The path to receiving personalized home care can often seem complex, especially when seeking to maintain independence and control over care decisions. In New Jersey, the Personal Preference Program (PPP) offers a solution designed to empower individuals eligible for NJ FamilyCare/Medicaid who require Personal Care Assistant (PCA) services. This program champions self-direction, allowing participants to shape their care according to their unique needs and preferences. This guide provides an in-depth look at New Jersey’s Preference Program, ensuring you have all the necessary information to understand and access this valuable resource for preference program care in New Jersey.
Understanding the Personal Preference Program (PPP) in New Jersey
The New Jersey Personal Preference Program (PPP) is a state-supported initiative focused on delivering self-directed services. These services are meticulously crafted to support individuals with personal care needs in maintaining their independence within the comfort of their homes and active engagement in their communities. Unlike traditional home care services that rely on agencies, PPP empowers participants to take charge of their care.
Key features of the PPP include:
- Personalized Care Plans: Participants have a significant voice in determining the types of services that best address their individual needs.
- Choice of Care Providers: A cornerstone of the PPP is the ability for participants to choose who provides their care. This can include friends, family members, or neighbors, fostering a more comfortable and trusting care environment.
- Flexible Service Scheduling: The program is designed to adapt to individual lifestyles, offering flexibility in when and where services are delivered, within the established program guidelines.
- Maintaining Independence: Ultimately, the PPP aims to empower individuals to remain in their homes and communities while receiving the necessary support to live fulfilling lives.
The PCA services offered through PPP are non-emergency, health-related tasks essential for a member’s well-being under NJ FamilyCare. These encompass help with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Examples include assistance with bathing, dressing, meal preparation, and light housekeeping – all crucial for maintaining health and comfort.
While PPP offers greater autonomy, it also entails increased personal responsibility in managing one’s care. This balance of control and accountability is what makes the Personal Preference Program a unique and valuable option for eligible New Jersey residents seeking preference program care.
Who is Eligible for the New Jersey Personal Preference Program?
Eligibility for the Personal Preference Program is determined by specific criteria to ensure that the program effectively serves those who can benefit most from self-directed care. To be eligible for PPP in New Jersey, applicants must meet the following requirements:
- NJ FamilyCare Eligibility: Applicants must be eligible for NJ FamilyCare, New Jersey’s publicly funded health insurance program, which includes Medicaid. Individuals can apply for NJ FamilyCare through their local County Social Service Agency or online.
- Approval for Personal Care Assistant (PCA) Services: Applicants must be assessed and approved for PCA services, indicating a medical necessity for personal care assistance. Furthermore, the need for PCA services must be expected to last for at least six months.
- Capacity for Self-Direction or Authorized Representative: A crucial aspect of PPP is self-direction. Applicants must be able to manage their services independently or have an Authorized Representative (AR) who can manage the services on their behalf. An AR can be a family member, friend, or legal guardian who can assist with decision-making and program management.
Meeting these eligibility criteria is the first step towards accessing the benefits of preference program care in New Jersey through the PPP.
How to Apply for the Personal Preference Program in New Jersey
The application process for the Personal Preference Program is straightforward, especially for individuals already enrolled in NJ FamilyCare Managed Care Organizations (MCOs), also known as HMOs or health plans. Here’s a step-by-step guide on how to apply:
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Contact Your NJ FamilyCare MCO: If you are enrolled in an MCO, your first step is to contact them directly. Inform them of your interest in the Personal Preference Program and request a PCA assessment for PPP enrollment. Each MCO has a dedicated contact number for member services:
Managed Care Organization 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 Option #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) -
PCA Assessment: The MCO will arrange for a PCA assessment to evaluate your needs and determine if you qualify for Personal Care Assistant services. This assessment is a standard part of the enrollment process for PPP.
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Enrollment in PPP: If you are approved for PCA services and meet the eligibility criteria for PPP, your MCO will guide you through the enrollment process. They will provide you with the necessary forms and information to officially join the Personal Preference Program.
By following these steps and working with your NJ FamilyCare MCO, you can successfully apply for the preference program care you need in New Jersey.
The Role of the Fiscal Intermediary (FI): Public Partnerships LLC (PPL)
A critical component of the Personal Preference Program is the Fiscal Intermediary (FI). The FI plays a vital role in supporting both the participant (as the employer) and their chosen workers. Currently, Public Partnerships LLC (PPL) serves as the Fiscal Intermediary for the New Jersey PPP.
