agency or other comparable entity within the respective region that provides paratransit service for a county under the Senior Citizen and Disabled Resident Transportation Assistance Program;
(6) one representative from each county chapter of the Arc of New Jersey, or a successor organization, within the respective region;
(7) one individual that represents one or more members of the Alliance for the Betterment of Citizens with Disabilities, or a successor organization, within the respective region;
(8) one representative of Community Access Unlimited, or a successor organization, within the respective region;
(9) one representative of the New Jersey Association of Community Providers, or a successor organization, within the respective region;
(10) one representative of the New Jersey Council on Special Transportation, or a successor organization, within the respective region;
(11) one representative of Easterseals New Jersey, or a successor organization, within the respective region; and
(12) one representative within the respective region, to be selected by the corporation in consultation with the department, of providers of transportation services to senior citizens or to individuals requiring transportation for health care services.
c. Each agency with an eligible representative of a regional paratransit coordinating council provided in subsection b. of this section shall submit information, in a form and manner determined by the Executive Director of the New Jersey Transit Corporation, to the executive director not later than 30 days following the enactment of P.L.2020, c.114 (C.27:25-35 et seq.) and on or before January 1 of each year thereafter identifying the name and contact information for the person to represent each respective agency. The term for each member on the regional paratransit coordinating council shall be one year provided, however, that any member may be selected to serve on the council for subsequent terms at the discretion of the respective agency. The executive director may appoint one member of each regional paratransit coordinating council to serve as the chair of that council.
d. Each regional paratransit coordinating council shall meet not less than quarterly, with the first meeting happening not less than 60 days following the enactment of P.L.2020, c.114 (C.27:25-35 et seq.). The chair, in consultation with the other members of the council, shall set meeting dates and shall lead the coordination effort. The members shall serve without compensation but may be reimbursed by the corporation, for reasonable expenses incurred in the execution of their duties.
e. The purpose of the regional paratransit coordinating councils is to exchange best practices among paratransit providers within the State. Those best practices shall include but are not limited to scheduling and routing, fleet maintenance, driver training, customer communications, safety practices, and improving the customer usability experience. The councils are also to establish a system to exchange information among and between paratransit providers so that: (1) each paratransit provider may provide basic information to its customers about other paratransit service options within each respective region; (2) paratransit providers may [eventually] share customer trip requests amongst each other; and (3) [a single platform may eventually be developed that enables a paratransit user to visit a single platform or place to request a trip, and that trip may be distributed amongst the paratransit providers in a manner that optimizes State cost and customer experience] paratransit providers may receive training and support to encourage participation in the paratransit brokerage program. The councils shall also exchange budget information and investigate more efficient means of organizing the [New Jersey Transit Corporation's expenditures for] provision of paratransit services [, use of State casino revenue funds, and appropriations for the division and department related to paratransit services, for the purpose of coordinating these three respective funding pools] to eliminate any duplicative funding [,] and to direct trips and funding to service providers that offer the highest quality service and overall best value.
f. The county plans required under section 6 of P.L.1983, c.578 (C.27:25-30) and any committees or groups organized to effectuate the purposes of the "Senior Citizen and Disabled Resident Transportation Assistance Act," P.L.1983, c.578 (C.27:25-25 et seq.) shall be consolidated into the regional paratransit coordinating councils. If necessary, county level subcommittees of the regional paratransit coordinating councils may be established to more effectively develop county plans; however, following the effective date of P.L.2020, c.114 (C.27:25-35 et seq.) county plans shall also take into account the larger regional and Statewide goals of integrating paratransit service and creating a more cohesive user experience under the [pilot program] paratransit brokerage program established [in P.L.2020, c.114 (C.27:25-35 et seq.)] under P.L. , c. (C. ) (pending before the Legislature as this bill).
