Be sure to complete NJ FamilyCare renewal app

It is important for families and staff to be aware of the necessity of completing the NJ FamilyCare renewal application if it arrives in the mail.  The renewal application is mailed to those who already have Medicaid, and it is necessary for it to be completed and mailed back quickly, in order to continue Medicaid benefits.  If this renewal application is ignored, the result would be the termination of Medicaid! 

Please note that the term "NJ FamilyCare" is the same as "Medicaid."  The "Aged, Blind, and Disabled" Medicaid program is one of the Medicaid categories in which many individuals with I/DD receive their Medicaid benefit.

Although a renewal application can be sent out as often as every year (depending upon the county in which one lives), some families may never have received a renewal application for their son/daughter's NJ FamilyCare/ Medicaid, while others may receive a renewal application every year.  The NJ FamilyCare/ Medicaid renewal application is sent through the regular mail, at different times in the year, so if a family does not receive it, they should not be concerned.

 

Important Updates from DDD

With the March 30 approval of its Community Care Waiver renewal, the Division is now moving toward full implementation of the Medicaid-based fee-for-service system, under which completion of the New Jersey Comprehensive Assessment Tool (NJ CAT) is required for individuals receiving Division-funded services in the new system.

Since 2015, the Division has sent multiple notifications regarding mandatory completion of the NJ CAT to individuals who receive or are eligible to receive Division-funded services. This week, a FINAL NOTIFICATION letter will be sent to individuals currently receiving Division-funded services and residing in their own home or with family who have not yet completed the NJ CAT.

To prevent discontinuation of Division-funded services, the NJ CAT must be completed by July 31, 2017.

Requesting to Complete the NJ CAT

For individuals receiving Division-funded services and residing in their own home or with family

Go to www.DDPIAssessmentUpdate.com and submit the following information:
• Individual’s name, six-digit DDD ID#, and email address
• Informant’s name, email address, phone number, and relationship to the Individual (the informant is a person who best knows the individual and his/her needs)

One to two weeks after the information is submitted, the identified informant will receive an email with a link to complete the NJ CAT online and a password. (If the informant does not have access to a computer, the information can be submitted by calling 732.640.0730, and the NJ CAT can be completed over the phone with a DDPI representative.)

Final Call to Participate in the NCI Survey Project

New Jersey’s service system for adults with intellectual/developmental disabilities, age 21 and older, has undergone and is continuing to move forward with a number of significant reforms. At the heart of these reforms is a strengthened commitment to ensuring the delivery of high quality services in the community that support and reflect individual choice.

As national best practices demonstrate, ensuring quality services is a process that begins with the measurement of key performance indicators. The National Core Indicators (NCI) is a national project whose purpose is to develop standard performance measures for state systems that provide services to adults with developmental disabilities.

The New Jersey Division of Developmental Disabilities is excited to participate in the NCI project through utilization of three of NCI’s voluntary surveys. The Adult Consumer Survey is a face-to-face conversation between individuals receiving services and trained interviewers. The Adult Family Survey and Family/Guardian Survey, both of which are anonymous, are completed online (or via a paper version if necessary).

Reminders to complete the survey, along with a National Core Indicators Overview, were mailed to family members/guardians in late May. If you have already completed the survey there is no need to complete it again.  Online responses to the survey should be completed by June 30, 2017. Paper versions of the survey should be mailed to the Division by June 16, 2015.  Division staff are continuing to call randomly selected individuals to request their voluntary participation in a face-to-face interview.

If you are a family member/guardian of an individual wo receives Division-funded services:

• You may receive a letter in the mail indicating you have been selected to participate in one of the NCI family surveys. THE MAILING WILL BE RECOGNIZABLE AS IT WILL BE PRINTED ON BRIGHT YELLOW PAPER, which will show through the window in the envelope. 
• There will be a web address (URL) through which you will access the survey. This web address will be unique to you and cannot be shared. There will also be contact information if you prefer to request a paper copy.
• It is your choice whether or not you would like to participate, but please know that staff at DDD is very interested in hearing about your experiences with the Division.

