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August 2017
 

MAAC Quarterly Meeting

The MAAC held its quarterly meeting and noted the robust growth of the MLTSS program. MLTSS enrollment increased to 51,793 as of July 2017.

Under the renewal for developmental disabilities, the State has successfully transferred the Community Care Waiver (CCW) program to fee-for-service.  In addition, after transferring children services from the Department of Children and Families to the Division of Developmental Disabilities, the program has managed to provide care to more than 5,000 people who were previously on a waiting list.

The MAAC also noted that enrollment of the NJ FamilyCare program increased by 11,141 individuals to bring total program enrollment to 1,773,206.  Furthermore, it was noted that in-patient costs would be the highest in program history, with an estimated $313 million being dedicated to NJ FamilyCare.  

Reorganization Plan No. 1 (2017)

On June 29, 2017, Governor Chris Christie issued Reorganization Plan  No. 1 (2017) to transfer the functions, powers, and duties of the Department of Human Services (DHS), including the Division of Mental Health and Addiction Services (DMHAS) to the Department of Health (DOH). According to Governor Chris, the Reorganization Plan is necessary to increase efficiency, coordination and integration of the State’s mental health and addiction prevention and treatment function.

Absent legislative action, the Reorganization Plan will go into effect 60 calendar days from introduction. Currently, the Assembly has passed a Resolution 42-25 opposing the plan, while the Senate has announced its intentions to vote on the Resolution in the near future. 

Governor Christie’s Statewide Drug Abuse Task Force

According to Chairman Charlie McKenna, the Governor’s Task Force on Drug Abuse Control, is likely to release its recommendations on how to address the growing opioid epidemic in New Jersey next month. Established earlier this year by Executive Order 219, the Task Force is charged with developing a comprehensive, coordinated strategy to combat the drug abuse epidemic.

The Task Force is challenged with reviewing existing statutes and regulations that impede access to care treatment and will consult with local, federal and private entities to develop solutions to the problem. According to the Governor’s Executive Order, 1,600 drug-overdose deaths were reported in New Jersey in 2015.

Legislation

S.1219/A.936 –Requires reporting of suspected abuse of institutionalized elderly to police and that facility employees receive notice of reporting requirement annually; designated as ‘Peggy’s Law.’

Signed by the Govenor on August 7, 2017.

A.320 – Establishes minimum Medicaid reimbursement rate for personal care services.

Concurred with the Governor’s Recommendations and passed by the Assembly 68-0 on July 31, 2017.

A.2503 –Provides protections for individuals with developmental disabilities; upgrades crimes committed against such individuals; and provides transparency and accountability in investigations of abuse, neglect, and exploitations of such individuals; designated as ‘Stephen Komninos’ Law.

Concurred with the Governor’s Recommendations and passed by the Assembly 68-0 on July 31, 2017.

S.2536/A.4163 –Clarifies DCA rulemaking authority over free-standing residential health care facilities, and prohibits eviction of residents from such facilities, except for good cause.

Substituted S.2563 and passed the Assembly 66-0 on July 31, 2017.

S.3400/A.5089 –Establishes minimum Medicaid reimbursement rate for private duty nursing services.

Introduced and referred to the Assembly Health and Senior Services Committee on July 13, 2017.



July 2017

FISCAL YEAR 2018 BUDGET

After a three-day Government shutdown, the Legislature and Governor Christie struck a deal which resulted in the signing of the Fiscal Year 2018 Budget. The major standoff between Assembly Speaker Vincent Prieto, Senate President Stephen Sweeney and Governor Chris Christie concerned the restructuring of Horizon Blue Cross Blue Shield (HBCBS). Governor Christie wished to restructure HBCBS to provide funding taken from the company’s surplus to battle the State’s current addiction epidemic. In the end, the FY 2018 Budget appropriated $34,670,313,000 in state funds and $15,823,846,786 in federal funds for the upcoming year.

This year’s budget appropriates $18.31 billion for the Department of Human Services. This budget signifies an increase of $37.1 million in funding from the previous fiscal year. The State will provide $6.65 billion in funding, while the Federal Government will supply an additional $9.88 billion in appropriations.
This year’s budget allotted $4.18 billion in state dollars and $7.71 billion for a total of $13.48 billion in funding for Medicaid based services. This appropriation totals nearly 74% of the Department of Human Service’s budget. Furthermore, the budget also designated $1,783,882,000 from State and Federal funds for medical coverage of nursing home residents. This funding level is an increase of nearly $85 million from fiscal year 2017.

TELEMEDICINE

The Legislature recently passed S291.A1464, which would authorize health care providers, including licensed physicians, nurses, and nurse practitioners to remotely provide health care services to patients via telemedicine and telehealth. The passage of the bill signifies the conclusion of a two year legislative effort to allow for health care providers to provide telemedicine to patients in New Jersey.

