Coming to Terms with Change

An overview of recent changes in the New Jersey service systems for individuals with developmental disabilities

The systems that serve individuals with developmental disabilities in New Jersey have been undergoing many changes in recent years.  The two most important ones are the shift of services for individuals under twenty-one from the Division of Developmental Disabilities to the Department of Children and Families, and the transition of all adult supports offered by the Division of Developmental Disabilities to a Medicaid Fee-for-Service system. This is a lot of change in a short amount of time for a system that has been basically the same for a very long time.  There are new names, new terms, and new concepts for all of us to absorb.   For an overview of the changes and how they’ve affected the services that SCARC provides, read on.

For children under the age of 21 – Department of Children and Families (DCF)

Until a few years ago, individuals with developmental disabilities of all ages were served by the Division of Developmental Disabilities.  In 2013, services for children with developmental disabilities were moved to DCF and are provided through its Division of Children’s System of Care.  This Division contracts with PerformCare NJ to provide a 24 hour, 7 day a week point of entry for accessing services.  To learn about how the system works, eligibility, and what services are available, an FAQ – Frequently Asked Questions (FAQ) for Families of Children with Developmental Disabilities –  is available on the PerformCare NJ website.

At SCARC, we provide three different DCF approved services for children under the age of twenty-one:

• Agency Hired Respite – This service provides temporary relief for families caring for a loved one with a developmental disability. A trained caregiver (now called a Direct Support Professional or DSP) engages in social and recreational experiences with children at home and in the community. Families have the flexibility of utilizing 60 hours of respite within a ninety day period.
• Agency Weekend Respite – This service provides community-based activities for children and teens.
  • Just Us Kids – Children, ages 5 through 15, can participate in this program that is held three Saturdays each month. Socialization and community inclusion are promoted through activities geared toward the ages and interests of the children attending.
  • Teen Scene – Young adults, ages 15 through 21, participate in a variety of activities three Saturday evenings each month. Dinners at local restaurants, movies, sporting events, etc. provide age appropriate options for socializing and fun with peers.
• Summer Experience – SCARC’s highly successful, two-week-long summer program is offered three times each summer. A wide variety of daily destinations provide community-based activities that support socialization, skill building, and educational opportunities.

For adults ages 21+ –  Division of Developmental Disabilities (DDD)

SCARC provides the same supports that they have for many years to individuals with developmental disabilities that are 21 years of age or over.  However, now that the state is transitioning into a Fee-for-Service system, those supports may be known by different names and accessed through individual budgets.

First, let’s explore what the term “Fee-for-Service” actually means.  Traditionally, services were provided through a “contract” that a provider had with DDD.  For example, a specific day program represented a contract between the state and SCARC to provide a certain number of individuals with a specific number of hours of care and activity in a group setting.  In an attempt to bring more Medicaid dollars into the state, New Jersey is transitioning to the Medicaid Fee-for-Service system which will result in Medicaid “matching” the dollars that NJ spends on services.  For every dollar NJ spends, Medicaid contributes a dollar to the state.  This new system requires that instead of funding contracts, individuals are “funded” or have budgets with which they can purchase services.  If an individual wishes to purchase, for example, day program services from SCARC, then SCARC must bill Medicaid for that service provided to that individual at a rate established by the state specifically for that service.

When the state completes their roll out of the Fee-for-Service system, all individuals with developmental disabilities that are over twenty-one will have an individual budget under the Supports Program or the Community Care Waiver (CCW).  Individual budgets can be used to purchase twenty-three specific services.  For a complete list, refer to the Supports Program Manual or the CCW Manual.

At SCARC, we provide six of those services for adults:

• Career Planning – Individuals, who would like to explore their options in the workforce, will complete an assessment and SCARC will assist them in developing a plan for attaining their goal of employment. Community-based experience helps individuals refine their expectations and skill needs.
• Community Inclusion – SCARC DSPs support individuals in participating in a wide variety of community-based activities.
• Day Habilitation – Previously known as day program, now often called Day Hab, SCARC provides a variety of options for individuals with differing support needs in their six distinctive programs
• Individual Supports – Available to individuals on the CCW in SCARC residential settings, this service provides assistance and support in all activities of daily living.
• Prevocational Training – SCARC DSPs will assist individuals in gaining skills that will make them more employable, and will provide exposure to work experiences that help an individual narrow their fields of interest.
• Supported Employment – Provided for individuals or in groups, these services help individuals find and maintain community-based employment at or above minimum wage.

One other significant change for adults in the Fee-for-Service system is the elimination of DDD case managers.  Instead, DDD has contracted with ninety-nine different state agencies to provide support coordination services.  Support Coordinators assist individuals with managing their budgets and accessing needed supports.  All adults have the option of selecting which agency they will contract with for this service.  Guidance with making that selection can be found in a helpful booklet – Selecting a Support Coordination Agency.

For more information on how these changes may specifically affect individuals with developmental disabilities, please contact our main office at 973-383-7442 and someone will be happy to help you with your questions.