The success of this survey project, and of any quality improvement strategies that may emerge as a result, is directly proportional to our ability to elicit thoughtful, honest participation by individuals and their families.

Your participation, assistance, and support are greatly appreciated, and we look forward to continuing to work with you to improve Division-funded services for adults with intellectual/developmental disabilities in New Jersey.

If you have questions or concerns about the surveys, please contact us by email at DDD.NCI@dhs.state.nj.us or by phone at 609.631.4626.

 

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Clarification on Hiring a Parent/Guardian as a Self-Directed Employee (SDE) Under the New Fiscal Intermediary

• DDD: Individuals participating in the DDD Self-Directed Employee option had not been able to employ a parent, guardian or spouse to provide DDD services under the old fiscal intermediary (Easter Seals) and will not be able to employ a parent, guardian or spouse to provide DDD services under Public Partnerships.

• PPP: Individuals participating in the DDS Personal Preference Program (PPP) had been able to employ a parent or guardian to provide PPP services under the old fiscal intermediary, and will continue to be able to employ a parent or guardian to provide PPP services under Public Partnerships.

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Updates for Individuals/Families Participating in DDD’s Self-Directed Employee Option

Orientation and Training session and In-Person Enrollment session added in Bergen County

Public Partnerships has added an Orientation and Training session and an In-Person Enrollment session in Bergen County for individuals, families and employees participating in DDD’s Self-Directed Employee option:

• Thursday, June 1, 2017
Saddle Brook Marriott
10:00 AM – 12:00 PM Orientation and Training
1:00 PM – 8:00 PM In-Person Enrollment

Details and registration links for these Public Partnerships sessions will be available on Public Partnership’s DDD Trainings page.  

Online or phone enrollment for individuals/families participating in DDD’s Self-Directed Employee option
To enroll with Public Partnerships as the employer of record, DDD individuals/families will need a PPL ID # (this is different from the DDD ID #). Call 844.842.5891 to get the PPL ID #, then:

• For online enrollment, go to www.pplenroll.com and register for access to the Online Enrollment System

• For enrollment over the phone, call 877.908.1752

There is a separate enrollment process for PPP participants. For information, please contact the PPP Customer Service Team (below) or visit Public Partnerships' DDS web page.

Upcoming Webinar

Q&A for DDD Self-Directing Individuals, Families and Self-Directed Employees Transitioning to the New Fiscal Intermediary

May date to be determined – more information to come!

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Updates for DDD Qualified and Community Providers on the Transition to a New Fiscal Intermediary

Qualified Providers: Public Partnerships will send  an email to Qualified Providers in early May that will include enrollment instructions, an IRS Form W-9, and a Payment Method Form. (Qualified Providers are agencies registered on DDD’s eRecord/iRecord.)

Community Providers: Public Partnerships will mail a letter to Community Providers in early May – from a list furnished by Easter Seals NJ – that will include enrollment instructions, an IRS Form W-9, and a Payment Method Form. (Community Providers are agencies not registered on DDD’s eRecord/iRecord.)

If you are a DDD Qualified or Community Provider and do not receive a communication from Public Partnerships by Friday, May 12, please contact the Public Partnerships’ DDD Customer Service Team at 844.842.5891 or njddd-cs@pcgus.com.

Please note: Public Partnerships will not process future provider/vendor payment vouchers without a W-9 on file. The provider/vendor payment voucher template will be available on the Public Partnerships website.

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4/10/17 - IMPORTANT UPDATES FROM DDD

FINAL CALL for Completion of Mandatory NJ CAT

As you know, the Division is in the process of transitioning to a fee-for-service system. To access services in that new system, every individual who currently receives or is eligible to receive Division-funded services must have a completed NJ CAT (NJ Comprehensive Assessment Tool).

