Global Options for Long-Term Care (GO)
What is the GO Waiver Program?Effective January 1, 2009, the State of New Jersey received approval from the U.S. Centers for Medicare and Medicaid Services to consolidate three Medicaid-supported home and community-based service programs operated by Department of Human Services, Division of Aging Services (DHS/DoAS) into a single program known as Global Options (GO) for Long Term Care.
The consolidation improves access to a wider range of in-home long-term supportive services for a greater number of seniors and adults with physical disabilities who meet the income, asset and nursing facility level of care requirements established by Medicaid. GO participants have the options to hire and direct their own service providers.
The move to GO gives care managers greater flexibility in modifying individual care plans as needs and preferences change over time. It also simplifies administrative processes for federal, state and local officials. Through GO, individuals have easier access to important home and community-based services.
Federal approval of GO furthers the state's ongoing efforts to make New Jersey's long-term care system more flexible and consumer-friendly. In 2006, he signed into law the Independence, Dignity and Choice in Long-Term Care Act that required, among other provisions, the rebalancing of Medicaid long-term care funding to improve support for in-home services.
GO is designed to supplement – not replace – the assistance already being provided by family, friends and neighbors. By providing a flexible package of services and supports, GO strengthens the ability of caregivers to continue in their vital role as primary support providers.
GO participants work with a care manager to create an individualized plan of care based on a comprehensive assessment of the participant’s healthcare needs. Once the plan of care is approved, community-based services are put in place and monitored to ensure quality and effectiveness.
Seniors, adults with physical disabilities and their caregivers seeking information and access to GO, as well as other state-funded or private pay home and community-based long-term care services, can do so by calling their local Area Agency on Aging toll-free at 1-877-222-3737, or by visiting the Aging & Disability Resource Connection (ADRC) website at www.adrcnj.org.
Who is Eligible for GO?A GO individual is a person who is a U.S. citizen or a qualified alien assessed by a State Community Choice counselor or an Aging and Disability Resource Connection (ADRC) assessor as clinically and financially eligible for Medicaid nursing facility level of care. An applicant must be 65 years or older, or between the ages of 21 and 64 who shall be determined disabled by the Social Security Administration (SSA) or be determined disabled by the Division of Medical Assistance and Health Services, Disability Review Section. Additionally, eligibility depends on whether there is an indication that the participant will need the level of care provided in a hospital, a nursing facility or an intermediate care facility in the near future (i.e., a month or less) unless he or she receives home and community-based services.
What Services May be Provided?GO participants are eligible for all New Jersey Title XIX Medicaid State Plan services authorized in a Plan of Care, which may include:
- Adult Day Health (Require prior authorization)
- Advanced Practice Nurse
- Hearing Aid
- Home Health
- Hospital Outpatient
- Medical Supplies & Equipment
- Nursing Facility
- Optical Appliances
- Personal Care Assistant (Require prior authorization)
- Prosthetic & Orthotic Devices
- Community Transition Services
- Transitional Care Management
GO enrollees must also receive Care Management services and at least one additional waiver service. Based upon the person’s assessed level of service needs, the participant can choose among a wide selection of waiver services, which may include:
- Assisted Living/Adult Family Care
- Attendant Care
- Caregiver/Participant Training
- Care Management
- Chore Service
- Environmental Accessibility Adaptations
- Home Based Supportive Care
- Home-Delivered Meal Service
- Personal Emergency Response Systems (PERS)
- Respite Care
- Special Medical Equipment and Supplies
- Social Adult Day Care
- Transition Services and Transitional Care Management
Are there Limits to GO Services?Yes. The service package is based on an assessment of the individual's care needs and is developed in collaboration with a care manager. The service package builds on available supports, and takes into consideration the individual’s functional abilities, personal goals and preferences, risk factors, back-up plans, and availability of services.
Who Provides these Services?Services may be provided by traditional Medicaid community agencies, new qualified non-traditional entities, or qualified Participant-Employed Providers (individuals hired by the participant). All service providers must demonstrate competence in the service to be provided and must meet qualification requirements, which have been approved by the federal government.
The Participant-Employed Provider service option allows a participant to work collaboratively with his/her care manager to employ his/her own provider and direct his/her own care. Prior to participating in the Participant-Employed Provider option the care manager will discuss the responsibilities and complexities to ensure this option is appropriate.
Is there a Cost Share for GO?There is no co-pay for GO except for the Assisted Living or Adult Family Care service. For those services, a person is always responsible to pay room and board fees. Those participants with income above the SSI (Supplemental Security Income) amount may have a cost share, based upon his or her gross monthly income and allowable deductions. The Care Manager calculates the cost share.
For Additional Information Contact:Your Local Area Agency on Aging at 1-877-222-3737.
GO Participant Handbook
- GO Handbook Cover Page [pdf 9k] [doc 42k]
- GO Handbook [pdf 71k] [doc 105k]
- GO Participant Enrollment Agreement [pdf 32k] [doc 57k]