Statewide Respite Care Program
The New Jersey Statewide Respite Care Program gives a short-term or periodic break to family from the demands of daily care for functionally impaired persons, including the frail elderly. The sliding scale ranges from 0% to 25% of the cost of services, based on the care recipient’s income.
This program provides respite care services in order to relieve caregivers of stress from providing daily care. This respite may be provided for a short time, or once in a while. For example, services could be provided to:
- Allow the caregiver to take a vacation
- Cover care when a caregiver needs surgery or has an emergency
- Give the caregiver time to take care of him/herself, run errands, etc.
Statewide Respite is care for the caregiver, not for the care recipient. While services are given to the care recipient, it’s for the purpose of giving the caregiver a break. If the care recipient needs more care than the caregiver can provide, or does not have a caregiver who gives daily, basic care, then Statewide Respite may not be the right program. The Aging & Disability Resource Connection can help find the right programs.
Special Needs Spotlight Webinar Series: Understanding Nj Medicaid For Individuals With Disabilities
The law firm Norris McLaughlin, P.A., is pleased to present the Special Needs Spotlight Webinar Series. In this next session, Understanding NJ Medicaid for Individuals With Disabilities, Shana Siegel, a Member of the firm and Chair of its Elder Care & Special Needs Law Practice Group, was joined by Gwen Orlowski, Executive Director of Disability Rights New Jersey.
Watch the recording here or read the transcript below:
How Does Medicaid Provide Financial Assistance To Medicare Beneficiaries In New Jersey
Many Medicare beneficiaries receive Medicaid financial assistance that can help them with Medicare premiums, lower prescription drug costs, and pay for expenses not covered by Medicare such as long-term care.
Our guide to financial assistance for Medicare enrollees in New Jersey includes overviews of these benefits, including Medicare Savings Programs, Medicaid long-term care coverage, and eligibility guidelines for assistance.
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Nj Familycare Aged Blind & Disabled
The NJ FamilyCare Aged, Blind, Disabled Programs are multiple programs for people who need access to health care services in the community, or in long-term care facilities. In determining whether a person is financially eligible for NJ FamilyCare ABD Programs, the applicantâs financial eligibility will be considered along with his or her spouse or parents. All of the NJ FamilyCare Aged, Blind, Disabled Programs have just one application called the NJ FamilyCare Aged, Blind, Disabled Program Application.
Senior Gold Prescription Discount Program
The Senior Gold Prescription Discount Program is a state-funded prescription program with a different co-payment structure and income eligibility guidelines than those of PAAD.
You may be eligible for Senior Gold if you meet the following requirements:
- You are a New Jersey resident.
- You are age 65 or older or between ages 18 and 64 and receiving Social Security Disability benefits.
In addition: All Medicare-eligible Senior Gold beneficiaries are also required to enroll in a Medicare Part D Prescription Drug Plan of their choice. They will be responsible for paying the monthly premium directly to the Medicare Part D plan. They also will be responsible for paying any late enrollment penalty imposed by Medicare for each month they were eligible to enroll in Medicare Part D but did not enroll.
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Age 65 Or Older And/or Disabled
If you were 65 or older or blind or disabled on December 31 of the tax year and your income was below the filing threshold amount for your filing status, and you satisfy the eligibility requirements, apply for the credit as follows:
- Homeowners who are eligible and file Homestead Benefit applications will automatically receive their property tax credits with their Homestead Benefits.
- Tenants and those homeowners who are not eligible for the Homestead Benefit because they were not homeowners on given date, may complete Form NJ-1040-HW to claim the property tax credit or they may claim the credit on Form NJ-1040. Do not file both Form NJ-1040 and Form NJ-1040-HW.
Understanding Nj Medicaid For Individuals With Disabilities
Shana Seigel: Today, were going to be talking about understanding New Jersey Medicaid programs. Many of you may know this is, I believe the eighth in a series of webinars that we have offered here. Its been a really wonderful project over the summer, and we are looking forward to then having all of these recordings that will be available for you to be able to then watch as you need a refresher at any time and share with others.
Today, I am thrilled to say that I have with me Gwen Orlowski, who is the Executive Director of Disability Rights of New Jersey. Gwen is a fantastic resource for seniors, their families, individuals with disabilities. And so, I really wanted to have Gwen participate today. Besides she knows more about Medicaid than anybody else in the state. So, Im going to turn it over to Gwen and let her give a fewtell us a little bit about herself and her organization.
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Who Is Eligible For Medicaid In New Jersey
In addition to the aged, blind, and disabled, the following New Jersey residents are eligible for Medicaid:
- Adults with incomes up to 138% of poverty
- Children with household incomes up to 350% of poverty are eligible for CHIP in New Jersey. This is one of the most generous thresholds in the country.