Beginning in 2015, the Division undertook a massive outreach effort to ensure that all individuals receiving or eligible to receive services were notified about the need to complete the new NJ CAT. This included five mailings from January 2015 through August 2016; targeted one-to-one outreach from case managers and support coordinators; and numerous announcements distributed by the Division.While the NJ CAT has now been completed for the majority of individuals, there remains a small number of individuals who still do not have a completed NJ CAT.

REMEMBER: the results of the NJ CAT establish an individual’s tier; each tier has a corresponding budget; and the budget is used to fund needed services. So, without a completed NJ CAT, an individual will not have a tier or budget – and therefore will not be able to access services in the new fee-for-service system. This is why it is imperative, now that we are moving closer to full implementation of the fee-for-service system, that the NJ CAT be completed for everyone served by the Division. The Division will soon be mailing a final NJ CAT notification letter to individuals who have not completed the NJ CAT.

Please distribute this communication to and among your networks; post the NJ CAT deadline on your websites and social media accounts; and check that any individual you serve or care for has completed the NJ CAT. It is imperative that people act now so that services are not discontinued. Any individual whose Division-funded services are discontinued can come back through DDD Intake at any point to re-establish DDD and Medicaid eligibility, and complete the NJ CAT to access needed services.

Release of Fee-for-Service Timeline

 

The Division has developed a Projected Timeline for the Shift to Fee-for-Service. Please note that, other than ensuring the NJ CAT has been completed, there is nothing that individuals/families need to do at this time.

The Division will contact individuals as they are identified to enroll into fee-for-service. The projected timeline includes suggestions that can help individuals/families become familiar with the transition process and prepare for eventual fee-for-service enrollment. Providers of residential and in-home individual support services that have not yet added the “Individual Supports” service to their Combined Application to Become a Medicaid/DDD Approved Provider should do so within the next few weeks. The application can be accessed via the Provider Portal.

In addition to the completed Combined Application, providers offering Individual Supports (residentially and/or in-home) must submit the Attestation for Provider of Individual Supports Service document available on the same webpage as the application.

Release of Community Care Waiver (CCW) Policy Manual

The Division is pleased to release the draft Community Care Waiver (CCW) Policies and Procedures Manual. Please note that while it is being released in draft form to give stakeholders an opportunity to provide feedback, the CCW policies and procedures will be in effect immediately for the small pilot cohort of CCW participants shifting into fee-for-service this spring. Comments and feedback regarding the CCW policy manual can be directed to DDD.CCWHelpdesk@dhs.state.nj.us.

The updated Supports Program Policies and Procedures Manual is expected to be released later this week.

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UPDATE:  DDD Supports Program Quick Guide for Families

We are excited to share with you a new resource for families developed by the Divisionof Developmental Disabilities in collaboration with the Regional Family Support Planning Councils. The Supports Program Policies and Procedures Manual: A Quick Guide for Families can assist families in gaining a basic understanding of the Supports Program and its service benefits.

While this guide can be helpful for any family newly entering Division services and the Supports Program, it is particularly valuable for middle and high school students with intellectual/developmental disabilities and their families.


DDD Important Updates

As you may know, New Jersey’s service system for adults with intellectual/developmental disabilities, age 21 and older, has undergone and is continuing to move forward with a number of significant reforms. At the heart of these reforms is a strengthened commitment to ensuring the delivery of high quality services in the community that support and reflect individual choice.

As national best practices demonstrate, ensuring quality services is a process that begins with the measurement of key performance indicators. The National Core Indicators (NCI) is a national project whose purpose is to develop standard performance measures for state systems that provide services to adults with developmental disabilities.

The New Jersey Division of Developmental Disabilities is excited to participate in the NCI project through utilization of three of NCI’s voluntary surveys. The Adult Consumer Survey is a face-to-face conversation between individuals receiving services and trained interviewers. The Adult Family Survey and Family/Guardian Survey, both of which are anonymous, are completed online (or via a paper version if necessary).

