=== PDF PAGE 1 ===
34:8-45.1a to 34:8-45.1c 
LEGISLATIVE HISTORY CHECKLIST 
Compiled by the NJ State Law Library 
 
LAWS OF: 
2014 
 
CHAPTER: 
29 
 
NJSA:  
34:8-45.1a to 34:8-4.1c  (Expands definition and licensure requirements for health care service                    
                                                                       firms) 
 
BILL NO: 
S667 
 (Substituted for A2207)  
 
 
SPONSOR(S) Pou and others 
 
DATE INTRODUCED: January 14, 2014 
 
COMMITTEE:  
ASSEMBLY: 
--- 
 
 
 
 
 
 
 
 
 
SENATE: 
Health, Human Services and Senior Citizens  
 
 
 
 
 
Budget and Appropriations 
 
AMENDED DURING PASSAGE: 
Yes 
 
DATE OF PASSAGE: 
 
ASSEMBLY: 
June 26, 2014 
 
 
 
 
 
SENATE: 
June 26, 2014 
 
DATE OF APPROVAL:  
August 1, 2014  
 
FOLLOWING ARE ATTACHED IF AVAILABLE: 
 
 
FINAL TEXT OF BILL (Second reprint enacted)  
 
 
Yes 
 
 
 
 
S667 
 
 
SPONSOR’S STATEMENT: (Begins on page 4 of introduced bill) Yes 
 
 
 
COMMITTEE STATEMENT: 
 
 
ASSEMBLY: 
No 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SENATE: 
Yes 
Health 
 
 
 
 
 
 
 
 
 
 
 
Budget 
 
(Audio archived recordings of the committee meetings, corresponding to the date of the committee statement, may possibly 
be found at www.njleg.state.nj.us) 
 
 
 
FLOOR AMENDMENT STATEMENT: 
 
 
 
No 
 
 
 
LEGISLATIVE FISCAL ESTIMATE: 
 
 
 
Yes 
 
 
A2207 
 
 
 
 
 
SPONSOR’S STATEMENT: (Begins on page 3 of introduced bill) Yes 
 
 
 
 
 
 
 
 
COMMITTEE STATEMENT: 
 
 
ASSEMBLY: 
Yes 
 
 
 
 
 
 
 
 
 
SENATE: 
No 
 
 
 
 
FLOOR AMENDMENT STATEMENT: 
 
 
 
Yes 
 
 
 
LEGISLATIVE FISCAL ESTIMATE: 
 
 
 
Yes 
(continued) 

=== PDF PAGE 2 ===
 
VETO MESSAGE: 
 
 
 
 
 
 
 
No 
 
 
GOVERNOR’S PRESS RELEASE ON SIGNING:  
 
 
 
No 
 
 
FOLLOWING WERE PRINTED: 
 
To check for circulating copies, contact New Jersey State Government 
 
Publications at the State Library (609) 278-2640 ext.103 or mailto:refdesk@njstatelib.org 
 
 
REPORTS: 
 
 
 
 
 
 
 
 
No 
 
 
HEARINGS: 
 
 
 
 
 
 
 
 
No 
 
 
NEWSPAPER ARTICLES: 
 
 
 
 
 
 
No 
 
LAW/KR 

=== PDF PAGE 3 ===
 EXPLANATION – Matter enclosed in bold-faced brackets [thus] in the above bill is 
not enacted and is intended to be omitted in the law. 
 
 Matter underlined thus is new matter. 
 Matter enclosed in superscript numerals has been adopted as follows: 
 
1Senate SHH committee amendments adopted June 5, 2014. 
 
2Senate SBA committee amendments adopted June 23, 2014. 
 
§§2-4 - 
C.34:8-45.1a to 
34:8-45.1c 
§5 - Note 
 
P.L.2014, CHAPTER 29, approved August 1, 2014 
Senate, No. 667 (Second Reprint) 
 
 
AN ACT concerning licensure of health care service firms and 
1 
amending 1and supplementing1 P.L.2002, c.126. 
2 
 
3 
 
BE IT ENACTED by the Senate and General Assembly of the State 
4 
of New Jersey: 
5 
 
6 
 
1. Section 1 of P.L.2002, c.126 (C.34:8-45.1) is amended to 
7 
read as follows: 
8 
 
1. a.  Notwithstanding any other law or regulation to the 
9 
contrary, an employment agency required to be licensed pursuant to 
10 
P.L.1989, c.331 (C.34:8-43 et [seq.] al.), or any other firm, 
11 
company, business, agency, or other entity that is not a home health 
12 
care agency licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et 
13 
seq.) or a hospice licensed pursuant to P.L.1997, c.78 (C.26:2H-79 
14 
et seq.), which places or arranges for the placement of personnel to 
15 
provide companion services, health care, or personal care services 
16 
in the personal residence of a person with a disability or a senior 
17 
citizen age 60 or older, regardless of the title by which the provider 
18 
of the [health care or personal care] services is known, shall be 
19 
[considered] 2[licensed] registered2 as a Health Care Service Firm 
20 
pursuant to 1[N.J.A.C.13:45B-14.1] N.J.A.C.13:45B-13.11 et seq. 
21 
and shall be subject to the rules and regulations governing Health 
22 
Care Service Firms adopted by the Division of Consumer Affairs in 
23 
the Department of Law and Public Safety. 
24 
 
As used in this [subsection] section: 
25 
 
“Companion services” means non-medical, basic supervision and 
26 
socialization services which do not include 2[direct physical contact 
27 
with the individual] assistance with activities of daily living2, 1and 
28 
which are1 provided in the individual’s home.  Companion services 
29 
may include the performance of household chores. 
30 
 
“Health care services” means any services rendered for the 
31 
purpose of maintaining or restoring an individual's physical or 
32 
mental health or any [health related] health-related services, and 
33 
for which a license or certification is required as a pre-condition to 
34 
the rendering of such services[;] . 
35 

=== PDF PAGE 4 ===
 
S667 [2R] 
2 
 
 
 
