State

NJACP is your resource for State issues, legislation and regulation affecting providers and people with intellectual and developmental disabilities.

 Information about the NJ Legislature
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Printable Pamphlet Roster of Legislators
The Legislative Process in NJ
NJ Legislature
NJACP Bill Update

Click on the bill update for a list and the status of legislation that NJACP is tracking.
Information about Department of Human Services/Division of Developmental Disabilities

NJ Department of Human Services
Rule Proposals
Office of Program Integrity and Accountability/Office of Licensing
Licensing Laws and Regulations
NJ Division of Developmental Disabilities
Division Policy Circulars
Fee for Service/Rate Setting Information
DDD Supports Program Information 

State Budget Update

 State lawmakers have reached a budget deal and plan to introduce their spending plan next week, Senate Budget Chairman Paul Sarlo (D-36) said Thursday.  “We have an agreement between the Senate and Assembly leadership now on a budget bill we hope to hear as soon as Monday,” Sarlo said.

The news comes a day after Senate President Stephen Sweeney and Assembly Speaker Vincent Prieto announced a deal to change the state’s school funding formula, which Governor Christie said on Thursday he would be willing to entertain. NJACP will keep members updated as additional information is available, specifically on a resolution for a Direct Support Professional wage increase. Please sign the petition above!

Assembly Human Services Committee Hold Hearing on DDD Transition to New Fiscal Intermediary

 The Assembly Human Services Committee held a four hour hearing on the Division of Developmental Disabilities (DDD) transition to a new fiscal intermediary, particularly for individuals who are self-directing and also accessing services through the Personal Preference Program (PPP) through Disability Services (DDS) on June 15th. Chairperson Valerie Huttle (D-37) and the committee heard testimony from parents and indviduals about their concerns with Public Partnerships, LLC (PPL), which replaced Easter Seals as fiscal intermediary. Individuals who are not dual enrollees in a self-directed program as well as PPP, have been notified by DDD the deadline to enroll is June 23rd.

Chairwoman Huttle discussed the transition to PPL to Department of Human Services Commissioner Beth Connolly and submitted a letter with a list of questions. The DHS forwarded the committee a letter with improvements in the transition to PPL, including, 700 individuals who are dually enrolled received a 90 day extension, the time to complete training has been extended and employees may access training on hard copy instead of a webinar, waived the continuing education requirements, the potential to remain with Easter Seals or the choice to move to more traditional agency based programs. In the letter, Commissioner Connolly explained the move to a new fiscal intermediary as necessary to bring three programs under one fiscal intermediary and standardize delivery of services rather than the state operating with three separate companies.

Chairperson Huttle indicated she will pose additional questions to the Commissioner from the testimony heard at the hearing and disseminate the responses. Parents were primarily concerned with processes and new requirements they felt diminished the goal of delivering person centered services, making it more difficult to self-direct services, including the liabilities, paperwork and process involved with acting as the employer of record, which was a responsibility formerly undertaken by Easter Seals. Also, benefits are no longer available for employees, such as health insurance through Easter Seals, therefore, making it more difficult to recruit employees in an industry with a workforce shortage. Many felt the transition was hurting their loved one’s ability to self-direct when the prior process was working well for them.

Several of those who testified also discussed the lack of responsiveness from PPL to their concerns and needs, including, the use of a fax machine and complicated use of email and attachments with requirements for programs such as requiring a PDF, which is a program found in offices and the parents commented “not in the homes of parents”, a lack of physical location of an office in New Jersey, an app to pay employees that is not functioning and lack of enrollment confirmation for employees who have submitted the required paperwork. The required paperwork is a 20 page application, which many parents felt would discourage employees from serving their loved ones, along with 20 hours of training.

Suggestions were made for improvements, including, a 90 day delay in the transition for all participants, not just those who are dually enrolled, grandfather current staff, some which have been employed over a decade from requirements such as background checks and training, reduction of paperwork requirements such as notetaking with 15 minute intervals, which removes the focus from serving the individual to completing paperwork, and the ability to permit parents to train employees on the custom needs of the individual they are seving. Most also felt there was little stakeholder input and discussed the need for meetings with the Division to hear and address parents’ concerns.

The hearing ended with each member of the committee expressing their compassion for the parents struggles and their dedication to resolving the issues brought forth through the testimony. Many parents delivered emotional testimony, leading the committee to suggest to parents and individuals that they reach out to legislators offices with calls and emails. The Chairperson and committee members will also continue discussions with the DHS and submit additional questions and issues to the DHS in an attempt to address  and clarify concerns. To listen to the hearing, visit the Legislature’s webpage and click on listen to archived proceedings, choose the Assembly Human Services Committee and the hearing dated June 15th.

