Home and Community-Based Service Program

When Medicaid was enacted by Congress in 1965, people with severe disabilities almost always lived in institutions. Since then, new medical treatments and the growing number of services that are available in the community have meant that it is often possible now for people with even the most severe disabilities to continue to live at home as long as they have the support services they need.

Personal Care Assistant (PCA) Services. This is an optional benefit offered to New Jersey Medicaid beneficiaries who are experiencing some functional impairment and need a Personal Care Assistant to help them with some aspects of daily living such as dressing or bathing. Recipients must have a doctor's order to receive this service, but they do not have to be permanently disabled. An estimated 16,000 people receive this service at any given time.

Section 1915[c] of the federal Social Security Act now allows states to "waive" requirements of the original Medicaid legislation and create so-called waiver programs that provide care in the home and in the community and are an alternative to institutional care.

In New Jersey, the Division of Disability Services administers three home and community-based services, or waiver programs. These are:

AIDS Community Care Alternatives Program (ACCAP) . At any one time this program can serve a maximum of 750 people statewide, including those of any age with AIDS and children up to age 13 who are HIV positive. It provides full Medicaid benefits plus case management, private-duty nursing, medical day care, personal care assistant services, and hospice care. Children receive additional benefits, including placement in a specialized group foster care home or reimbursement to their foster parents, through DYFS.

"Community Resources for People with Disabilities Waiver (CRPD). The waiver is designed to provide services in addition to full Medicaid benefits to people who otherwise would be unable to live in the community and would probably have to move into a nursing home or other institution. Additional services included in the waiver are case management, environmental/vehicle modifications, community transitional services and personal emergency response systems (PERS). Up to 150 individuals enrolled in this waiver are also eligible to receive private duty nursing services".

TBI (Traumatic Brain Injury) Waiver. This waiver program can serve up to 350 people between the ages of 21 and 64 who have survived a traumatic brain injury after the age of 16. People in the program receive full Medicaid benefits plus additional services including case management, a structured day program, respite care and night supervision.

For information on these programs, call 1-888-285-3036.