Performcare Full Length

Performcare (NJ Children System of Care)

What is the Children’s System of Care (CSOC): The NJ agency responsible for providing services to individuals under the age of twenty one.

What is Performcare:

The administrator for CSOC. It provides support services and case management services to children, including those with intellectual and/or developmental disabilities.

Who is eligible:

• Children up to age 21 that have an intellectual and/or developmental disabilities. Services typically start at age 5 but younger children may receive services.
  • Services typically start at age 5 but younger children may receive services.
    

  • Definition of Developmental Disability: a severe, chronic disability of an individual, which:
    • Is attributable to a mental or physical impairment or combination of both;
    • Is manifest before age 22;
    • Is likely to continue indefinitely;
    • Results in substantial functional limitations in three or more areas of major life activities;
      • Receptive and expressive language function
      • Self-care
      • Learning
      • Self-direction
      • Capacity for independent living
      • Economic self-sufficiency
        
      • Mobility

        A diagnosis must be made by a licensed clinician through some evaluation process.

• Must be a United States citizen or permanent resident, and
• Must be a NJ resident

Behavioral Health Needs: Performcare also provides services to children with behavioral health needs. For more detailed information regarding children having such needs, please see: www.performcarenj.org/pdf/families/faq-for-families-of-children-behavioral-health-needs.pdf

What if my child is first applying between the ages of 18-21:you must complete an application through the New Jersey Division of Developmental Disabilities. If found eligible by DDD, by CSOC until age 21. nj.gov/humanservices/ddd/documents/Full-Application-for-Eligibility-English.pdf

Eligibility does not depend on:

1. income
2. whether you have private insurance
3. whether you have Medicaid, but, if your child has private insurance, those benefits must be exhausted first.
   

If rejected:

• Appeal immediately or
• Reapply when your child is older or has a change in circumstances.You can apply at any age, but children under 3 are not generally approved and those ages three to five are considered on a case by case basis.

If approved:

• You should receive a letter within 60 days of all information being submitted

What happens after my child is approved:

• You can apply for Family Support Services over the phone by calling 1-877-652-7624.
• You are not guaranteed to receive any particular service that Performcare offers.
• Eligibility for any service depends on each child’s situation and state funding availability.
• If you are approved for any support services, you will receive a letter.
• You need to reapply annually over the phone.

What services does Family Support Services supply:

• Care Management Services: Children with complex cases due to multiple issues or providers may get assigned a care manager through their county’s Care Management Organization (CMO). The care manager helps coordinate care and links the family to the services they need and community resources. Also, each CMO runs a resource net for its community.
  
  
• Respite: if approved, may choose one of the following:
  • In-home respite, allotted 60 hours for every 90 days
  • Agency hired worker who is trained and employed by the agency or
  • Self-hire worker who is recruited by the family. The family pays the worker and files for reimbursement OR
    • After School Care - Provided by agencies and held at the agency's site. Parents are responsible for transportation. Certain criteria apply. OR
    • Weekend Recreation - Agency provides social and recreational activities at agency site. May include outings. Parents provide transportation to the agency.
      
      

• Overnight Respite: Services provided in a licensed facility with round the clock supervision and care.
  
  
• ABA Therapy: Must obtain through private insurance, if covered. If your child has Medicaid, then must obtain through the MCO.
  
  
• Individual Support Services: Helps teach adaptive behavior and skill development for activities of daily living (ADLs)
  
  
• Camp: Two weeks of summer camp. 10 days of day camp or 6 nights of overnight camp. There are reimbursement limits. There is a separate application for camp funding.
  
  
• Educational Advocacy: Provides assistance to parents and legal guardians in understanding their rights regarding their child’s special education needs.
  
  
• Home modification: Adaptations to the home to ensure the health, welfare, and safety of the individual or to enable the individual to function more independently in the home.. Examples include: widening of doorways, ramps, vertical platform lifts, grab-bars, and their installation. PerformCare covers $11,000 for every 3 years.
  
  
• Assistive technology: An item, piece of equipment or product system that is designed to maintain, increase or improve the functional capabilities of the child and is not solely therapeutic. Examples of items that may be covered include travel chairs, walkers and positioning systems.
  
  
• Vehicle Modifications: Modifications to a car or van that is the child’s primary means of transportation to accommodate the special needs of the child. Examples of items that may be covered include motorized lifts and ramps.

Equipment provided in this category is subject to a maximum limit per child, per three-year cycle.

Family Support Organizations (FSO): Organizations located in each county that are run by families. FSOs provide family members with support and connection to others with similar experiences.

Mobile Response Stabilization Services: PerformCare offers 24 hours a day/7 days a week emergency response when a child is in crisis. Call 1-877-652-7624. Will come to the house.

Intensive in home treatment and out of home treatment: Please see the following link:

thearcfamilyinstitute.org/file_download/inline/3f8799ed-16c7-449f-b04b-6f1c19f84e36

How are the costs of services handled:

Some services require that private health insurance benefits must be exhausted first.

Families referred for services who are not already Medicaid or NJ Family Care eligible may be required to complete an eligibility application. This applies even if your child has private insurance.

For additional information regarding PerformCare, see the following links:

performcarenj.org/pdf/families/family-support-services-facts.pdf

performcarenj.org/families/disability/determination-eligibility.aspx