'Real Life Choices' Funding Caps May Conflict With State & Federal Law
by
Herbert D. Hinkle, Esq. and Valerie A. Powers Smith, Esq.
Hinkle & Fingles, Attorneys at Law
2651 Main Street
Lawrenceville, New Jersey 08648
(609) 896-4200 or (215) 860-2100
In an effort to contain costs, the New Jersey Division of
Developmental Disabilities has replaced its Self-Determination Project
with a program called “Real Life Choices” (“RLC”). Under RLC, clients
who are eligible for residential placement may opt for this program
instead.
Under RLC, a client is assigned to 1 of 4 funding levels depending on
the nature of the disability. Families can then use the funding to set
up their own program. This approach is controversial because funding
is not based on individual needs and the actual costs of service.
Rather, funding is set artificially according to the funding level
assigned.
While RLC may be beneficial to some clients, it conflicts with the
Medicaid-funded Community Care Waiver (CCW) that is used to fund it.
Among the services provided under the CCW are: case management,
respite care, habilitation (including pre-vocational, educational, and
supported employment services), home and vehicle accessibility
adaptations, personal emergency response systems, therapies, and other
individual supports.
Before RLC, whenever a DDD client/CCW recipient needed a service
covered under the CCW, it was provided. Now, access to needed CCW
services has been restricted in some cases because of the RLC funding
level assigned acts as a cap. CCW and other Medicaid programs prohibit
limiting services to a certain dollar amount.
The RLC funding caps also run afoul of the New Jersey Developmentally
Disabled Rights Act, which emphasized planning (Individual
Habilitation Plan) to meet all of a client’s individual needs; and a
mandate that services provided by DDD must maximize developmental
potential.
Hopefully, DDD will iron out the problems with RLC as it gains
experience. For now, families experiencing difficulties can use DDD’s
appeal procedures or complain to the federal Center of Medicaid &
Medicare Services (CMS).
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Herbert D. Hinkle, his partner, Ira M. Fingles, and their colleagues,
S. Paul Prior and Valerie A. Powers Smith, maintain a statewide law
practice with offices in Lawrenceville, Marlton, and Florham Park, New
Jersey, and Yardley and Plymouth Meeting, Pennsylvania. They lecture
and write frequently on topics of law, aging, disability and estate
planning and are available
to speak to groups in New Jersey and Pennsylvania
at no charge.
Comments and suggestions
for future articles should be mailed to: Hinkle & Fingles, 2651 Main Street, Suite A, Lawrenceville, New Jersey 08648-1012.
Copyright 2004
Herbert D. Hinkle. All rights reserved.
