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When Medicaid was enacted by Congress in 1965, people with severe disabilities almost always lived in institutions. Since then, new medical treatments and the growing number of services that are available in the community have meant that it is now often possible for people with even the most severe disabilities to continue to live at home, as long as they have the support services they need.

As a result, New Jersey had offered a variety of services to consumers under its Medicaid 1115 (c) Waiver programs.  These programs included the:

• AIDS Community Care Alternatives Program (ACCAP);
• Community Resources for People with Disabilities (CRPD);
• Traumatic Brain Injury (TBI), and
• Global Options for Long-Term Care Program (GO).

These programs have provided a combination of both traditional medical services (i.e. dental services, skilled nursing services) as well as non-medical services (i.e. respite, case management, and environmental modifications) to those who meet both the established clinical and financial criteria.  These programs were implemented to provide support services to an individual in the community to: prevent placement in an institutional setting (e.g. nursing home or hospital) or provide support to individuals who are re-entering a community setting after a period of institutionalization.

In 2012, New Jersey received federal approval under of an 1115 (a) demonstration waiver for the Comprehensive Medicaid Waiver, which included Managed Long Term Services and Supports (MLTSS)—a new way to help individuals live in the community for as long as possible with services and supports. Beginning July 1, 2014, participants in ACCAP, CRPD, TBI and GO will be automatically enrolled in the MLTSS program through their current Medicaid managed care organization (MCO).  If individuals are receiving Personal Care Assistance (PCA) services and Adult Day Health Care, they have also been receiving them through their MCO since 2011.

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