“Personal care services” [shall] means services performed by 
1 
licensed or certified personnel for the purpose of assisting an 
2 
individual with activities of daily living that may involve physical 
3 
contact.  Services include, but are not [be] limited to, bathing, 
4 
toileting, transferring, dressing, grooming, and assistance with 
5 
ambulation, exercise, or other aspects of personal hygiene. 
6 
 
b. [An agency or other entity which places or arranges for the 
7 
placement of personnel in the personal residence of a person with a 
8 
disability or a senior citizen age 60 years or older for the exclusive 
9 
purpose of providing companion, housekeeping, meal preparation, 
10 
shopping, laundry, cleaning, or transportation services shall not be 
11 
considered a Health Care Service Firm pursuant to this act.] 
12 
(Deleted by amendment, P.L.    , c.    ) (pending before the 
13 
Legislature as this bill) 
14 
 
c. 
As a condition of being 
2[licensed] registered2 under 
15 
P.L.1989, c.331 (C.34:8-43 et al.), a health care service firm shall 
16 
obtain within 12 months of 2[licensure] registration2 accreditation 
17 
from an accrediting body that is recognized by the 2[Director of the 
18 
Division of Consumer Affairs] Commissioner of Human Services 
19 
as an accrediting body for homemaker agencies participating in the 
20 
Medicaid program, as set forth at N.J.A.C.10:60-1.22.  For purposes 
21 
of accreditation pursuant to this subsection, the accrediting body 
22 
shall apply the standards set forth in N.J.A.C.13:37-14.1 et seq. and 
23 
N.J.A.C.13:45B-13.1 et seq., as applicable. 
24 
 
d. As a condition of 2[licensure] registration2 under P.L.1989, 
25 
c.331 (C.34:8-43 et al.), 2[a] every2 health care service firm 2[1that 
26 
receives government funds for any services provided1]2 shall 
27 
2[cause to be prepared] submit to the director2 an 1[annual]1 audit 
28 
1the third calendar year after 2[licensure] registration2 and every 
29 
third year thereafter1.  The audit shall be conducted by a 
30 
2[qualified]2 certified public accountant 2licensed by the State of 
31 
New Jersey2 and shall encompass an examination of the subject 
32 
firm’s 
financial 
records, 
financial 
statements, 
the 
general 
33 
management of its operations, and its internal control systems.  
34 
2The audit shall include an audit report with an unqualified opinion 
35 
and shall be accompanied by any management letters prepared by 
36 
the auditor in connection with the audit commenting on the internal 
37 
controls or management practices of the health care service firm.2 
38 
The audit shall be divided into two components: compliance and 
39 
financial.  The compliance component of the audit shall evaluate the 
40 
firm’s compliance with relevant laws and regulations governing 
41 
health care service firms.  The financial component shall include an 
42 
audit of the financial statements and accompanying notes, as 
43 
specified in the Statements on Auditing Standards issued by the 
44 
American Institute of Certified Public Accountants.  2[If the subject 
45 
firm is a recipient of State Medicaid funds and is therefore required 
46 

=== PDF PAGE 5 ===
 
S667 [2R] 
3 
 
 
to submit an annual cost report, that cost report shall be included in 
1 
the audit, and the auditor shall include an opinion on the accuracy 
2 
of the cost report.]2  
3 
(cf:  P.L.2002, c.126, s.1) 
4 
 
5 
 
2. (New section)  The Director of the Division of Consumer 
6 
Affairs in the Department of Law and Public Safety shall enter into 
7 
a memorandum of understanding with an accrediting body 2chosen 
8 
by the director through appropriate procurement processes2 
9 
authorized to accredit a health care service firm pursuant to 
10 
subsection c. of section 1 of P.L.2002, c.126 (C.34:8-45.1).  The 
11 
memorandum of understanding shall establish the standards for 
12 
accreditation and for reporting the results of audits performed 
13 
pursuant to subsection d. of section 1 of P.L.2002, c.126 to the 
14 
Division. 
15 
 
16 
 
13. (New Section) No more than three years after the enactment 
17 
of P.L.    , c.   (pending before the Legislature as this bill), the 
18 
Director of the Division of Consumer Affairs shall submit a written 
19 
report to the Governor and to the Legislature pursuant to section 2 
20 
of P.L.1991, c.164 (C.52:14-19.1), providing a comprehensive 
21 
review and analysis on the effectiveness of the licensure, 
22 
accreditation, and audit provisions of P.L.    , c.   (pending before 
23 
the Legislature as this bill) 
2and recommendations for any 
24 
additional resources necessary to make such provisions more 
25 
effective2.1 
26 
 
27 
 
1[3.] 4.1 The Director of the Division of Consumer Affairs in 
28 
the Department of Law and Public Safety, pursuant to the 
29 
“Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et 
30 
seq.), shall adopt rules and regulations necessary to effectuate the 
31 
purposes of this act. 
32 
 
33 
 
1[4.] 5.1 
This act shall take effect on the first day of the 
34 
eighteenth month next following the date of enactment, but the 
35 
Director of the Division of Consumer Affairs may take such 
36 
anticipatory administrative action in advance thereof as shall be 
37 
necessary for the implementation of this act. 
38 
 
39 
 
40 
                                 
41 
 
42 
 
Expands definition and licensure requirements for health care 
43 
service firms.  
44 

=== PDF PAGE 6 ===
  
SENATE, No. 667  
 
STATE OF NEW JERSEY 
216th LEGISLATURE 
   
PRE-FILED FOR INTRODUCTION IN THE 2014 SESSION 
 
 
Sponsored by: 
Senator  NELLIE POU 
District 35 (Bergen and Passaic) 
 
 
 
 
SYNOPSIS 
 
Expands definition and licensure requirements for health care service firms.  
 
CURRENT VERSION OF TEXT  
 
Introduced Pending Technical Review by Legislative Counsel 
    

=== PDF PAGE 7 ===
 
S667 POU 
2 
 
 EXPLANATION – Matter enclosed in bold-faced brackets [thus] in the above bill is 
not enacted and is intended to be omitted in the law. 
 
 Matter underlined thus is new matter. 
 
 
AN ACT concerning licensure of health care service firms and 
1 
amending P.L.2002, c.126. 
2 
 
3 
 
BE IT ENACTED by the Senate and General Assembly of the State 
4 
of New Jersey: 
5 
 
6 
 
1. Section 1 of P.L.2002, c.126 (C.34:8-45.1) is amended to 
7 
read as follows: 
8 
 
1. a. Notwithstanding any other law or regulation to the 
9 
contrary, an employment agency required to be licensed pursuant to 
10 
P.L.1989, c.331 (C.34:8-43 et [seq.] al.), or any other firm, 
11 
company, business, agency, or other entity that is not a home health 
12 
care agency licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et 
13 
seq.) or a hospice licensed pursuant to P.L.1997, c.78 (C.26:2H-79 
14 
et seq.), which places or arranges for the placement of personnel to 
15 
provide companion services, health care, or personal care services 
16 
in the personal residence of a person with a disability or a senior 
17 
citizen age 60 or older, regardless of the title by which the provider 
18 
of the [health care or personal care] services is known, shall be 
19 
[considered] licensed as a Health Care Service Firm pursuant to 
20 
N.J.A.C.13:45B-14.1 et seq. and shall be subject to the rules and 
21 
regulations governing Health Care Service Firms adopted by the 
22 
Division of Consumer Affairs in the Department of Law and Public 
23 
Safety. 
24 
 
As used in this [subsection] section: 
25 
 
“Companion services” means non-medical, basic supervision and 
26 
socialization services which do not include direct physical contact 
27 
with the individual, provided in the individual’s home.  Companion 
28 
services may include the performance of household chores. 
29 
 
