Understanding the Nursing Home Transition and Diversion (NHTD) Program

An Introduction to the NHTD Program

The Nursing Home Transition & Diversion Waiver (NHTD) program is an innovative Medicaid initiative designed to support seniors and individuals with disabilities in living independently in their communities. By providing tailored services and resources, the program aims to prevent unnecessary institutionalization and empower participants to maintain their independence and dignity through person-centered care. This article explores the structure, goals, eligibility criteria, services offered, and participant protections within the NHTD program, highlighting its vital role in transforming long-term care in New York State.

Understanding the Core Purpose of the NHTD Program

Learn how the NHTD program helps seniors and individuals with disabilities avoid unnecessary nursing home stays

Program overview

The Nursing Home Transition & Diversion Waiver program (NHTD) is a Medicaid-supported initiative designed to help eligible seniors and individuals with physical disabilities live independently in their communities. It offers a variety of services tailored to each person's needs to support their desire to avoid or transition out of nursing home care.

Operated through Regional Resource Development Centers (RRDCs) across New York State, the program coordinates assessments, service planning, and resource allocation to ensure effective community placement. These regional centers act as a hub for information, eligibility determination, and ongoing support to participants and their families.

Participants in the NHTD program typically reside in their own homes or suitable community arrangements and receive services that promote safety, independence, and social inclusion. Coverage extends to specific counties, including Onondaga, Oneida, Herkimer, Jefferson, Lewis, St. Lawrence, Oswego, and Madison.

Primary objectives

The main goal of the NHTD waiver is to support individuals in living where they choose—preferably in the community—by delaying or preventing unnecessary nursing home placements. It emphasizes personalized care planning, giving participants control over the services they receive.

By providing vital supports such as service coordination, assistive technology, environmental modifications, and community integration counseling, the program aims to improve quality of life. It also promotes independence and empowerment, helping individuals maintain their dignity while receiving necessary medical and social services. Overall, the NHTD program aligns with the philosophy that seniors and persons with disabilities should have the right to choose their living environment and receive care in the least restrictive setting feasible.

Who Benefits from the NHTD Program?

Find out who qualifies: Helping seniors and adults with physical disabilities live in their communities

Who does the NHTD program help?

The NHTD program supports Medicaid-eligible seniors and adults with physical disabilities who need nursing home-level care but prefer to stay in their own homes or community settings. It is designed for individuals who wish to age in place and maintain independence with the help of personalized services.

Participants include people aged 18 and older, including those under 65 with verified physical disabilities, as well as seniors aged 65 and above. Many are living in their own homes, in community-based residences, or are transitioning from nursing facilities or hospitals.

The program offers a broad range of services to meet individual needs, such as care coordination, home modifications, assistive technology, and community integration support. These services help prevent unnecessary nursing home placements, facilitate hospital discharges, and promote quality of life.

Overall, the NHTD program aims to empower individuals by providing the necessary supports for safe, independent living, aligning with the philosophy that everyone has the right to choose a living arrangement that best suits their needs and preferences.

Who does the NHTD program help?

The NHTD program helps Medicaid-eligible seniors and individuals with physical disabilities who require nursing home-level care but wish to remain in or return to their homes and community settings. It serves adults aged 18 and older, including those under 65 with verified physical disabilities and seniors 65 and older. Participants include people living in their own homes, in community settings, or transitioning from nursing homes and hospitals. The program provides a range of services such as care coordination, home support, environmental modifications, and community integration to prevent or delay institutionalization. Overall, it aims to promote independence, person-centered care, and aging in place for eligible individuals across New York State.

Range of Services and Benefits Offered

Explore the comprehensive services to promote safety, independence, and social engagement

What services and benefits does the NHTD program offer?

The NHTD (Nursing Home Transition and Diversion) waiver program provides a variety of supports aimed at helping eligible individuals live independently in their communities instead of in nursing homes. Participants have access to services that are carefully tailored to meet their unique needs, preferences, and goals.

Among the core services are care coordination, which helps develop personalized care plans and monitor progress. Participants also receive assistance with daily living tasks through personal assistance services, including support with household activities like grocery shopping, meal preparation, and light housekeeping.

Environmental modifications and assistive technology are available to make homes safer and more accessible, promoting independence. Structured day programs and community integration counseling foster social participation and skill-building, while respite care provides temporary relief for family caregivers.