Invitations to complete the online surveys will be mailed by the Division to family members/guardians in early February, along with a National Core Indicators Overview. At the same time, Division staff will call randomly selected individuals to request their voluntary participation in a face-to-face interview. 

If you are an individual who receives Division-funded services:
• You may receive a phone call in the coming weeks from a DDD staff person asking if you would be willing to participate in a face-to-face conversation about your experiences with the Division.
• If you choose to participate, we will schedule a time and place to meet that is convenient for you. 
• While you will be talking with an interviewer face-to-face, your responses will be confidential.
• It is your choice whether or not you would like to participate, but please know we are very interested in hearing about your experiences with the Division!

If you are a family member/guardian of an individual who receives Division-funded services:
• You may receive a letter in the mail indicating you have been selected to participate in one of the NCI family surveys. THE MAILING WILL BE RECOGNIZABLE AS IT WILL BE PRINTED ON BRIGHT YELLOW PAPER, which will show through the window in the envelope. 
• In this letter, there will be a web address (URL) where you will access the survey. This web address will be unique to you and cannot be shared. There will also be contact information if you prefer to request a paper copy.
• It is your choice whether or not you would like to participate, but please know we are very interested in hearing about your experiences with the Division!

If you are a Support Coordinator, Service Provider, Division staff, or other community partner, I ask for your support and assistance to:
• REMIND the individuals and families in your networks to expect a mailing on bright yellow paper with a link to one of the two surveys, and possibly a phone call to schedule an interview.
• EDUCATE the individuals and families in your networks about the importance of the survey.
• ENCOURAGE the individuals and families in your networks to participate in the survey!

Service providers and community partners should be aware that you may see individuals being interviewed by DDD staff at your locations.

The success of this survey project, and of any quality improvement strategies that may emerge as a result, is directly proportional to our ability to elicit thoughtful, honest participation by individuals and families.

Your participation, assistance, and support are greatly appreciated, and we look forward to continuing to work with you to improve Division-funded services for adults with intellectual/developmental disabilities in New Jersey.

If you have questions or concerns about the surveys, please contact us by email at DDD.NCI@dhs.state.nj.us or by phone at 609.631.4626.

For a copy of the survey, click here.

 

System Change to Medicaid and Fee-for-Service

As of January 22, 2013 The Division of Developmental Disabilities (DDD) officially adopted a new rule mandating MEDICAID ELIGIBILITY in order to receive services through DDD for adults age 21 and over.  The rule adoption is also in preparation for DDD's Supports Program and move toward fee for service.

Individuals who are currently DDD eligible must obtain Medicaid eligibility or services may be discontinued.  If you have questions regarding this information please contact your DDD case manager directly.

As we navigate through DDD's changes in funding and service options, it is critical that consumers and caregivers stay informed and connected. Please visit Abilities website frequently for updates and information.

CLICK HERE for DDD's Fee-for-Service page

CLICK HERE for information on selecting a Support Coordination Agency

Tier-Based Service Model and Release of Fee-for-Service Budgets Quick Reference Guide

The fee-for-service (FFS) tier-based service model will help the Division ensure that, in a system with finite resources, individuals with like needs receive like budgets with which to access services and supports to help meet those needs.
In the tier-based model in New Jersey:

  • DDD-funded services will be accessed (1) through enrollment on one of two Medicaid waivers - either the Supports Program or the Community Care Waiver (CCW), and (2) will be funded based on an individual's assigned tier. Waiver eligibility and tier assignment are both based on assessed level of need as determined through completion of the NJCAT (NJ Comprehensive Assessment Tool)
  • Each tier has a corresponding budget that is the same for the Supports Program or the CCW - except for the addition of an available budget component for "Individual Supports" for individuals enrolled on the CCW
  • The FFS tier-based budget is used by an individual to access prior authorized FFS services and supports
  • Some FFS services and supports have a corresponding tier-based reimbursement rate. When submitting a claim for tier-based services, a provider will bill at the rate that corresponds to the tier of the individual to whom the service was delivered. Other FFS services will be billed at a standard rate regardless of an individual's tier.