Studies Shed Light on High Cost of Housing in New Jersey

The Garden State was the sixth-most-expensive state for renters, based on a new report published by the National Low Income Housing Coalition cited by the Housing and Community Development Network of New Jersey.  “In order to afford a modest two-bedroom home in the Garden State, a family must earn an hourly wage of $27.31, far more than the state’s average hourly wage of $17.86 or the $8.44 minimum wage,” the HCDN said in a news release. “As the Fair Market Rent in the state for a two-bedroom rental is $1,420, a family must earn $56,810 annually in order to make it affordable. Using that formula, a minimum wage worker would have to work 129 hours per week year-round to be able to afford a two-bedroom home at FMR.”

The organization has urged state officials to “Build a Thriving New Jersey” and invest $600 million into housing residents can afford. HCDN said that, as part of its campaign, funding for 10 community developments, which was in the past diverted or abandoned, may be used.  The firm said it hopes to carry out its mission with the help of the Affordable Housing Trust Fund, the State Rental Assistance Program, the Neighborhood Revitalization Tax Credit Program, as well as Lead Poisoning Prevention and Weatherization and Homeless Service programs.

“Home rental costs are steadily increasing each year and, when you factor in other expenses like groceries and utilities, it’s a struggle for countless New Jersey residents,” Staci Berger, CEO and president of the HCDN, said. “Our housing market is like a car dealership that only sells Maserati cars and only a handful of Ford Fiestas. We need more variety, so that all our residents can afford to call New Jersey home. We can’t ‘Build a Thriving New Jersey’ if our elected officials don’t make investments that help create a balanced housing market.”

The report, “Out of Reach 2017,” was released at an event in Jersey City by the Garden State Episcopal Community Development Corp. Jersey City Deputy Mayor Marcos Vigil, Jersey City Council President Rolando Lavarro and Councilwoman Joyce Waterman attended the event.

“We have the resources to solve the affordable housing crisis by realigning federal tax expenditures and reinvesting the savings in rental housing programs that serve our nation’s most vulnerable,” Diane Yentel, CEO and president of the NLIHC, said. “We lack only the political will to do so.”

To view entire article, click here.

 

NJ Primary/General Election Update on the More Competitive New Jersey Districts

New Jersey’s June 6th primary resulted in all incumbents in the 120 seats up for election in the New Jersey Legislature to maintain their seats for the general election this November. However, there are 10 open seats on the ballot due to a Legislators’ retirement or they are not running this year. Fourtey seats are up in the Senate and 80 in the Assembly. Currently, Democrats control both houses, outnumbering Republicans 24 to 16 in the Senate and 52 to 28 in the Assembly. The Democrats are far likely to retain their majority in the Legislature than lose it to the Republicans because there are very few competitive districts and most incumbents win in the general election. Below is a district by district list of the more competitive races:

  • District 2 – Atlantic County

Republicans are hoping to pick up a Senate seat in south Jersey’s 2nd district now that Democratic Senator Jim Whelan is retiring. Republican Assemblyman Chris Brown, who became a local champion for fighting against Christie’s state takeover of Atlantic City, is campaigning against Democrat Colin Bell, a former county freeholder. If the Republicans take the seat, it would increase their count in the Senate. The district is almost evenly split between Republican and Democrat voters, therefore, the race could be close.

  • District 7 – Burlington County

Republican Senator Diane Allen is retiring this year and that leaves the Senate seat in District 7 open. Assemblyman Troy Singleton will attempt to move up to the Senate and will be challenged by Republican Ron Prisco. Senator Allen was well known in the district having been a news ancor for a major Philadelphia network, however, with the district leaning Democrat, Assemblyman Singleton is the favored winner, which would be a one seat increase for the Senate Democrats.

  • District 11 – Monmouth County

Another district which is evenly split between Republican and Democrat voters is District 11, where incumbent Senator Jennifer Beck is facing a tough challenge from Vin Gopal, the former chairman of the county’s Democratic Party. Last election, Senator Beck’s running mates lost their seats to two Democrats (Joann Downey and Eric Houghtaling). The two Assemblypersons are also facing a challenge from Republicans Rob Acerra and Mike Whelan. The races in District 11 are anticipated to be very costly without a clear prediction of who will prevail.

