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Thank you to all of the participants of our FI Transition workgroup meeting!

You may access the meeting presentation here:

Next Steps: Our next meeting is scheduled for Wednesday, March 6, 2023 3:00 – 4:00 pm

Access All Past Meeting: PPP Community Workgroup

PPP Fiscal Intermediary Transition Update

Improving the Program

  • Innovative and creative technology that offers caregiver training, a provider directory, and user-friendly Electronic Visit Verification tools.
  • Efficient processes focusing on timely enrollment timeframes and other enhancements that improve the self-directed service option.
  • Contractual accountability between Managed Care Organizations (MCOs) and Fiscal Intermediary (FI) partner.

Best Practices in Design and Oversight

  • Continuous improvement through community partnership and collaborative engagement with participants, families, caregivers, DMAHS PPP Team, and each MCO.
  • Smooth transition for participants, families, and caregivers.
  • Transparency and accountability built into implementation and operations.

Logistics for new PPP Fiscal Intermediary model

  • Maintain existing operating partnerships between DMAHS, MCOs, and PPL (current fiscal intermediary) during transition period.
  • Engage with our community to define the current and future state of the program, including accountability metrics. Support ongoing partnership with the nationally-recognized model we have been using to implement the electronic visit verification (EVV) mandate.
  • Amend the MCO contract – Initial amendment 7/1/23 addressed transition; future amendments to reflect best practice and process improvements defined with community workgroups.
  • Evaluate individual MCO readiness to transition to a selected vendor with innovation and process improvements in place and without disruption to members and their workers.
 
 
FI Transition Timeline

2023

Summer

  • Planning community discussions that engage attendees in asking questions, sharing feedback, and offering ideas for improving the PPP program. 
  • Transition planning for 10/1 and beyond.

Fall

  • Scheduled community discussions to hear from participants, families, caregivers.
  • Monthly workgroup meetings begin.
  • Transition contracts in place between MCOs and PPL.

2024

  • A thoughtful and phased process for continuous improvement that reflects best practice and community priorities.
 
 
To learn more about the PPP and learn details about how to apply please see below!

The New Jersey Personal Preference Program (PPP) offers an alternative way for NJ FamilyCare members who qualify for the Personal Care Assistant (PCA) services benefit to remain in their home and active in their community, and does not require the use of a home health care agency.  

PCA services are non-emergency, health related tasks through NJ FamilyCare. Tasks include help with activities of daily living (ADLs) and with household duties essential to the patient's health and comfort, such as bathing, dressing, meal preparation, and light housekeeping.

Through a monthly budget, you work with a financial consultant to develop a monthly budget, through which you will decide the services you need and the individuals and/or agencies you wish to hire to provide the identified services. If you are cognitively impaired or unable to make decisions on your own, you can choose an authorized representative to assist you.

The PPP also provides fiscal management services to assist you with the financial aspects of the program. PCG Public Partnerships, LLC (PPL) is the fiscal intermediary (FI) for the PPP, and is responsible for handling payroll responsibilities, acting as a bookkeeping service, processing time sheets and issuing paychecks to your workers. 

The PPP requires greater individual responsibility, but in return, offers you greater control, flexibility and choice over the services you receive.

 
 
WHY CHOOSE THE PERSONAL PREFERENCE PROGRAM?

PPP allows you:

  • Choose the home care services you want;
  • Hire workers, including people you know/trust such as friends, relatives and neighbors;
  • Schedule services to meet your individual needs;
  • Exercise greater independence and control over your life.
 
 
USING YOUR MONTHLY BUDGET

You may use your monthly budget for:

  • Employment of individuals, including family members, to provide personal assistance;
  • Cleaning services from private companies to clean your home’s personal areas including bedroom, bathroom, kitchen, etc.;
  • Errand service to assist with banking, shopping, post office and other types of routine tasks; and,
  • Laundry service from a laundromat or other provider.
  • Services from a home health agency;
  • Equipment, small appliance, technology or other items that increase independence (e.g., microwave oven or washing machine); and,
  • Supplies and equipment that promote or enhance independence that are not covered by Medicaid.
 
 
ELIGIBILITY

Applicants must be:

  • NJ FamilyCare eligible
  • Approved for Personal Care Assistant Services (PCA) and need PCA services for at least six months.
  • Able to self-direct services or choose a representative who can act on his/her behalf
 
 
TO APPLY

If you are enrolled in a NJ FamilyCare health plan, please contact your health plan to request a PCA assessment for enrollment into PPP.

Aetna Better Health of New Jersey 1-855-232-3596
AMERIGROUP New Jersey, Inc. 1-855-661-1996
Fidelis Care 1-855-642-6185
Horizon NJ Health 1-855-465-4777
UnitedHealthcare Community Plan 1-800-645-9409
 
 
STATE PROGRAM OFFICE CONTACT INFORMATION

NJ Division of Medical Assistance and Health Services
P.O. Box 712
Trenton, NJ 08625
Telephone: 609-631-2481
Fax: 609-588-3806

MAHS.PPP@dhs.nj.gov

 
 
 
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