“Health care services” means any services rendered for the 
30 
purpose of maintaining or restoring an individual's physical or 
31 
mental health or any [health related] health-related services, and 
32 
for which a license or certification is required as a pre-condition to 
33 
the rendering of such services[;] . 
34 
 
“Personal care services” [shall] means services performed by 
35 
licensed or certified personnel for the purpose of assisting an 
36 
individual with activities of daily living that may involve physical 
37 
contact.  Services include, but are not [be] limited to, bathing, 
38 
toileting, transferring, dressing, grooming, and assistance with 
39 
ambulation, exercise, or other aspects of personal hygiene. 
40 
 
b. [An agency or other entity which places or arranges for the 
41 
placement of personnel in the personal residence of a person with a 
42 
disability or a senior citizen age 60 years or older for the exclusive 
43 
purpose of providing companion, housekeeping, meal preparation, 
44 

=== PDF PAGE 8 ===
 
S667 POU 
3 
 
 
shopping, laundry, cleaning, or transportation services shall not be 
1 
considered a Health Care Service Firm pursuant to this act.] 
2 
(Deleted by amendment, P.L.    , c.    ) (pending before the 
3 
Legislature as this bill) 
4 
 
c. 
As a condition of being licensed under P.L.1989, c.331 
5 
(C.34:8-43 et al.), a health care service firm shall obtain within 12 
6 
months of licensure accreditation from an accrediting body that is 
7 
recognized by the Director of the Division of Consumer Affairs.  
8 
For purposes of accreditation pursuant to this subsection, the 
9 
accrediting body shall apply the standards set forth in 
10 
N.J.A.C.13:37-14.1 et seq. and N.J.A.C.13:45B-13.1 et seq., as 
11 
applicable. 
12 
 
d. As a condition of licensure under P.L.1989, c.331 (C.34:8-
13 
43 et al.), a health care service firm shall cause to be prepared an 
14 
annual audit.  The audit shall be conducted by a qualified certified 
15 
public accountant and shall encompass an examination of the 
16 
subject firm’s financial records, financial statements, the general 
17 
management of its operations, and its internal control systems.  The 
18 
audit shall be divided into two components: compliance and 
19 
financial.  The compliance component of the audit shall evaluate the 
20 
firm’s compliance with relevant laws and regulations governing 
21 
health care service firms.  The financial component shall include an 
22 
audit of the financial statements and accompanying notes, as 
23 
specified in the Statements on Auditing Standards issued by the 
24 
American Institute of Certified Public Accountants.  If the subject 
25 
firm is a recipient of State Medicaid funds and is therefore required 
26 
to submit an annual cost report, that cost report shall be included in 
27 
the audit, and the auditor shall include an opinion on the accuracy 
28 
of the cost report.  
29 
(cf:  P.L.2002, c.126, s.1) 
30 
 
31 
 
2. The Director of the Division of Consumer Affairs in the 
32 
Department of Law and Public Safety shall enter into a 
33 
memorandum of understanding with an accrediting body authorized 
34 
to accredit a health care service firm pursuant to subsection c. of 
35 
section 1 of P.L.2002, c.126 (C.34:8-45.1).  The memorandum of 
36 
understanding shall establish the standards for accreditation and for 
37 
reporting the results of audits performed pursuant to subsection d. 
38 
of section 1 of P.L.2002, c.126 to the Division. 
39 
 
40 
 
3. The Director of the Division of Consumer Affairs in the 
41 
Department of Law and Public Safety, pursuant to the 
42 
“Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et 
43 
seq.), shall adopt rules and regulations necessary to effectuate the 
44 
purposes of this act. 
45 

=== PDF PAGE 9 ===
 
S667 POU 
4 
 
 
 
4. This act shall take effect on the first day of the eighteenth 
1 
month next following the date of enactment, but the Director of the 
2 
Division of Consumer Affairs may take such anticipatory 
3 
administrative action in advance thereof as shall be necessary for 
4 
the implementation of this act. 
5 
 
6 
 
7 
STATEMENT 
8 
 
9 
 
This bill concerns the provision of home health services by 
10 
health care service firms, which are regulated by the Division of 
11 
Consumer Affairs (DCA) in the Department of Law and Public 
12 
Safety. 
13 
 
This bill expands the definition of health care service firms to 
14 
include firms that place or arrange for the placement of personnel to 
15 
provide companion services (the current definition only includes 
16 
firms that place or arrange for the placement of personnel to provide 
17 
health care or personal care services).  The bill further requires that 
18 
health care services firms obtain accreditation and comply with 
19 
annual auditing requirements.  
20 
 
The bill defines “companion services” to mean non-medical 
21 
basic supervision and socialization services which do no include 
22 
direct physical contact with the individual, and which are provided 
23 
in the individual’s home.  The bill defines “personal care services” 
24 
to mean services performed by licensed or certified personnel for 
25 
the purpose of assisting an individual with activities of daily living 
26 
that may involve physical contact, and would include such services 
27 
as bathing, toileting, transferring, dressing, grooming, and 
28 
assistance with ambulation, exercise, or other aspects of personal 
29 
hygiene. 
30 
 
The bill requires that a health care service firm obtain within 12 
31 
months of licensure, accreditation from an accrediting body that is 
32 
recognized by the Director of DCA.  The Director of DCA is to 
33 
enter into a memorandum of understanding with the accrediting 
34 
body regarding the required standards for accreditation.  
35 
 
As a condition of licensure, a health care service firm is to cause 
36 
to be prepared an annual audit.  The audit is to be conducted by a 
37 
qualified certified public accountant and include an examination of 
38 
the subject firm’s financial records, financial statements, the 
39 
general management of its operations, and its internal control 
40 
systems.  The audit is to be divided into legal compliance and 
41 
financial components, and the financial component is be done in 
42 
accordance with the Statements on Auditing Standards issued by the 
43 
American Institute of Certified Public Accountants.  A firm that 
44 
receives State Medicaid funds is also required to submit an annual 
45 
cost report with its audit, and an opinion from the auditor on the 
46 
accuracy of the cost report. The Director of DCA is to enter into a 
47 

=== PDF PAGE 10 ===
 
S667 POU 
5 
 
 
memorandum of understanding with an accrediting body for 
1 
purposes of accrediting health care service firms, and the 
2 
memorandum of understanding is to establish the standards for 
3 
accreditation and audit reporting requirements. 
4 
 
The bill would take effect on the first day of the eighteenth 
5 
month next following the date of enactment.  The Director of DCA 
6 
is authorized to take such anticipatory administrative action as is 
7 
necessary for the implementation of the bill. 
8 

=== PDF PAGE 11 ===
SENATE HEALTH, HUMAN SERVICES AND SENIOR 
CITIZENS COMMITTEE 
 
STATEMENT TO  
 
SENATE, No. 667  
 
with committee amendments 
 
STATE OF NEW JERSEY 
 
DATED:  JUNE 5, 2014 
 
 
The Senate Health, Human Services and Senior Citizens 
Committee reports favorably and with amendments Senate Bill No. 
667. 
 
