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A growing number of individuals who live and receive services in the community are choosing to self-direct their services. The purpose of self-direction is to expand individual choice and control over the services and supports that people need to live in the community.

Individuals can self-direct some or all their services by hiring a self-directed employee and/or accessing a program, class or service that is available to the general public through a community vendor

Unlike traditional provider-managed services, where claims are submitted directly to Medicaid by the provider, self-directed services are billed and paid through a fiscal management services agency, also known as a fiscal intermediary.

Two Models of Self-Direction

There are two self-directed employee (SDE) service models available:

  • Vendor Fiscal/Employer Agent, with Public Partnerships LLC (PPL) as the fiscal intermediary.
    • Forms and information related to the VF/EA model are available on the PPL NJDDD website.
  • Agency with Choice, with Easterseals NJ as the fiscal intermediary.

To learn more about self-directed services and each of the available SDE models, please review the pre-recorded webinars and informational materials below:

 
 
SDE Service Documentation for VF/EA Model

All self-directed employees (SDEs), including family members and SDEs living with the individual, are required to maintain service documentation for the Division-funded services they deliver.

Beginning with the Public Partnerships (PPL) payroll period of August 24-September 6, with timesheet submission deadline of September 7, 2020, the Division is moving forward with a soft rollout of mandatory service documentation. Full implementation is expected to move forward in late fall/early winter.

For SDEs submitting timesheets electronically through PPL's BetterOnline portal or Time4Care mobile application, service notes will be added by clicking on the Activity button for each date of service.

For SDEs submitting paper timesheets, the timesheet must be submitted to PPL, and then the timesheet AND service documentation log(s) must be faxed to the Division at 609.341.2226.

Please review the July 22 webinar slide deck for details: Service Documentation for Self-Directed Employees

Questions can be submitted to the Fee-for-Service Helpdesk: DDD.FeeForService@dhs.nj.gov 

 
 
Electronic Visit Verification (EVV)

EVV Overview Webinar 12-10-2020: Webinar Slides | Webinar Recording

Section 12006(a) of the federal 21st Century Cures Act mandates that states implement electronic visit verification (EVV) for all Medicaid personal care services and home health services that require an in-home visit by a provider. 

  • EVV is a web-based system that verifies when provider visits occur and documents the precise time services begin and end. It ensures that people receive their authorized services. 
  • EVV allows providers to confirm that services were actually delivered using a variety of electronic methods like a phone call, smart phone application, or a free EVV device in the home.
  • EVV is required for self-directed employees providing any of the following services:
    • Community Based Supports
    • Individual Supports
    • In-Home Respite
  • EVV is not required when the services are delivered:
    • in a provider-managed, licensed residential setting such as a group home.
    • by an SDE who lives in the same residence as the individual receiving services, whether that SDE is a family member or non-family member.

Information about EVV is available on the Division of Medical Assistance and Health Services (DMAHS) Electronic Visit Verification webpage.

 
 
 
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