Other services include home health services such as nursing, physical therapy, medication management, nutritional counseling, peer mentoring, wellness programs, and community transitional services. Overall, these services work together to enhance safety, independence, and quality of life.

Participant benefits

Participants in the NHTD program gain numerous advantages. They experience increased independence by receiving personalized supports designed to fit their lifestyles. The program emphasizes safety through environmental adaptations and mobility assistance.

Most beneficiaries enjoy a higher quality of life by remaining active and engaged in their communities. The array of services also reduces the likelihood of lengthy or unnecessary institutional stays, aligning with the philosophy that seniors and individuals with disabilities should receive care in the least restrictive settings possible.

Moreover, program participants are empowered through active involvement in care planning and service choices, fostering a sense of control and dignity. Access to diverse services under the Medicaid-funded program supports individuals in maintaining and improving their health, well-being, and social connections in community settings.

This comprehensive approach aims to keep seniors and those with disabilities safely at home, living independently for as long as possible, thus contributing to a more inclusive and supportive community environment.

Accessing the NHTD Program: Application and Eligibility Process

Start your journey: How to apply and what to expect during eligibility assessments

How can someone apply for the NHTD program?

Applying for the NHTD (Nursing Home Transition and Diversion) Waiver involves several steps centered around connecting with local program providers. The first step is to make a referral to a Regional Resource Development Center (RRDC), which manages the application process.

Once referred, applicants undergo a thorough eligibility assessment. This involves an assessment using tools such as the UAS-NY, which evaluates the individual’s need for nursing home level care. The assessment helps determine if the person qualifies based on medical needs, functional capacity, and other criteria.

If the individual meets the eligibility requirements, a Service Coordinator is assigned to develop a personalized care plan. This plan includes a variety of services tailored to the individual’s needs, preferences, and goals.

To complete the application, applicants must submit relevant documentation verifying income, assets, and medical necessity. Following submission, their eligibility is verified through review by Medicaid and other relevant agencies.

Upon approval, participants begin receiving services like service coordination, assistive technology, and supports for community living. The process also involves ongoing monitoring to ensure the services continue to meet the individual’s needs.

The entire process, from referral to initial service delivery, can take several months depending on the individual case and available resources. It’s recommended to work closely with the RRDC to ensure all required assessments and documentation are completed promptly.

What is involved in the eligibility assessment?

The eligibility assessment is a critical step in accessing the NHTD program. It involves a comprehensive evaluation of the individual’s medical, functional, and living situation.

Assessment tools like the UAS-NY are utilized to determine if the person requires nursing home-level care, an essential criterion for the program. This assessment considers factors such as mobility, cognitive ability, and daily living activities.

Besides medical need, eligibility criteria also include income and asset limits, with specific thresholds set for the year. For example, in 2025, the monthly income limit is $1,800, and asset limits are set at $32,396 for most individuals.

Additional factors assessed include whether the person resides in a community setting, their ability to safely live with supports, and their preference to avoid institutionalization.

Once the assessment confirms eligibility, the Service Coordinator proceeds with developing a tailored care plan that aligns with the individual’s needs and goals.

In summary, the assessment ensures that only those who genuinely require and can benefit from community-based services receive support under the NHTD waiver, fostering independence and personalized care.

Participant Rights, Protections, and Program Structure

What rights and protections do participants have within the NHTD program?

Participants in the NHTD program are afforded a comprehensive set of rights designed to promote their independence, dignity, and safety. They are actively involved in creating and reviewing their Service Plans, ensuring services align with their personal preferences and needs.

Participants can choose their residence, service providers, and coordination support, fostering autonomy and control over their care. They are fully informed about their rights, available services, and the procedures for filing complaints or disputes.

Protection measures include access to Fair Hearings and Case Conferences, which serve as avenues for resolving service issues or denials fairly.

Confidentiality and privacy are central to the program, and participants have the right to receive services free from coercion or undue influence. The emphasis remains on personal empowerment, allowing individuals to remain active in decision-making and community engagement.

Overall, these protections ensure that individuals receive respectful, individualized care while safeguarding their liberty and personal choices.

Advancing Community Care and Independence

The NHTD program exemplifies a people-centered approach to long-term care, focusing on empowering individuals to live independently and participate actively in their communities. By offering a broad range of services tailored to individual needs and ensuring participant rights are protected, the program has become a vital component of New York’s strategy to make long-term care more humane, accessible, and responsive. As the program continues to evolve, it remains dedicated to the vision of aging in place with dignity, autonomy, and full community integration.