g. The New Jersey Transit Corporation shall utilize each regional paratransit coordinating council to disseminate information about the [new Access Link program structure] paratransit brokerage program developed pursuant to [section 4 of P.L.2020, c.114 (C.27:25-38)] P.L. , c. (C. ) (pending before the Legislature as this bill) and coordinate with the council in [determining the operating standards required for] helping paratransit providers to compete to [provide Access Link trips and when developing the system for paying paratransit providers to provide regular and routine trips requested through the Access Link program] fulfill requests for paratransit service under the paratransit brokerage program.
h. [The regional paratransit coordinating councils shall also advise other paratransit providers in each region and develop support materials to assist other paratransit providers in adopting and implementing the best practices training package developed under phase three of the pilot program established pursuant to paragraph (1) of subsection d. of section 5 of P.L.2020, c.114 (C.27:25-39).] (Deleted by amendment, P.L. , c. ) (pending before the Legislature as this bill)
(cf: P.L.2020, c.114, s.6)
11. Section 2 of P.L.2016, c.25 (C.27:25-5c) is amended to read as follows:
2. a. [The] Before the implementation of the paratransit brokerage program established pursuant to P.L. , c. (C. ) (pending before the Legislature as this bill), the corporation shall designate an Access Link Customer Service Group to receive and act upon complaints from passengers with disabilities regarding Access Link service. The corporation shall provide for the establishment of procedures and methods by which such complaints shall be received, processed, and acted upon and for their resolution and settlement. The Access Link Customer Service Group shall, within 21 business days of the receipt of a complaint, respond in writing as to the disposition or status of the complaint. Any person who has not received a written response to a complaint within 21 business days may petition the New Jersey Transit General Manager of ADA Services for a hearing upon that complaint, under rules promulgated by the general manager for the hearing and disposition of such matters. [As used in this section, "Access Link" means the paratransit service implemented by the corporation for purposes of complying with the "Americans with Disabilities Act of 1990," Pub.L.101-336 (42 U.S.C.s.12101 et seq.).]
b. The corporation shall provide to each person using Access Link, at the time the person is determined to be qualified for Access Link service and at least once in each calendar year thereafter in which the person remains a user, information as to the procedure to be followed in making and pursuing complaints to the Access Link Customer Service Group or the New Jersey Transit General Manager of ADA Services pursuant to this section. The direct telephone number for the Access Link Customer Service Group shall be prominently displayed in all Access Link vehicles.
c. The New Jersey Transit General Manager of ADA Services shall report annually to the board, summarizing the Access Link Customer Service Group's activities for the preceding year, including the number of complaints received, the nature of the complaints, and the resolution of the complaints and setting forth any recommendations for changes which would improve transportation services for passengers with disabilities. The New Jersey Transit General Manager of ADA Services shall make a copy of the report publicly available on the corporation's website.
d. Notwithstanding any provision of this section to the contrary, after the implementation of the paratransit brokerage program established pursuant to P.L. , c. (C. ) (pending before the Legislature as this bill), the transportation broker shall receive and act upon complaints from paratransit service passengers in accordance with the provisions of P.L. , c. (C. ) (pending before the Legislature as this bill), as well as any rules and regulations adopted thereunder.
e. As used in this section:
"Access Link" means the paratransit service implemented by the corporation, before the implementation of the paratransit brokerage program, for purposes of complying with the "Americans with Disabilities Act of 1990," Pub.L.101-336 (42 U.S.C.s.12101 et seq.).
"Transportation broker" means the same as the term is defined in section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
(cf: P.L.2016, c.25, s.2)
12. Section 1 of P.L.2020, c.62 (C.27:25-5d) is amended to read as follows:
1. a. [The] (1) Before the implementation of the paratransit brokerage program established pursuant to P.L. , c. (C. ) (pending before the Legislature as this bill), the New Jersey Transit Corporation shall operate, or cause to be operated, its Access Link service in an area of the State under a state of emergency if the New Jersey Transit General Manager of ADA Services determines, in consultation with the Director of the State Office of Emergency Management, that Access Link service in that area may be safely provided without undue risk of harm to drivers and persons using the service.
