The journey to maintaining independence while managing personal care needs can be navigated with support and the right programs. In New Jersey, the Personal Preference Program (PPP) stands out as a valuable resource for individuals seeking greater control over their care. This program, designed for NJ FamilyCare/Medicaid members, offers a unique approach to personal care assistance, allowing for self-direction and flexibility.
Understanding the Personal Preference Program (PPP)
The Personal Preference Program (PPP) in New Jersey is a state-supported initiative that empowers individuals eligible for Personal Care Assistant (PCA) services to manage their care at home and within their community. Unlike traditional home care services that rely on agencies, PPP enables participants to take charge of their care by choosing who provides their services, what those services entail, and when and where they are delivered, all within established program guidelines.
This self-directed model is built upon the principle of personal choice. It recognizes that individuals are the best experts on their own needs and preferences. By participating in PPP, you gain the ability to:
- Customize Your Care: Select the specific home care services that align with your unique requirements and lifestyle.
- Choose Your Caregivers: Hire individuals you trust, which can include friends, family members, or neighbors, to serve as your personal care assistants.
- Control Your Schedule: Plan and manage your services according to your personal schedule and preferences, promoting greater autonomy and convenience.
- Enhance Independence: Maintain a higher degree of independence and control over your daily life, remaining active and engaged in your community.
PCA services under PPP encompass non-emergency, health-related tasks crucial for your well-being and comfort. These typically include assistance with:
- Activities of Daily Living (ADLs): Essential self-care tasks such as bathing, dressing, eating, toileting, and mobility.
- Instrumental Activities of Daily Living (IADLs): Tasks that support independent living, such as meal preparation, light housekeeping, managing medications, and running errands.
Who is Eligible for the Personal Preference Program in New Jersey?
To be eligible for the Personal Preference Program, applicants must meet specific criteria. These requirements ensure that the program effectively serves those who can benefit most from self-directed care. Eligibility is based on the following:
- NJ FamilyCare Enrollment: Applicants must be eligible for and enrolled in NJ FamilyCare, New Jersey’s Medicaid program. You can verify your eligibility or apply through your local County Social Service Agency or apply online.
- PCA Service Approval: Applicants must be approved to receive Personal Care Assistant (PCA) services, indicating a medical necessity for personal care assistance. Furthermore, the need for PCA services should be expected to last for at least six months.
- Self-Direction Capability: Participants must be capable of self-directing their care. This means they can manage their services independently or have an Authorized Representative (AR) who can act on their behalf to make informed decisions and manage the program requirements. An AR can be a family member, friend, or legal guardian who can assist with program management.
How to Apply for the Personal Preference Program
The application process for the Personal Preference Program is straightforward, particularly for those already enrolled in NJ FamilyCare through a Managed Care Organization (MCO). If you are enrolled in an MCO (also known as an HMO or health plan), the first step is to contact your specific MCO to request a PCA assessment. This assessment will determine your eligibility for PCA services and enrollment into the PPP.
Here is a list of NJ FamilyCare MCOs and their contact numbers to initiate your application:
| Managed Care Organization (MCO) | Contact Number |
|---|---|
| Aetna Better Health of New Jersey | 1-855-232-3596 |
| Aetna Assure Premier Plus (D-SNP) | 1-844-362-0934 |
| Fidelis Care (formerly known as WellCare) | 1-855-642-6185 (Option #3, then #2) |
| Horizon NJ Health | 1-855-465-4777 |
| UnitedHealthcare Community Plan | 1-800-645-9409 (Option #3) |
| Wellpoint (formerly known as Amerigroup) | 1-855-661-1996 (Option #1) |
By contacting your MCO, you will be guided through the necessary steps to complete the PCA assessment and proceed with your PPP application if you are deemed eligible.
Navigating the Fiscal Intermediary (FI) Role
The Personal Preference Program incorporates a Fiscal Intermediary (FI) to alleviate some of the administrative and financial responsibilities associated with being an employer in a self-directed care model. Currently, Public Partnerships LLC (PPL) serves as the FI for the NJ PPP.
PPL plays a crucial role in supporting both you (the employer) and your chosen caregiver (the worker). Their support encompasses:
For You, the Employer:
- Financial Management: PPL handles the complexities of employer fees and tax obligations, ensuring compliance with regulations.
- Payment Processing: They process payments for employer taxes and fees, streamlining financial administration.
- Workers’ Compensation Insurance: PPL arranges for the necessary Workers’ Compensation insurance coverage for your caregiver.
- Backup Plan Assistance: They help you create a backup plan to ensure continuity of care in unforeseen circumstances.
- Goods and Services Payments: PPL processes payments for approved goods and services related to your care, according to program guidelines.
For Your Worker:
- Payroll Processing: PPL manages payroll for your caregivers, ensuring timely and accurate payments.
- Hiring Support: They provide resources, tips, and guidance on finding and hiring qualified personal care assistants.
PPL Contact Information:
- Phone (English): 1-844-880-8702
- Phone (Spanish): 1-844-880-8703
- Fax: 1-844-627-6834
- Email: [email protected]
- Website: PPL Program Website
Conclusion: Embracing Self-Direction with PPP
The New Jersey Personal Preference Program offers a transformative approach to personal care assistance. It empowers NJ FamilyCare/Medicaid members to take the reins of their care, fostering independence, choice, and flexibility. By understanding the program’s benefits, eligibility criteria, and application process, you can explore whether PPP is the right path to meet your personal care needs and enhance your quality of life. For further information or specific inquiries, do not hesitate to contact the PPP State Program Office or PPL for dedicated support and guidance.
