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.

S3992

SENATE, No. 3992

STATE OF NEW JERSEY

222nd LEGISLATURE

�

INTRODUCED MARCH 19, 2026

Sponsored by:

Senator� JOSEPH F. VITALE

District 19 (Middlesex)

Senator� ANGELA V. MCKNIGHT

District 31 (Hudson)

Co-Sponsored by:

Senators Turner and Diegnan

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

���� As introduced.

��

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 p
ersonal 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.

����
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 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.�

���� The sponsor believes that the existing policy puts
pressure on seniors who need
nursing facility
level of care to leave their homes and seek care in long-term care facilities,
a policy that is more expensive for the State and unfair to seniors who

have worked all their lives to maintain the independence and dignity of living
in their own home.� In addition, 40 hours per week of PCA services is
insufficient to supplement care from a beneficiary�s family and friends.� Since
New Jersey�s cost of living is one of the highest in the country, these
caregivers often need more hours of PCA services for their loved one in order
to maintain their own employment.� Increasing the service cap for the State�s
most vulnerable Medicaid beneficiaries will ensure that they can thrive within
the community for additional years.

���� Specifically,
the bill directs the Department of
Human Services to approve, as medically necessary, up to
91 hours
of PCA
services per calendar week for any
eligible Medicaid beneficiary who is

clinically eligible for nursing facility level of care
. The department is also required to
modify the existing assessment tool for PCA services to reflect the provisions
of this bill.
