NJ Global Options for Long-Term Care (GO) Waiver Explained

Long-term care is a term that refers to the ongoing assistance that some people need with their daily activities due to aging, disability, or chronic illness. Long-term care can be provided in various settings, such as nursing homes, assisted living facilities, or at home. However, many people prefer to receive long-term care at home, where they can maintain their independence and comfort.

One of the challenges of receiving long-term care at home is the cost. Long-term care can be expensive, and not everyone can afford it out of pocket. Medicare, the federal health insurance program for seniors and people with disabilities, does not cover most long-term care services. Medicaid, the joint federal and state health insurance program for low-income people, does cover long-term care, but only for those who meet specific financial and medical criteria.

Fortunately, some Medicaid programs offer more flexibility and options for people needing long-term home care. One of these programs is the Global Options for Long-Term Care (GO) Waiver in New Jersey. In this article, we cover the GO Waiver, who is eligible for it, what services and supports it offers, and how it compensates family caregivers who provide long-term care at home.

Overview of the GO Waiver

The GO Waiver is a Medicaid Home and Community-Based Services (HCBS) waiver program that provides services and supports for individuals who require nursing facility-level care but wish to remain in their homes or community settings. The GO Waiver allows participants more choice and control over their long-term care services and providers. It also enables participants to hire their own personal care assistants, including family members, friends, or neighbors.

The New Jersey Department of Human Services (DHS) and the Division of Aging Services (DoAS) administer the GO Waiver. The GO Waiver operates under a federal waiver authority that allows the state to waive specific Medicaid rules and regulations to provide more flexible and individualized services to eligible participants.

The GO Waiver serves individuals who are 65 years of age or older and individuals with physical disabilities who are 21 years of age or older. The GO Waiver has an enrollment cap of 26,000 participants as of 2023. The GO Waiver is an entitlement program, which means that there is no waiting list for eligible applicants.

Eligibility Requirements

To be eligible for the GO Waiver, an individual must meet the following requirements:

• Be a resident of New Jersey.
• Be a U.S. citizen or qualified alien.
• Have a Social Security number.
• Meet the income and resource limits for Medicaid eligibility.
• Require a nursing facility level of care as determined by a comprehensive assessment.
• Choose to receive services in a home or community rather than a nursing facility.
• Have a service plan that meets the individual's needs and preferences and does not exceed the cost of nursing facility care.

The income limit for the GO Waiver is 300% of the Federal Benefit Rate (FBR), which is $2,382 per month for an individual and $4,764 per month for a couple in 2023. The resource limit is $2,000 for an individual and $3,000 for a couple. Resources are assets that can be converted to cash, such as bank accounts, stocks, bonds, real estate, etc. Some resources are excluded from the limit, such as a primary residence, one vehicle, personal belongings, etc.

Services and Supports

The GO Waiver offers various services and supports to help participants live independently and safely in their homes or community settings. The services and supports include:

• Care management: A service that helps participants access and coordinate their long-term care services and supports. Care managers are assigned by local Area Agencies on Aging (AAAs) or Managed Long-Term Services and Support (MLTSS) plans.
• Respite: A service that provides temporary relief to unpaid caregivers responsible for the participant's primary care. An agency or an individual provider can provide respite in-home or out-of-home.
• Adult family care: A service that provides room, board, personal care, supervision, and companionship to participants who live with an unrelated caregiver in a private home.
• Assisted living: A service that provides residential living arrangements that include personal care services, 24-hour supervision, meals, medication management, recreational activities, etc.
• Assisted living program in subsidized housing: A service that provides assisted living services in a subsidized housing setting licensed by the state.
• Attendant care: A service that assists with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), such as personal hygiene, bathing, dressing, eating, preparing meals, housecleaning, laundry, etc. An agency or an individual provider can provide attendant care.
• Caregiver participant training: A service that provides training and education to unpaid caregivers on providing care to the participant. An agency or an individual provider can provide the training.
• Chores: A service that assists with household tasks essential to the participant's health and safety, such as heavy cleaning, minor home repairs, yard work, etc. An agency or an individual provider can provide chores.
• Community transition: A service that helps participants transition from a nursing facility to a home or community setting. The service covers expenses related to moving, such as security deposits, utility deposits, furniture, household items, etc.
• Environmental accessibility adaptations: A service that provides physical modifications to the participant's home or vehicle that are necessary to ensure the participant's health, welfare, and safety. The changes can include ramps, grab bars, widened doorways, lifts, etc.
• Home-based supportive care: A service that provides non-medical assistance and supervision to participants living in their homes or apartments. The service can include personal care, homemaker, companion, chore, and transportation services.
• Home-delivered meals: A service that provides nutritious meals delivered to the participant's home. The service can accommodate special dietary needs and preferences.
• Personal emergency response system (PERS): A service that provides an electronic device that enables the participant to summon help in an emergency. The device can be worn as a pendant or wristband and activated by pressing a button or voice activation.
• Social adult day care: A service that provides socialization, recreation, meals, and supervision to participants who attend a licensed facility during the day. The service can also provide transportation to and from the facility.
• Specialized medical equipment and supplies: A service that provides items necessary to treat or manage the participant's medical condition. The items can include wheelchairs, walkers, oxygen tanks, catheters, ostomy supplies, etc.
• Transportation: A service that provides transportation to and from medical appointments and other essential activities. An agency or an individual provider can provide the transportation.

Compensation for Caregivers

One of the benefits of the GO Waiver is that it gives participants more choice and control over their long-term care providers. Participants can choose to receive their services through one of two options:

• Agency with Choice (AWC): A model that allows participants to select and direct their own personal care assistants whom a licensed home health agency employs. The agency handles the personal care assistants' payroll, taxes, insurance, and background checks. The participants are responsible for recruiting, training, scheduling, supervising, and evaluating their personal care assistants. The participants can hire family members (except spouses), friends, or neighbors as personal care assistants.
• Self-Directed Employee (SDE): A model that allows participants to hire and manage their personal care assistants employed by a fiscal intermediary. The fiscal intermediary handles the personal care assistants' payroll, taxes, insurance, and background checks. The participants are responsible for recruiting, training, scheduling, supervising, and evaluating their personal care assistants. The participants can hire family members (except spouses), friends, or neighbors as personal care assistants.

Both models offer compensation for caregivers who provide long-term care at home. The state determines the compensation rate, and varies depending on the type of service and the level of care required by the participant. As of 2023, the compensation rate for personal care assistants ranges from $11.50 to $14 per hour.

A Note from Givers

If you are interested in applying for the GO Waiver or finding out if you are eligible for compensation as a caregiver, please fill out this form, and we will get back to you as soon as possible.

At Givers, we are passionate about supporting caregivers and advocating for their rights. Caregivers are part of the healthcare system, and they deserve to be paid for the work that they do. Caregivers need more than money; they need resources, education, community, and recognition.