As amended by the committee, this bill concerns the provision of 
home health services by health care service firms, which are regulated 
by the Division of Consumer Affairs in the Department of Law and 
Public Safety. 
 
This bill expands the definition of health care service firms to 
include firms that place or arrange for the placement of personnel to 
provide companion services.  (The current definition only includes 
firms that place or arrange for the placement of personnel to provide 
health care or personal care services.)  The bill further requires that 
health care services firms obtain accreditation and comply with 
auditing requirements.  
 
The bill defines “companion services” to mean non-medical basic 
supervision and socialization services which do no include direct 
physical contact with the individual, and which are provided in the 
individual’s home.  The bill defines “personal care services” to mean 
services performed by licensed or certified personnel for the purpose 
of assisting an individual with activities of daily living that may 
involve physical contact, and would include such services as bathing, 
toileting, transferring, dressing, grooming, and assistance with 
ambulation, exercise, or other aspects of personal hygiene. 
 
The bill requires that a health care service firm obtain, within 12 
months of licensure, accreditation from an accrediting body that is 
recognized by the Director of the Division of Consumer Affairs.   
 
The bill would also require that, as a condition of licensure, a 
health care service firm must cause to be prepared an audit every three 
years.  The audit must be conducted by a qualified certified public 
accountant and include an examination of the subject firm’s financial 
records, financial statements, the general management of its 
operations, and its internal control systems.  The audit must be divided 
into legal compliance and financial components, and the financial 

=== PDF PAGE 12 ===
2 
 
component must be done in accordance with the Statements on 
Auditing Standards issued by the American Institute of Certified 
Public Accountants.  A firm that receives State Medicaid funds is also 
required to submit an annual cost report with its audit, and an opinion 
from the auditor on the accuracy of the cost report.   
 
The Director of the Division of Consumer Affairs is to enter into a 
memorandum of understanding with an accrediting body for purposes 
of accrediting health care service firms, and the memorandum of 
understanding is to establish the standards for accreditation and audit 
reporting requirements. 
 
The bill also requires that, no more than three years after the 
enactment of the bill, the Director of the Division of Consumer Affairs 
must report to the Governor and the Legislature, providing a 
comprehensive review and analysis on the effectiveness of the 
licensure, accreditation, and audit provisions of the bill. 
 
The bill would take effect on the first day of the eighteenth month 
next following the date of enactment.  The Director of DCA is 
authorized to take such anticipatory administrative action as is 
necessary for the implementation of the bill. 
 
The committee amended the bill to change the auditing 
requirement from an annual audit to an audit every three years, and to 
apply the requirement only to health care service firms that receive 
government funds for services provided.  The committee amendments 
also add the requirement that the Director of the Division of Consumer 
Affairs report to the Governor and the Legislature on the bill’s 
implementation.  The committee amendments also include technical 
corrections. 
 
This bill was pre-filed for introduction in the 2014-2015 session 
pending technical review.  As reported and amended by the committee, 
the bill includes the changes required by technical review, which has 
been performed. 

=== PDF PAGE 13 ===
SENATE BUDGET AND APPROPRIATIONS COMMITTEE 
 
STATEMENT TO  
 
[First Reprint] 
SENATE, No. 667  
 
with committee amendments 
 
STATE OF NEW JERSEY 
 
DATED:  JUNE 23, 2014 
 
 
The Senate Budget and Appropriations Committee reports 
favorably Senate Bill No. 667 (1R), with committee amendments. 
 
As amended, this bill concerns the provision of home health 
services by health care service firms, which are regulated by the 
Division of Consumer Affairs in the Department of Law and Public 
Safety. 
 
This bill expands the definition of health care service firms to 
include firms that place or arrange for the placement of personnel to 
provide companion services.  The current definition only includes 
firms that place or arrange for the placement of personnel to provide 
health care or personal care services.  The bill further requires that 
health care services firms obtain accreditation and comply with 
auditing requirements.  
 
The bill defines “companion services” to mean non-medical basic 
supervision and socialization services which do no include assistance 
with activities of daily living, and which are provided in the 
individual’s home.  The bill defines “personal care services” to mean 
services performed by licensed or certified personnel for the purpose 
of assisting an individual with activities of daily living that may 
involve physical contact, and would include such services as bathing, 
toileting, transferring, dressing, grooming, and assistance with 
ambulation, exercise, or other aspects of personal hygiene. 
 
The bill requires that a health care service firm obtain, within 12 
months of licensure, accreditation from an accrediting body that is 
recognized by the Commissioner of Human Services as an accrediting 
body for homemaker agencies participating in the Medicaid program.   
 
The bill would also require that, as a condition of licensure, a 
health care service firm must cause to be prepared an audit every three 
years.  The audit must be conducted by a certified public accountant 
licensed in the State of New Jersey and must include an examination 
of the subject firm’s financial records, financial statements, the general 
management of its operations, and its internal control systems.  The 
audit must include an audit report with an unqualified opinion and 

=== PDF PAGE 14 ===
2 
 
shall be accompanied by any management letters prepared by the 
auditor in connection with the audit commenting on the internal 
controls or management practices of the health care service firm.  The 
audit must be divided into legal compliance and financial components, 
and the financial component must be done in accordance with the 
Statements on Auditing Standards issued by the American Institute of 
Certified Public Accountants.   
 
The Director of the Division of Consumer Affairs is to enter into a 
memorandum of understanding with an accrediting body chosen 
through appropriate procurement processes for purposes of accrediting 
health care service firms, and the memorandum of understanding is to 
establish the standards for accreditation and audit reporting 
requirements. 
 
The bill also requires that, no more than three years after the 
enactment of the bill, the Director of the Division of Consumer Affairs 
must report to the Governor and the Legislature, providing a 
comprehensive review and analysis on the effectiveness of the 
licensure, accreditation, and audit provisions of the bill. 
 
The bill would take effect on the first day of the eighteenth month 
next following the date of enactment.  The Director of the Division of 
Consumer 
Affairs 
is 
authorized 
to 
take 
such 
anticipatory 
administrative action as is necessary for the implementation of the bill. 
 
FISCAL IMPACT 
 
The bill would increase costs at the Division of Consumer Affairs 
in order to hire additional staff needed to provide State oversight of 
firms that would be required to be registered as health care service 
firms.  These costs would likely be offset by revenue from fees 
charged to firms applying for registration, currently $500 per primary 
location per year.  The Office of Legislative Services (OLS) is unable 
to estimate the total increase in costs and revenues, as the OLS does 
not have information on how many firms will need to be registered 
under the bill. 
 
