Resources

The effective utilization of resources across diverse systems is essential for navigating the complexities of the adult world. Our specialization in Medicaid, managed care organizations, and community mapping equips us to offer insightful and strategic approaches tailored to specific needs. This expertise not only clarifies our methodologies but also enhances our ability to identify opportunities and optimize processes, leading to improved outcomes for the communities we serve.

Medicaid, SSI & Your Managed Care Organization (MCO)

Receiving Social Security Income?

New Jersey residents receiving Supplemental Security Income (SSI) from the federal Social Security Administration (SSA) are automatically eligible for Medicaid. The Division offers fact sheets on SSI benefits and the SSI Continued Medicaid Eligibility (1619b) program, which outlines how individuals can maintain Medicaid eligibility even if their income exceeds certain limits.

SSI is a monthly benefit provided by the federal government to adults with disabilities who have limited income and resources, particularly recommended for those turning 18 who plan to access Division of Developmental Disabilities (DDD) services. Applications for SSI can be completed online, and it's useful to consult the Division’s fact sheet that differentiates Supplemental Security Income from Social Security Disability Insurance (SSDI).

The monthly SSI benefit amount depends partly on the individual’s income, as parental income and resources are no longer considered once the individual turns 18. It’s crucial for SSI recipients to report their current wage information to the SSA.

For individuals aged 18 and older already receiving SSI or SSDI benefits, creating an online My Social Security account can be beneficial for managing their benefits.

Not Eligible for Social Security Income?

If your monthly income or financial resources exceed SSI limits, you can still apply for New Jersey Medicaid by visiting your County Board of Social Services. Be sure to review the Medicaid ABD Checklist to ensure you have all the necessary documents for your application.

Medicaid as a DAC (Disabled Adult Child)

An individual may qualify for Medicaid as a Disabled Adult Child (DAC) under Section 1634 of the Social Security Act if they are at least 18 years old, have blindness or a disability that began before age 22, were receiving SSI due to that condition, and have lost SSI because they now receive Social Security benefits from a parent's record due to the parent’s retirement, death, or disability. Eligibility for Medicaid can continue as long as the individual is determined to be blind or disabled and meets specific income and resource limits. For further details, individuals can refer to the Disabled Adult Children (DAC) flyer.

Managed Care Organizations (MCO)

In 1995, New Jersey transitioned Medicaid beneficiaries from a traditional fee-for-service health coverage model, where providers bill Medicaid directly, to managed care. In this system, beneficiaries enroll in a health plan or managed care organization (MCO) that coordinates their healthcare and provides additional services alongside the standard NJ FamilyCare Medicaid benefits. Currently, five MCOs participate in New Jersey's NJ FamilyCare Medicaid program: Aetna Better Health of New Jersey, Fidelis Care, Horizon NJ Health, UnitedHealthcare Community Plan, and Wellpoint (formerly Amerigroup New Jersey). Managed care offers New Jersey beneficiaries improved access to healthcare providers and better care coordination compared to the traditional fee-for-service model. Additionally, managed care health plans deliver a comprehensive range of preventive health services, enhancing overall healthcare outcomes when combined with the full array of Medicaid benefits.

Division of Developmental Disabilities (DDD)

The Overview

The Supports Program and Community Care Program were created by New Jersey's Division of Developmental Disabilities (DDD) to provide public funding for services that help eligible adults with intellectual and developmental disabilities, aged 21 and older, live as independently as possible. To qualify for DDD services, individuals must be New Jersey residents, Medicaid eligible, and meet specific functional criteria, including having a developmental disability that manifested before age 22, is lifelong, and significantly limits their ability to perform at least three essential life activities such as self-care, learning, mobility, communication, self-direction, economic self-sufficiency, and independent living. Eligible individuals must enroll in one of DDD's Medicaid waiver programs—the Supports Program (SP) or the Community Care Program (CCP)—which provide services enabling them to live in their own homes or community settings. While there is a waiting list for the Community Care Program, individuals can access services through the Supports Program while awaiting evaluation.

Enrollment in the Supports Program

After an individual is deemed eligible for DDD services, the following steps outline the enrollment process for the Supports Program:

  1. The individual or their family selects a Support Coordination Agency or is automatically assigned one.

  2. The agency assigns a Support Coordinator.

  3. The Support Coordinator reviews the Supports Program Participant Enrollment Agreement with the individual.

  4. The individual signs the Participant Enrollment Agreement.

Additionally, those on the Community Care Program waiting list can enroll in the Supports Program and receive services while remaining on the waiting list.

Enrollment in the Community Care Program

Once an individual is confirmed eligible for DDD services and meets all criteria for the Community Care Program (CCP), the following steps outline the enrollment process to begin receiving services:

  1. The individual or their family selects a Support Coordination Agency or is automatically assigned one.

  2. The agency assigns a Support Coordinator.

  3. The Support Coordinator reviews the Participant Enrollment Agreement with the individual.

  4. The individual signs the Participant Enrollment Agreement.

Role of a Support Coordination Agency and Support Coordinator

The Support Coordination Agency assigns a professional Support Coordinator who will reach out to the individual or family to introduce themselves and initiate the planning process. The Support Coordinator serves as the primary contact for the family, helping connect them with community services and resources. The Support Coordination Agency is available 24/7 for emergencies and can schedule additional interactions at the family’s convenience. The Support Coordinator aims to build a strong relationship with the individual and their family, understand their needs, and is knowledgeable about local services and the policies of the Supports and Community Care Programs. Their role is divided into four main areas: assisting individuals in identifying their goals through the Person Centered Planning Tool (PCPT), developing an Individualized Service Plan (ISP) with input from the individual and the planning team, coordinating necessary services and resources, and monitoring the quality of services to ensure they meet the individual's needs and support their progress toward desired outcomes.

Why choose Stilled Waters as my Support Coordination Agency?

At Stilled Waters, we recognize that choosing a support coordination agency can be a daunting decision. We are committed to guiding you through this journey and providing support at every step. Our team prioritizes expertise, compassion, and active listening while advocating for your needs, ensuring that you feel valued and understood throughout the process.

County Resources & Field Offices Locations

Field Office Service Locations

New Jersey has nine Community Services Offices that serve all 21 counties. To find your community services office, select the county of residence for the individual who is receiving or will receive DDD services.

County Board of Social Services (CBOSS)

County Social Service Agencies provide a range of services and programs. It is recommend to call your county to confirm hours of operations before visiting. Find your CBOSS here.

County Boards of Social Services in New Jersey offer a variety of services, including:

  • Financial Assistance: Programs like Temporary Assistance for Needy Families (TANF) and General Assistance for low-income individuals and families.

  • Food Assistance: The New Jersey Supplemental Nutrition Assistance Program (SNAP) to help eligible residents purchase food.

  • Child Welfare Services: Support for child protection, foster care, and adoption services.

  • Healthcare Assistance: Help with Medicaid enrollment and other health-related services.

  • Housing Assistance: Programs to assist with housing needs, including emergency housing and rental assistance.

  • Support for Individuals with Disabilities: Services that provide resources and support for individuals with physical and developmental disabilities.

  • Workforce Development: Job training and employment services, including Work First New Jersey (WFNJ).

  • Aging Services: Programs specifically designed to support older adults, including services related to home care and community resources.