New Assessment Tool for Persons who Need Assistance with their Personal Care
Some Medicaid beneficiaries with intellectual and developmental disabilities (I/DD) need assistance with the activities of daily living (ADLs) such as dressing, bathing, feeding, and toileting. When medically necessary, assistance with the ADLs is available for persons who are enrolled in NJ’s Medicaid managed care organizations (MCOs). These services are known as Personal Care Assistant (PCA) services. For new referrals, an MCO nurse does an initial assessment to determine if the person with I/DD is eligible for this type of assistance, and, if yes, how many hours per week this assistance will be provided and covered by the MCO. After the initial assessment, the individual is reassessed on an annual or semi-annual basis, or when the individual has a change in his/her condition. The PCA services can be provided through either a PCA agency that is in your MCO’s network or they can be self-directed through the program known as the Personal Preference Program (PPP). Through the PPP program, the individual or legal guardian is permitted to hire a family member, friend, or neighbor to provide the person with I/DD with the needed assistance with activities of daily living.
This webinar provides important information on the new PCA/PPP assessment tool, which was developed by the State Medicaid office. After many months of development and field testing, this assessment tool is now being used by all of New Jersey’s Medicaid MCOs.
Speakers: Maribeth Robenolt, RN, MPH, Director, MLTSS Quality Monitoring, and Steve Tunney, RN, MSN, Director, Office of Customer Service
Presented on June 29, 2015