According to the Division of Consumer Affairs, there are currently 
998 registered health care service firms in New Jersey (including 
multiple sites operated by a single entity).  The number of hospices 
and employment and personnel firms that currently provide services 
that would require registration as a health care service firm under the 
bill is unknown.  It is also possible that some firms may opt to 
discontinue providing certain services in order to avoid the registration 
requirement. 
 
COMMITTEE AMENDMENTS 
 
The committee amended the bill to: 
• Require that applicable firms be registered, rather than 
licensed, as health care service firms; 

=== PDF PAGE 15 ===
3 
 
• Change the definition of “companion services” so that 
companion services is defined to exclude assistance with 
activities of daily living, but allows direct physical contact; 
• Require that the accrediting body for health care service firms 
be recognized by the Commissioner of Human Services as an 
accrediting body for homemaker agencies participating in the 
Medicaid program, rather than by the Director of the Division 
of Consumer Affairs; 
• Require that the certified public accountant who conducts an 
audit of a health care service firm be licensed by the State; 
• Require that the certified public accountant’s audit include an 
audit report with an unqualified opinion, and be accompanied 
by any management letters prepared by the auditor in 
connection with the audit commenting on the internal controls 
or management practices of the health care service firm; 
• Delete a provision that would have required a Medicaid cost 
report to be included in the audit; 
• Clarify that the accrediting body must be chosen through 
appropriate procurement processes; and 
• Require that the report to the Governor and the Legislature by 
the Director of the Division of Consumer affairs also include 
any recommendations for any additional resources necessary to 
make the provisions of the bill more effective. 

=== PDF PAGE 16 ===
Office of Legislative Services 
State House Annex 
P.O. Box 068 
Trenton, New Jersey  08625 
 
Legislative Budget and Finance Office 
Phone (609) 292-8030 
Fax (609) 777-2442 
www.njleg.state.nj.us 
 
 
LEGISLATIVE FISCAL ESTIMATE 
[Second Reprint] 
SENATE, No. 667 
STATE OF NEW JERSEY 
216th LEGISLATURE 
 
DATED: JUNE 30, 2014 
 
 
SUMMARY 
 
Synopsis: 
Expands definition and licensure requirements for health care service 
firms. 
Type of Impact: 
An expenditure increase, offset by a revenue increase. 
Agencies Affected: 
Division of Consumer Affairs in the Department of Law and Public 
Safety. 
 
 
Office of Legislative Services Estimate 
Fiscal Impact 
Years 1-3   
State Cost 
Indeterminate – See comments below 
State Revenue 
Indeterminate – See comments below 
 
• The bill would increase the number of firms that would be required to register as health care 
service firms, leading to an increase in State costs related to the oversight of these firms, and 
an increase in revenues from registration fees. 
 
• The bill’s accreditation and auditing requirements would have minimal fiscal impact on the 
State, as costs could be imposed on health care service firms.  If the expanded requirements 
cause some firms not to renew their registrations as health care service firms, State costs and 
revenues related to these firms may decrease. 
 
 
BILL DESCRIPTION 
 
 
Senate Bill No. 667 (2R) of 2014 expands the definition of health care service firms, which 
are regulated by the Division of Consumer Affairs (division) in the Department of Law and 
Public Safety, to include firms that place or arrange for the placement of personnel to provide 
companion services.  The current definition only includes firms that place or arrange for the 
placement of personnel to provide health care or personal care services.  The bill further requires 
that health care service firms obtain accreditation and comply with auditing requirements.  

=== PDF PAGE 17 ===
FE to S667 [2R] 
2 
 
 
The bill defines “companion services” to mean non-medical basic supervision and 
socialization services which do not include assistance with activities of daily living, and which 
are provided in the individual’s home.  The bill also clarifies the definition of “personal care 
services” as services performed by licensed or certified personnel for the purpose of assisting an 
individual with activities of daily living that may involve physical contact, and would include 
such services as bathing, toileting, transferring, dressing, grooming, and assistance with 
ambulation, exercise, or other aspects of personal hygiene. 
 
The bill requires that a health care service firm obtain, within 12 months of licensure, 
accreditation from an accrediting body that is recognized by the Commissioner of Human 
Services as an accrediting body for homemaker agencies participating in the Medicaid program.   
 
The bill would also require that, as a condition of licensure, a health care service firm must 
cause to be prepared an audit every three years.  The audit must be conducted by a certified 
public accountant licensed in the State of New Jersey and must include an examination of the 
subject firm’s financial records, financial statements, the general management of its operations, 
and its internal control systems.  The audit must include an audit report with an unqualified 
opinion and shall be accompanied by any management letters prepared by the auditor in 
connection with the audit commenting on the internal controls or management practices of the 
health care service firm.  The audit must be divided into legal compliance and financial 
components, and the financial component must be done in accordance with the Statements on 
Auditing Standards issued by the American Institute of Certified Public Accountants.   
 
The Director of the Division of Consumer Affairs is to enter into a memorandum of 
understanding with an accrediting body chosen through appropriate procurement processes for 
purposes of accrediting health care service firms, and the memorandum of understanding is to 
establish the standards for accreditation and audit reporting requirements. 
 
The bill also requires that, no more than three years after the enactment of the bill, the 
Director of the Division of Consumer Affairs must report to the Governor and the Legislature, 
providing a comprehensive review and analysis on the effectiveness of the licensure, 
accreditation, and audit provisions of the bill, and recommendations for any additional resources 
necessary to such provisions more effective. 
 
 
FISCAL ANALYSIS 
 
EXECUTIVE BRANCH 
 
 
None received. 
 
 
OFFICE OF LEGISLATIVE SERVICES 
 
 
The Office of Legislative Services (OLS) concludes that, by expanding the definition of 
health care service firms to include firms providing companion services, the bill would likely 
increase the number of firms that would be required to register as health care service firms, 
leading to an increase in State costs at the division related to the oversight of these firms.  These 
costs would be offset by revenue from registration fees, currently $500 per primary location per 
year.  According to the division website, there are currently 998 registered health care service 
firms in New Jersey (counting multiple sites operated by a single entity as multiple firms).  The 
OLS does not have information on how many firms that are not currently health care service 
firms but are currently providing companion services that, under the bill, would require them to 

=== PDF PAGE 18 ===
FE to S667 [2R] 
3 
 
register as health care service firms.  The OLS notes that the bill’s definition of a health care 
service firm may be interpreted to include firms whose employees perform only household 
chores for applicable individuals, which could be interpreted to include a large number of firms 
that provide cleaning and other household services.  It is uncertain to what extent these firms 
would be classified as health care service firms by the division, and therefore subject to 
registration under this bill.  It is also noted that some firms may opt to discontinue providing 
companion services to applicable individuals in order to avoid the registration requirement and 
the associated oversight and costs. 
 
