Bill Text: NJ S633 | 2010-2011 | Regular Session | Introduced
Bill Title: Establishes the "Veterans Home Health Care Demonstration Program"; appropriates $1 million.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2010-01-12 - Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee [S633 Detail]
Download: New_Jersey-2010-S633-Introduced.html
STATE OF NEW JERSEY
214th LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2010 SESSION
Sponsored by:
Senator ANDREW R. CIESLA
District 10 (Monmouth and Ocean)
SYNOPSIS
Establishes the "Veterans Home Health Care Demonstration Program"; appropriates $1 million.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel
An Act establishing the "Veterans Home Health Care Demonstration Program" and making an appropriation.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. This act shall be known and may be cited as the "Veterans Home Health Care Demonstration Act."
2. As used in this act:
"Adjutant General" means the Adjutant General of the Department of Military and Veterans' Affairs.
"Department" means the Department of Military and Veterans' Affairs.
"Program" means the "Veterans Home Health Care Demonstration Program" established pursuant to this act.
"Veteran" means a person who has served in any branch of the armed forces of the United States for at least 90 days and who has been honorably separated therefrom.
3. The Adjutant General in consultation with the Commissioner of Health and Senior Services shall establish the "Veterans Home Health Care Demonstration Program" to provide home health and homemaker services to frail elderly or disabled veterans through approved agencies, organizations or other entities for the purpose of enabling these veterans to remain in their homes and community and to avoid placement in a nursing home or other long-term care facility.
4. The Adjutant General shall solicit proposals for pilot projects to provide home health and homemaker services to veterans from agencies, organizations or other entities interested in participating in the program.
The Adjutant General shall review the project proposals and approve and fund, within the limits of moneys appropriated for this purpose, three proposals which best meet the objectives of the program and which include procedures for evaluating the effectiveness of the proposed project.
5. A frail elderly or disabled veteran who is a resident of this State is eligible for the program if:
a. the veteran meets financial eligibility limits for the program established by the Adjutant General;
b. the agency, organization or other entity administering the pilot project from which the veteran is seeking services certifies that the veteran is at risk of placement in a nursing home or other long-term care facility but could be appropriately cared for in the veteran's home or in the community if services provided under the program are available to the veteran;
c. the estimated cost of the services provided to the veteran under the program does not exceed 70% of the average cost of a comparable level of nursing home or long-term care; and
d. the veteran is not eligible for home health and homemaker services under the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
6. a. The agency, organization or other entity administering a pilot project under the program shall perform a comprehensive medical, social and financial assessment of each applicant for services, according to guidelines established by the Adjutant General, to determine if the applicant is eligible for the program pursuant to section 5 of this act.
b. The assessment shall be used by the agency, organization or other entity administering the pilot project as a basis for preparing a services plan designed to meet the specific health and social needs of each applicant who is eligible for the program, which shall include: a list of the services to be provided; an estimate of the frequency with which, and total length of time that, each service will be provided; an estimate of the cost of each service and the total cost of implementing the plan; and a statement of the percentage or amount of money that an eligible veteran shall be required to contribute toward the cost of services provided under the plan, which shall be determined by the agency, organization or other entity in accordance with the sliding fee scale established by the Adjutant General pursuant to section 8 of this act. The plan shall be revised as frequently as necessary, but a comprehensive reassessment of each eligible veteran shall be made annually.
c. The plan shall be discussed with the eligible veteran and the veteran's spouse, if married. The plan shall not be implemented until the eligible veteran and the veteran's spouse approve the plan in writing.
d. The assessment and the services plan shall be completed on forms prescribed by the Adjutant General.
7. a. The Adjutant General shall, by regulation, stipulate which home health and homemaker services are eligible for reimbursement under the program, except that these services shall, at a minimum, include services provided or arranged by a licensed home health agency, including nursing, homemaker-home health aide, chore, nutritional and personal care services and physical, speech and occupational therapy; services provided by a State licensed medical day care program; and case management services.
b. The Adjutant General shall establish a written contract with each agency, organization or other entity which is approved to administer a pilot project under the program pursuant to section 3 of this act, setting forth in detail the services to be provided to eligible veterans by that pilot project and the obligations and responsibilities of the agency, organization or other entity.
8. a. The Adjutant General shall establish a sliding fee scale which shall be used to determine the percentage or amount of money that an eligible veteran and the veteran's spouse, if married, shall be required to contribute toward the cost of services provided under the program, which percentage or amount shall be based on an eligible veteran's and the veteran's spouse, if married, ability to pay for the services provided under the program, except that no eligible veteran and the veteran's spouse shall have to pay more than 50% of the cost of services authorized and provided pursuant to this act.
b. If the costs of providing services to an eligible veteran under the program are covered in whole or in part by any other State or federal government program or insurance contract, the other government program or insurance carrier shall be the primary payer and the program shall be the secondary payer.
9. The Adjutant General shall establish a fee schedule for payments or reimbursements to home health care providers under the program.
10. The Adjutant General shall report to the Governor and the Legislature no later than 18 months after the effective date of this act on the activities of the program and its effectiveness in meeting its objectives, including an assessment of the most efficient and effective method of establishing a Statewide program and the projected cost of doing so, and accompanying the report with any recommendations for changes in the law or regulations governing the program that the Adjutant General deems necessary.
11. The Adjutant General, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations necessary to effectuate the purposes of this act.
12. There is appropriated $1,000,000 from the General Fund to the Department of Military and Veterans' Affairs to carry out the purposes of this act.
13. This act shall take effect on the 90th day after its enactment and shall expire two years after the effective date.
STATEMENT
This bill establishes a two-year demonstration program in the Department of Military and Veterans' Affairs to provide home health care services to frail and elderly and disabled veterans who would otherwise require long-term institutional care and who are not eligible for coverage under the Medicaid program. This bill includes a $1,000,000 appropriation to develop and implement the demonstration program.
This program is to be developed by the Adjutant General, in consultation with the Commissioner of Health and Senior Services, and is to be comprised of three pilot projects administered by agencies or organizations selected by the Adjutant General of the Department of Military and Veterans' Affairs. The program is required to provide at least the following services: nursing, homemaker-home health aide, chore, nutritional and personal care services and physical, speech and occupational therapy through a licensed home health agency, in addition to medical day care and case management services.
The Adjutant General is directed to: establish financial eligibility limits for the demonstration program; establish guidelines for the comprehensive medical, social and financial assessment required to determine each applicant's eligibility for this program and to prepare the specific plan of services needed by the applicant; and establish a fee scale for the services provided by the program based on the veteran's and the veteran's spouse, if married, ability to pay (but not exceeding 50% of the costs of the services provided).
The bill further requires that the Adjutant General report to the Governor and the Legislature within 18 months of the effective date of the bill on the activities and effectiveness of the demonstration program, and to include in that report a cost estimate for establishing a Statewide program and any recommendations for statutory or regulatory changes in the program that the Adjutant General believes to be necessary.
