» Changes Made in Eligibility for New Jersey Global Options for Long Term Care

Changes Made in Eligibility for New Jersey Global Options for Long Term Care

Moorestown, NJ (Law Firm Newswire) May 10, 2012 - On Jan. 1, 2009, the Centers for Medicare and Medicaid Services (CMS) gave the New Jersey Department of Health and Senior Services (DHSS) approval to consolidate three Medicaid Waiver programs: Assisted Living/Adult Family Care, also known as AL/AFC, Caregiver Assistance Program, or CAP, and the Community Care Program for the Elderly and Disabled (CCPED) into one program called Global Options for Long Term Care (GO).

Elder care attorney Susan M. Green of the Begley Law Group in Moorestown, N.J., said that the change was an improvement.

“Since this consolidation, at least 20 percent more participants have been served,” Green said. “Further, the average annual cost of GO is roughly two-thirds less than a nursing facility.”

GO is for individuals who are eligible for a nursing facility level of care, but who wish to remain in their homes. To meet the nursing facility level of care, individuals who do not have any defects in cognition must need assistance on a limited basis with at least three daily living activities, and individuals who do have cognitive deficits must need supervision with at least three daily living activities. GO enrollees must also meet income and asset requirements.

Additionally, GO participants agree to allow the county and the state to enter the participant’s home in order to monitor the services provided. This program is intended as a supplement to, not a replacement for, the assistance already being provided by family members and other loved ones, neighbors and friends.

Care managers work with GO participants to create individualized plans of care based on the participant’s health care needs. Care managers do not provide direct services, such as transportation, medical care, social work and therapeutic counseling.

GO was established as a participant-directed care program. With the help of the care manager, the participant is able to determine what services he or she needs, select providers of these services, and then ensure that the services are provided.

Eligibility

To be eligible for GO, an individual must meet all of the following criteria:
1. Resident of New Jersey
2. 65 years of age or older, or age 21-64 and physically disabled (as determined by the Social Security Administration or the Disability Review Section of the Division of Medical Assistance and Health Services)
3. Qualify for Medicaid financial eligibility
a. Qualify for SSI in the community, or
b. Qualify for Medicaid Only – Institutional Only, or
c. Qualify for New Jersey Care
c.i. Income at or below 100% of the poverty level as determined by the federal government, i.e. $11,170/year for a family of 1 or $15,130/year for a family of 2, and
c.ii. Resources at or below $4,000
4. Clinically eligible for a nursing facility level of care
5. Reside in an approved community living arrangement

Individuals who are under 21 or who are between 21 and 64, but who have a chronic mental illness, intellectual disability, or developmental disability are ineligible for GO.

To learn more about the Begley Law Group or to contact a New Jersey life care planning attorney, call 1.800.533.7227 or visit www.begleylawgroup.com.

Colleen Caruso
Begley Law Group, P.C.
509 S. Lenola Road, Building 7
Moorestown, NJ 08057
Tel: 800.533.7227


View Larger Map

  • PERSONAL INJURY SETTLEMENTS: HOUSING FOR PLAINTIFFS WITH DISABILITIES
    by Thomas D. Begley, Jr., CELA Introduction Housing for an individual with disabilities is a major concern. The purchase of a residence is a very important decision involving a number of factors. This is particularly true where the individual is receiving means-tested public benefits such as Supplemental Security Income (SSI) and Medicaid. If there is a special needs trust involved, the SSI and State Medicaid Regulations must be carefully considered. Selecting the Right Home Often, a home must be made handicap accessible. In selecting a home, care must be taken to ensure that the home can be adapted for the [...]
  • YOU HAVE JUST BEEN DIAGNOSED WITH EARLY ALZHEIMER’S: NOW WHAT?
    by Thomas D. Begley, Jr., CELA Background on Alzheimer’s According to the American Alzheimer’s Association, Alzheimer’s disease is a progressive brain disorder that damages and eventually destroys brain cells, leading to memory loss and changes in thinking and other brain functions. It usually develops slowly and gradually gets worse as brain function declines and brain cells eventually wither and die. Ultimately, Alzheimer’s is fatal and currently, there is no cure. An estimated 5.3 million Americans of all ages have Alzheimer’s disease in 2015. Thirty-six percent are age 85 or older, 43% are between 75 and 84, 16% are between 65 [...]
  • THE CONTINUUM OF CARE
    by Thomas D. Begley, Jr., CELA Families of many individuals who require long-term care believe that their only option is to place their loved one in a nursing home. Actually, there is an eight-step continuum of care: Informal Caregiving. Most care for Alzheimer’s patients is provided by informal caregiving provided by a family member or friend who aids and supervises the daily care of the patient. Geriatric Care Managers. Geriatric Care Managers generally perform six functions: an initial assessment of the patient, development of a Care Plan, implementation and coordination of the Care Plan, monitoring services, appropriate re-assessment, and appropriate [...]

See other news sources publishing this article. BETA | Tags: , , , , , , , , , , , ,



Get headlines from Law Firm Newswire sent right to your inbox.

* indicates required