New Jersey Medicaid Personal Preference Program (PPP) What is the PPP Program: It Is an alternative way for certain Medicaid recipients who qualify for the Personal Care Assistant (PCA) services to receive in home assistance with Activities of Daily Living (ADLs). How does the PPP Program differ from the Personal Care Assistant benefit under Medicaid: PCA - Use an agency hired assistant hired by the managed care plan. PPP - The individual or their guardian can choose the care provider, including a parent, other relative or friend. Who is eligible: Anyone having both a financial and a functional need. Financial Need - Must have Medicaid under NJ FamilyCare Plan A. Functional Need - Must have a need for assistance with their ADLS. Examples of ADLs include bathing, grooming, dressing, eating and transfer/mobility. Additional key fact: Minors can qualify if the minor meets the functional and financial needs requirements. How to apply: Get a scrip from your doctor requesting personal care assistance Call your Medicaid Managed Care Organization (MCO) for a PCA assessment for enrollment in the PPP program If the applicant is already enrolled in the PCA program, inform the Medicaid health plan that you want to switch to the PPP program. A nurse will come out to the residence to make an assessment as to eligibility and level of need. What happens if approved: A budget will be given based on their level of need. The individual or their guardian will select the care provider (employee). A third party, who can be a parent or other relative, must be chosen to approve the employee timesheets and must be a different person than the employee. A financial consultant will come to the residence to assist the individual in how to spend the budget to meet the personal care needs. During this visit, the financial consultant will do an intake session with the individual, the employee and the party that will sign the timesheets. There will be periodic follow up meetings between the parties. A portion of the budget may be able to be used errands, services and other items. See link for more information. www.state.nj.us/humanservices/dmahs/clients/njppp.html How is the PPP Program managed: PPP provides fiscal management services through a fiscal intermediary that is responsible for handling payroll responsibilities, acting as a bookkeeping service, processing time sheets and issuing paychecks to your workers. How does payment work: The third party representative must approve the employee timesheets. The timesheets are then submitted online or via a mobile app and the employee is paid. Does receipt of PPP services affect other programs: PPP is separate from DDD and does not come out of the Supports Budget. It also does not affect the receipt of SSI. What happens if an individual is rejected: You can appeal if you are rejected or believe the hours are inadequate. You can also appeal if the hours ever end up getting reduced. What happens if there is a change in my circumstances: You can request a reassessment. Additional Resources Call the PPP Helpline Number: 609-631-2481, which is available Monday thru Friday from 8:30 to 4:30. You will need to leave a voicemail message. Calls are generally returned within a few hours. Visit: www.state.nj.us/humanservices/dmahs/clients/PPP_Fact_Sheet.pdf
