Caregiver Assistance
My Patient Guide
Guiding you every step of the way.
What is CAP?
CAP is a Medicaid Waiver program that provides a broad array of in-home services to enable an individual, at risk of placement in a nursing facility and who meets income and resource requirements, to remain in his or her community home. By providing a uniquely designed package of supports for the individual, CAP delays or prevents placement in a nursing facility.
What services may be provided?
CAP offers all New Jersey Title XIX Medicaid services authorized in a Plan of Care (POC) except Nursing Facility, Personal Care Assistant and Medicaid Hospice services. All CAP participants receive Care Management services. In addition, the POC specifies other services to be delivered, which may include:
- Respite Care
- Homemaker Services
- Environmental Accessibility Adaptations
- Personal Emergency Response Systems (PERS)
- Home-Delivered Meal Service
- Caregiver/Recipient Training
- Social Adult Day Care
- Special Medical Equipment and Supplies
- Transportation
- Chore Services
- Attendant Care
- Home-Based Supportive Care
Are there limits to CAP services?
Yes. Cost caps are applied to specific services under CAP as well as to the cost per person per month. CAP services are limited to a maximum of $1,000 per month or $12,000 annually. The service package provided is based on an assessment of the individual’s needs, unique care plan, and availability of services and funding.
Who provides these services?
Services may be provided by traditional Waiver service providers, new qualified non-traditional entities, or qualified Client-Employed Providers. 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 Client-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. The ability to direct one’s own care will be confirmed prior to participation as the employer of one’s providers.
Who is eligible for CAP services?
A CAP eligible individual is a New Jersey resident who:
Meets the following clinical requirements:
- Is at least 65 years old or 21- 64 and determined disabled by the Social Security Administration or by the Disability Review Section of the Division of Medical Assistance and Health Services, New Jersey Department of Human Services; and
- Has been assessed by the staff of the New Jersey Department of Health and Senior Services, Regional Office of Community Choice Options, and found to be in need of nursing facility level of care; and
- Resides in a home that he/she owns or rents, or lives in an unlicensed home of a relative.
Meets financial eligibility by:
1. Qualifying for Supplemental Security Income (SSI) in the community; or
2. Qualifying for Institutional Medicaid:
- Has a gross monthly income at or below $1,869 per month;
- Resources at or below $2,000; or
3. Qualifying for New Jersey Care:
- Has a gross monthly income that is no more than 100% of the Federal Poverty Level ($851 in 2007)
- Resources at or below $4,000.
A Spouse's income is not considered in the determination of eligibility, but the spouse's resources are considered.
Is there a co-pay for CAP?
There is no co-pay for the CAP program.
How do I apply for CAP?
Individuals interested in receiving services through CAP may contact the NJ EASE site in their county. NJ EASE is the Easy Access Single Entry point for senior service information, and can be reached toll free by dialing 1-877-222-3737. NJ EASE workers will assist callers and refer individuals to the proper application point.
For additional information contact:
New Jersey Department of Health and Senior Services
Division of Aging and Community Services
Office of Community Support
PO Box 807
Trenton, NJ 08625-0807
Phone: 609-943-4060
Home and Community
Based Programs
Home / Community Programs
Home / Community Programs
