NHTDWaiver Program in New York

NHTD funds a range of community-based services that replace what would otherwise require a nursing facility. Participants get personal care at home, skills training, community integration support, and environmental modifications so they can manage daily life safely without institutional care.

The Nursing Home Transition and Diversion Waiver is a New York State Medicaid program authorized under federal Section 1915(c). It provides home and community based services to eligible seniors and adults with physical disabilities who require nursing-home-level care but want to stay in the community.

You may be a strong candidate if you have active New York community Medicaid, require a nursing-home level of care, are 65 or older or between 18 and 64 with a verified physical disability, and can live safely in the community with waiver support. The New York State Department of Health makes the final eligibility decision, not a home care agency.

NHTD covers service coordination, home and community support services, community transitional services, environmental modifications, assistive technology, independent living skills training, structured day programs, respite care, and more. Specific services are authorized through your individual service plan.

NHTD stands for Nursing Home Transition and Diversion. Transition means helping someone leave a nursing home and return to the community. Diversion means helping someone at risk avoid nursing home placement in the first place.

Section 1915(c) of the Social Security Act lets states use Medicaid funding for home and community based services instead of institutional care. NHTD operates under this authority. The federal Centers for Medicare and Medicaid Services must approve the waiver, including the total number of participants allowed.

Yes. Participant direction is a core feature of NHTD. Participants choose the services they receive, the providers they work with, and the outcomes they want. Services must still be authorized in the individual service plan, and providers must be approved NHTD providers.

NHTD does not provide housing directly, but participants transitioning from a nursing facility may have certain one-time costs covered, such as a security deposit or utility setup. Some participants may also qualify for a state-funded housing subsidy administered through the program, subject to available funds.

Start by contacting the Regional Resource Development Center (RRDC) for your area. The RRDC reviews your referral, sets up an interview, and walks you through documentation. You need active New York Medicaid first. Cottage Home Care can help you understand your current Medicaid coverage type before you begin.

Success in NHTD is measured against each participant's own goals, set out in their individual service plan. For some, that means staying out of a nursing home. For others, it means successfully transitioning back to community life. Service Coordinators monitor progress and adjust the plan as needs change.

NHTD supports Medicaid-eligible New Yorkers 65 and older, or ages 18 to 64 with a verified physical disability, who need nursing-home-level care but want to remain in the community.

No. The TBI Waiver is separate from NHTD and serves adults with traumatic brain injuries. NY Medicaid Code 81 identifies enrollees actively enrolled in or eligible for the TBI Waiver.