The bill’s expansion of accreditation and auditing requirements for health care service firms 
may also slightly increase the cost to oversee these firms, as the division will be required to enter 
into a memorandum of understanding with an accrediting body and verify that firms are in 
compliance with these requirements.  These costs may be imposed on health care service firms, 
through fees charged by the accreditation agency or increased registration fees charged by the 
State.  It is noted that increasing the cost to remain registered as a health care service firm 
(through increased fees or the cost of regulatory compliance) may cause some firms to choose 
not to renew their registrations, reducing costs related to the oversight of these firms and 
revenues from their registration fees. 
 
Because of uncertainty regarding all of the factors described above, the OLS is not able to 
determine the net fiscal impact of the bill.  However, it is noted that licensure and registration 
programs operated by the division generally set fees to approximate the costs incurred by the 
division to regulate the licensed and registered entities. 
 
 
Section: 
Human Services 
Analyst: 
David Drescher 
Associate Fiscal Analyst 
Approved: 
David J. Rosen 
Legislative Budget and Finance Officer 
 
 
This legislative fiscal estimate has been produced by the Office of Legislative Services due to the 
failure of the Executive Branch to respond to our request for a fiscal note. 
 
This fiscal estimate has been prepared pursuant to P.L.1980, c.67 (C.52:13B-6 et seq.). 
 

=== PDF PAGE 19 ===
(Sponsorship Updated As Of: 6/24/2014) 
ASSEMBLY, No. 2207  
 
STATE OF NEW JERSEY 
216th LEGISLATURE 
 
INTRODUCED JANUARY 27, 2014 
 
 
Sponsored by: 
Assemblywoman  VALERIE VAINIERI HUTTLE 
District 37 (Bergen) 
Assemblyman  JOSEPH A. LAGANA 
District 38 (Bergen and Passaic) 
Assemblyman  THOMAS P. GIBLIN 
District 34 (Essex and Passaic) 
Assemblyman  CARMELO G. GARCIA 
District 33 (Hudson) 
 
Co-Sponsored by: 
Assemblyman Coughlin and Assemblywoman Spencer 
 
 
 
 
SYNOPSIS 
 
Expands definition and licensure requirements for health care service firms. 
 
CURRENT VERSION OF TEXT  
 
As introduced. 
 

=== PDF PAGE 20 ===
 
A2207 VAINIERI HUTTLE, LAGANA 
2 
 
 EXPLANATION – Matter enclosed in bold-faced brackets [thus] in the above bill is 
not enacted and is intended to be omitted in the law. 
 
 Matter underlined thus is new matter. 
 
 
AN ACT concerning licensure of health care service firms and 
1 
amending P.L.2002, c.126. 
2 
 
3 
 
BE IT ENACTED by the Senate and General Assembly of the State 
4 
of New Jersey: 
5 
 
6 
 
1. Section 1 of P.L.2002, c.126 (C.34:8-45.1) is amended to 
7 
read as follows: 
8 
 
1. a.  Notwithstanding any other law or regulation to the 
9 
contrary, an employment agency required to be licensed pursuant to 
10 
P.L.1989, c.331 (C.34:8-43 et [seq.] al.), or any other firm, 
11 
company, business, agency, or other entity that is not a home health 
12 
care agency licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et 
13 
seq.), which places or arranges for the placement of personnel to 
14 
provide companion, health care, or personal care services in the 
15 
personal residence of a person with a disability or a senior citizen 
16 
age 60 or older, regardless of the title by which the provider of the 
17 
[health care or personal care] services is known, shall be 
18 
considered a Health Care Service Firm pursuant to N.J.A.C.13:45B-
19 
14.1 et seq. and shall be subject to the rules and regulations 
20 
governing Health Care Service Firms adopted by the Division of 
21 
Consumer Affairs in the Department of Law and Public Safety. 
22 
 
As used in this [subsection] section: 
23 
 
“Companion services” means basic supervision and socialization 
24 
services. 
25 
 
"Health care services" means any services rendered for the 
26 
purpose of maintaining or restoring an individual's physical or 
27 
mental health or any [health related] health-related services, and 
28 
for which a license or certification is required as a pre-condition to 
29 
the rendering of such services[;] . 
30 
 
"Personal care services" shall include, but not be limited to, 
31 
bathing, toileting, transferring, dressing, grooming, and assistance 
32 
with ambulation, exercise, or other aspects of personal hygiene. 
33 
 
b. An agency or other entity which places or arranges for the 
34 
placement of personnel in the personal residence of a person with a 
35 
disability or a senior citizen age 60 years or older for the exclusive 
36 
purpose 
of 
providing 
[companion,] 
housekeeping, 
meal 
37 
preparation, shopping, laundry, cleaning, or transportation services 
38 
shall not be considered a Health Care Service Firm pursuant to this 
39 
act. 
40 
 
c. 
As a condition of licensure under P.L.1989, c.331 (C.34:8-
41 
43 et al.), a health care service firm shall obtain accreditation from 
42 
an accrediting body that is recognized by the Commissioner of 
43 
Human Services as an accrediting body for homemaker agencies 
44 

=== PDF PAGE 21 ===
 
A2207 VAINIERI HUTTLE, LAGANA 
3 
 
 
participating 
in 
the 
Medicaid 
program, 
as 
set 
forth 
at 
1 
N.J.A.C.10:60-1.2. 
2 
 
d. As a condition of licensure under P.L.1989, c.331 (C.34:8-
3 
43 et al.), a health care service firm that receives government funds 
4 
for any services provided shall cause to be prepared an annual audit 
5 
of its financial transactions.  The audit shall be conducted in 
6 
accordance with the federal “Single Audit Act of 1984”, Pub.L.98-
7 
502, as amended by the “Single Audit Act Amendments of 1996,” 
8 
Pub.L.104-156 (31 U.S.C. s.7501 et seq.), generally accepted 
9 
auditing standards as specified in the Statements on Auditing 
10 
Standards issued by the American Institute of Certified Public 
11 
Accountants, and Government Auditing Standards issued by the 
12 
Comptroller General of the United States. 
13 
(cf:  P.L.2002, c.126, s.1) 
14 
 
15 
 
2. The Director of the Division of Consumer Affairs in the 
16 
Department of Law and Public Safety, pursuant to the 
17 
“Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et 
18 
seq.), shall adopt rules and regulations necessary to effectuate the 
19 
purposes of this act. 
20 
 
21 
 
3. This act shall take effect on the first day of the fourth month 
22 
next following the date of enactment. 
23 
 
24 
 
25 
STATEMENT 
26 
 
27 
 
This bill concerns the provision of home health services by 
28 
health care service firms regulated by the Division of Consumer 
29 
Affairs (DCA) in the Department of Law and Public Safety. 
30 
 
The bill expands the definition of a health care service firm to 
31 
include firms that place or arrange for the placement of personnel to 
32 
provide companion services exclusively in the personal residence of 
33 
a person with a disability or senior citizen 60 years of age or over. 
34 
The definition in current law only includes firms that place or 
35 
arrange for the placement of personnel to provide health care or 
36 
personal care services. 
37 
 
The bill requires that health care service firms, as a condition of 
38 
licensure, obtain accreditation from an accrediting body that is 
39 
recognized by the Commissioner of Human Services as an 
40 
accrediting body for homemaker agencies participating in the 
41 
Medicaid program.  As an additional condition of licensure, if a 
42 
health care service firm receives government funds for any services 
43 
provided, it must also cause to be performed an independent audit 
44 
of its financial transactions. 
45 
 
The bill provides for rulemaking by the Director of DCA, and 
46 
has a delayed effective date of the first day of the fourth month 
47 
following its enactment. 
48 

=== PDF PAGE 22 ===
ASSEMBLY APPROPRIATIONS COMMITTEE 
 
STATEMENT TO  
 
ASSEMBLY, No. 2207  
 
with committee amendments 
 
STATE OF NEW JERSEY 
 
DATED:  JUNE 23, 2014 
 
 
The Assembly Appropriations Committee reports favorably 
Assembly Bill No. 2207, with committee amendments.  
 
