Applications for Medicaid/MLTSS are still being accepted at the County Boards of Social Services

Increasing numbers of frail elderly are trying to arrange for care in their houses or apartments because admission to nursing facilities is so problematic at this time. About one third of the state’s skilled nursing facilities are considered to be incapable of appropriately isolating COVID-19 patients, and have been  barred from any new admissions. Of course, arranging for home care is increasing difficult due to a serious shortage of trained personnel who are capable and willing — understandably — to go into a home setting, due to the risk of infection. Geriatric care managers (Aging and Life Care Specialists) can be very useful in establishing a home care arrangement, even in these trying times.

The Medicaid/MLTSS program can provide home and community -based services to financially-eligible individuals who are over 65 or are disabled and who require hands-on care and supervision with 3 or more of their activities of daily living. It is necessary to contact the Office of Community Choice Options (OCCO) to order the Pre-Admission Screening (PAS). Here’s the latest list of offices and contact numbers.  MLTSS and OCCO Contact List 3.20.20

Previously, this evaluation took place at the residence of the applicant. Now it is being done by telephone. It’s very important to order the PAS because an applicant must be clinically in need of these long-term care services in order to be approved for Medicaid/MLTSS services. To do so, first the family/caregiver calls the ADRC (Aging Disability Resource Connection) in their county.  The ADRCs are sort of the portal-of-entry to gain access to many different government programs. The ADRC will complete the first telephone screening.  The ADRC will then send their screening to OCCO.  The OCCO nurse will contact the family to review the initial screening and gather additional information.


Office of Community Choice Options:

While awaiting the PAS evaluation, it’s necessary to address the financial eligibility requirements, which are stringent and complex. Legal sandtraps are everywhere in the process. The application is then filed at the local County Board of Social Services once all of those benchmarks have been reached.

Call for advice and assistance with medicaid eligibility, applications and appeals … 732-382-6070

Medicaid’s Home and Community Care Program is developing new procedures

Frail elderly (over 65) and disabled individuals in New Jersey who reside in the community and require substantial assistance with their Activities of Daily Living (ADL’s) have opportunities to obtain home health care and an array of other benefits through the Medicaid Program. Gross monthly income presently cannot exceed $2,130, and there are resource limits as well for eligibility ($2,000 for the applicant and a modest allowance for the community spouse).  A person receiving SSI would be financially eligible, as could low-income, low-asset SSD recipients. Currently referred to as “GO” (Global Options), the programs are being consolidated under the umbrella of a revamped “Comprehensive Waiver” Medicaid program approved last October 1, 2012. The services available are called “long-term services and supports” (LTSS).

Medicaid applications are filed in the county where the applicant resides. The portal of entry is through the county’s  Aging and Disability Resource Center/ADRC. Attached is the screening tool that is used for these intakes, to give you an idea of the clinical issues they consider. After screening, the intake worker should generally make a referral to the Office of Community Choice Options (OCCO) for a full clinical/medical/nursing evaluation as well as a referral to the County Board of Social Services which would process the actual application. The applicant or their authorized representative or a family member still needs to have a face-to-face meeting at the County Board to complete the application.

Screening Tool 2013 LTCSS