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NHTD Waiver in Monroe County, NY: Who Qualifies and How to Apply
# NHTD Waiver in Monroe County, NY: Who Qualifies and How to Apply
If you or a loved one lives in Monroe County — Rochester, Greece, Irondequoit, Brighton, Pittsford, or any surrounding town — and you want to stay at home rather than enter a nursing facility, the NHTD Waiver may be the most important program you have never heard of.
This guide explains exactly what the NHTD Waiver is, who qualifies in Monroe County, what services it covers, and how to start the enrollment process.
What Is the NHTD Waiver?
NHTD stands for Nursing Home Transition and Diversion. It is a New York State Medicaid waiver program that pays for home and community-based services for adults with physical disabilities or seniors who meet a nursing-facility level of care but want to live in the community instead.
“Waiver” means that the federal government has waived certain standard Medicaid rules to allow the state to use Medicaid funding for these home-based supports rather than only paying for institutional nursing home care.
The NHTD Waiver has two tracks:
- Transition: For individuals currently living in a nursing home or other facility who want to move back into the community
- Diversion: For individuals at risk of nursing home placement who want to remain at home with additional support
Both tracks provide the same types of services, which are fully funded by Medicaid for eligible individuals — no out-of-pocket cost.
Who Qualifies for the NHTD Waiver in Monroe County?
To be eligible for the NHTD Waiver in Monroe County, an individual must meet all of the following criteria:
1. Age and disability status
- Adults 18 and older with a physical disability, OR
- Seniors 65 and older who meet nursing-facility level of care criteria
2. Medicaid eligibility
- Active New York State Medicaid coverage is required. This includes traditional Medicaid and most Medicaid managed care plans.
3. Nursing facility level of care
- A physician or healthcare professional must certify that the individual’s care needs are at the level that would qualify them for nursing home placement.
4. Safe community living
- The individual must be able to live safely in the community with the services the waiver provides. A Service Coordinator works with the individual to build a care plan that makes community living feasible.
5. Voluntariness
- The individual must want to live in the community. NHTD is not imposed — it is a choice.
Important note: NHTD Waiver is specifically for physical disabilities and seniors. If the primary diagnosis is a developmental disability or intellectual disability, a different waiver program (such as the OPWDD waiver) applies.
What Does the NHTD Waiver Cover in Monroe County?
The NHTD Waiver covers a broad range of services that allow Monroe County residents to live independently. Covered services include:
- Home and Community Support Services (HCSS): Daily hands-on assistance with personal care, bathing, dressing, meals, and mobility
- Service Coordination: A dedicated coordinator who manages your care plan, connects you to community resources, and monitors your services
- Residential Habilitation: Skill-building support to help individuals maintain independence at home
- Community Integration Counseling: Support for individuals transitioning from a facility back into community life
- Environmental Modifications: Home modifications such as grab bars, ramps, or accessible bathroom fixtures
- Assistive Technology: Equipment and devices that support independent living
- Moving Assistance: Help with the practical costs of transitioning from a facility to a community residence
- Fiscal Intermediary Services: For individuals who prefer to self-direct their care
What the NHTD Waiver does not cover: Skilled nursing (covered by regular Medicaid), hospitalization, or services available through standard Medicaid.
How to Apply for the NHTD Waiver in Monroe County
Step 1: Contact a NHTD Waiver Provider or Care Coordinator
The first step is connecting with a licensed NHTD Waiver provider like Priority Cares. We help Monroe County families understand eligibility and start the application process at no cost.
Step 2: Initial Eligibility Screening
A care coordinator conducts an initial conversation to assess whether NHTD Waiver is the right program for you or your loved one. This includes reviewing the primary diagnosis, current living situation, Medicaid status, and care needs.
Step 3: Physician Documentation
A physician or other qualified healthcare professional must complete documentation confirming that the individual’s care needs meet nursing-facility level of care.
Step 4: UAS-NY Assessment
New York State uses a standardized assessment tool called the Uniform Assessment System (UAS-NY) to evaluate care needs. A nurse or social worker conducts this assessment in the home or at a clinical setting.
Step 5: Individualized Service Plan (ISP)
A Service Coordinator develops an Individualized Service Plan (ISP) that outlines what services will be provided, by whom, and how often. The ISP must be approved by the New York State Department of Health NHTD Program.
Step 6: Enrollment and Services Begin
Once approved, services begin according to the ISP. Priority Cares provides HCSS and other direct care services in Monroe County, including Greece, Irondequoit, Brighton, Henrietta, Pittsford, Webster, Penfield, Chili, and surrounding communities.
How Long Does NHTD Enrollment Take?
The enrollment process typically takes 30–90 days from initial contact to services starting, depending on physician availability, assessment scheduling, and ISP development. Starting the process early — before a crisis or hospitalization — is strongly recommended.
Monroe County NHTD Waiver: Getting Started
Priority Cares is a licensed NHTD Waiver provider serving all Monroe County communities. Our care coordinators handle the full enrollment process for Rochester-area families, including:
- Free initial eligibility review
- Assistance obtaining physician documentation
- Care planning and ISP development
- Ongoing service coordination
To start the process, call us at (585) 201-7179. There is no cost for the initial eligibility review, and there is no obligation to enroll.
The NHTD Waiver exists specifically so that Monroe County residents with physical disabilities and seniors can remain in their homes and communities. If you or someone you love might qualify, call Priority Cares today.