To assist individuals, families and providers, the Division has developed two quick reference guides:

    Fee-for-Service System Individual Budgets: Quick Reference Guide
    Fee-for-Service Rate Schedule: Quick Reference Guide, released May 2015

Important System Updates and News from our CEO

The links below open a .pdf version of emailed updates.  CLICK HERE to sign up for emailed updates

Stakeholder Clarification: Supports Program vs. Community Care Waiver (CCW)

In the Medicaid-based, fee-for-service system, individuals will access Division services through one of two Medicaid waiver programs – either the Supports Program or the Community Care Waiver (CCW). Individuals do not “choose” which waiver program to be enrolled in; rather, waiver program enrollment is based on an individual’s assessed needs and eligibility criteria.

Detailed information regarding these two waiver programs is/will be available in the program Policies and Procedures Manuals:

• The draft Supports Program Policies and Procedures Manual is available now on the Division’s website and the finalized version (based on stakeholder review and comment) is expected to be released soon.
• The draft Community Care Waiver Policies and Procedures Manual is currently being developed and is expected to be released for stakeholder review and comment soon.

The Division has recently conducted a series of webinars specifically dedicated to the new Supports Program. Please see the announcement above regarding a webinar the Division is offering in October that focuses on the Community Care Waiver.

NJ CAT Assessments

The NJ CAT (NJ Comprehensive Assessment Tool) is the Division’s new standardized needs-assessment survey that must be completed by all individuals who receive or are eligible to receive Division-funded services. For individuals currently living in a licensed residential setting, the NJ CAT survey will be completed by the residential provider. All other individuals and/or their guardians should have received a “Dear Participant” notification letter that included instructions about contacting the Rutgers Developmental Disabilities Planning Institute (DDPI) to request to complete the NJ CAT.

If you or an eligible individual in your care has not received notification, please contact the Supports Program Help Desk so that appropriate direction can be provided. While there is not a specific deadline by which the NJ CAT survey must be completed, it is important that it be completed as soon as possible to ensure a smooth transition into the new system. (Please note that transitioning to the fee-for-service model is not optional and is required for any eligible individual who wishes to access or continue to access Division-funded services.)

Update on the NJ CAT Re-Assessment Process

The final batch of NJ CAT notification letters has now been distributed. (Notifications for individuals residing in licensed residential settings were distributed to residential providers). Please note that every individual who is eligible to receive and/or currently receiving Division-funded services must complete the NJ CAT (New Jersey Comprehensive Assessment Tool). If you do not receive a notification regarding completion of the NJ CAT, please contact the Supports Program Help Desk. 

As previously announced, in order to ensure that the Division has the most current and accurate information about individuals’ support needs prior to shifting into the new Fee-for-Service system, the Division is reassessing all individuals utilizing the New Jersey Comprehensive Assessment Tool (NJ CAT). Beginning in April and continuing through the end of summer, NJ CAT notification letters are being sent to individuals in phases.

IF an individual is:
(a) currently in the interim system (those who have entered DDD services starting in 2013, are in iRecord, have the new ISP, and have a Support Coordinator) –OR–
(b) currently receiving day services ONLY (and no other services, such as respite, family support, etc.) –OR–
(c) living in a licensed residential setting

THEN that individual (or the residential provider) should have received a notification letter to contact the Developmental Disabilities Planning Institute (DDPI) to request to complete the NJ CAT. (If you fall into one of these three categories and have not yet received a notification letter, contact the Division’s Fee-for-Service Help Desk at DDD.FeeForService@dhs.state.nj.us.) 

