New Jersey Department of Health and Senior Services
NEED-BASED CARE ALLOCATION TOOL
ADL Activities of Daily Living IADL Instrumental Activities of Daily Living
ADHS Adult Day Health Services MDS-HC Minimum Data Set–Home Care
ADRC Aging and Disability Resource Connection NBCAT Need-Based Care Allocation Tool
DHSS Department of Health and Senior OCCO Office of Community Choice Options
GO Global Options PAS PreAdmission Screen(ing)
HBSC Home Based Supportive Care PCA Personal Care Assistant Services
HCBS Home & Community Based Services
1. The NBCAT is an ADL and IADL support tool, an 12. ADHS hours can be combined with either PCA or
objective tool using objective measures. HBSC hours.
2. The tool is modeled after the PCA Beneficiary 13. ADL or IADL support hours for all state and/or
Assessment Tool that was developed by the federal publicly-funded services are to be
Department of Human Services, Division of combined and should not exceed the total
Disability Services. It has been tailored by DHSS hours/score computed using this tool. Care
using language adapted from the MDS-HC Managers must take all publicly-funded ADL or
assessment tool. IADL support hours into consideration when
3. Each ADL or IADL section consists of a series of constructing the Plan of Care.
subsets which carry specific parameters and 14. The tool reflects a snapshot in real time. Record all
corresponding scores. formal and informal services currently being
4. The parameters used in the tool range from utilized by the Participant.
independent through completely dependent on 15. GO is meant to supplement, not replace, the
others for assistance. assistance already being provided by family,
5. The tool is scored based on a point system, a friends, and neighbors.
weighted scale index. While not freely encouraging conversion of
6. The scoring scale in each section is not always in informal unpaid or privately paid caregiving
incrementally equal order (e.g., Bathing = 0, 2, 4, support hours to formal support hours,
5, 6) nor are sections equally weighted/scored caregiver stress/fatigue can be taken into
(e.g., Eating = 0-4 versus Bathing = 0-6). account when constructing the Plan of Care.
7. The Total Need-Based Score translates to the 16. Based on professional judgment of the Care
number of hours allocated for ADL or IADL formal Manager, if additional care hours are needed
care assistance. above and beyond the hours computed using the
8. There is no diagnosis section because the tool is tool, the process is as follows:
not diagnosis-driven. It is a need-based tool that is Less than or equal to 40 hours or $2841 --
to be used as a guide for service planning. the Care Manager completes the justification
9. The NBCAT is used only for GO in-home service at the end of the NBCAT entering the amount
planning. The tool is not used to plan Assisted of hours they believe are justified to address
Living, Nursing Facility or JACC services. the health needs of the participant. The Care
Coordinator or Care Management Supervisor
10. The tool is completed by the Care Manager at the reviews the NBCAT, seeks justification from
time of the initial NBCAT screening when planning the CM and if agrees signs the increase.
services, as part of the annual Re-evaluation/Plan
of Care process, when a subsequent NBCAT If greater than 40 hours or $2841 -- the Care
screening is needed to reflect a significant change Manager prepares justification paperwork
in caregiver or functional status, and for GO and submits the request to their County
transition planning at the Nursing Facility Liaison for review and action.
Interdisciplinary Team Meeting. The Care 17. The original copy of the tool will be retained in the
Manager will use the tool as a guide when care management file and a copy is to be provided
developing the Plan of Care. to the Participant or the Participant Authorized
11. PCA and HBSC, provided by an agency or a PEP, Representative.
are mutually exclusive of one another. The
Participant must choose either PCA or HBSC.
LTC-32 (User Guide)