MLTSS and how to apply for this program in Camden County, NJ
Managed Long-Term Support and Services is Medicaid/SSI program run by the State of New Jersey that offers a variety of ways to help elderly people stay in their homes, and will cover assisted living and nursing homes if your insurance company won’t.
MLTSS on the NJ Website
I am in the process of applying for MLTSS because I want to get help for my mother to stay in her (senior) apartment, until she can’t stay safe there independently, so I also need to get the ball rolling for an assisted living placement. This process takes time and energy, and you have to do it yourself, so get started as soon as you can. Here are the steps in the order I did them.
(The program my mom needed was formerly the “GO Program”:Global Options for Long-Term Care Program (GO).
These programs have provided a combination of both traditional medical services (i.e. dental services, skilled nursing services) as well as non-medical services (i.e. respite, case management, and environmental modifications) to those who meet both the established clinical and financial criteria. These programs were implemented to provide support services to an individual in the community to: prevent placement in an institutional setting (e.g. nursing home or hospital) or provide support to individuals who are re-entering a community setting after a period of institutionalization.)
(If you don’t already have Power of Attorney, get it now. Some people I spoke with said they couldn’t legally speak with me about Mom’s case without it.)
INITIAL ELIGIBILITY SCREENING
10/24/2015 Camden County Board of Social Services: Danielle (856) 858-2438
Over the phone, Danielle asked a series of general questions about Mom’s situation, focusing on safety (medications, personal care needs, transportation) and asked some general questions about Mom’s finances.
Danielle determined that Mom would be appropriate for the program. She gave me the general CCBSS number to call to schedule an appointment, and I tried it forever, couldn’t get through to anyone.
PA-4 PHYSICIAN CERTIFICATION (mailed from CCBSS)
This is a one page form to be completed by the family physician. The form requires short answers about “Medical Care Needs” such as primary diagnosis, physical/cognitive limitations, and the last question is “Is there reasonable indication that the patient might need hospital or nursing home care within 30 days without home and community-based services?” Mom’s doctor answered yes to this.
The doctor completed this form on 11/16/2015, mailed it back to me, and then on 11/18/2015 I mailed a copy of it to:
Camden County Board of Social Services
Attn: Medical Unit A
600 Market Street
Camden, NJ 08102
(609) 704-6050 State of NJ Department of Human Services. They told me Mom’s case had been assigned to a nurse, and the nurse would be calling to schedule a home visit for assessment.
I haven’t yet received an application for SSI, I don’t know why. But mailed with the PA-4, there was a list of financial documents that would be required for the application. I have been getting those together.
VISIT FROM NJ STATE NURSE FOR MEDICAL QUALIFICATION
11/25/2015 Julie Kobian, RN came to Mom’s apartment (609) 704-6050
The state nurse was here for 2 hours. During that time she reviewed the discharge paperwork from Mom’s hospitalizations/medications, read reports from the doctors, performed a quick physical, and observed Mom move around the apartment. She also asked Mom about her safety. At the end of the meeting, the nurse told us that she deemed Mom medically eligible for SSI. This eligibility is good for one year, so we have time to get the financial steps completed.
In order to qualify for Medicaid you must be 65 years old or blind or disabled and either a US Citizen (or lawfully admitted for permanent resident) and a resident of New Jersey.
Documents which should be included include but are not limited to:
Age: US passport, birth certificate, driver’s license, baptismal certificate, state-issued ID.
Citizenship: US passport, birth certificate, naturalization papers, alien registration card, final adoption decree.
Identity: US passport, photo license, school ID, US military ID
Marital Status: marriage certificate, divorce decree, death certificate, separation papers.
NURSING HOME AND COMMUNITY-BASED WAIVER PROGRAM ELIGIBILITY
(If the senior’s insurance doesn’t cover assisted living, this is what they need)
You are allowed only $2,000 in resources.
You must meet certain income criteria and be resource eligible. The income can be earned or unearned. You’ll need to gather documents that can prove how much money you receive each month, and what other financial resources you have (assets, social security, pensions, alimony, etc). Pre-paid, irrevocable burial arrangements and other policies with cash value are considered in this assessment, so have this documentation as well. You must provide the last 5 years of printed bank statements. (This may take up to two weeks to get.)
They also want to see Living Expenses: rent receipts, telephone bills, electric bills, water/sewer bills, health insurance bills, mortgage statements, gas/oil bills, renter insurance, unpaid medical bills, real estate tax bills, homeowner insurance, outstanding loans.
In addition to the documentation above, bring documents that show there is a designated Power of Attorney or Third Party Signator.
12/1/2015 Camden County Board of Social Services (856) 225-8264
I finally managed to schedule an appointment to go to Camden County BSS on Tuesday, December 15th at 10am. The worker said that Camden County had received the PA-4, and the medical approval (from the state nurse’s home visit). The worker said they would mail an application and the list of financial documents that I must bring with me to that appointment.
These are things that Mom needs, that MLTSS will qualify her for:
The Personal Preference Program
The Personal Preference Program allows consumers to:
• Choose services they want
• Individually hire workers, people they know/trust including relatives, friends and neighbors
• Schedule services to meet their needs
• Exercise greater control over their lives
http://www.familiesoflovedones.com (helpful!) and http://www.bc.edu (academic) and http://www.state.nj.us.humanservices/dds (this link is pretty useless)
Managed Long Term Supports and Services
(Administered through SSI)
• TBI (traumatic brain injury) behavioral management
• Assisted Living (ALR/CPCH)
• Assisted Living Program in Subsidized Housing (ALP)
• Adult Family Care (AFC)
• Respite Care: daily and hourly
• Social Adult Day Care
• Residential Modifications
• Home-Delivered Meal Service
• Community Transition Services
• Caregiver/Participant Training
• Transitional Care Management
• Personal Emergency Response System (PERS): Set-up and monitoring
• Specialized Medical Equipment and supplies
• Chore services
• Attendant Care
• Home-based Supportive Care (HBSC)
• Physical Therapy (group and individual)
• Medication Dispensing Device: set-up and/or monthly monitoring
• Nursing Facility Services: Custodial
• Occupational Therapy (group and individual)
• Private Duty Nursing
• Speech, language and hearing therapy
• Structured Day Program
• Supported Day Services
• Vehicle Modifications
• MLTSS Personal Care Assistanct (PCA)
• Cognitive Therapy (group and individual)
• Non-medical transportation
More information I found to support a senior wants to stay at home:
Camden County Senior and Disabled Services
Aging and Disability Resource Center
email@example.com (856) 858-3220 or (877) 222-3737
Fifth Legislative District
MacKenzie Belling, Constituent Services Representative
firstname.lastname@example.org (856) 547-4800
Project Lifesaver: This program is offered by the Camden County Sheriff’s Office in an effort to provide enhanced support and assistance to residents with Alzheimer’s disease or a related dementia disorder. Participants wear a special wrist bracelet that –should they become lost, can assist local law enforcement in locating them using the mobile locator tracking system. (856) 225-5470
Helping Hands: a community outreach program designed to assist aging adults by providing help with non-medical tasks. (856) 757-3270 (M-F mornings only)
Senior Safe Home Program: Home safety repair for senior citizens in Camden County
Sen-Han Transit: Non-emergency medical transportation, shuttle service, shopping, personal business, nutrition sites (856) 456-3344
Homemaker Assistance Network: HAN homemaker service helps you with home management and maintenance so you can continue to live as independently as possible. (856 456-1121
SNAP (Food Stamp) Outreach (856) 662-4884 ext. 144