N.J. Admin. Code § 10:140-2.1

Current through Register Vol. 56, No. 11, June 3, 2024

Section 10:140-2.1 - Eligibility standards

(a) For the purposes of the Personal Assistance Services Program, an eligible applicant or consumer shall meet the following standards, except as noted at N.J.A.C. 10:140-2.2:

1. An eligible applicant or consumer shall be 18 years of age or older and shall have a permanent physical disability;

2. An eligible applicant or consumer shall be a resident of the State of New Jersey and must reside within the geographic boundaries thereof in order to qualify for services. Residency shall be determined by physical domicile in New Jersey.

3. An eligible applicant or consumer shall be in need of personal assistance services pursuant to a written personal assistance services plan, prepared by the applicant or consumer, and approved by the staff of the county designated agency;

4. An eligible applicant or consumer shall be one who is self-directed and capable of managing and supervising his or her personal assistance services, as determined by an assessment conducted by an assessor;

5. A relative or other informal caregiver is not available to provide the services that the consumer needs;

6. An eligible applicant or consumer shall live, or plan to live upon becoming eligible, in a private house or apartment, group home, educational facility (for example, dormitory or campus apartment), rooming or boarding house, residential health care facility or an alternative housing arrangement acceptable to the Division for the purposes of the Personal Assistance Services Program; and the personal assistance services that the eligible applicant or consumer receives are supplemental to, and not duplicative of, services provided to the person in the rooming or boarding house, group home, educational facility, transitional housing or residential health care facility pursuant to licensure requirements. Individuals who reside in, or are a patient in a facility or setting where personal care services are the responsibility of those entities shall be ineligible for the Personal Assistance Services Program. An exception to this paragraph may be granted by the Division Director in circumstances where personal care services are not being provided by the facility and the individual meets all other requirements of this chapter;

7. The attending physician for the eligible applicant or consumer shall confirm in writing that he or she has a permanent physical disability and is capable of self-direction, and that the personal assistance services will be appropriate to meet the eligible applicant or consumer's needs; and

8. The eligible applicant or consumer shall receive no more than 40 hours per week of personal assistance services from the program in combination with any other program. Exceptions to this paragraph may be granted by the Division Director to individuals who can demonstrate the need for additional hours and demonstrate that the absence or loss of the services would constitute a clear risk to health and safety.

(b) Consumers must utilize any Federally funded programs for which they are entitled before receiving services from the program.

(c) The Division must operate the Personal Assistance Services Program within its financial appropriation and may suspend the enrollment of consumers or truncate the hours provided to consumers as financial restrictions/limitations require.

(d) In circumstances where requests for services exceed program resources, the Division shall invoke an order of selection to prioritize the order in which resources will be used to provide services to existing consumers. The order of selection shall be based on the qualifying program activities set forth at 10:140-1.5(b).

(e) Services available under the program are limited to those services related to personal care. The Division has no obligation to fund or facilitate a consumer's ability to comply with program rules by providing other services or accommodations.

(f) It is the responsibility of the consumer to maintain Program eligibility in good standing. A consumer shall be determined to be in good standing by doing the following:

1. Maintaining qualifying activity in accordance with this chapter;

2. Complying with the payment of cost share in accordance with 10:140-4.3;

3. Complying with the training requirements in accordance with 10:140-6.1; and

4. Notifying the county designated agency of any change(s) in Program activity as described at N.J.A.C. 10:140-1.1 and 1.5(a) and (b), including, but not limited to, acquiring new employment, loss of employment, withdrawal from, or completion of, a post-secondary educational or training program, new enrollment in a post-secondary educational or training program, participation in new volunteer activity, or withdrawal from, or termination of, participation in a volunteer activity. Consumers shall be required to submit documentation to support such change.

i. Consumers must notify their county designated agency Program coordinator of any significant change in Program activity immediately, but no longer than 15 business days. Notification may be performed verbally, in writing, or electronically (computer message).

ii. The county designated agency shall inform the consumer in writing of the need to provide documentation of involvement in Program activity within 30 days of receipt of request to ensure compliance with 10:140-1.1 and 1.5(a) and (b). The written notification shall inform the consumer that failure to respond to the request in writing within the 30-day timeframe shall result in a suspension from the Program.

iii. In the event that the requested documentation under (c) above is received in a timely manner and meets the criteria established under 10:140-1.1 and 1.5(a) and (b), the consumer's eligibility status for PASP shall remain in good standing.

iv. In the event the requested documentation is received within the 30-day timeframe, but is deemed as unacceptable (does not meet Program activity requirements), the consumer shall be notified in writing of this determination by the county designated agency. In the event the consumer is unable to provide appropriate documentation to ensure compliance with 10:140-1.1 and 1.5(a) and (b), he or she will be terminated from the Program within 30 days of receipt of the letter. A notice of termination shall be issued to the consumer by the county designated agency pursuant to the actions described in this section.

5. In situations in which a consumer no longer meets eligibility requirements under 10:140-1.1 through no fault of his or her own (such as employer closure/moving, significant health change, volunteer agency closure, etc.), a Program activity plan shall be required and implemented within 90 days from the date of activity change in order to remain eligible for the Program.

i. The Program activity plan must be submitted to the county designated agency in writing along with documentation to support said activity.

ii. The Program activity plan shall be reviewed and approved by the designated State agency.

iii. Failure to provide the Program activity plan and/or implement the approved activity within 90 days of date of activity change shall result in a termination from the Program due to continued non-compliance with 10:140-1.1.

N.J. Admin. Code § 10:140-2.1

Amended by 48 N.J.R. 1818(b), effective 9/6/2016

Amended by 56 N.J.R. 261(a), effective 2/20/2024