Please note: it can take 1-2 weeks after contacting DDPI to receive a response with instructions for completing the NJ CAT online or by telephone.

Accessing Individual Tier Information

AFTER 9/1/2016

Tier Request Form to be Replaced by Auto-Generated Tier Assignment Letters

Effective September 1, 2016, the Division will disseminate an auto-generated tier assignment letter upon completion of the NJ CAT (NJ Comprehensive Assessment Tool), and therefore will eliminate the Request for Tier Assignment process established in June 2015. Mailing of tier assignment letters to individuals who have already completed the NJ CAT is expected to begin August 2016.

The tier assignment is based on the NJ CAT self-care, behavior, and medical scores. An individual budget amount that corresponds to the individual’s tier assignment becomes effective only when:

a) An individual enrolls in the Fee-for-Service Supports Program
-OR-
b) An individual already enrolled on the Community Care Waiver (CCW) shifts into the Fee-for-Service system

Until an individual is enrolled or transitioned by the Division into the new Fee-for-Service system, the tier and the corresponding budget amount are not in effect.

Information about tiering and acuity is available in Section 3.4 of the Supports Program Policies and Procedures Manual. Information about individual budgets is available in the Fee-for-Service Individual Budgets: Quick Reference Guide.
 

 

BEFORE 9/1/2016

The Division has begun the process of releasing tier assignment information to individuals/families who submitted a request to receive that information. If it has been 30 days or more since you completed the NJ CAT assessment, you may submit a Request for Tier Assignment Form by uploading the completed form to our secure online site or sending it via regular postal mail. Please see the form link and submission instructions below.

Once an individual has gone through the NJ CAT, he/she will be able to access his/her “tier” assignment (which is utilized to determine the budget level) by completing and submitting the Request for Tier Assignment Form (PDF document), which is also available on the Fee-for-Service Implementation page of the Division’s website.

Submit Online (preferred method):
1. Go to the secure site: https://secureupload.dhs.state.nj.us/su/
2. Enter Contact (Requestor’s) Name, Phone Number and Email Address
3. In the DDD SU Unit dropdown menu, please select “Request Tier”
4. Click Submit  Tier Assignment Request

Submit By Mail:
NJ Division of Developmental Disabilities
PO Box 726
Trenton, NJ 08625-0726


Social Security Launches iAppeals- an improved online appeals process

Filing an appeal of your Social Security disability decision is easier and faster than ever. You can now upload documents online to support your appeal. This will help speed up the time it takes to receive a decision from Social Security. www.socialsecurity.gov/disabilityssi/appeal.html

 

The Achieving a Better Life Experience (ABLE) Act

Signed in to law by President Obama, the The Achieving a Better Life Experience (ABLE) Act allows people with disabilities and their families to set up a special savings account for disability-related expenses.  Earnings on an ABLE account would not be taxed, and account funds would generally not be considered for the supplemental security income (SSI) program, Medicaid, and other federal means-tested benefits.

Here are some key points you should be aware of:

  • Eligible individual is someone who becomes disabled before age 26
  • Each individual may only open one ABLE account.
  • Individuals can save up to $100,000 without risking eligibility for Social Security.  Once exceeding that limit, SSI benefits would be suspended but NOT terminated.
  • ABLE accounts do not affect Medicaid.
  • Up to $14,000 may be deposited annually into the ABLE account (annual gift-tax exemption limit).
  • Each state must put regulation in place, and may regulate accounts differently from each other.
  • Funds in the ABLE account can be used for qualified disability expenses such as: education; housing; transportation; employment training and support; assistive technology and personal support services; health, prevention, and wellness; financial management and administrative services; legal fees; expenses for oversight and monitoring; funeral and burial expenses; and any other expenses approved by the Secretary of the Treasury under regulations.
  • Earnings and distributions from the ABLE account for qualified disability expenses would not count as taxable income.