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NEW JERSEY DEPARTMENT OF HUMAN SERVICES

DIVISION OF MEDICAL ASSISTANCE AND HEALTH SERVICES

PERSONAL PREFERENCE PROGRAM

FACT SHEET

The New Jersey Personal Preference Program (PPP) offers an alternative way for

each year. Children age 18 and under who are lawfully admitted can be

eligible even if they have lived in this country fewer than five years;

 Parents/Caretaker Relatives with income up to 138% FPL ($2,829/month for

a family of four) must have tax dependent children in their household in

order to be eligible under this category. The dependent children in the

household must be insured also. Immigrant adults must have Legal

Permanent Resident status in the US for at least five years in order to be

eligible for NJ FamilyCare;

 Adults without dependent children with ages 19-64 and income up to 138%

FPL ($1,387/month for a single person and $1,868/month for a couple).

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The PPP’s goal is to offer you a State Plan Medicaid PCA service option that you

direct and in which you manage a monthly budget and receive counseling services,

in lieu of traditional agency-delivered services.

The PPP allows you to direct and manage your activities such as bathing, feeding,

dressing, transferring, grooming, meal preparation, laundry and light

housekeeping. The PPP provides an alternative to traditional agency services and

allows you greater control of the services you receive. Please note that your

budget may not pay for or provide skilled professional medical services, such as

private duty nursing.

Through a monthly budget, you work with a financial consultant to develop a

intermediary (FI) for the PPP, and is responsible for handling payroll

responsibilities, acting as a bookkeeping service, processing time sheets and

issuing paychecks to your workers.

The PPP requires greater individual responsibility, but in return, offers you greater

control, flexibility and choice over the services you receive.

The Personal Preference Program Allows You to:

 Choose the home care services you want;

 Hire workers, including people you know/trust such as friends, relatives and

neighbors;

 Schedule services to meet your individual needs;

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 For individuals currently receiving (or who are eligible to receive) Medicaid

PCA services from a home health agency;

 Requires that participants have the ability to direct and manage services, or

elect a representative that can assist them with the program.

In Order to Qualify for PCA Services, Recipients Must:

 Have NJ FamilyCare Plan A;

 Obtain a doctor’s order to receive the service (do not have to be permanently

disabled);

 Live in a community-based residence, such as a private home, apartment,

rooming house, boarding home or group home, skill development home,

FINANCIAL COUNSELING SERVICES

You will have an assigned financial consultant, employed by PPL, who will help

you with navigating the program. Consultants serve as trainers, resource-locators

and advisors. Consultants regularly check-in and answer any questions you may

have for as long as you remain enrolled in the PPP.

PPL will assign a consultant that lives in your community and is familiar with the

program. Where possible, PPL will provide a consultant that is bilingual. However,

consultants may at times be reassigned as new consultants are hired, consultants

may move to new locations, or consultants change positions. If your consultant is

reassigned, you will be notified ahead of time, when possible. Your new consultant

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budget.

 Respond to all critical incidents reported by you, the state program office or

PPL, and assist in the resolution of any problems in securing necessary care.

 Provide training and support services to you in the areas of recruitment,

assistance with identifying equipment needs such as assistive technology,

and other purchases not otherwise covered by NJ FamilyCare, which would

reduce your need and increase your independence.

 Interact with PPL as necessary to resolve issues with you and/or your

authorized representative.

 Complete quarterly face-to-face visits with you to monitor your progress,

determine satisfaction and offer assistance.

assessment (or most recent reassessment) as the basis for determining your

monthly budget. Your number of authorized hours is converted into a dollar

amount using the current reimbursement rate. A standard administrative deduction

is then calculated to cover the costs of counseling and bookkeeping services. The

remaining amount is available to you for purchasing services.

The financial consultant will assist you in developing a cash management plan to

help determine how best to spend your monthly budget to purchase services that

you need.

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 Employment of individuals, including family members, to provide personal

Possible Additional Uses of the Monthly Allowance:

 Services from a home health agency;

 Equipment, small appliance, technology or other items that increase

independence (e.g., microwave oven or washing machine); and,

 Supplies and equipment that promote or enhance independence that are not

covered by Medicaid.

NEED FOR AUTHORIZED REPRESENTATIVE

If you are unable to manage the responsibilities of directing and supervising your

own personal care needs, you will be required to have an authorized representative

authorized representative receives no monetary compensation for this service and

may not serve as your worker. If you desire to have an authorized representative

but cannot identify a person to serve in that capacity, the financial consultant will

assist you in identifying an appropriate individual to serve as an authorized

representative.

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financial consultant. The profile determines your level of risk in case of an

emergency, such as a worker calling out or a natural disaster situation. The Risk

Assessment Profile will include three possible levels of risk, “High,” “Moderate,”

or “Minimal.” This profile is required to be completed before you can create your

cash management plan.

The Risk Assessment Profile will determine what type of back-up system, if any,

will be required to participate in the PPP. If the profile indicates that you have

have a “High” level of risk, you are required to include a back-up plan. The

financial consultant will work with you, and/or your authorized representative, to

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management plan, as you see fit. PPL serves as your agent and handles all payroll

responsibilities, tax deductions, workers’ compensation and withholding

obligations. PPL provides you with a detailed financial statement, showing all

and employing their own direct care workers. While PPP may not be the choice for

all participants, it is an available option to consider.

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enrollment process. The MCO’s Care Managers help provide options counseling,

and can complete the initial enrollment packet to be forwarded to PPL.

NJ Department of Human Services