Requires DHS to increase home and community-based services under Medicaid.
Impact
This legislation is expected to create a substantial shift in how Medicaid funds are distributed, with a focus on reducing institutional care for eligible individuals. The bill aims to implement a five-year strategic plan to rapidly expand home and community-based services, which may lead to a decreased number of individuals residing in institutional facilities. Additionally, the bill mandates reductions in institutional bias within state policy, encouraging a more accessible and equitable distribution of care funding.
Summary
Assembly Bill A4585 is designed to significantly enhance home and community-based services under New Jersey's Medicaid program. The bill mandates that the Commissioner of Human Services (DHS) must aim to shift 80 percent of eligible Medicaid participants who would otherwise require nursing home care into home and community-based services by 2027. Furthermore, the bill outlines a requirement that 60 percent of the state's long-term services funding support be allocated to these home and community services. By 2029, the intention is to increase this funding allocation to 70 percent.
Contention
Despite its supportive framework, there are anticipated points of contention regarding the implementation of the bill. Stakeholders may have varying opinions about how effectively the plan will address the needs of those requiring care, especially in light of the complexities surrounding funding allocation and service delivery. There may be concerns regarding ensuring living wages for caregivers, as well as the ability to effectively integrate services among providers and promote supportive housing, as mandated by the bill.
Provides for presumptive eligibility for home and community-based services and services provided through program of all-inclusive care for the elderly under Medicaid.
Establishes program for certain individuals to become certified homemaker-home health aides and provide services to certain Medicaid and Medicaid-Medicare dually eligible enrollees under increased reimbursement rates.
Increases cap on personal care assistant services from 40 hours to 91 hours per week for Medicaid beneficiary determined clinically eligible for nursing facility level of care.
Requires hourly reimbursement rate for home health aide services provided through Statewide Respite Care Program and Jersey Assistance for Community Caregiving Program to be no less than Medicaid fee-for-service rate for personal care services; makes appropriation.
To Amend The Medicaid Fraud Act And The Medicaid Fraud False Claims Act; And To Update Language And Definitions To Reflect Changes Within The Healthcare System;.
Requires Medicaid reimbursement for covered behavioral health services provided by local education agency to student who is eligible Medicaid beneficiary.
Requires Medicaid reimbursement for covered behavioral health services provided by local education agency to student who is eligible Medicaid beneficiary.
Provides for presumptive eligibility for home and community-based services and services provided through program of all-inclusive care for the elderly under Medicaid.