  • District 16 – Hunterdon, Mercer, Middlesex and Somerset Counties

Republicans lost a seat in the last election to Assemblyman Andrew Zwicker in central Jersey’s split 16th district. Now, former Republican Assemblywoman Donna Simon is running to win her seat back.

But Assemblyman Jack Ciattarelli, the Republican who holds the district’s other seat, is not on the ballot, giving Democrats hope to take full control of the district. Simon is running with Mark Caliguire, Zwicker with Roy Freiman. Assemblyman Ciattarelli is banned, under New Jersey law, from running for two offices in one year, therefore, his gubernatorial bid precludes him running to keep his seat in the Assembly.

  • District 3 – Cumberland, Gloucester and Salem Counties

Senate President Stephen Sweeney is facing a challenge from Fran Grenier, the Salem County Republican Party chair who has the backing of the powerful New Jersey Education Association (NJEA).

The NJEA has been angry with Sweeney over the last few years, especially for not posting union supported bills, and is trying to remove him from office, however, Sweeney is still favored to win.

  • Other Districts

The remaining retiring Legislators are from districts where their respective parties have strongholds and candidates running from the same party as the incumbent will likely win. The veteran legislators not running this year are: Senators Joseph Kyrillos (R-13), Raymond Lesniak (D-20), and Kevin O’Toole (R-40), and Assemblyman John Wisniewski (D-19). Senator Lesniak and Assemblyman Wisniewski are also precluded from running in this election because of their gubernatorial primary bids.

Leadership Positions

It also appears, assuming a Sweeney win in the 3rd District, that Senator Sweeney will continue to hold the post of Senate President. The post of Assembly Speaker is less clear. Current Speaker Vince Prieto is being challenged already by Assemblyman Craig Coughlin who released enough signatures of Assembly colleagues willing to support him as Speaker to theoretically knock out Speaker Prieto. However, it is extremely early in the process. These discussions typically take place after the November general election. It has been heard that Assemblyman Coughlin does not have the position solidly in place and there is the possibility of a consensus candidate other than Coughlin or Prieto. Geography is also critical here, tradition holds if the Senate President is from the south, the Speaker will be from the north and vice versa. For more on the leadership position struggle, click here.

Gubernatorial Candidate Positions on Healthcare Issues

Lt. Gov. Kim Guadagno, Republican (via spokesperson Ricky Diaz)

“I’m not going to get into hypotheticals since the bill is now being debated in the Senate, but the Lt. Governor has long opposed Obamacare and believes it’s unraveling. She would urge Congress to make sure that any federal plan to repeal and replace it maintains coverage for those who now have health care, protects New Jerseyans with pre-existing conditions, provides choice, improves care and reduces costs.”

Phil Murphy, Democrat (via campaign spokesman Derek Roseman)

“Phil has been clear that the first order of business must be to defend the ACA and protect the health care of the millions of New Jerseyans it benefits. If the Republicans succeed, it would create a several-billion-dollar hole in our already-constrained budget. Phil is studying all options — including a public option — in order to protect health care as a right, not a privilege, for all New Jerseyans. But make no mistake, repeal of the ACA would be a humanitarian and fiscal disaster for our state. Phil’s first priority is to defend the law, and he has consistently called on Governor Christie to end his silence and stand up for New Jersey.”

Gubernatorial Candidate Positions on other  Issues

Legalizing marijuana: Murphy has said he will make legalizing recreational marijuana a priority. Guadagno opposes the idea; she supports decriminalization but not legalization.

Out-of-network reform: The question of how to protect consumers from surprise medical bills has dogged the state Legislature for almost a decade and generated a fantastic display of lobbying power. Murphy said he will close the “out-of-network loophole.” His campaign declined to weigh in on the current bill (A1952). Guadagno has not taken a public position on the issue.

Obamacare/Medicaid expansion: One of the biggest challenges facing New Jersey’s next governor will likely be funding for the state’s $15 billion Medicaid program. Murphy is an ardent Obamacare supporter and says the state must defend against federal funding cuts to the Medicaid expansion population. Guadagno opposes Obamacare, but she would like to see Congress preserve coverage at current levels in whatever replacement plan they craft.

Single-payer: Murphy has said he would consider a single-payer health care system, but he has not provided any details. Guadagno opposes such a system.

 DDD Holds Leadership Meeting

On May 22, DDD held its monthly membership meeting with the three provider associations focusing mainly on housing.  The following reflects the discussion.

Housing

Jonathan Seifreid shared a number of documents for Leadership review prior to their distribution to the provider community, including:

  • Guidance for the Conversion of Housing Payments from Division Contract to the Supportive Housing Connection.
  • Guidance for Individuals and Families on the Conversion of Housing Payments from Division Contract to the Supportive Housing Connection.
  • Sample Residency Agreement(for provider controlled settings).

