N.J. Admin. Code § 10:60C-2.1

Current through Register Vol. 56, No. 24, December 18, 2024

Section 10:60C-2.1 - Eligibility requirements for the Personal Preference Program

(a) For the purposes of enrollment and continued participation in the Personal Preference Program, an eligible individual must meet the following standards:

1. An eligible applicant or participant 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 the State of New Jersey. Exceptions to this rule include participants who are enrolled in a college/university on a full-time basis in- or out-of-State subject to the following:

i. Participant students must be present at their New Jersey address to participate in home visits and nursing reassessments, in accordance with N.J.A.C. 10:60C-2.2(a)13.

ii. Participant students must provide documentation of progress towards completion of a planned educational goal, such as a degree, certification, accreditation, etc.

2. An eligible applicant or participant must be eligible for a Medicaid/NJ Family Care program pursuant to N.J.A.C. 10:49.

3. An eligible applicant or participant must have and maintain Medicaid/NJ Family Care eligibility as categorically needy as defined at N.J.A.C. 10:49.

4. An eligible applicant or participant must be capable of self-directing services and/or be willing to use an authorized representative to manage services pursuant to N.J.A.C. 10:60C-2.2(c) and 3.3.

5. An eligible applicant or participant must live in either a private house or apartment, college/university housing, rooming or boarding house (except for a class C boarding home), a Division of Child Protection and Permanency foster home, skill-development home, supervised apartment, or other congregate living program where personal care assistance is not provided as part of the service package, which is included in the beneficiary's living arrangement.

(b) Individuals who reside in, or are inpatient in, a residential care setting where personal care services are the responsibility of those entities are ineligible for the Personal Preference Program.

(c) Individuals who reside in residential care settings remain ineligible to receive services from the Personal Preference Program during periods they temporarily or intermittently leave the setting or reside elsewhere.

(d) An eligible participant may not receive Personal Preference services while attending a camp program or a day program. In these situations, PCA is the responsibility of the program.

(e) It is the responsibility of the participant and/or representative, where appropriate, to maintain program eligibility in good standing by complying with all requirements, as specified at N.J.A.C. 10:60C-2.2.

N.J. Admin. Code § 10:60C-2.1

Amended and recodified from 10:142-2.1 by 56 N.J.R. 2294(a), effective 12/2/2024