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THE JOURNEY TO COMMUNITY HOUSING WITH SUPPORTS
MANAGED LONG TERM SERVICES AND SUPPORTS (MLTSS) PROGRAM ADMINISTERED BY DMAHS New Jersey residents with Medicaid, who are living in institutions or nursing homes for more than 90 days, may qualify for this program under the Managed Long Term Services and Supports (MLTSS) program within the NJ Comprehensive Medicaid Waiver. The person must meet financial criteria and be assessed to require a “nursing home level of care.” Services are planned so that the person has a smooth and successful transition moving back into a home of their own. A person requiring too little or conversely too much support may not qualify for the program. An interdisciplinary team works with the person to develop an individualized plan of care based upon his/her needs. Funding for in-home services might include home health aides, adult day care, transportation, behavioral health care and meal delivery. Personal income such as Social Security benefits must pay for living expenses and housing.
These Medicaid funded long-term care and home and community-based services are overseen by Managed Care Organizations (MCO). An MCO is also known as Health Management Organization (HMO). They approve and coordinate all community-based services as well as acute and primary health care. People who qualify for a nursing home level of care must meet the clinical and financial guidelines for MLTSS. Funding is determined based upon an assessment and person-centered planning. These comprehensive supports could be provided in-home, in an assisted living facility, in community residential services, or in a nursing home as long as the person meets the standard of care for this waiver. A person cannot receive MLTSS and DDD services at same time.
Go to WWWNJGOVHUMANSERVICESDMAHSHOMEMLTSS HTML for information regarding the MLTSS Waiver.
NJ Department of Human Services Division of Medical Assistance and Health Services (NJDMAHS) The Division of Medical Assistance and Health Services (DMAHS) administers the state- and federally-funded Medicaid and NJ FamilyCare programs for certain groups of low-to-moderate income adults and children. MLTSS or Managed Long Term Services and Supports refers to the coordination of the waivers for people with higher levels of medical care needs administered through the Division of Medical Assistance and Health Services. The NJ Comprehensive Medicaid Waiver encompasses four previous waivers called Global Options for Long-Term Care (GO); AIDS Community Care Alternatives Program (ACCAP); Community Resources for People with Disabilities (CRPD); and, Traumatic Brain Injury (TBI) Waiver that now operate within one managed care system.
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