If signed, the legislation would permit health care providers to remotely provide health care services to patients through the use of telemedicine, and if necessary, to engage in telehealth to facilitate health care. In order to provide telemedicine, health care providers must register with the Department of Health and indicate the care they wish to offer. Proponents of the legislation argued that telemedicine would provide more accessible health care to patients residing in rural settings.

SNAP CUTS

The House Budget Committee has approved a budget plan that would convert the Supplemental Nutrition Assistance Program (SNAP) to a block grant program and slash funding by $150 billion over 10 years. Approximately 43.6 million individuals participate in SNAP.

Proponents of SNAP argue that if the Republican controlled Legislature were able to pass cuts to the program, America will be faced with the largest hunger crisis since the Great Depression. Last year, in New Jersey alone, 850,000 residents received approximately $1.2 billion annually from SNAP to purchase food.
 

PERSONAL CARE SERVICES NEW HOURLY RATE

On June 19, 2017, the Legislature passed S1018.A.320 (Weinberg/Singleton), which establishes the minimum Medicaid reimbursement rate for personal care services. The legislation establishes a State Medicaid fee-for-service rate of$15.50 per hour. This fee applies to services offered through the Medicaid fee-for-service delivery system or through a managed care delivery system. Furthermore, the rate will be indexed for inflation on July 1 of each year.
 

‘PEGGY’S LAW’ & THE SAFE CARE CAM PROGRAM

The State Senate unanimously approved Senators Jim Holzapfel and Diane Allen’s and Assemblymen David Wolfe and Gregory McGuckin’s measure to protect senior citizens in assisted living facilities on June 29, 2017, sending the legislation to Governor Christie’s desk. The legislation, A.936/S.1219, requires any caretaker, social worker, physician, nurse or other staff member of a care facility to report to local enforcement any instance where there is reasonable cause to suspect an elderly resident is being abused or exploited.

Furthermore, the state Division of Consumer Affairs is expanding the ‘Safe Care Cam’ program to provide hidden cameras to family members of elderly and disabled patients who suspect that their loved ones are being abused by caregivers. In 2016, 307 home health aides were disciplined by the State Board of Nursing for alleged criminal activity. Since the program’s expansion in early May, authorities have seen referrals of alleged cases increase.

In addition to the expansion of the ‘Safe Care Cam’ program, the Division of Consumer Affairs also eliminated rules that would allow new health care workers to start working in the homes of patients while a criminal background check was pending.
 

EMERGENCY SPECIAL NEEDS REGISTRIES

S.2875/A.2741, sponsored by Senators Joseph Vitale and Linda Greenstein, and Assemblymen Craig Coughlin and Jamel Holley, was unanimously released by the Senate Community and Urban Affairs Committee on June 19, 2017. The legislation, was unanimously approved by the Assembly in September, and authorizes municipal governing bodies to pass ordinances requiring the municipal clerk to create and maintain confidential contact lists to help ensure the safety of residents who may require special assistance during an emergency.

Under current law, counties are authorized to maintain such registries. The proposed legislation would include the name, address and special circumstance of each resident. The municipal clerk would provide copies of the list to police departments, fire departments, first aid and rescue squads serving the municipality. The legislation mandates that this list is not public record.

LEGISLATION

S.2844/A.4425 – Eliminates certificate of need requirement for inpatient hospital beds for treatment of psychiatric and substance use disorder dual diagnosis.
Signed by Governor Christie on July 3, 2017.

S.468/A.837 – Establishes ‘Hazardous Drug Safe Handling Act;” requires promulgation of standards and regulations concerning safe handling of hazardous drugs by certain care personnel. Signed by Governor Christie on May 11, 2017.

S.2209/A.3601 – Concerns regulation of guaranteed asset protection waivers by DOBI.
Signed by Governor Christie on May 11, 2017.

S.1475/A.3304 – Establishes three-year Medicaid home visitation demonstration project.
Signed by Governor Christie on May 1, 2017.

AJR.76/SJR.16 – Designates September ‘Affordable Housing Awareness Month.’
Signed by Governor Christie on May 11, 2017.

S.516/A.2503 – Provides protections for individual with developmental disabilities; upgrades crimes committed against such individuals; and improves transparency and accountability in investigations of abuse, neglect, and exploitation of such individuals; designated as ‘Stephen Komninos’ Law.’
Passed both Houses on June 22, 2017. Currently awaiting Governor Christie’s signature.

S.1162 – Imposes prevailing wage for public work on properties receiving tax abatements or exemptions.
Passed the Senate 23-15 on June 26, 2017.

S.2563 – Clarifies DCA rulemaking authority over free-standing residential health care facilities, and prohibits evictions of residents from such facilities, except for good cause. Passed the Senate 37-0 on June 19, 2017.

