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NHTD Waiver in New York: Who Qualifies, What’s Covered, and How to Apply
Many families in New York are unaware that a specific Medicaid program exists for adults with physical disabilities and traumatic brain injury who want to remain at home — or return home from a nursing facility. That program is the NHTD Waiver, and it covers a range of services that standard Medicaid home care does not.
What Is the NHTD Waiver?
The Nursing Home Transition and Diversion (NHTD) Medicaid Waiver is a New York State program designed for two groups of people:
- Adults who are currently living in nursing homes and want to return to the community
- Adults who are at risk of nursing home placement and want to remain at home
The waiver covers services beyond what standard Medicaid pays for — including home modifications, assistive technology, community integration support, and coordinated service planning. It is specifically for adults with physical disabilities, including traumatic brain injury (TBI). It is not for intellectual or developmental disabilities (that’s a separate program) and it is not exclusively for seniors.
Who Qualifies
To be eligible for the NHTD Waiver in New York, an individual must:
- Be 18 years of age or older
- Have a physical disability or traumatic brain injury that requires nursing-home level of care
- Be currently enrolled in Medicaid or be in the process of enrolling
- Choose to live in the community (home, family home, or supported apartment) rather than a nursing facility
- Be able to direct their own care or have someone assist them in doing so
Adults who were injured in accidents, who have degenerative conditions such as multiple sclerosis or muscular dystrophy, or who sustained a TBI from any cause frequently qualify — and many are not aware the program exists.
What the NHTD Waiver Covers
The NHTD Waiver funds services that standard Medicaid home care does not typically include:
- Service coordination — a dedicated coordinator manages the care plan, schedules services, and advocates for the individual
- Home modification — ramps, grab bars, widened doorways, and other physical changes that make the home accessible and safe
- Assistive technology — communication devices, mobility equipment, environmental control systems
- Community integration counseling — support for transitioning from a facility back to community life
- Independent living skills training — building daily living skills for greater self-sufficiency
- Personal care and home health aide services — direct in-home support
The specific services authorized depend on the individual’s assessed needs and their Individual Service Plan.
How to Apply
A note before you start: New York State is currently not accepting most new referrals to the NHTD waiver. Limited openings are released through the Regional Resource Development Centers (RRDCs), so the RRDC for your region is the place to get on track. If you are already on the NHTD waiver, you can choose or switch your service provider.
1. Contact your Regional Resource Development Center (RRDC) — The application process runs through the RRDC for your region, which can tell you whether openings are available. A service coordinator then helps assess your situation and guide you through the steps.
2. Medicaid enrollment — If not already enrolled, Medicaid eligibility must be established before the waiver application proceeds.
3. Functional assessment — A clinical assessment determines whether the individual meets nursing-home level of care criteria.
4. Individual Service Plan development — Working with the service coordinator, an individualized plan is developed that outlines what services are needed and how they will be delivered.
5. Waiver openings — NHTD operates with a limited number of openings, which are released through the RRDCs; your RRDC can advise on current availability in your area.
How Priority Cares Can Help
In New York City we are a NYS DOH-approved NHTD and TBI waiver provider (service coordination, independent living skills training, community integration counseling and behavioral supports). We don’t send home care aides in New York City, but we’ll connect you with a licensed home care agency and walk you through Medicaid and MLTC. If you or your loved one is already on the NHTD waiver, you can choose or switch your provider; for new clients, we can check TBI waiver eligibility. Call (718) 400-6166.
