N.J. Admin. Code § 10:142-2.2

Current through Register Vol. 56, No. 16, August 19, 2024

Section 10:142-2.2 - Participant responsibilities

(a) Participants must agree to be the employer of record as defined by the Internal Revenue Service (IRS) at Section 3504 of the IRS Code and Revenue Procedure 70-6f, the Fair Labor Standards Act of 1938 at 29 CFR Part 201, and shall be expected to make decisions regarding their services and carry out required program activities, which include but are not limited to:

1. Hiring and firing employees within legal and regulatory requirements;

2. Training and supervising employees;

3. Adhering to all applicable Federal and State laws;

4. True, accurate, and timely reporting of employee time including completion of timesheets;

5. Setting of employee wages based on available funds and within State policy;

6. Determining job tasks and work schedule of employees;

7. Creating and managing the cash management plan to ensure services are provided within the allocated budget and in accordance with the plan and submitted by required deadlines;

8. Arranging to obtain goods and services, and submitting required documentation for payment of same within required timeframes;

9. Keeping required records (such as employee timesheets, hospitalization records, purchase of goods, supplies, and vendor services, etc.);

10. Accounting for and agreeing to use program funds in accordance with the approved cash management plan;

11. Arranging to obtain services, supports, and goods from available providers and suppliers;

12. Understanding and following program guidelines;

13. Maintaining scheduled appointments at required intervals, including, but not limited to, home visits and in-home nursing reassessments with a registered nurse employed by the State staff or an MCO.

14. Maintaining workers' compensation insurance coverage in accordance with N.J.S.A. 34:15-1 et seq.;

15. Informing the Division, or other agent thereof, for program purposes, of any change in the participant's contact information (such as address/phone number) or Medicaid eligibility;

16. Informing the Division if the participant is admitted to a medical facility, institutional setting, or residential facility within three days of admission;

17. Maintaining compliance with the Fair Labor Standards Act (FLSA);

18. Participating in a Risk Assessment Profile to evaluate the level of risk initially and at periodic intervals;

19. Preparing an emergency back-up plan that may be activated in situations in which a regular domestic household employee(s) or agency provider is unable to provide needed care;

20. Informing the program consultant in the event of a change in coverage afforded by managed care organization (MCO) providers; and

21. Participating in quality assurance reviews based on a random selection process, to be determined by the State program office, in compliance with CMS requirements.

(b) Failure to comply with requirements in (a)1 through 21 above may result in disenrollment from the program.

(c) Participants who are unable to manage their services independently or refuse to perform the responsibilities under (a)1 through 21 above, shall be mandated to use an authorized representative in order to receive program services.

(d) Prospective applicants who withdraw from the program enrollment process following prepayment of workers' compensation insurance by the VF/EV under N.J.A.C. 10:142-7.1(b), shall be responsible for reimbursement of above expenses by the program.

1. All applicants shall be required to sign a written agreement of understanding in regards to reimbursement for workers' compensation fees in the event of withdrawal from enrollment pursuant to (d) above.

2. In the event an applicant withdraws prior to enrollment in the program, the VF/EA shall be responsible for billing the applicant and collecting worker compensation fee expenses incurred. With consent from the State program office, the VF/EA may take action to refer the matter to a collection agency, as necessary, pursuant to N.J.A.C. 10:142-7.1(b), to obtain reimbursement for fees previously paid.

N.J. Admin. Code § 10:142-2.2

Adopted by 49 N.J.R. 3993(a), effective 12/18/2017