Division of Disability Services

Personal Assistance Services Program Change in Agency Name; Consumer Fees; Sliding Fee Scale

Proposed Readoption with Amendments: N.J.A.C. 10:140

The agency proposal follows:

Summary

N.J.S.A. 30:4G-21 requires the Commissioner of the Department of Human Services to promulgate rules to effectuate the purposes of the Personal Assistance Services Act. The Department of Human Services, Division of Disability Services proposes to amend the provisions of N.J.A.C. 10:140-1.4 to revise the definition of "designated State agency," and the name of the agency responsible for handling administrative reviews and hearings under N.J.A.C. 10:140-3.10 and 3.11. The rules propose to amend the provisions under N.J.A.C. 10:140-4.2 to provide for an increase in the reimbursement rate ceiling and to revise the consumer sliding fee scale under N.J.A.C. 10:140-4.3.

The Personal Assistance Services Program provides up to 40 hours per week of personal assistance services to persons from the age of 18 through the age of 65 with chronic physical disabilities and is administered by county designated agencies approved by the Commissioner of the Department of Human Services. Personal assistance services include routine non-medical tasks that are performed by a personal assistant to enable individuals to be employed, to receive training or education related to employment, or to support community-based independent living.

The enabling legislation for the Personal Assistance Services Program places the administration of the program under the Department of Human Services, under the State Office on Disability Services. The State Office on Disability Services was upgraded to Division status, and in view of this change, the proposed amendments reflect revisions to the definition of designated State agency and name of the agency responsible for processing requests for administrative reviews and hearings.

The proposed amendments reflect an increase to the maximum allowable fee for contracting with provider agencies for personal assistance services. Under the proposed amendments the weekday rates will be increased from $12.00 to $13.00 per hour on weekdays, and from $14.00 to $15.00 per hour on weekends and holidays. The Department believes that the increase will give county agencies an improved ability to contract with providers in a competitive market and afford an opportunity for providers to offer an increase in wages for personal assistants that are employed under the program.

The proposed amendments contain a revision of the existing consumer sliding fee scale, which is used to determine the ability of program recipients to pay towards the cost of their personal assistance services. The Consumer Advisory Council on Personal Assistance Services Program requested that the Department of Human Services to revise the current sliding fee in response to concerns by consumers that the current scale causes financial burden. The Advisory Council recommended adjustments in order to minimize the financial hardship experienced by consumers. The Consumer Advisory Council on Personal Assistance Services believes, and the Department agrees, that the adjustments made to the scale will reduce financial burdens and therefore enable consumers to contribute towards the costs and still remain on the program.

The proposed amendments qualify as an exception to the calendar publication requirement under N.J.A.C. 1:30-3.3(a) in that a sixty-day comment period is being provided.

Social Impact

The Division of Disability Services anticipates that the proposed readoption with amendments will provide a positive social impact on the lives of individuals in New Jersey with chronic physical disabilities. As of November 1, 2001, 500 individuals were being served statewide under the Personal Assistance Services Program.

The Personal Assistance Services Program provides a means by which individuals with physical disabilities can enhance their independence and self-sufficiency through their direction of personal assistance services. Such services enable individuals with disabilities to become employed, prepare for employment, remain employed, pursue an education, or remain independent and allow participation in their community.

The services provided under the Personal Assistance Services Program enable consumers to be employed or prepare for employment in order to become self-sufficient, and thus result in a significant social benefit for people with disabilities. For the general public, the benefit of fuller integration of people with disabilities provides for a more representative society. The full participation, integration and productivity of those served by this program in all aspects of community life, advances civil liberties to the benefit of society as a whole. To the extent that the increase in reimbursement rates will provide for greater access to personal assistance services and the adjustments to the sliding fee scale will help to reduce financial burdens on consumers and allow services to be continued, the amendments are expected to have a positive social impact.

Economic Impact

No adverse economic impact is anticipated from these proposed amendments. The full cost of the Personal Assistance Services Program, as established through the enabling legislation, has been wholly State supported through a line item in the State budget every year. For State Fiscal Year 2002, $6.4 million from general and casino revenues has been appropriated to administer this program. A maximum of 15 percent of this amount is designated for administrative expenses, per the enabling statute.

The economic impact on the target population of physically disabled individuals is expected to be very positive. These individuals will be able to remain employed or will be able to prepare for employment, thus gaining the skills necessary for future economic self-sufficiency.

Individuals who apply for services under the Personal Assistance Services Program and who qualify under the current Social Services Block Grant guidelines receive services at no cost. Individuals with incomes in excess of those guidelines are required to contribute towards the cost of their services pursuant to a sliding fee scale. The cost share fee contributions that are received from eligible individuals will have a positive impact on the program in that the funds collected will go towards the expansion of services to individuals who otherwise would remain on a waiting list.

The proposed rate increase will also impact on the cost share provision.

Some consumers may experience an increased financial burden with the implementation of the rate increase at the county level. To address this issue revisions to the consumer sliding fee scale have been proposed to offset financial burdens that result from the rate increase. Individuals may also request a reduction in their cost share liability based on the submission of verifiable expenses, in situations were adjustments to the scale were not sufficient to reduce financial burden for consumers under N.J.A.C. 10:140-4.4. This provision gives individuals the ability to remain in the program and continue to receive services while still contributing towards the cost of services, at a rate that would minimize financial hardship to them. The Department will accommodate the rate increase with additional funds that were provided for a direct care salary provision in the state budget under the fiscal year 2002 Appropriations Act.

Federal Standards Statement

A federal standards analysis is not required because the rules proposed for re-adoption with amendments are not subject to any federal requirements or standards.

Jobs Impact

The rules proposed for readoption with amendments will not result in jobs being generated or lost.

Agricultural Impact Statement

The Division of Disability Services anticipates no impact on the agriculture industry in New Jersey as a result of the rules proposed for readoption with amendments.

Regulatory Flexibility Analysis

The providers under this program historically have been entities of county government, such as County Offices for the Disabled, Boards of Social Services, or components of the county departments of human services. The enabling legislation for the Personal Assistance Services Program allows private not for profit organizations which have experience in providing information and services for disabled adults to be providers under the program as well. These organizations are small businesses, as that term is defined in N.J.S.A. 52:14B-1 et seq., and for the purposes of the rules proposed for readoption with amendments, are subject to the same reporting, recordkeeping and other compliance requirements as the government entities. These requirements would include, but not necessarily be limited to maintaining and submitting time sheets and maintaining case files and training records.

No differentiation based on business size is being provided in the rules because the requirements are neither difficult nor excessive. The standards are being kept consistent in order to ensure equity of service delivery and protection for the consumers, who are expected to benefit from increased accessibility to personal assistant services.

Full text of the proposal follows (additions indicated in boldface thus; deletions indicated in brackets [thus]):