S.2579 – Concerns long term tax exemptions on certain age-restricted low-income housing.
Passed the Senate 37-0 on June 19, 2017.

S.2877 – Establishes New Jersey Caregiver Task Force to evaluate and provide recommendations on caregiver support services.
Passed the Senate 37-0 on June 19, 2017.



May 2017

MAAC QUARTERLY ASSISTANCE ADVISORY COMMITTEE (MAAC)

The MAAC held its quarterly meeting on April 13, 2017. An update of the MLTSS program noted the continuing growth of the program with enrollment totaling 49,995 as of March 2017. Private Duty Nursing continues to top the list of service utilization followed by nursing facility and home based services.

According to the Office of After a three-day Government shutdown, the Legislature and Governor Christie struck a deal which resulted in the signing of the Fiscal Year 2018 Budget. The major standoff between Assembly Speaker Vincent Prieto, Senate President Stephen Sweeney and Governor Chris Christie concerned the restructuring of Horizon Blue Cross Blue Shield (HBCBS). Governor Christie wished to restructure HBCBS to provide funding taken from the company’s surplus to battle the State’s current addiction epidemic. In the end, the FY 2018 Budget appropriated $34,670,313,000 in state funds and $15,823,846,786 in federal funds for the upcoming year.
This year’s budget appropriates $18.31 billion for the Department of Human Services. This budget signifies an increase of $37.1 million in funding from the previous fiscal year. The State will provide $6.65 billion in funding, while the Federal Government will supply an additional $9.88 billion in appropriations.
This year’s budget allotted $4.18 billion in state dollars and $7.71 billion for a total of $13.48 billion in funding for Medicaid based services. This appropriation totals nearly 74% of the Department of Human Service’s budget. Furthermore, the budget also designated $1,783,882,000 from State and Federal funds for medical coverage of nursing home residents. This funding level is an increase of nearly $85 million from fiscal year 2017. is expected to continue its growth, adding over 4,000 new enrollees in FY 2018 raising total enrollment above 53,000. The number of nursing home residents is expected to remain just above 28,000 with recommended appropriations increasing slightly to $1.78 billion.

Enrollment in MLTSS has been rapidly increasing since the program began in FY 2015, in part to the NJH FamilyCare managed care plans identifying non-MLTSS clients who may be eligible for the program and encouraging enrollment.

FY2018 BUDGET HEARINGS

Medical coverage for nursing home residents that includes capitation payments to managed care organizations on behalf of nursing facility residents enrolled in MLTSS, suggests that actual spending is expected to increase from approximately $1.76 billion in FY 2017 to $1.79 billion in FY 2018. Costs for nursing homes services are expected to decrease slightly. This suggests that the difference in spending may be attributable to increases in other care received by these individuals.

LEGISLATION

S.2563 – Clarifies DCA rulemaking authority over free-standing residential health care facilities, and prohibits eviction of residents from such facilities, except for good cause.
Released from the Senate Health, Human Services and Senior Citizens Committee with amendments on May 1, 2017.

S.468/A.837 – Establishes ‘Hazardous Drug Safe Handling Act;’ requires promulgation of standards and regulations concerning safe handling of hazardous drugs by certain health care personnel.
Passed by the Assembly on March 16, 2017 and sent to the Governor.

A.4729 – Eliminates certificate of need requirement for special care nursing facilities.
Introduced and referred to Assembly Health and Senior Services Committee on March 20, 2017.

A.4467 – Establishes ‘Affordable Housing Obligation Study Commission.’
Introduced and referred to Assembly Housing and Community Development Committee on March 6, 2017.

A.4425 – Eliminates certificate of need requirement for inpatient hospital beds for treatment of psychiatric and substance use disorder dual diagnosis.
Unanimously reported from the Assembly Health and Senior Services Committee on February 27, 2017.

A.3601/S.2209 – Concerns regulation of guaranteed asset protection waivers by DOBI.
Substituted for A.3601 and passed in the Senate 38-0 on February 13, 2017.

A.680 – Requires emergency action plans for delivery of oxygen to patient residences during health public health emergency.
Passed in the Assembly 70-0-0. Received in Senate and referred to Senate Health, Human Services and Senior Citizens Committee.

A.4139 – Requires health care facilities to test for and remediate lead in drinking water, and disclose test results.
Unanimously released by the Assembly Environment and Solid Waste Committee on February 13, 2017.

S.1018 – Establishes minimum Medicaid reimbursement rate for personal care services.
Reported out of the Senate Health, Human Services and Senior Citizens Committee with amendments on January 30, 2017. Referred to Senate Budget and Appropriations Committee.

S.1058 – Requires Commissioner of Health to take certain actions to ensure that residential units are available in assisted living facilities for individuals with special needs.
Reported out of the Senate Health, Human Services and Senior Citizens Committee on January 30, 2017. Referred to Senate Budget and Appropriations Committee.

 

 

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