STATE OF NEW JERSEY
222nd LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION
Sponsored by:
Assemblywoman SHANIQUE SPEIGHT
District 29 (Essex and Hudson)
Co-Sponsored by:
Assemblywomen Reynolds-Jackson and Haider
SYNOPSIS
Increases cap on personal care assistant services from 40 hours to 91 hours per week for Medicaid beneficiary determined clinically eligible for nursing facility level of care.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel.
An Act concerning personal care assistant services provided under Medicaid and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Notwithstanding any regulation to the contrary, the Department of Human Services shall approve, as medically necessary, up to 91 hours of personal care assistant services per calendar week for any eligible Medicaid beneficiary who is clinically eligible for nursing facility level of care. The department shall modify the existing assessment tool for personal care assistant services in accordance with the provisions of this section.
Prior to the implementation of the provisions of P.L. , c. (C. ) (pending before the Legislature as this bill), the Commissioner of Human Services shall provide a separate rate certification for an increase of personal care assistant services hours pursuant to this section within the State’s managed long-term services and supports program in compliance with federal standards, including but not limited to 42 C.F.R. 438.4. Implementation of an increase of personal care assistant services hours during a State Fiscal Year shall require a mid-year rate adjustment for the managed long term services and supports program.
As used in this section,
“Medicaid” means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Personal care assistant services" means health related tasks associated with the cueing, supervision, or the completion of activities of daily living, as well as related tasks, performed by a qualified individual in a beneficiary's home, or at a place of employment or post-secondary educational or training program, under the supervision of a registered professional nurse, certified as medically necessary, and in accordance with a beneficiary's written plan of care.
2. The Commissioner of Human Services shall apply for such State plan amendments or waivers as may be necessary to implement the provisions of this act and secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.
3. The Commissioner of Human Services, in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt such rules and regulations as the commissioner deems necessary to carry out the provisions of this act.
4. This act shall take effect
immediately.
STATEMENT
This bill increases the cap on personal care assistant (PCA) services from 40 hours to 91 hours per week for a Medicaid beneficiary determined clinically eligible for nursing facility level of care.
The bill requires that prior to the implementation of the provisions of the bill, the Commissioner of Human Services is to provide a separate rate certification for an increase of personal care assistant services hours within the State’s managed long-term services and supports program in compliance with federal standards, including but not limited to 42 C.F.R. 438.4. Implementation of an increase of personal care assistant services hours during a State Fiscal Year is to require a mid-year rate adjustment for the managed long term services and supports program.
The bill also directs the Department of Human Services to modify the existing assessment tool for PCA services to reflect the provisions of this bill.
The bill defines “personal care assistant services” to mean health related tasks associated with the cueing, supervision, or the completion of activities of daily living, as well as related tasks. PCA services are certified as medically necessary; delivered in accordance with a beneficiary's written plan of care; and performed by a qualified individual, typically in a beneficiary's home, and under the supervision of a registered professional nurse.
Currently, pursuant to State regulation, the Medicaid program limits PCA services to a maximum of 40 hours per week per beneficiary. Additional hours of service may be approved by the Department of Human Services on a case-by-case basis and based on exceptional circumstances. Increasing the service cap to 91 hours per week for the State’s most vulnerable Medicaid beneficiaries will ensure that they can thrive within the community for additional years.