Requires DHS to increase home and community-based services under Medicaid.
Assembly Bill 4308 requires the New Jersey Department of Human Services to expand home and community-based services (HCBS) under Medicaid and to shift a larger share of long-term services and supports away from institutional care. The bill sets policy targets for the Commissioner of Human Services to aim, by 2027, to place 80 percent of Medicaid participants eligible for nursing home care into HCBS and to direct 60 percent of long-term services and supports funding to HCBS, then to increase that share to 70 percent by 2029.
The bill also directs DHS to create a five-year strategic plan to expand HCBS, reduce the number of people institutionalized in State developmental centers, and take steps to reduce institutional bias in Medicaid eligibility, authorization, and coverage rules. It further requires DHS to develop an equitable plan across provider types with stakeholder input before enhanced federal American Rescue Plan Act funding expires, manage payment methods to support a living wage for caregivers, coordinate with the Department of Community Affairs to expand affordable supportive housing, and promote integrated care models such as PACE. DHS must also submit annual progress reports and seek any necessary state plan amendments or waivers to obtain federal Medicaid matching funds.
If enacted, the bill would add new statutory directives to Title 30 governing how DHS administers Medicaid long-term services and supports, with a clear policy preference for home and community-based care over institutional placement. It would not itself create a new benefit category, but it would require the department to pursue waivers, state plan amendments, payment reforms, and administrative changes to meet the bill’s targets and reporting obligations. The measure would affect Medicaid beneficiaries eligible for nursing home care, individuals in developmental centers, caregivers and HCBS providers, and agencies involved in supportive housing and integrated care.
No committee transcripts or votes were provided, so there is no recorded debate or roll-call history to indicate formal support or opposition. Based on the bill text alone, the measure appears strongly pro-expansion of community-based care, caregiver compensation, and housing supports, reflecting a policy goal of reducing institutionalization and improving access to services at home and in the community. The absence of recorded votes or hearing testimony means the overall sentiment in the available record is neutral to favorable by default, but not documented through legislative discussion.
The main likely points of contention are the feasibility and cost of the bill’s targets, including the 80 percent placement goal, the 60 percent and 70 percent funding allocation benchmarks, and the requirement to expand services while maintaining adequate provider rates and caregiver wages. Stakeholders could also disagree over how quickly DHS can reduce institutional bias, whether Medicaid eligibility and authorization changes would be administratively workable, and how to balance funding between institutional and community-based settings. Providers, advocates for people with disabilities and older adults, budget-minded legislators, and state administrators would be the most likely groups to hold differing views on implementation, financing, and timelines.