- Pregnant women with incomes up to 200% of poverty .
New Jersey Medicaid And The Trump Administration
The Trump Administration vowed to repeal the ACA and replace it, but that did not come to pass. There were several legislative efforts to repeal or change various aspects of the ACA in 2017, including bills that would have ended the enhanced federal funding for Medicaid expansion and switched general Medicaid funding to block grants or per-capita allotments, with an overall goal of sharply cutting federal Medicaid spending. But none of those bills passed. The only part of the ACA that was repealed was the individual mandate penalty.
For New Jerseys population that was already eligible for Medicaid prior to 2014, the federal matching rate was only 50%, but for those newly eligible for Medicaid under the ACAs expansion, the federal government paid 100% of the costs through 2016, and is now paying 94% of the costs. As of 2020, the federal government paid 90% of costs, and the funding split remains at that level going forward.
If the ACA had been repealed, nearly two-thirds of the adults who would have lost access to Medicaid have jobs or are in a household where someone has a job . These are the people who work in the service industry, construction, home health care, retail, and the education system. They are vital to our economy and our lives, but their employers often dont provide coverage , and their income just isnt high enough to purchase health insurance, particularly in a high cost-of-living state like New Jersey.
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Division Of Developmental Disabilities
Shana Seigel,: Yes. Great.
Gwen Orlowski: Shana, But Im going to want to be clear about this on the QIT and the spousal impoverishment. Those are in the waiver documents itself. But I dont think that DDDS figured out how to operationalize them because I think the chances are nearly non-existent. So again, if you have that issue, you might need to seek counsel because it would be novel.
Shana Seigel: Calling Gwen in that case.
Gwen Orlowski: Yeah. Its novel, yes. But its there in the waiver documents.
Shana Seigel: Right, right. These are a little theoretical here. But thank you for that clarity. Yes. So, in order to qualify for this program, which as most of you know, comes with a much more substantial budget than the supports program, you would be either coming up on the waiting list or determined to be at imminent risk of homelessness. So, you would have a situation where you have parents who are older, have a parent who passes away, and that would be a situation where you would then be bumped up to the top of that waiting list. Im happy to talk with you about the specifics, you know, with anyone about the specifics of how that all works. And you must meet the functional criteria for DDD services, and you must meet the criteria. And as you know, this is a substantially higher level of impairment than would be required under the supports program. But it also comes with a much higher budget.
Shana Seigel: Great. Very much appreciated.
Traumatic Brain Injury Fund
The TBI Fund provides New Jersey residents of any age, who have survived a traumatic brain injury, the opportunity to access the brain injury related services and supports they need to live in the community. The Fund purchases supports and services to foster independence and maximize quality of life when insurance, personal resources, and/or public programs are unavailable to meet those needs. A portion of the Fund also is used to support public education, outreach, and prevention activities related to TBI. To qualify for the Fund, an individual must have less than $100,000 in liquid assets, be a New Jersey resident for at least 90 consecutive days, and provide medical documentation of a brain injury. Contact Division of Disability Services to request a TBI Fund Application at 1-888-285-3036.
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New Jersey Cat Assessment And Due Process
Gwen Orlowski: Yeah, while were waiting for that, Shana, I had one other thing I just want to share, that weright before COVID happened in February, and it involves the New Jersey CAT assessment and due process. So, we took the position that when people had either initial or new assessments, that if they didnt like the results of that assessment, that they had a constitutional due process fair hearing right. And people were very frustrated that that wasnt happening. And we did advocate with DDD. And they did change that, and their website reflects that as of February of 2020. So, if you areyou know, there again, were in a period where nothing is really happening. But once were on the other side of this, and I do believe we will be on the other side of this, at some point in time, know that you also have that fair hearing right, because due to the New Jersey CAT, we did that advocacy, and that changed in February of 2020.
Nj Property Tax Reimbursement Program
The Senior Freeze Program reimburses eligible senior citizens and disabled persons for property tax or mobile home park site fee increases on their principal residence. To qualify, you must meet all the eligibility requirements for each year from the base year through the application year
*Income requirements and tax year changes yearly. Please contact our office for current filing year information.
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Property Tax Deduction Credit
Homeowners and tenants who pay property taxes, on a principal residence in New Jersey, either directly or through rent, may qualify for either a deduction or a refundable credit when filing an Income Tax return.
The property tax deduction reduces your taxable income. You can deduct your property taxes paid or $15,000, whichever is less. For Tax Years 2017 and earlier, the maximum deduction was $10,000. For tenants, 18% of rent paid during the year is considered property taxes paid. Keep in mind that the amount of property taxes paid that you could deduct depends on a number of factors, such as the number of owners or units. The property tax credit reduces your tax due because it is subtracted directly from your tax liability. The benefit is a refundable credit of $50.You can claim only one of these benefits on your tax return.
