Personal Preference Program: An Overview

Posted By: Post 21 Club on March 12, 5:12 PM

Q: “Why should I be interested in the Personal Preference Program (PPP)?”

A: If you and/or your relatives spend a significant part of your week providing caregiving services to your adult child who lives with Autism, the Federal government and NJ State can and will compensate all those involved, up to certain limits, as “employees” of the affected individual?

All that is required is completion of an application process, and filling out regular timesheets online.  When one considers the amount of love, time, and effort that goes into providing care to the individual(s), being paid for these services can be a great help.  What you should know and be aware of:

WHY PARTAKE IN THE PERSONAL PREFERENCE PROGRAM?

PPP enables affected individuals (“consumers”) to:

  • Choose the services they need and want
  • Hire anyone they want: relatives, friends, neighbors
  • Design a service plan to meet their schedule
  • Buy equipment, devices, make home modifications
  • Exercise greater control, flexibility and choice over their personal care

 

ACCESS A CASH ALLOWANCE

An affected individual can use a cash allowance to:

  • Purchase services from an agency
  • Pay friends or relatives when providing caregiving
  • Make modifications to the home, such as a ramp or chair lift, that help the Consumer live more independently
  • Buy equipment, appliances, technology or other items that increase independence, such as a microwave oven, or front loading washing machine that the Consumer can reach from a wheelchair

 

DETAILS: Once families have established their Medicaid eligibility through an NJ Family Care Managed Care Organization/insurance company, they are eligible for Personal Care Assistant services (PCA).
These are non-emergency, health related tasks administered by NJ FamilyCare. Tasks include help with activities of daily living (“ADL”’s), and also household duties essential to the patient's health and comfort, such as bathing, dressing, meal preparation, and light housekeeping.

A. BACKGROUND

1. What is the Personal Preference Program (“PPP”)?

PPP is a way for affected individuals to receive Personal Care Assistant (PCA) services via NJ FamilyCare.

(Per the NJ Department of Human Services, NJ FamilyCare is not a welfare program, but rather the State of New Jersey's way of providing affordable health coverage for kids and certain low-income parents.  See www.nj.gov/humanservices/dmahs/clients/njfamilycare/ )

2. Using a "Cash & Counseling" approach, along with the concept of "consumer direction," PCA services can be accessed under PPP, which allows seniors and people with disabilities who are NJ FamilyCare recipients to direct and manage their own services.

With a monthly cash allowance, participants - or "consumers" - work with a consultant to develop a Cash Management Plan (CMP). This plan helps them decide the services they need and the individuals and/or agencies they can hire to provide those services. Consumers who are cognitively impaired or unable to make their own decisions can choose a representative to make decisions on their behalf.

3. Financial Management PPP also includes Fiscal Management (FM) services to help consumers with the financial aspects of the program. The FM handles all enrollment and payroll responsibilities for individuals/agencies and acts as a bookkeeping service. They also visit every 3 months to monitor and manage services and ensure the safety and well-being of consumers.

BACKGROUND SUMMARY: The Personal Preference Program requires greater individual responsibility. But in return, it offers the consumers more control, flexibility and choice over the services they receive.

B. ELIGIBILITY
Applicants must be:
·   NJ FamilyCare eligible
·   Approved for Personal Care Assistant Services (PCA) and need PCA services for at least six months.
·   Able to self-direct services or choose a representative who can act on his/her behalf
 
C. TO APPLY:
If you are enrolled in a NJ FamilyCare Managed Care Organization (MCO), please contact your MCO to request a PCA assessment for enrollment into PPP.
Aetna
Amerigroup
Horizon NJ Health
United Health Care
WellCare
If you are not enrolled in an MCO, please contact us at 1-888-285-3036 for assistance.
 
CONTACT INFORMATION
Division of Disability Services
11A Quakerbridge Plaza, Mercerville NJ
(Mailing: PO Box 705 Trenton NJ 08625)

Telephone: 888-285-3036
Fax: 609-631-4365
 
RELATED LINKS
2017 PPP FI Transition Information (English) (Spanish
PPP brochure (English) (Spanish) 
 
KEY STAFF
Ursula Baker,  PPP Program Manager
 
 
For more information, or if you have further issues, please contact me at the address below.
Thank you!
Hyun Kim
Consultant, PCG

Personal Preference Program: An Overview

Fee for Service Clarification

Posted By: Post 21 Club on June 23, 7:25 PM

June 23, 2017: DDD Procedural Clarification on “Fee for Service” by Post 21 Club  

If you’re a parent who lives in New Jersey and you care for one or more adult children with Autism, you’re used to changes in the DDD support system every few years.  Here’s what you’ve seen, heard, or dealt with: “Self Determination”…”Real Life Choices”….”Self-Directed Services”.  Now, “Fee-for-Service” is set for implementation!

What does “Fee-for-Service” mean?  Potentially a good thing, as it is coincident with the onset of “Tier Funding”, which for some affected individuals means funding levels more appropriateness to their functioning levels.  Funding and provided services are more tightly linked, presumably increasing service value delivered “per dollar”.

Right now there appears to be a gap of understanding.  Many Providers and participants think it means that Program and Service Providers need to set staff and resources aside to keep time records taken at 15 minute intervals during each weekday.  Nothing can be further than the truth.

“Fee-for-Service” was adopted by the State Division of Developmental Disabilities as a way to facilitate choice and flexibility for Parents, and to foster competition between Program and Service providers.  Recently, when asked about the additional burden of keeping records at 15-minute intervals, the DDD desk (at the Phoenix House Provider Fair in Nutley, NJ) clarified that that was not the intention.  For example, if a given program lasts for, say, 4 hours, the paperwork is appropriately adjusted so that the Provider does not have file repetitive and redundant paperwork.  This is contrary to the current understanding of many Providers.

Indeed, many Program and Service providers are already girding for additional paperwork that would more resemble the arduous internal timekeeping in a busy law firm than the back office of an Autism program or service provider.  Providers should circle back with the DDD and re-clarify and confirm proper paperwork procedures under the new Fee-for-Service structure, prior to possibly squandering precious resources under a possible procedural mis-understanding.

Fee for Service Clarification
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