New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 164A - ADULT DAY SERVICES PROGRAM FOR PERSONS WITH ALZHEIMER'S DISEASE OR RELATED DISORDERS › Subchapter 3 - APPLICATION PROCESS AND RESPONSIBILITIES OF AGENCIES › Section 10:164A-3.2 - Funding requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The
				agency shall submit a cost proposal, which shall itemize all costs incurred in
				the operation of the agency, with supportive documentation. No more than 15
				percent of the total program operating budget shall be allowed for
				administrative costs and no more than one percent of the total program
				operating budget shall be allowed for advertising costs. The Department shall
				analyze the cost proposal and contrast costs with comparable facilities within
				their region to determine the agency's allowable cost per unit of service. The
				Department shall reimburse from 20 percent to 75 percent of the agency's
				allowable costs.
(b) For clients
				whose income falls below 300 percent of SSI, the Department shall pay 75
				percent of the agency's allowable costs. The agency shall obtain up to the
				remaining 25 percent of the agency's allowable costs (not reimbursed by the
				Department) from other sources such as donations, foundation funds, or from the
				client's families or funds in accordance with the sliding fee scale developed
				in accordance with the table in (c) below. The amount of the center's per diem
				cost reimbursed by clients and/or families shall not exceed 25 percent of the
				per diem rate established by the Department for these clients.
(c) For clients whose income falls between
				300 percent of SSI and 80 percent of the maximum moderate income limit for the
				highest income region published by the Council on Affordable Housing (COAH),
				effective July 1 of each year, incorporated herein by reference, the Department
				will subsidize between 20 and 60 percent of the agency's allowable costs in
				accordance with the sliding fee scale developed in accordance with the table
				below. The percentage of the agreed upon rate not paid by the Department will
				be the responsibility of the client. The following table reflects the formulas
				used to calculate income levels for each rate of reimbursement.
Income Guidelines
Percent of COAH
Formula for
Percent
Percent
Agency
for Highest Single
Highest
							 Couple's
Paid by
Paid by
Responsibility
Person's Income
s
							 Income
Department
Client
80%
80% COAH*
20%
80%
0%
+ F**
70%
2x300% SSI
30%
70%
0%
for Single
60%
60%
							 COAH
45%
55%
0%
+ F
50%
50%
							 COAH
60%
40%
0%
+ F
% of SSI for
Highest Single
Person's Income
300%
300% SSI +
							 F
75%
25%
0%
269%
269% SSI +
							 F
75%
20%
5%
238%
238% SSI +
							 F
75%
15%
10%
207%
207% SSI +
							 F
75%
10%
15%
175%
175% + F
175%
175%
20%
Below 175%
174 + F
175%
0%
25%
*5*Where: *5**COAH is the single person income limit. *5***F
				  is the factor used to calculate Highest Couple's Income limit. F = *5*(2x300%
				  SSI)--70% COAH. *5*
(d) If
				the agency accepts the proposed per diem rate, a Letter of Agreement will be
				prepared for signature by authorized representatives of the Department and the
				agency. The Department shall then pay the agreed upon per diem costs per client
				per day of authorized service.
(e)
				Upon execution of a Letter of Agreement, the agency may begin to identify
				eligible clients and submit a Waiting List Application form to the Department
				requesting approval for funding for each eligible client. Priority shall be
				given to clients below 300 percent of SSI.
(f) Depending on the availability of funding,
				the Department shall authorize enrollment of the client for up to three days
				per week.