Another Home Based Medicaid Option? Part 2

Last week I wrote about another possible home based Medicaid option in New Jersey beyond the traditional one.  It’s called the Personal Preference Program or PPP.  It gives the Medicaid recipient and his or her family members more control over the type of care the recipient receives.

As I stated last week the application process is the same.  One must meet the same financial requirements and produce 5 years of records, etc.  Proof of the need for nursing home level care is also a requirement, however, once approved an application to the PPP program is made for self directed personal care assistance services.

This application triggers a screening process to determine eligibility for the PPP program.  Because this is a “self directed” program, meaning there is more autonomy in terms of choice, an authorized representative, who will assist in managing the services for the Medicaid recipient must be interviewed and approved for this role.  For example, persons with a violent felony record or allegations of abuse of vulnerable populations  cannot serve as authorized representatives.

A consultant, who is an employee of a counseling agency under contract with the State of New Jersey or the Vendor Fiscal Employer Agent, conducts this evaluation.  The consultant is also responsible for monitoring the care and for any neglect or abuse going forward.

A budget is then established to be used for the services, support and goods that will enable the Medicaid recipient to complete the activities of daily living.  This budget is based on the number of hours the recipient has been approved for in accordance with the assessment that is done after Medicaid approval and the rate of reimbursement.  These funds are maintained in an account to be used for payroll for hired individuals and equipment and supplies.  Timesheet records and invoices must be kept.

So what exactly can the money be used for and what can’t it be used for?  I’ll cover that next week.