Personal Preference Program (PPP)
The Personal Preference Program (PPP) is a New Jersey Medicaid (NJ FamilyCare) program that allows qualified individuals to directly manage their own personal care services instead of using a traditional home health care agency. This program grants patients greater control, flexibility, and choice over their own care.
Key Features
- Direct Hiring: You can directly hire a spouse, family member, relative, friend, or neighbor who is at least 18 years old. However, a legal guardian serving as an Authorized Representative cannot simultaneously be the caregiver (worker). Caregivers must have legal authorization to work in the United States.
- Self-Directed Operation: You can set the caregiver’s work schedule and wages within the budget range approved by the MCO (Managed Care Organization).
- Monthly Budget Support: The monthly budget is calculated by converting the MCO-approved PCA hours into a dollar amount based on the current reimbursement rate, minus administrative fees.
- Flexible Funding Use: Funds can be used to purchase approved goods and services that support independent living. Examples: Laundry services, errand services, and equipment for independent living (e.g., microwave, washing machine, etc.). However, medical services such as Private Duty Nursing are excluded from coverage.
- Non-Duplication: Using both the PPP and traditional Agency PCA services simultaneously is considered a duplication of benefits and is not permitted.
Eligibility
- The patient must be enrolled in NJ FamilyCare.
- There must be a physician’s prescription stating that PCA services are required for at least 6 months.
- The individual must practically require assistance with ADLs (Activities of Daily Living) such as bathing, eating, and mobility. Minors may also apply if they meet the requirements (with a guardian acting as a representative).
- The individual must have the ability to manage services directly or be able to manage them through an Authorized Representative.
- Residents of private homes, apartments, or group homes are eligible. However, those residing in assisted living facilities, adult foster care, or facilities where PCA services are already included in the service package are excluded.
Application and Contact
- Contact Your MCO: Contact your MCO and the state that you are “interested in the PPP” or request a “PCA Assessment.” An MCO Care Manager will then provide options counseling and guide you through the application process.
- Assessment & PPP Selection: During the nurse’s home visit assessment, clearly state your preference to use the PPP (Self-Directed) option instead of an agency-provided service.
- After MCO approval, a Financial Consultant from the assigned Fiscal Intermediary will assist with developing the budget plan and completing the enrollment process.
Managed Care Organizations (MCO) in New Jersey
- NJ PPP Direct Inquiry: 609-631-2481 / MAHS.PPP@dhs.nj.gov
- AWCA provides counseling free of charge (201-862-1665 / info@awcanj.org).
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