(2) After the implementation of the paratransit brokerage program established pursuant to P.L. , c. (C. ) (pending before the Legislature as this bill), the transportation broker shall cause to be operated ADA paratransit service in an area of the State under a state of emergency if the Commissioner of Transportation determines, in consultation with the Director of the State Office of Emergency Management, that such service may be safely provided in that area without undue risk of harm to drivers and persons using the service.
b. As used in this section:
"Access Link" shall have the same meaning as provided in section 2 of P.L.2016, c.25 (C.27:25-5c) [; and] .
"ADA paratransit service" means the same as the term is defined in section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
"State of emergency" means a natural or man-made disaster or emergency for which a state of emergency has been declared by the Governor.
"Transportation broker" means the same as the term is defined in section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
(cf: P.L.2020, c.62, s.1)
13. Section 3 of P.L.1983, c.578 (C.27:25-27) is amended to read as follows:
3. As used in [this act] P.L.1983, c.578 (C.27:25-25 et seq.):
a. "Corporation" means the New Jersey Transit Corporation.
b. "Board" means Board of Directors of the New Jersey Transit Corporation.
c. "Eligible counties" means counties submitting a proposal meeting the program guidelines.
d. "New Jersey Special Services Citizen Advisory Committee" means a committee representing advocacy groups from senior citizens and the disabled and other interested parties appointed by the Executive Director of the New Jersey Transit Corporation.
e. "Accessible" means a service that can be used by all individuals, including those who cannot negotiate steps or who can negotiate steps with great difficulty.
f. "Disabled" means any individual who, by reason of illness, injury, age, congenital malfunction, or other permanent or temporary incapacity or disability, is unable without special facilities or special planning on design to utilize mass transportation facilities and services as effectively as persons who are not so affected.
g. "Geographic region" means one of the following regions of the State: the southern region encompassing the counties of Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, and Salem; the central region encompassing the counties of Hunterdon, Mercer, Middlesex, Monmouth, Ocean and Somerset; and the northern region encompassing those counties remaining in the State.
h. "Paratransit brokerage program" means the program established pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
i. "Paratransit
service" means any transportation service other than fixed route
transportation service, except not including private
or charter services provided by taxicabs, limousines, or transportation network
companies.
(cf: P.L.1983, c.578, s.3)
14. Section 4 of P.L.1983, c.578 (C.27:25-28) is amended to read as follows:
4. a. The board shall establish and administer a program to be known as "The Senior Citizen and Disabled Resident Transportation Assistance Program" for the following purposes:
(1) To assist counties to develop and provide accessible feeder transportation service to accessible fixed-route transportation services where such services are available, and accessible local transit service to senior citizens and the disabled, which may include but not be limited to [door-to-door] paratransit service, fixed route service, local fare subsidy, and user-side subsidy, which may include but not be limited to private ride or taxi fare subsidy; and to coordinate the activities of the various participants in this program in providing the services to be rendered at the county level and between counties; and
(2) To enable the corporation to develop, provide and maintain capital improvements that afford accessibility to fixed route and other transit services in order to make rail cars, rail stations, bus shelters and other bus equipment accessible to senior citizens and the disabled; to render technical information and assistance to counties eligible for assistance under this act; and to coordinate the program within and among counties.