It was noted that an agency may use a lease or residency agreement and both can be personalized for the agency; for example, the agency may decide to add additional information, however, essential elements as outlined by DDD must remain in the document.

Moving forward in FFS, DDD housing funding will change.  Sixty thousand dollars will be provided for homes for accessibility and agencies may ask for additional funding for sprinklers and fire alarms.  Major maintenance for properties will continue for state owned properties.  Once the house flips to FFS, funding will go away.

Funding:

Detailed information will be provided but Assistant Commissioner Liz Shea noted that there will continue to be “start-up” money between now and December 31.  These funds will cover start-up operations/development, for vehicles and funds for furniture.  There will be no new acquisition funds after July 1.  As of January 1, funds will still be made available for furniture but will no longer be available for startup operations/development, or vehicles.

Purchase of Homes:

DDD is reviewing it policies and procedures for review and approval of housing sites/housing.  More information will be forthcoming from DDD.  The thrust of the discussion was whether DDD would have any involvement if an agency is not seeking any state funding for the purchase of a home.

Oversight

Clarification was requested regarding the various oversight to which providers will be subjected.  Ms. Shea noted that Support Coordinators will have oversight of the individual, case managers will continue to provide intensive case management for high profile cases, the provider unit will focus on training to give providers assistance in technical areas and help providers move to a more employment based  focus as well as providing assistance for more creative housing solutions.  There will be staff that will oversee quality (they are adding more staff to this function). Staff will review service plans (on paper) and will conduct site visits as necessary.  The Quality staff will also examine the adequacy of provider networks including the availability of psychiatrists, psychologists, etc.  And finally, licensing will still be conducting its review as

will Medicaid. The associations raised concern regarding the number of entities with oversight (DDD, DHS, and Medicaid) and specifically what that oversight will entail.  Providers were led to believe that there would be a streamlining of the State’s oversight.  This will be discussed in greater depth at a future meeting.

Transitioning to FFS

There are three agencies in a Pilot that is intended to “test” the billing process.  Ten additional agencies will be in the July FFS flip.   The Pilot should flip approximately 2000-2500 people between July 1, 2017 and September 2017.  If individuals receive residential services from these agencies but are attending a day program run by a separate agency, the day program must be prepared to flip, as well (or they will relocate individuals to a different day program that is ready).

Individuals that are with the ten agencies must have selected a support coordination agency or they will be auto-assigned.  Ms. Shea noted that for the first quarter, the contract will be guaranteed so there is a cushion to support providers as they go through the transition, however, agencies must agree to not seek a reassessment in year one.  To facilitate a more timely transition to FFS, Support Coordinators will not complete a full ISP prior to the flip but, rather, they will have additional time to complete a comprehensive ISP.  She noted, however, that the minute a person wants to adjust their plan or request a reassessment, then the Support Coordinator will have to develop a comprehensive ISP at that time.  It was questioned if there will be something included in the limited ISP or existing IHP that is not acceptable to Medicaid.  This issue will be discussed further and clarification will be sought from Medicaid.

Agencies that would like to flip homes/programs beginning July 1, should reach out to Ms. Shea as each agency will have to be reviewed and approved.  DDD must stay within the budget so if all agencies with high level tiers want to flip at the same time, DDD could run out of funds prior to the end of the fiscal year.

NJ Legislature Considering Changes to Paid Family Leave Plans  

Concerned that New Jersey lags behind other states in the utilization of its current paid family leave program, Senate President Steve Sweeney (D-3) and Assembly Speaker Vince Prieto (D-32) developed two separate plans to enrich the benefit, making it easier for employees to consider using it. Currently, businesses with fewer than 50 employees do not have to guarantee an employee’s position will be available when the leave is ended. Prieto’s plan contains job protection for all employees taking paid family leave with the belief that if a person’s job is not protected they will not use the benefit in a time of need.

Both plans also increase the amount of each employees paycheck during utilization of paid leave. Currently, the law limits pay while taking leave to two-thirds of a paycheck. Prieto’s bill increases pay to 90% for the lowest earners and 80% for higher earners, with caps on both. Sweeney has a more complicated calculation which is less than Prieto’s and does not guarantee job protection. Neither proposal has been heard in committee or contains a fiscal estimate. Employees pay into the program in each paycheck and there are also suggestions that increases to that contribution could fund any of either bills changes.

For more information regarding both proposals, click here.

