ASSEMBLY AGING AND HUMAN SERVICES COMMITTEE

STATEMENT TO

ASSEMBLY, No. 4090

with committee amendments

STATE OF NEW JERSEY

DATED:  JUNE 24, 2024

      The Assembly Aging and Human Services Committee reports favorably and with committee amendments Assembly Bill No. 4090.

      As amended by the committee, this bill increases the cap on personal care assistant (PCA) services from 40 hours to 91 hours per week for a Medicaid beneficiary determined clinically eligible for nursing facility level of care. 

      As amended, the bill requires that prior to the implementation of the provisions of the bill, the Commissioner of Human Services is to provide a separate rate certification for an increase of personal care assistant services hours within the State’s managed long-term services and supports program in compliance with federal standards, including but not limited to 42 C.F.R. 438.4.  Implementation of an increase of personal care assistant services hours during a State Fiscal Year is to require a mid-year rate adjustment for the managed long term services and supports program.

      The bill also directs the Department of Human Services to modify the existing assessment tool for PCA services to reflect the provisions of this bill.

      The bill defines “personal care assistant services” to mean health related tasks associated with the cueing, supervision, or the completion of activities of daily living, as well as related tasks.  PCA services are certified as medically necessary; delivered in accordance with a beneficiary's written plan of care; and performed by a qualified individual, typically in a beneficiary's home, and under the supervision of a registered professional nurse.

      Currently, pursuant to State regulation, the Medicaid program limits PCA services to a maximum of 40 hours per week per beneficiary.  Additional hours of service may be approved by the Department of Human Services on a case-by-case basis and based on exceptional circumstances.  Increasing the service cap to 91 hours per week for the State’s most vulnerable Medicaid beneficiaries will ensure that they can thrive within the community for additional years.
COMMITTEE AMENDMENTS

      The committee amended the bill to require the Commissioner of Human Services, prior to the implementation of the provisions of the bill, to provide a separate rate certification for an increase of personal care assistant services hours within the State’s managed long-term services and supports program in compliance with federal standards, including but not limited to 42 C.F.R. 438.4.  Implementation of an increase of personal care assistant services hours during a State Fiscal Year is to require a mid-year rate adjustment for the managed long term services and supports program.