If you are just starting to learn about the NHTD waiver program, you are not alone. Many families hear the term for the first time when a loved one needs long-term support but wants to remain at home instead of moving into a nursing facility.
The Nursing Home Transition and Diversion, or NHTD, waiver is a New York Medicaid program that helps eligible adults receive community-based services rather than institutional care. For people who qualify, it can provide important support while preserving more independence and choice.
What Is the NHTD Waiver Program?
The NHTD waiver is designed for New Yorkers who need a home-level of care but prefer to live in the community. It serves adults ages 18 to 64 with a verified physical disability, as well as adults ages 65 and older, as long as they meet the program’s requirements.
The goal is not simply to replace institutional care. It is to help participants live as safely and independently as possible in a home or community setting with the right supports in place.
Who May Be Eligible?
In general, a person may be eligible if they:
- are eligible for community-based Medicaid
- need nursing home level of care, aged 18 to 64 with a verified physical disability, or age 65 or older
- can live safely in the community with available supports and services
There are also important limitations. For example, people living in certain licensed congregate care settings are generally not eligible. In addition, some other Medicaid programs may overlap with NHTD in ways that affect eligibility unless the person unenrolls from the overlapping program.
What Services Can the NHTD Waiver Cover?
One of the biggest strengths of the NHTD program is its range of services. These services are based on the participant’s approved plan and individual needs.
Examples of NHTD services include:
- Service Coordination
- Home and Community Support Services
- Independent Living Skills Training
- Assistive Technology
- Environmental Modifications
- Community Integration Counseling
- Home Visits by Medical Personnel
- Nutritional Counseling
- Respite Services
- Social Transportation
- Home-delivered meals
- Wellness Counseling
These services are meant to support health, safety, independence, and community living.
How the Application Process Works
The application process begins with the Regional Resource Development Center, or RRDC. This is the entry point for all NHTD referrals in New York.
Here is a simplified version of the process:
- Contact the RRDC
The applicant, family member, representative, discharge planner, or another approved helper can contact the RRDC to begin the referral.
- Attend an Intake Meeting
The RRDC reviews basic eligibility, explains the program, and completes required forms. At this stage, the applicant signs a Freedom of Choice form if they want to continue.
- Choose a Service Coordination Provider
The applicant selects a Service Coordination provider, and a Service Coordinator is assigned to help with the next steps.
- Complete Assessments and Planning
The Service Coordinator helps develop the Initial Service Plan, Plan of Protective Oversight, and required assessments, including a level-of-care review.
- Wait for the RRDC Decision
The completed application is reviewed, and the RRDC issues a Notice of Decision approving or denying eligibility.
If approved, services can begin once authorization is in place.
Why Families Consider NHTD
The NHTD waiver gives people more say in where they live and how they receive care. Rather than entering a nursing facility automatically, eligible participants may be able to stay in familiar surroundings with supports tailored to their needs. That focus on personal choice, independence, and community integration is a major reason many families explore the program.
If you need help understanding home care options or next steps for a loved one, HouseCalls Home Care is here to help. Call 718-922-9200, email info@HouseCallshc.org, or visit our website to learn more.
