Medicaid Waiver Programs in New Jersey

A "Medicaid waiver" is a program that provides funding for Medicaid-qualified individuals who suffer from developmental disabilities and other medical issues. It gets its name from the fact that certain Medicaid requirements are "waived" in order for the states to implement these special programs. The goal is to provide alternative care to people who would otherwise be institutionalized because of their medical or developmental challenges. New Jersey has three such waiver programs.

Community Resources for People with Disabilities (CRPD) Waiver

• The CRPD waiver aims to help people transition back into the community or allow them to remain in a community-care setting instead of a nursing home or hospital. The state limits services to no more than 300 people at any given time Disabled people of any age are eligible to participate, as long as they have met the requirements for disability set forth by the Social Security Administration (SSA).

  The New Jersey Division of Division of Disability Services will not consider parental income or resources for children needing the services. For married adults, the spouse's income will not be considered, but assets easily converted to cash will be.

  This waiver provides services such as a case manager, private licensed nurse, vehicle and home modification, personal emergency response system and one-time transition fees like necessary apartment furnishings, utility connections or pest control. The state permits nursing services for a maximum of 16 hours daily, and the residence must have another live-in adult who assumes 24-hour responsibility for the Medicaid recipient.

  In order to qualify for this waiver, a person must need a caseworker and at least one other service.

AIDS Community Care Alternatives Program (ACCAP) Waiver

• The ACCAP waiver provides a variety of services for AIDS patients or all ages and HIV patients under the age of 13. The state limits services to 750 people at a time. Like the CRPD waiver, the state will apply the same guidelines regarding income and resources for adult and child recipients, the SSA definition of disability and the necessity of a live-in caregiver or other adult for private nursing services.

  This program provides case management, private nursing services, personal care services supervised by a registered nurse and 24-hour hospice care to individuals who have been given a life expectancy of less than six months.

Traumatic Brain Injury Waiver (TBI)

• The TBI waiver provides a variety of services for people suffering from brain injuries. According to the Division of Disability Services, the majority of recipients comprise young adults who can no longer benefit from intensive rehabilitation. The state funds 350 cases at any given time and participants must meet the SSA criteria for disability. The injury must have occurred after age 21 but before age 65. Recipients must rate at least a four on the Rancho Los Amigos Level of Cognitive Functioning Scale. Services under this waiver include case management, counseling, home and vehicle modifications, day programs, an adult companion and a range of therapies including speech, occupational and physiotherapy.