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Bill > A926


NJ A926

NJ A926
Requires Medicaid coverage for assisted living services for individuals with serious mental illnesses.


summary

Introduced
01/13/2026
In Committee
01/13/2026
Crossed Over
Passed
Dead

Introduced Session

2026-2027 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 State Medicaid program to cover assisted living services for individuals diagnosed with a serious mental illness who do not require assistance with basic self-care activities (like bathing or dressing), referred to as "activities of daily living" or ADLs, but who struggle with more complex tasks necessary for independent living, known as "instrumental activities of daily living" or IADLs. These IADLs include things like managing medications, following treatment plans, handling finances, and maintaining their living space. To determine eligibility, the Commissioner of Human Services will establish a process where a licensed mental health professional will conduct a functional assessment, considering medical records, psychiatric history, and input from doctors and family members. The Commissioner will also seek federal approval and funding to implement these changes, which will take effect six months after the bill is enacted.

Committee Categories

Health and Social Services

Sponsors (2)

Last Action

Introduced, Referred to Assembly Aging and Human Services Committee (on 01/13/2026)

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