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Bill > S4555
NJ S4555
NJ S4555Requires Medicaid coverage for assisted living services for individuals with serious mental illnesses.
summary
Introduced
06/02/2025
06/02/2025
In Committee
06/02/2025
06/02/2025
Crossed Over
Passed
Dead
Introduced Session
2024-2025 Regular Session
Bill Summary
This bill requires the State Medicaid program to cover assisted living services for individuals diagnosed with a serious mental illness who do not require assistance with activities of daily living, but who demonstrate the inability to perform the instrumental activities of daily living necessary for independent living, as determined by a licensed mental health professional. The bill defines "activities of daily living" (ADLs) to mean those activities related to basic self-care, whether done independently or with supervision or assistance, such as bathing, dressing, feeding, or walking. "Instrumental activities of daily living" (IADLs) are activities, whether performed independently or with supervision or assistance, that enable an individual to live independently. IADLs typically require more complex organizational and cognitive skills than ADLs and include, but are not limited to, managing medications, following a prescribed medical or mental health treatment plan, managing personal finances, and cleaning personal living spaces. The Commissioner of Human Services will establish a functional assessment process by which a licensed mental health professional will determine whether an individual with a serious mental illness meets the criteria for assisted living services under the bill. The factors to be considered as part of this assessment include the individual's medical records, psychiatric history, functional evaluations, and input from treating physicians, mental health professionals, and family members. The commissioner will apply for any Medicaid State plan amendments or waivers necessary to implement the provisions under the bill and secure federal financial participation for State Medicaid expenditures under the federal Medicaid program. The provisions of the bill will become effective on the first day of the sixth month following the date of enactment.
AI Summary
This bill requires the New Jersey Medicaid program to cover assisted living services for individuals diagnosed with a serious mental illness who do not require assistance with basic activities of daily living (ADLs) like bathing or dressing, but who cannot independently perform instrumental activities of daily living (IADLs) such as managing medications, handling personal finances, or maintaining living spaces. The Commissioner of Human Services will establish a functional assessment process where licensed mental health professionals evaluate an individual's eligibility by reviewing medical records, psychiatric history, and input from medical professionals and family members. The assessment will determine if the person meets the criteria for assisted living services, with the goal of helping individuals with serious mental illnesses live more independently. The bill defines "serious mental illness" according to existing state administrative code and requires the commissioner to apply for necessary federal Medicaid waivers and amendments to implement the program. The provisions will become effective six months after the bill's enactment, allowing time for administrative preparation and federal approval.
Committee Categories
Health and Social Services
Sponsors (2)
Last Action
Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee (on 06/02/2025)
Official Document
bill text
bill summary
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bill summary
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bill summary
Document Type | Source Location |
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State Bill Page | https://www.njleg.state.nj.us/bill-search/2024/S4555 |
BillText | https://pub.njleg.gov/Bills/2024/S5000/4555_I1.HTM |
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