It took a year for Gail Smith, a nursing home resident in Somerset County, to save enough from her monthly Medicaid allowance to afford new clothing when she lost significant weight, and she still had to buy second-hand.

“It hurts to have our personalities squashed and to lose our independence,” Smith told New Jersey lawmakers Monday. “We’re not just waiting to die. We want to thrive.”

Smith is among a growing group of advocates who want the state to increase the $50 monthly “personal needs allowance” provided to nursing home residents who have Medicaid. Residents use the money to pay for their cellphone, cable TV, haircuts, clothing, toiletries, books, and gifts, among other things.

The Assembly Health Infrastructure Committee unanimously approved legislation Monday that would add an annual cost-of-living increase to the monthly allotment starting next year, a change advocates said amounts to a few dollars a month. Many said the bill, introduced late last week by a trio of Assembly Democrats, doesn’t go far enough. There is currently no Senate version.

John Indyk, a vice president with the Health Care Association of New Jersey, which represents nursing homes, testified in favor of the measure and called it “a fair and reasonable approach for the time being.”

“If the state can find money to do more, we should do that,” Indyk said.

Known as PNAs, these personal needs payments range from $30 — the federal minimum — in Alabama and South Carolina to $160 in Florida and $200 in Alaska, according to the nonprofit National Consumer Voice for Quality Long-Term Care. Ten states pay less than New Jersey and three others, including Delaware and New York, also pay $50 a month, the group said.

While nursing homes provide care, food, some basic supplies, activities, and a place to live, residents must pay for many things themselves, including stamps, delivery fees, and some transportation. Advocates said residents need more money if they want fresher food options or an occasional treat, better bedding, and toiletries that aren’t watered down.

“It seems like the state always finds money for things that are important. Please show us that we are important and change this bill to raise the PNA by more than just a tiny cost-of-living adjustment,” Smith told lawmakers, her voice cracking.

Smith and other advocates have long pushed for a separate, bipartisan bill that would boost the monthly allotment to $140 and also add an annual cost-of-living adjustment. That measure, sponsored by Assemblyman Christopher DePhillips (R-Bergen), was passed by a different Assembly committee in early May, but has not advanced further, while a Senate version has not been posted for a hearing.

DePhillips, a member of the Health Infrastructure Committee, supported the cost-of-living measure Monday to move it out of committee, but called its proposed increase to the $50 monthly benefit not enough.

“I understand there are different perspectives on this bill. And budgetary concerns are obviously top of mind for all of us,” DePhillips said. “But we are so far behind that doing it incrementally is something that is unworkable.”

Tanette Clegg, a resident at Trenton Gardens nursing home, called the bill heard Monday a “slap in the face” to residents who testified about the issue in May. Others complained that the new bill was developed without their input and was scheduled for Monday’s hearing before nursing home residents could arrange transportation to join.

Clegg said her Trenton Gardens neighbors struggle to pay for used clothing and, at $45, she can barely cover the cost of a shampoo and haircut at the facility. Clegg described the home’s food as “inexplicably bad,” leaving residents desperate for outside options they can’t afford.

“It’s not healthy or tasty and we rarely get fresh fruits or vegetables, if we get them at all,” Clegg said, adding that she is bothered that residents like her must keep coming to the Statehouse to demand action.

Assemblywoman Shanique Speight (D-Essex), a chief sponsor on both bills, assured advocates she and others continue to work to advance the more generous bill.

“Hearing the testimonies that I’ve heard has had an impact on my heart and will never leave my mind,” Speight said.

Assemblyman Sterley Stanley (D-Middlesex), the committee’s chair and a lead sponsor on the bill that advanced Monday, called the legislation a “starting point.”

“I don’t see why both can’t work together,” Stanley said.

Ray DiFrancesco, a former resident at a Princeton nursing home who was able to move into an assisted living facility when his health improved, said he now enjoys benefits his previous neighbors can’t access. A shuttle bus allows him to shop around for food bargains and visit thrift shops or dollar stores, while nursing home residents are forced to order from catalogs, pay delivery fees, or spring for a car service if they must go out.

“When you have only $50 a month, you can only afford the basics,” DiFrancesco said, adding, “That PNA gets eaten up real quickly.”

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