2020 Pacesetter Prize Winner
Choice of Setting and Provider
Why a Pacesetter Prize for New Jersey?
New Jersey is a national leader in utilizing managed care to give people needing LTSS more choices of care providers and settings for receiving care. It is a key reason New Jersey is this year’s Pacesetter Prize winner in Choice of Setting and Provider. New Jersey improved its ranking in this category from No. 36 in 2017 to No. 19 in 2020. Its overall State Scorecard rank rose from No. 17 to No. 12 during the same time period.
- Launched in 2014, New Jersey’s unique managed long-term services and supports (MLTSS) program greatly increased access to home- and community-based settings (HCBS) for Medicaid-eligible adults with complex care needs by requiring enrollment in a managed care plan. Only 30 percent of LTSS recipients were in HCBS at the program’s launch. By 2018, this rose to nearly 50 percent.
- New Jersey promotes person-centeredness and choice by making personal care services, including self-directed options, available to all Medicaid members based on assessed need. New Jersey’s largest self-direction program grew from approximately 9,800 participants in 2016 to more than 18,000 in 2019.
- New Jersey’s Community Care Program is an HCBS waiver program that helps individuals with intellectual and developmental disabilities live as independently as possible in the community. Individuals have the choice to self-direct their services and live in their own home with family or friends, or independently. Alternately, they can choose to live in a group home or supervised apartment and have a provider coordinate their services for them.
- The Jersey Assistance for Community Caregiving program provides people ineligible for Medicaid with access to HCBS and may delay the need for institutional care.
What’s next for New Jersey?
New Jersey will continue to encourage HCBS, and plans to sustain its Money Follows the Person program, which helps eligible nursing home and developmental center residents transition into a community-based setting. The state will also continue engaging with stakeholders to discuss MLTSS program improvements and expand the number of formal and informal caregivers to continue meeting individuals’ LTSS needs at home