As amended, this bill concerns the provision of home health 
services by health care service firms regulated by the Division of 
Consumer Affairs in the Department of Law and Public Safety. 
 
The bill expands the definition of health care service firms to 
include firms that place or arrange for the placement of personnel to 
provide companion services.  (The current definition only includes 
firms that place or arrange for the placement of personnel to provide 
health care or personal care services.)  The bill also requires that health 
care service firms obtain accreditation and comply with certain 
auditing requirements.   
 
The bill defines “companion services” to mean non-medical, basic 
supervision and socialization services which do no include direct 
physical contact with the individual, and which are provided in the 
individual’s home.  The bill redefines “personal care services” to mean 
services performed by licensed or certified personnel for the purpose 
of assisting an individual with activities of daily living that may 
involve physical contact, and include services such as bathing, 
toileting, transferring, dressing, grooming, and assistance with 
ambulation, exercise, or other aspects of personal hygiene. 
 
The bill requires that a health care service firm obtain, within 12 
months of licensure, accreditation from an accrediting body that is 
recognized by the Director of the Division of Consumer Affairs.   
 
The bill requires that, as a condition of licensure, a health care 
service firm that receives government funds for any services provided 
must cause to be prepared an audit every three years.  The audit must 
be conducted by a qualified certified public accountant and include an 
examination of the subject firm’s financial records, financial 
statements, the general management of its operations, and its internal 
control systems. The audit must be divided into legal compliance and 
financial components, and the financial component must be done in 
accordance with the Statements on Auditing Standards issued by the 
American Institute of Certified Public Accountants.  A firm that 
receives State Medicaid funds is also required to submit an annual cost 

=== PDF PAGE 23 ===
2 
 
report with its audit, and an opinion from the auditor on the accuracy 
of the cost report.   
 
The bill requires the Director of the Division of Consumer Affairs 
to enter into a memorandum of understanding with an accrediting body 
for purposes of accrediting health care service firms, and provides that 
the memorandum of understanding is to establish the standards for 
accreditation and audit reporting requirements. 
 
The bill provides that, no more than three years after enactment of 
the bill, the Director of the Division of Consumer Affairs must report 
to the Governor and the Legislature, providing a comprehensive 
review and analysis on the effectiveness of the licensure, accreditation, 
and audit provisions of the bill. 
 
The bill requires the Director of the Division of Consumer Affairs 
to adopt rules and regulations necessary to effectuate the purposes of 
the bill.  
 
The bill takes effect on the first day of the 18th month next 
following the date of enactment, but permits the Director of the 
Division of Consumer Affairs to take anticipatory administrative 
actions in advance of the bill’s effective date. 
 
FISCAL IMPACT: 
 
The Office of Legislative Services (OLS) expects the bill will 
increase costs at the Division of Consumer Affairs to hire additional 
staff needed to provide State oversight of firms required to be 
registered as health care service firms.  These costs will likely be 
offset by revenue from fees charged to firms applying for registration, 
currently $500 per primary location per year.  The OLS is unable to 
estimate the total increase in costs and revenues because it does not 
have information on how many firms will need to be registered under 
the bill. 
 
According to the Division of Consumer Affairs, there are currently 
998 registered health care service firms in New Jersey (including 
multiple sites operated by a single entity).  The number of firms that 
currently provide services that require registration as a health care 
service firm under the bill is unknown.  It is also possible that some 
firms may opt to discontinue providing certain services to avoid the 
registration requirement. 
 
COMMITTEE AMENDMENTS: 
 
The amendments revise certain defined terms (“companion 
services” and “personal care services”) under the bill.   
 
The amendments require that as a condition of being licensed 
health care service firms must obtain accreditation from an accrediting 
body recognized by the Director of the Division of Consumer Affairs 
(as opposed to the Commissioner of Human Services as previously 
required by the bill) within 12 months of licensure.  

=== PDF PAGE 24 ===
3 
 
 
The amendments require that as a condition of being licensed 
health care service firms, that receive government funds for any 
services provided, must cause an audit to be prepared by a qualified 
certified public accountant every three years (as opposed to being 
conducted annually in accordance with the federal “Single Audit Act 
of 1984” as previously required by the bill).  
 
The amendments require the Director of the Division of Consumer 
Affairs to enter into a memorandum of understanding with an 
accrediting body for purposes of accrediting health care service firms.    
 
The amendments require the Director of the Division of Consumer 
Affairs to submit a report to the Governor and the Legislature, 
providing a review and analysis of the licensure, accreditation, and 
audit provisions of the bill, no more than three years after enactment of 
the bill.  
  
The amendments delay the effective date of the bill from the fourth 
month to the 18th month next following the date of enactment, and 
permit the Director of the Division of Consumer Affairs to take 
anticipatory administrative actions in advance of the bill’s effective 
date. 

=== PDF PAGE 25 ===
STATEMENT TO 
 
[First Reprint] 
ASSEMBLY, No. 2207 
 
with Assembly Floor Amendments 
(Proposed by Assemblywoman VAINIERI HUTTLE) 
 
ADOPTED: JUNE 23, 2014 
 
 
 
These amendments make the following changes to the bill: 
• Require that applicable firms be registered, rather than 
licensed, as health care service firms; 
• Change the definition of “companion services” so that 
companion services is defined to exclude assistance with 
activities of daily living, but allows direct physical contact; 
• Require that the accrediting body for health care service firms 
be recognized by the Commissioner of Human Services as an 
accrediting body for homemaker agencies participating in the 
Medicaid program, rather than by the Director of the Division 
of Consumer Affairs; 
• Require that the certified public accountant who conducts an 
audit of a health care service firm be licensed by the State; 
• Require that the certified public accountant’s audit include an 
audit report with an unqualified opinion, and be accompanied 
by any management letters prepared by the auditor in 
connection with the audit commenting on the internal controls 
or management practices of the health care service firm; 
• Delete a provision that would have required a Medicaid cost 
report to be included in the audit; 
• Clarify that the accrediting body must be chosen through 
appropriate procurement processes; and 
• Require that the report to the Governor and the Legislature by 
the Director of the Division of Consumer affairs also include 
any recommendations for any additional resources necessary to 
make the provisions of the bill more effective. 
 