Medicare Savings Programs: Partial Medicaid Program
Gwen Orlowski: Yeah, Ill keep this quick. But this is what we call a partial Medicaid program. So, you dont get Plan A, you dont get waiver services. All you get is the state paying your Part B premium. And sometimes the state, under the QMB Program, Qualified Medicare Beneficiary , also pay for the deductible and the monthly premium. Having said that, in New Jersey, the QMB criteria align with aged, blind, and disabled. So, really, there shouldnt be very many people who are enrolled in aged, blind, and disabled. There sometimes are QMB people because they have too many resources, see the resources here go up to $7860, and under ADD its $4,000. But for most people, it should align. I would say the other thing I would say about this program is, it may not matter for children right now, because if theyre even adult children, if theyre in a full-scope Medicaid program, Medicaid is paying for this premium. But it may matter for aging parents, that as they go onto Medicare, they may want to look whether or not theyre eligible for this program if theyre low income, because the Medicare Part B premium is significant, and to have that paid for by Medicaid. Again, this is the Medicaid program, can really be a benefit to a financial benefit to a family. Next slide, please.
Shana Seigel: Right. No. Absolutely. OK.
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New Jersey Has Accepted Federal Medicaid Expansion
- 2,053,575 Number of New Jerseyans covered by Medicaid/CHIP as of October 2021
- 769,724 Increase in the number of New Jerseyans covered by Medicaid/CHIP fall 2013 to October 2021
- 40% Reduction in the uninsured rate from 2010 to 2019
- 54% Increase in total Medicaid/CHIP enrollment in New Jersey since Medicaid expansion took effect
Disability Health & Wellness Initiatives
The New Jersey Disability Health & Wellness program serves to consult and collaborate on projects that seek to promote healthy living and prevention of secondary conditions for people with disabilities. As such, the Division works to identify gaps in the State healthcare system improve state surveillance activities and facilitate partnerships between state agencies, community organizations, service providers and individuals with disabilities.
The DH& W program staff work with policy makers, health educators, public and private agencies, and experts in the field of health and wellness to brainstorm and implement ways to integrate health and wellness options for people with disabilities into the general health promotion activities in existence within the state.
You Cannot Get Aged Blind Or Disabled Cash Assistance If You:
- Are eligible for the Temporary Assistance to Needy Families or State Family Assistance program
- Do not pursue federal aid assistance without good cause
- Do not participate in substance use disorder treatment without good cause
- Do not follow through with the SSI application process without good cause
- Are eligible for SSI benefits or are an ineligible spouse of an SSI recipient or
- Do not follow a Social Security Administration program rule or application requirement and SSA denied or terminated your benefits.
Medicaid Managed Long Term Services And Supports
Managed Long Term Services and Supports refers to the delivery of long-term services and supports through New Jersey Medicaid’s NJ FamilyCare managed care program. MLTSS is designed to expand home and community-based services, promote community inclusion, and ensure quality and efficiency.
MLTSS uses NJ FamilyCare managed care organizations to coordinate ALL services. MLTSS provides comprehensive services and supports, whether at home, in an assisted living facility, in community residential services, or in a nursing home.
For individuals 21 and older contact your local County Area Agency on Aging – Aging and Disability Resource Connection to find out more information on services and resources in your area and to be clinically screened for MLTSS.
For children birth through 20 years old contact the Division of Disabilities Services at 1-888-285-3036 to speak with an Information and Referral Specialist.
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What Is The Look
When applying for New Jersey Medicaid, it is important to understand that there is a 5-year period where Medicaid checks to make sure that nothing was sold or was given away under what is considered to be the fair market value. If a violation is found, Medicaid will consider the applicant ineligible for a certain period of time.
What Are The Medicaid Income And Asset Limits For The Elderly Seeking Assistance To Cover Assisted Living In New Jersey
Medicaid is a health care program that is funded by both the State of New Jersey and the Federal Government. It is designed for those with limited resources and limited income and is designed to help people of all ages.
If your loved one is in need of being moved to an assisted living facility and cannot afford the monthly fee associated with this type of care, they may be able to receive assistance through Medicaid if they are at least 65 years old.
In this brief guide, you will be introduced to the income and asset limits imposed by the program.
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Income And Asset Limits
Below, we will list each Medicaid program offered in the State of New Jersey and the income and asset limits associated with that particular program for an individual:
NOTE:Elderly individuals who are residents of an assisted living facility or a nursing home are required to pay all of the income that they have with the exception of $50.00 each month, which is a personal needs allowance.