b. In the State fiscal year beginning July 1 following the effective date of P.L.2009, c.261 and in each fiscal year thereafter, there shall be appropriated to the corporation from the revenues deposited in the Casino Revenue Fund established pursuant to section 145 of P.L.1977, c.110 (C.5:12-145) a sum equal to 8.5 percent of the revenues deposited in the fund during the preceding fiscal year, as determined by the State Treasurer, to effectuate the purposes and provisions of P.L.1983, c.578 (C.27:25-25 et seq.). If the paratransit brokerage program is expanded, pursuant to subsection d. of section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill), to include the provision of any paratransit services otherwise provided by counties under P.L.1983, c.578 (C.27:25-25 et seq.), the corporation shall be responsible for defraying all costs associated with the provision of these services under the program, which costs shall be paid from the monies deposited into the Casino Revenue Fund pursuant to this subsection, and which monies shall be transferred to the Department of Transportation in accordance with the provisions of subsection e. of section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
Notwithstanding the provisions of any other law, rule, or regulation to the contrary, for the State Fiscal Years 2022, 2023, and 2024, appropriations to the corporation from the revenues deposited in the Casino Revenue Fund or the Property Tax Relief Fund, as appropriate, shall be given priority to ensure that the corporation receives an amount equal to 8.5 percent of the sum of the revenues deposited in the Casino Revenue Fund during the preceding fiscal year, adding back any reductions in revenues during the preceding fiscal year that directly resulted from the temporary credit allowable under section 1 of P.L.2021, c.314 or the temporary deduction allowable under section 3 of the P.L.2021, c.314, as determined by the State Treasurer, to effectuate the purposes and provisions of P.L.1983, c.578 (C.27:25-25 et seq.).
(cf: P.L.2021, c.314, s.6)
15. Section 7 of P.L.1983, c.578 (C.27:25-31) is amended to read as follows:
7. a. [Moneys] Except for any monies that may be transferred to the Department of Transportation pursuant to subsection e. of section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill), monies under this program shall be allocated by the corporation in the following manner:
(1) [85%] 85 percent shall be available to be allocated to eligible counties for the purposes specified under paragraph (1) of subsection a. of section 4 of [this act.] P.L.1983, c.578 (C.27:25-28); and
(2) [15%] 15 percent shall be available for use by the corporation for the purposes specified under paragraph (2) of subsection a. of section 4 of [this act] P.L.1983, c.578 (C.27:25-28) and for the general administration of the program, but no more than [10%] 10 percent of the total moneys allocated under this program shall be used for the general administration of the program.
b. The amount of money which each eligible county may receive shall be based upon the number of persons resident in that county of 60 years of age or older expressed as a percentage of the whole number of persons resident in this State of 60 years or older, as provided by the U.S. Bureau of the Census. As similar data become available for the disabled population, such data shall be used in conjunction with the senior citizen data to determine the county allocation formula. No eligible county shall receive less than [$150,000.00] $150,000 during a fiscal year under this program, except that during the first fiscal year no county shall receive less than [$50,000.00] $50,000 nor more than [$150,000.00] $150,000.
c. The governing body of an eligible county, or a group or groups designated as an applicant or as applicants by the county after a public hearing in which senior citizens and the disabled shall have the opportunity to comment on the appropriateness of such designation, may make application to the board for moneys available under subsection b. of this section. The application shall be in the form of a proposal to the board for transportation assistance and shall specify the degree to which the proposal meets the purposes of the program under paragraph (1) of subsection a. of section 4 of [this act] P.L.1983, c.578 (C.27:25-28) and the implementation criteria under the program guidelines and the proposal shall have been considered at a public hearing. The board shall allocate moneys based upon a review of the merits of the proposals in meeting the purposes of the program, and the implementation criteria, under the program guidelines. The governing body of an eligible county shall schedule a public hearing annually for interested parties to provide the governing body with any facts, materials, or recommendations that would be of assistance regarding the efficacy of the program established under paragraph (1) of subsection a. of section 4 [this act] P.L.1983, c.578 (C.27:25-28).
(cf: P.L.2009, c.261, s.2)
16. Section 2 of P.L.1987, c.455 (C.34:16-52) is amended to read as follows:
2. As used in [this act:
a. "Division" means the Division of Vocational Rehabilitation Services in the Department of Labor and Workforce Development.
b.] P.L.1987, c.455 (C.34:16-51 et seq.):
"Citizen with a disability" means any individual who, by reason of illness, injury, age, congenital condition, or other permanent or temporary incapacity or disability, is unable without special facilities or special planning or design to utilize mass transportation facilities and services as effectively as persons who are not so affected.
