Sponsored by:
Senator TROY SINGLETON
District 7 (Burlington)
Senator DECLAN J. O'SCANLON, JR.
District 13 (Monmouth)
Co-Sponsored by:
Senators Madden, Gopal, Beach and A.R.Bucco
SYNOPSIS
Makes certain changes to the hourly reimbursement rate for personal care services reimbursed by Medicaid.
CURRENT VERSION OF TEXT
As reported by the Senate Health, Human Services and Senior Citizens Committee on May 21, 2018, with amendments.
An Act making certain changes to Medicaid reimbursement for personal care services and amending P.L.2017, c.239.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 1 of P.L.2017, c.239 (C.30:4D-7n) is amended to read as follows:
1. 1[a.]1 The hourly reimbursement rate for personal care services within the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), whether the services are provided in the Medicaid fee-for-service delivery system or through a managed care delivery system, shall be no less than the established State Medicaid fee-for-service rate and no less than $19 per hour. [Any and all rate] Rate increases realized pursuant to this section1, less verifiable direct and indirect administrative costs of the employer related thereto, including, but not limited to, applicable payroll taxes and insurance costs,1 shall be used solely to increase [wages for workers who directly provide personal care services] 1[the average direct care worker compensation rate] wages for workers who directly provide personal care services1.
1[b. As used in this section, “direct care worker compensation” means all direct and indirect labor costs for personal care assistants and home health aides, including hourly pay rates, overtime hourly reimbursement rates; work-related travel costs; performance bonus payments; paid time off; paid time used for training purposes; payroll taxes; all relevant insurance costs, including workers’ compensation, liability, health, disability, and life; and relevant retirement funding provided by the employer.
c. The average direct care worker compensation rate for each provider shall be calculated by the Division of Medical Assistance and Health Services in the Department of Human Services as provided pursuant to section 2 of P.L.2017, c.239 (C.30:4D-7o).]1
(cf: P.L.2017, c.239, s.1)
2. Section 2 of P.L.2017, c.239 (C.30:4D-7o) is amended to read as follows:
2. 1[a.]1 Every provider that receives reimbursement for personal care services pursuant to a Medicaid managed care contract 1or a Medicaid fee-for-service delivery system1 shall annually provide a report to the Division of Medical Assistance and Health Services in the Department of Human Services regarding the use of funds received as reimbursement for personal care services, including assurances that the increased funds received pursuant to section 1 of P.L.2017, c.239 (C.30:4D-7n)1, less verifiable direct and indirect administrative costs of the employer related thereto, including, but not limited to, applicable payroll taxes and insurance costs,1 are being used [exclusively] 1[primarily] exclusively1 for salary increases for workers who directly provide personal care services and detailed data on the salary increases resulting from section 1 of P.L.2017, c.239 (C.30:4D-7n); including the prior salary, current salary, and other changes to the salary of the workers who directly provide personal care services.
1[b. Every provider that receives reimbursement for personal care services pursuant to a Medicaid managed care contract shall provide a report to the Division of Medical Assistance and Health Services in the Department of Human Services detailing the provider’s expenditures for direct care worker compensation, as defined in section 1 of P.L.2017, c.239 (C.30:4D-7n) for the previous three calendar years. This information shall be provided to the department no less than 60 days after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill). The department shall determine the average hourly rate for direct care worker compensation for personal care assistants and home health aides by calculating total expenditures for direct care worker compensation by the number of hours reimbursed for personal care assistants and home health aides over the previous three calendar years. This sum shall be used as the average direct care worker compensation rate pursuant to section 1 of P.L.2017, c.239 (C.30:4D-7n).]1
(cf: P.L.2017, c.239, s.2)
3. The Commissioner of Human Services, pursuant to the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations as the commissioner determines necessary to effectuate the purposes of this act.
4. This act shall take effect July 1, 2018, and shall apply to services provided on or after the effective date of this act and to any Medicaid managed care contract executed or renewed on or after the effective date of this act.