 

=== PDF PAGE 26 ===
Office of Legislative Services 
State House Annex 
P.O. Box 068 
Trenton, New Jersey  08625 
 
Legislative Budget and Finance Office 
Phone (609) 292-8030 
Fax (609) 777-2442 
www.njleg.state.nj.us 
 
 
LEGISLATIVE FISCAL ESTIMATE 
[Second Reprint] 
ASSEMBLY, No. 2207 
STATE OF NEW JERSEY 
216th LEGISLATURE 
 
DATED: JUNE 30, 2014 
 
 
SUMMARY 
 
Synopsis: 
Expands definition and licensure requirements for health care service 
firms. 
Type of Impact: 
An expenditure increase, offset by a revenue increase. 
Agencies Affected: 
Division of Consumer Affairs in the Department of Law and Public 
Safety. 
 
 
Office of Legislative Services Estimate 
Fiscal Impact 
Years 1-3   
State Cost 
Indeterminate – See comments below 
State Revenue 
Indeterminate – See comments below 
 
• The bill would increase the number of firms that would be required to register as health care 
service firms, leading to an increase in State costs related to the oversight of these firms, and 
an increase in revenues from registration fees. 
 
• The bill’s accreditation and auditing requirements would have minimal fiscal impact on the 
State, as costs could be imposed on health care service firms.  If the expanded requirements 
cause some firms not to renew their registrations as health care service firms, State costs and 
revenues related to these firms may decrease. 
 
 
BILL DESCRIPTION 
 
 
Assembly Bill No. 2207 (2R) of 2014 expands the definition of health care service firms, 
which are regulated by the Division of Consumer Affairs (division) in the Department of Law 
and Public Safety, to include firms that place or arrange for the placement of personnel to 
provide companion services.  The current definition only includes firms that place or arrange for 
the placement of personnel to provide health care or personal care services.  The bill further 

=== PDF PAGE 27 ===
FE to A2207 [2R] 
2 
 
requires that health care service firms obtain accreditation and comply with auditing 
requirements.  
 
The bill defines “companion services” to mean non-medical basic supervision and 
socialization services which do not include assistance with activities of daily living, and which 
are provided in the individual’s home.  The bill also clarifies the definition of “personal care 
services” as services performed by licensed or certified personnel for the purpose of assisting an 
individual with activities of daily living that may involve physical contact, and would include 
such services as bathing, toileting, transferring, dressing, grooming, and assistance with 
ambulation, exercise, or other aspects of personal hygiene. 
 
The bill requires that a health care service firm obtain, within 12 months of licensure, 
accreditation from an accrediting body that is recognized by the Commissioner of Human 
Services as an accrediting body for homemaker agencies participating in the Medicaid program.   
 
The bill would also require that, as a condition of licensure, a health care service firm must 
cause to be prepared an audit every three years.  The audit must be conducted by a certified 
public accountant licensed in the State of New Jersey and must include an examination of the 
subject firm’s financial records, financial statements, the general management of its operations, 
and its internal control systems.  The audit must include an audit report with an unqualified 
opinion and shall be accompanied by any management letters prepared by the auditor in 
connection with the audit commenting on the internal controls or management practices of the 
health care service firm.  The audit must be divided into legal compliance and financial 
components, and the financial component must be done in accordance with the Statements on 
Auditing Standards issued by the American Institute of Certified Public Accountants.   
 
The Director of the Division of Consumer Affairs is to enter into a memorandum of 
understanding with an accrediting body chosen through appropriate procurement processes for 
purposes of accrediting health care service firms, and the memorandum of understanding is to 
establish the standards for accreditation and audit reporting requirements. 
 
The bill also requires that, no more than three years after the enactment of the bill, the 
Director of the Division of Consumer Affairs must report to the Governor and the Legislature, 
providing a comprehensive review and analysis on the effectiveness of the licensure, 
accreditation, and audit provisions of the bill, and recommendations for any additional resources 
necessary to such provisions more effective. 
 
 
FISCAL ANALYSIS 
 
EXECUTIVE BRANCH 
 
 
None received. 
 
 
OFFICE OF LEGISLATIVE SERVICES 
 
 
The Office of Legislative Services (OLS) concludes that, by expanding the definition of 
health care service firms to include firms providing companion services, the bill would likely 
increase the number of firms that would be required to register as health care service firms, 
leading to an increase in State costs at the division related to the oversight of these firms.  These 
costs would be offset by revenue from registration fees, currently $500 per primary location per 
year.  According to the division website, there are currently 998 registered health care service 
firms in New Jersey (counting multiple sites operated by a single entity as multiple firms).  The 

=== PDF PAGE 28 ===
FE to A2207 [2R] 
3 
 
OLS does not have information on how many firms that are not currently health care service 
firms but are currently providing companion services that, under the bill, would require them to 
register as health care service firms.  The OLS notes that the bill’s definition of a health care 
service firm may be interpreted to include firms whose employees perform only household 
chores for applicable individuals, which could be interpreted to include a large number of firms 
that provide cleaning and other household services.  It is uncertain to what extent these firms 
would be classified as health care service firms by the division, and therefore subject to 
registration under this bill.  It is also noted that some firms may opt to discontinue providing 
companion services to applicable individuals in order to avoid the registration requirement and 
the associated oversight and costs. 
 
The bill’s expansion of accreditation and auditing requirements for health care service firms 
may also slightly increase the cost to oversee these firms, as the division will be required to enter 
into a memorandum of understanding with an accrediting body and verify that firms are in 
compliance with these requirements.  These costs may be imposed on health care service firms, 
through fees charged by the accreditation agency or increased registration fees charged by the 
State.  It is noted that increasing the cost to remain registered as a health care service firm 
(through increased fees or the cost of regulatory compliance) may cause some firms to choose 
not to renew their registrations, reducing costs related to the oversight of these firms and 
revenues from their registration fees. 
 
Because of uncertainty regarding all of the factors described above, the OLS is not able to 
determine the net fiscal impact of the bill.  However, it is noted that licensure and registration 
programs operated by the division generally set fees to approximate the costs incurred by the 
division to regulate the licensed and registered entities. 
 
 
Section: 
Human Services 
Analyst: 
David Drescher 
Associate Fiscal Analyst 
Approved: 
David J. Rosen 
Legislative Budget and Finance Officer 
 
 
This legislative fiscal estimate has been produced by the Office of Legislative Services due to the 
failure of the Executive Branch to respond to our request for a fiscal note. 
 
This fiscal estimate has been prepared pursuant to P.L.1980, c.67 (C.52:13B-6 et seq.). 
 