[c.] "Division" means the Division of Vocational Rehabilitation Services in the Department of Labor and Workforce Development.
"Paratransit" means and includes any service, other than motorbus regular route service and charter services, including, but not limited to, dial-a-ride, nonregular route, jitney or community minibus, and shared-ride services such as vanpools, limousines, or taxicabs which are regularly available to the public. Paratransit shall not include limousine or taxicab service reserved for the private and exclusive use of individual passengers.
[d.] "Paratransit brokerage program" means the program established pursuant to section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
"Public transportation" means all rail passenger service operated by the New Jersey Transit Corporation, and all motorbus regular route service operated pursuant to P.L.1979, c.150 (C.27:25-1 et seq.) or operated pursuant to R.S.48:4-3.
[e.] "Sheltered (extended) employment programs" means those programs established pursuant to regulations adopted pursuant to section 8 of P.L.1955, c.64 (C.34:16-27).
[f.] "Sheltered workshop" means a facility possessing a valid certificate to vend services to the division issued by the director thereof, in compliance with the rules and regulations governing vocational rehabilitation facilities.
(cf: P.L.2017, c.131, s.144)
17. Section 3 of P.L.1987, c.455 (C.34:16-53) is amended to read as follows:
3. a. The Commissioner of Labor and Workforce Development is directed to establish and implement within 120 days of the effective date of [this act] P.L.1987, c.455 (C.34:16-51 et seq.) a program to be administered by the division to defray the public transportation or paratransit expenses of citizens with disabilities enrolled in sheltered (extended) employment programs at sheltered workshops. The program may provide for the defraying of these expenses by the purchase of bus cards or other appropriate methods as prescribed by the commissioner.
b. Notwithstanding any provision of this section to the contrary, if the paratransit brokerage program is expanded, pursuant to subsection d. of section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill), to include the provision of any paratransit services otherwise provided under this section, the department shall be responsible for defraying all costs associated with the provision of these services under the program, which monies shall be transferred to the Department of Transportation in accordance the provisions of subsection e. of section 2 of P.L. , c. (C. ) (pending before the Legislature as this bill).
(cf: P.L.2017, c.131, s.145)
18. Section 2 of P.L.1973, c.126 (C.27:1A-65) is amended to read as follows:
2. For the purposes of P.L.1973, c.126 (C.27:1A-64 et seq.), unless the context clearly indicates otherwise:
["Access Link service" means the paratransit service implemented by the New Jersey Transit Corporation for the purposes of complying with the "Americans with Disabilities Act of 1990," Pub.L.101-336 (42 U.S.C. s.12101 et seq.)] "ADA paratransit service" means the same as the term is defined in section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).
"Carrier" means any individual, copartnership, association, corporation, joint stock company, public agency, trustee, or receiver operating motor buses or rail passenger service on established routes within this State or between points in this State and points in adjacent states.
"Commissioner" means the Commissioner of Transportation; provided, however, that the commissioner may delegate any of the commissioner's powers or duties under P.L.1973, c.126 (C.27:1A-64 et seq.) to any subordinate division, agency, or employee of the Department of Transportation or to the New Jersey Transit Corporation.
"Disabled veteran" means "disabled veteran" as defined in N.J.S.11A:5-1.
"Motor bus" means "autobus" as defined in R.S.48:4-1, and includes those autobuses, commonly called jitneys, as defined in R.S.48:16-23.
"Offpeak times" means the hours from 9:30 a.m. to 4 p.m. and from 7 p.m. to 6 a.m. during the weekdays, and all day on Saturdays, Sundays, and holidays.
"Person with disabilities" means any individual who, by reason of illness, injury, age, congenital malfunction, or other permanent or temporary incapacity or disability, is unable without special facilities or special planning or design to utilize mass transportation facilities and services as effectively as persons who are not so affected. A "person with disabilities" shall include a person determined by the New Jersey Transit Corporation to be eligible for [its Access Link] ADA paratransit service.
