New Jersey Personal Preference Program (PPP)

Description

 Under PPP, family members can be hired as paid caregivers.

Recognizing the needs and preferences of many the state’s seniors, New Jersey’s Medicaid program began the Personal Preference Program. The PPP provides financial assistance to elderly and / or disabled, Medicaid-qualified residents to help them live independently and manage their activities of daily living.

Based on the “Cash and Counseling” model, the program distributes to participants a budget that would otherwise be spent on services for them. Participants have the power to select their own care providers. Program participants can hire friends and family members, so relatives can be paid to be caregivers if they are at least 18 years old.

This program and the category of programs are referred to by many different names. The Personal Preference Program might be referred to as Personal Care Assistance (PCA) services. Cash and Counseling programs, in general, are also known as consumer direction, self-direction and participant-direction.

 Did You Know?  Cash and Counseling programs are a win-win for consumers and state governments. Participants report higher satisfaction and the state experiences cost savings.

 

Eligibility Guidelines

Functional Need
Program candidates must have a need for assistance with their activities of daily living, such as bathing, toileting, and eating as determined by a healthcare professional. However, their needs cannot be so severe that full-time nursing home level care is required.

Financial Need
Candidates must be financially eligible for NJ Medicaid (FamilyCare). These requirements vary depending on one's marital status and whether one's spouse is also applying.

Individuals Applying for Medicaid - In 2017, seniors can have up to $2,205 in monthly income. Persons over that limit may still qualify if they have excessively high medical expenses. Since 2014, the state began to allow the applicants who are over the gross month income limit to use a special type of account to ensure that they spend their excess income on medically necessary goods or services. Individual applicants can have countable assets valued at $2,000. 

Couples Applying for Medicaid - Married couples applying can have $3,000 in countable assets. Their home and vehicle are non-countable assets and don't count towards the $3,000 limit. However, couples whose home equity is valued at more than $840,000 are not considered exempt. 

Couples with One Spouse Applying - Persons in this situation have considerably more flexibility when seeking Medicaid. The non-applicant spouse can have up to $120,900 in resources. Joint income, up to a certain level, can be allocated to the non-applicant to provide them with sufficient financial resources on which to live. This calculation includes accounting for local housing costs. Shifting joint income can also lower the applicant's income to the acceptable limit.

Individuals or couples who exceed these limits may still be able to receive benefits. However, using qualified income trusts and Medicaid-compliant annuities are complicated. Professional financial planners can help to re-structure income and property so that needy families can comply with to the eligibility rules. Learn more about how they could help your family.

Benefits and Services

One of the best things about the Personal Preference Program is that participants have a great deal of flexibility on how to spend the funds given to them for their care. We divide the types of expenditures into three categories that are considered eligible.

1) Personal Assistance Services – a hired individual that assists the program participant to manage their activities of daily living and instrumental activities of daily living such as bathing, grooming, meal preparation, eating, mobility, housekeeping, shopping and laundry.

2) Assistive Technology – appliances, devices and controls that increase the individual’s ability to live independently, such as remote controls, specially designed cooking equipment and motion-sensitive lighting.

3) Home Modifications – changes to one’s home to accommodate for physical challenges, such as stair glides, handicap ramps, walk-in tubs, grip bars for the bathroom, and doorway alterations to accommodate for wheelchairs.

 

How to Apply / Learn More

The program is managed by the New Jersey Division of Disability Services. One can learn more or begin the application process by visiting this page or by calling their toll-free number at 1-888-285-3036.

To apply for this program, one must be accepted into Medicaid in New Jersey and should then contact their Managed Care Organization (MCO). 

A downloadable brochure about PPP is available here.