New Jersey S 1497: Increases hourly limit of reimbursable personal care assistant services under NJ WorkAbility Program.

Bill Text

SENATE, No. 1497

STATE OF NEW JERSEY
220th LEGISLATURE

INTRODUCED FEBRUARY 10, 2022

Sponsored by:
Senator VIN GOPAL
District 11 (Monmouth)

SYNOPSIS
Increases hourly limit of reimbursable personal care assistant services under
NJ WorkAbility Program.

CURRENT VERSION OF TEXT
As introduced.

S1497 GOPAL
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AN ACT concerning the NJ WorkAbility Program and 1
supplementing Title 30 of the Revised Statutes. 2
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BE IT ENACTED by the Senate and General Assembly of the State 4
of New Jersey: 5
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1. Services provided to employed, permanently-disabled 7
individuals through the NJ WorkAbility Program, established 8
pursuant to P.L.2000, c.116, and in accordance with the federal 9
“Ticket to Work and Work Incentives Improvement Act of 1999,” 10
Pub.L.106-170, shall be provided by health maintenance 11
organizations and fee-for-service providers that have executed a 12
contract with the Division of Medical Assistance and Health 13
Services in the Department of Human Services to provide benefits 14
through the State Medicaid program, established pursuant to 15
P.L.1968, c.413 (C.30:4D-1 et seq.), except that reimbursable 16
personal care assistant services shall be limited to a maximum of 17
112 hours per calendar work week. 18
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2. The Commissioner of Human Services shall apply for such 20
State plan amendments or waivers as may be necessary to 21
implement the provisions of this act and to secure federal financial 22
participation for State Medicaid expenditures under the federal 23
Medicaid program. 24
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3. The Commissioner of Human Services shall adopt rules and 26
regulations pursuant to the "Administrative Procedure Act," 27
P.L.1968, c.410 (C.52:14B-1 et seq.), to effectuate the purposes of 28
this act. 29
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4. This act shall take effect immediately, and shall apply to any 31
contract executed on or after the effective date of this act between 32
the Division of Medical Assistance and Health Services in the 33
Department of Human Services and a health maintenance 34
organization or a fee-for-service provider that provides benefits 35
through the State Medicaid program, established pursuant to 36
P.L.1968, c.413 (C.30:4D-1 et seq.). 37
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STATEMENT 40
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This bill increases the hourly limit of reimbursable personal care 42
assistant services under the NJ WorkAbility Program from 40 hours 43
per calendar workweek to 112 hours per calendar workweek. The 44
NJ WorkAbility Program provides full State Medicaid health 45
coverage to individuals with disabilities who are working and whose 46
earnings would otherwise make them ineligible for Medicaid. The 47
regulations (N.J.A.C.10:72-9 et seq.) governing the Program provide 48

S1497 GOPAL
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that all services available through the NJ WorkAbility Program 1
must be provided through existing Medicaid contracts held by the 2
Division of Medical Assistance and Health Services (DMAHS) in 3
the Department of Human Services. Currently, the reimbursement 4
of personal care assistant services under such contracts is limited to 5
40 hours per calendar work week. 6
Individuals must meet the following guidelines in order to be 7
eligible for the NJ WorkAbility Program: 1) be between the ages of 16 8
and 64; 2) work part time, full time, or be self-employed and have 9
proof of employment; 3) have a permanent disability as determined by 10
the United States Social Security Administration or the Disability 11
Review Team in DMAHS; and 4) have an earned income below 250 12
percent, and an unearned income below 100 percent, of the federal 13
poverty level. An individual participating in the program must pay a 14
$25 monthly premium in order to receive full Medicaid coverage. 15