"Senior citizen" means any individual 62 years of age or over.
(cf: P.L.2020, c.155, s.1)
19. Section 4 of P.L.1973, c.126 (C.27:1A-67) is amended to read as follows:
4. In establishing this program, the commissioner shall, after consulting with the Commissioner of Community Affairs, the Director of the Division of Aging Services in the Department of Human Services, and the Board of Public Utilities, establish uniform procedures for:
a. Determining the eligibility of persons to receive the reduced fares provided pursuant to P.L.1973, c.126 (C.27:1A-64 et seq.), which shall include those persons determined by the New Jersey Transit Corporation to be eligible for [its Access Link] ADA paratransit service;
b. Making reduced fares available to eligible persons; and
c. Auditing and accounting to insure that no carrier receives payments in excess of the value of services actually rendered to senior citizens, persons with disabilities, and disabled veterans pursuant to P.L.1973, c.126 (C.27:1A-64 et seq.).
(cf: P.L.2020, c.64, s.2)
20. Section 8 of P.L.1973, c.126 (C.27:1A-71) is amended to read as follows:
8. The commissioner is hereby authorized to hire, employ, or assign secretarial, clerical, and other personnel as shall be required for complying with the provisions of P.L.1973, c.126 (C.27:1A-64 et seq.). The commissioner shall also expend a reasonable sum, not to exceed $50,000 annually, for advertising to make senior citizens, persons with disabilities, and disabled veterans aware of the program, the availability and cost of the reduced fares thereunder, the hours when reduced fares may be used, the public transportation facilities made accessible to persons with disabilities, and the availability of other transportation services offered to the public for use by persons with disabilities including [Access Link] ADA paratransit service.
(cf: P.L.2020, c.155, s.2)
21. Section 2 of P.L.1987, c.99 (C.27:1A-74) is amended to read as follows:
2. The Commissioner of Transportation shall, after consulting with other relevant departments and agencies, adopt reasonable regulations necessary to carry out the purposes of P.L.1987, c.99 (C.27:1A-73 et seq.) pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.). The regulations shall include a procedure by which the commissioner shall:
a. issue an identification card , upon certification of a physician or upon certification of another person as prescribed by the commissioner, that a person with disabilities requires the assistance of a travel attendant in order to use public transportation; and
b. automatically issue an identification card to a person determined by the New Jersey Transit Corporation, after the effective date of P.L.2020, c.64, to be eligible for [its Access Link] ADA paratransit service at the time of that determination. For a person determined eligible for [Access Link] ADA paratransit service prior to the effective date of P.L.2020, c.64, the commissioner shall issue an identification card within 60 days after the effective date of P.L.2020, c.64 or immediately upon request of the eligible person, whichever shall be earlier.
(cf: P.L.2020, c.64, s.3)
22. The following sections are repealed:
Section 4 of P.L.2020, c.114 (C.27:25-38);
Section 5 of P.L.2020, c.114 (C.27:25-39); and
Section 7 of P.L.2020, c.114 (C.27:25-41).
23. Notwithstanding the repeal of section 5 of P.L.2020, c.114 (C.27:25-39), the repeal shall not eliminate or reduce any obligations of the New Jersey Transit Corporation with respect to the contract entered into with a qualified community organization to develop a paratransit best practices training module, except that the repeal shall cancel all responsibilities of the organization under the contract to develop the training module.
24. This act shall take effect immediately.
STATEMENT
This bill requires the Department of Transportation (DOT) to oversee the implementation of a paratransit brokerage program, through which the provision of certain forms of paratransit service would be managed by a transportation broker and made available through an interactive brokerage software.