 

NJ Senate Confirms Commissioner for Department of Labor

The state Senate on Thursday voted, 38-0, to confirm the appointment of Aaron Fichtner as commissioner of the Department of Labor and Workforce Development.  Fichtner had been serving as acting commissioner since September.

 

Gov. Christie’s Proposed Budget for Fiscal Year 2018 is Now Available Online

 The proposed spending plan, which Christie unveiled last month, totals $35.5 billion and does not include many major changes.  The budget would grow state spending by 2.9 percent. Spending has increased about 20 percent since Christie took office seven years ago. The budget assumes strong revenue growth, at 3.6 percent, and leaves a thin reserve of less than $500 million. The state’s fiscal year begins July 1.  View the budget book here here

 

Community Health Law Project Announces It Will Be Accepting New Clients Under a Contract with the Division of Developmental Disabilities (DDD)

The Law Project is very pleased that once again its attorneys and advocates can provide legal and advocacy assistance to individuals and families in the community who are receiving services from the Division of Developmental Disabilities.

The Law Project has provided representation to residents of New Jersey for forty years through its five regional offices and four satellite offices. Attorneys and advocates will provide representation and brief service in many civil law issues and in entitlement cases.

Assistance will be available in areas including:

  • Housing advocacy such as landlord-tenant disputes
  • Public entitlements, including eligibility for SSI, SSDI, public assistance, and food stamps
  • Medicaid, Medicare, and other healthcare issues such as managed care disputes
  • Child support, visitation, domestic violence
  • Barrier-free accessibility, American with Disabilities Act and New Jersey Law Against Discrimination matters
  • Surrogate decision making issues including wills, living wills, advance directives, powers of attorney, and uncontested guardianships (also limited guardianship and conservatorship)

Please see the CHLP web site at http://www.chlp.org for further information about the Law Project.

The Community Health Law Project is a private not-for-profit organization dedicated to providing legal and advocacy services, training, education, and related activities to persons living with disabilities and the frail elderly, emphasizing those more vulnerable and needy.

 

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:

  1. An individual enrolls in the Fee-for-Service Supports Program

-OR-

  1. 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.

 

Rutgers Pilot Could Signal a Move Toward Telemedicine

 A Rutgers Pilot program could signal a move toward telemedicine for New Jersey. The issue has been debated in committee in the Legislature and various interests have been unable to agree on parameters moving forward. However, many other states have already taken this step and a new Rutgers pilot program may provide a frame of reference for a program in New Jersey. Senator Joe Vitale (D-19), Chair of the Senate Health and Human Services committee reports he is considering holding additional hearings on the issue to determine which providers can participate and how they can be paid.

 

Rutgers Center for State Health Policy Releases Evaluation of NJ’s 1115 Waiver

The Rutgers Center for State Health Policy’s Draft Interim Evaluation of NJ’s 1115 Waiver is now posted on the DHS website: http://www.state.nj.us/humanservices/dmahs/home/Medicaid_Waiver_Interim_Evaluation.pdf

Listed on http://www.state.nj.us/humanservices/dmahs/home/waiver.html

 

 

Valerie Sellers Shares Response to Audit Report with Sue Livio of the STAR LEDGER

There is no question that every individual living within the community should receive the best and most appropriate care possible. There are thousands of individuals living within group homes and other supported settings that are, in fact, living safe and fulfilling lives.  Poor quality of care is not defensible and lessons will be learned from the auditor’s findings.  However, there are circumstances that are often simply beyond the control of providers.  For example, agencies are at the mercy of their managed care organizations (MCOs) for the repair or replacement of durable medical equipment, such as a wheelchair.  Also, delays in the placement of individuals are often not within control of an agency but rather the control rests with the Developmental Center as to when a client will be released to live within the community.   Having said this, pointing fingers serves no useful purpose.  The focus must continue to be on providing the best quality of care to all individuals with intellectual and developmental disabilities living within our communities as well as those that will eventually reside in communities throughout New Jersey; it should not be on keeping people within Developmental Centers.  The findings of this report will help focus on the continued need for the recruitment, training and retention of qualified and committed staff, however, it should not ignore or dismiss the work of thousands of direct support professionals who provide quality care that allows the individuals they serve to live within our communities and as our neighbors.

Read Susan Livio’s Article: Audit: Move to group homes caused problems for some disabled people in N.J.

 

DDD Announces a Change in the Process for Major Maintenance Funding

Please see the attached letter announcing a change to the process for major maintenance and capital funding payment.  Also attached is an updated DDD Capital Package checklist for your use.