PPL provides essential support services, including:
For the PPP Participant (Employer):
- Managing Employer Responsibilities: PPL assists with the financial and administrative tasks associated with being an employer, such as paying employer fees and taxes.
- Processing Payments: They handle the processing of payments for employer taxes and fees, ensuring compliance and accuracy.
- Workers’ Compensation Insurance: PPL arranges for the required Workers’ Compensation insurance coverage for hired workers.
- Backup Plan Development: They assist in creating a backup plan to ensure continuity of care in unforeseen circumstances.
- Goods and Services Payments: PPL processes payments for approved goods and services that support the participant’s care plan, within program guidelines.
For the Worker:
- Payroll Processing: PPL manages payroll for workers, ensuring timely and accurate payments.
- Hiring Support: They offer tips and resources to help participants find and hire qualified workers.
Contact Information for PPL Customer Service:
- Phone (English): 1-844-880-8702
- Phone (Spanish): 1-844-880-8703
- Fax: 1-844-627-6834
- Email: [email protected]
- PPL Program Website: https://pplfirst.com/programs/new-jersey/personal-preference-program-ppp
Understanding the role of the FI, specifically PPL, is crucial for participants in navigating the administrative and financial aspects of the preference program care model.
Resources for Current PPP Participants in New Jersey
For individuals already participating in the Personal Preference Program, several resources are available to provide ongoing support and address any questions or concerns.
- PPP Contact Information: For specific inquiries or assistance, current participants can access detailed contact information through the PPP Contact Information document.
- PPP Fact Sheet: A comprehensive overview of the program can be found in the PPP Fact Sheet.
- Current PPP Participant Contacts: For further assistance, a dedicated contact list is available for current PPP participants here.
These resources are designed to empower current participants to effectively manage their preference program care and address any needs that may arise.
Training and Workshops for PPP
To further support participants and stakeholders, the New Jersey PPP offers training and workshops to enhance understanding and program utilization.
- Overview of the Personal Preference Program: An introductory presentation providing a comprehensive overview of the PPP is available here.
- General PPP FAQ: Common questions and answers about the program are addressed in the General PPP FAQ document.
These training resources are invaluable for both prospective and current participants seeking to deepen their understanding of preference program care in New Jersey.
Navigating Fiscal Intermediary Transition (FIT)
The Fiscal Intermediary landscape can evolve, and Managed Care Organizations (MCOs) may transition to new FI vendors over time. To keep participants informed about any transitions, the PPP provides resources related to the Fiscal Intermediary Transition (FIT) process.
- PPP FI Transition Document: Details about the transition process are outlined in the PPP FI Transition document.
- FIT Frequently Asked Questions (FAQ): For answers to common questions about the transition, refer to the FIT Frequently Asked Question May 2024 document.
Staying informed about FIT ensures a smooth continuation of preference program care during any vendor changes.
Join the PPP Community Workgroup
To foster collaboration and continuous improvement, the PPP team hosts monthly meetings through the Community Workgroup. These meetings, held on the first Wednesday of each month, are dedicated to guiding the FI transition process and developing best practices for self-directed services.
- Join the Community Workgroup: Learn how to participate and contribute to the workgroup here.
- Access Past Meeting Materials: Review minutes and materials from previous meetings to stay updated on discussions and progress here.
- Workgroup Schedule for 2024: Plan ahead and see the meeting schedule for the year here.
Participation in the Community Workgroup offers a valuable opportunity to engage with the PPP and contribute to the evolution of preference program care in New Jersey.
State Program Office Contact Information
For direct inquiries or correspondence with the New Jersey Personal Preference Program State Program Office, please use the following contact details:
NJ Division of Medical Assistance and Health Services
P.O. Box 712
Attention: Personal Preference Program
Trenton, NJ 08625
Telephone: 609-631-2481
Email: [email protected]
This direct contact information ensures that you can reach the program office for any specific questions or needs related to preference program care.
Conclusion: Embracing Personalized Care with the New Jersey PPP
The New Jersey Personal Preference Program stands as a testament to the state’s commitment to providing person-centered care. By empowering individuals to direct their services, choose their care providers, and schedule care that fits their lives, the PPP offers a pathway to greater independence and control. For those seeking preference program care in New Jersey, the PPP represents a valuable option worth exploring. By understanding the program’s features, eligibility criteria, and application process, individuals can take informed steps towards accessing the personalized care they deserve.