Under current law, the State is required to provide various forms of paratransit service, including: (1) ADA paratransit service, which is currently administered by the New Jersey Transit Corporation (NJ Transit) under the Access Link program, which service is required under the federal "Americans with Disabilities Act of 1990"; and (2) Medicaid paratransit service, which is currently administered by the Department of Human Services (DHS), through a contracted broker, under the State Medicaid program, which service is required under Title XIX of the federal "Social Security Act."
Under the bill, the provision of these paratransit services would be consolidated into one paratransit brokerage program overseen by the DOT. Specifically, the paratransit brokerage program would be managed by a transportation broker contracted by the DOT and facilitated through the use of an interactive brokerage software, which would allow eligible persons to schedule requests for service and allow participating providers to competitively bid to fulfill these requests. Importantly, this brokerage model is intended to achieve cost savings and operational efficiencies in the provision of paratransit service, which efficiencies are not achievable under the current, fragmented service models.
In managing the paratransit brokerage program, the bill requires the transportation broker to assume the following responsibilities: (1) maintaining a paratransit provider network for ADA paratransit service and Medicaid transportation service, respectively, with sufficient capacity to provide all required forms of paratransit service within all applicable service areas in the State; (2) ensuring that each provider of ADA paratransit service and Medicaid paratransit service is qualified to provide the service and complies with all applicable provisions of law or regulation; (3) ensuring that each recipient of ADA paratransit service and Medicaid paratransit service is eligible to receive the service; (4) compensating each paratransit provider that operates in the program; (5) receiving and acting upon passenger complaints; and (6) divesting from any ownership stake or equity interest in any entity or organization that operates as a paratransit provider under the program.
The bill also requires the DOT and DHS to develop separate standards concerning the provision of ADA paratransit service and Medicaid paratransit service, respectively, under the program. At a minimum, these standards would be required to prescribe minimum functionality requirements for interactive brokerage software to ensure that the provision of ADA paratransit service and Medicaid paratransit service, respectively, complies with all applicable requirements of law.
Thereafter, the bill requires the DOT, in consultation with DHS and NJ Transit, to issue a request for proposal (RFP) and enter into a contract for the development of the interactive brokerage software. After this software has been developed, the bill also requires the DOT, in consultation with DHS and NJ Transit, to issue an RFP and enter into a contract for the procurement of the transportation broker. In each case, the contractor selected by the DOT would be required to demonstrate experience in the development of a similar software platform or the administration of a similar brokerage program.
Immediately after the paratransit brokerage program has been implemented, the program would be limited to the provision of ADA paratransit service and Medicaid transportation service by paratransit providers other than county transit agencies and community organizations. However, within two years following the implementation of the program, and every five years thereafter, the DOT would be required to conduct a study to assess whether the program should be expanded to incorporate other forms of paratransit service or to allow county transit agencies and community organizations to operate as paratransit providers. Thereafter, the bill provides that the program could be expanded, subject to the determinations of this study and the adoption of rules and regulations effectuating such expansion.
Under the bill, the operational and administrative costs of the paratransit brokerage program would be defrayed by proportionate funding from the DHS and NJ Transit, with DHS responsible for the costs of Medicaid paratransit service and NJ Transit responsible for the costs of ADA paratransit service. In each case, the bill requires these monies to be transferred to the DOT and paid to the transportation broker. Using these monies, the transportation broker would be required to compensate the paratransit providers operating in the program, which compensation would be based exclusively on the requests for paratransit service that have been fulfilled by the provider. Of the remaining funds, the bill permits the transportation broker to retain such amounts as may be prescribed in the transportation brokerage contract to support the costs of managing the program.
The bill would also amend and repeal various sections of statutory law to reflect the creation of the paratransit brokerage program and to allow for the possibility of program expansion. Specifically, the bill would repeal several sections of the "Paratransit Services Improvement Act," P.L.2020, c.114 (C.27:25-35 et seq.), which sections set forth an alternative process for integrating the provision of certain paratransit services. However, the bill would amend this law to clarify that the Regional Paratransit Coordinating Councils would also be responsible for encouraging participation in the program.
