What Is the Nursing Home Transition and Diversion (NHTD) Medicaid Waiver Program?

Welcome to Homecare Advisory Group! We are passionate about providing insightful home care guidance. In this article, we will explore an essential program for New York State’s residents – the Nursing Home Transition and Diversion (NHTD) Medicaid Waiver Program. Whether you are considering this program for yourself or a loved one, this comprehensive guide will help you understand its features, benefits, and application process.

Information for applicants and participants

For individuals who live in New York State, are on Medicaid, and do not wish to live in a nursing home, they have another option: the Nursing Home Transition and Diversion (NHTD) Medicaid Waiver Program. Below, Home Care Advisory Group gives valuable information about the NHTD. For more information, please call us at 212-540-2984.

  • The Purpose of the NHTD Medicaid Waiver Program

    The primary aim of the NHTD Medicaid Waiver Program revolves around two main goals:

    1. Empowerment: This program aims to uphold the rights of senior citizens and individuals with disabilities to have control over their lives. It emphasizes self-management, risk management, and learning from various life experiences.
    2. Health and Welfare: It ensures that the health and welfare of each participant are maintained while they live in the community. By aligning services with individual needs, the program facilitates a supportive and inclusive environment.

  • Who is Eligible for the NHTD Program?

    To participate in the NHTD Medicaid Waiver Program, you must meet specific eligibility criteria. These criteria ensure that the services are provided to those who need them the most:

    New York State Residency: You must be a resident of New York State.

    Medicaid Eligibility: You must be eligible for community-based Medicaid.

    Level of Care Requirement: You must require a nursing home-level care.

    Age and Disability: You must be at least 65 years old or between 18 and 64 with a verified physical disability.

  • How Are Services Determined?

    One of the core features of the NHTD Medicaid Waiver Program is its focus on individual choice and decision-making. Under this program, participants are the primary decision-makers, which means they have the power to:

    Select Services: Choose the services they receive based on their unique needs, goals, and strengths.

    Choose Providers: Select the service providers that will assist them in their daily living and health care needs.

    Determine Outcomes: Decide the outcomes they wish to achieve through these services.

    Additionally, if funds are available, eligible participants may also receive a state-funded housing subsidy. This subsidy can help participants secure a comfortable living arrangement within their community, further enhancing their independence and quality of life.

  • Services Offered Through NHTD

    The services provided through the NHTD Medicaid Waiver Program aim to promote independence, self-reliance, and community inclusion. These services can be broadly categorized into health care, personal support, and community integration services. Below is a detailed overview of the different types of services participants can access through this program:

    Personal Care Services: Assistance with daily activities such as dressing, bathing, grooming, and meal preparation.

    Home Health Aide: Support with health-related tasks such as medication management, wound care, and monitoring vital signs.

    Physical Therapy: Services to help improve mobility, strength, and physical independence.

    Occupational Therapy: Assistance to help you manage daily activities efficiently, such as cooking, cleaning, and self-care tasks.

    Speech Therapy: Support to improve communication skills and address issues related to speech, language, or swallowing.

    Counseling: Emotional and psychological support to enhance mental health and well-being, including individual and group counseling.

    Transportation Services: Help with getting to and from medical appointments, grocery shopping, or community activities.

    – Respite Care: Temporary relief for primary caregivers, giving them a break from their caregiving duties while ensuring the participant’s needs are met.

  • Creating Your Service Plan

    Each participant works collaboratively with a provider to develop a personalized Service Plan. This plan outlines the specific services and support you will receive to meet your individual needs and goals. The Service Plan is designed with the aim of increasing your independence, fostering your self-reliance, and integrating you more fully into the community.

    The development of the Service Plan involves:

    Assessment: A thorough assessment of your needs, strengths, and goals.

    Customization: Selecting and tailoring services that align with your unique situation.

    Coordination: Coordinating the different services and providers to ensure seamless and continuous care.

    Review and Adjustment: Regularly reviewing and adjusting the Service Plan to reflect any changes in your needs or goals.

  • How to Apply for the NHTD Program

    The application process for the NHTD Medicaid Waiver Program may differ slightly based on whether you are currently residing in a nursing home or living within the community. Below is a step-by-step guide to help you navigate the application process:

    Step-by-Step Application Process

    1. Initial Contact: If you currently reside in a nursing home, your first step is to discuss your goal of transitioning to community living with your discharge planner. The discharge planner will likely refer you to organizations like Open Doors or the Regional Resource Development Center (RRDC). If you are living in the community, you can directly contact the RRDC in your region to start the application process.
    2. Intake Meeting: This initial meeting with the RRDC will help determine your eligibility and needs. During this meeting, you will provide information about your current living situation, health status, and care needs.
    3. Service Coordinator Assignment: Once your eligibility is confirmed, you will be assigned a Service Coordinator. The Service Coordinator will be your primary point of contact throughout the process.
    4. Developing Your Initial Service Plan (ISP): With the assistance of your Service Coordinator, you will develop your Initial Service Plan (ISP). This plan will outline the specific services and supports you need to transition to community living and ensure your health and welfare are maintained.
    5. Plan Approval and Implementation: After your ISP is developed, it will be reviewed and approved by the relevant authorities. Once approved, the services outlined in your ISP will be implemented, and you will begin receiving the support you need to live independently in your community.

  • The Role of Service Coordinators

    Service Coordinators play a crucial role in your journey through the NHTD Medicaid Waiver Program. They offer continuous support and guidance to ensure your transition and ongoing care are smooth and effective. Some of the key responsibilities of Service Coordinators include:

    Needs Assessment: Conducting a comprehensive assessment of your needs, strengths, and goals.

    Service Planning: Helping you create and update your Service Plan to ensure it aligns with your evolving needs.

    Provider Selection: Assisting you in choosing appropriate service providers that meet your specific requirements.

    Coordination and Monitoring: Ensuring the quality and continuity of your care by coordinating with different service providers and regularly monitoring your progress.

    Advocacy: Advocating on your behalf to ensure you receive the services and support you need.

  • Why Is It Called the “1915(c) Medicaid Waiver” Program?

    Since 1981, states have had the flexibility to offer home and community-based services to individuals at risk of institutionalization or nursing facility care. These extra services, which are not typically provided by Medicaid, help keep individuals in their communities. The NHTD Waiver is one such program that falls under Section 1915(c) of the Social Security Act.

    This section allows states to waive certain Medicaid requirements to provide home and community-based services (HCBS) to individuals who would otherwise require institutional care. In 2007, the Centers for Medicare and Medicaid Services (CMS) approved New York State to provide NHTD waiver services, allowing the program to thrive and expand its reach.

  • The Benefits of the NHTD Medicaid Waiver Program

    The NHTD Medicaid Waiver Program offers numerous benefits to its participants, including:

    Independence: By receiving services in a community setting, participants can maintain their independence and continue living in their preferred environment.

    Personalized Care: The services provided are tailored to meet each individual’s unique needs, preferences, and goals.

    Improved Quality of Life: Access to a wide range of services and supports helps enhance participants’ overall quality of life.

    Community Integration: The program promotes greater community inclusion and participation, fostering a sense of belonging and connection.

    Caregiver Relief: Respite care services provide temporary relief for primary caregivers, allowing them to rest and recharge while ensuring the participant’s needs are met.

  • Conclusion

    The NHTD Medicaid Waiver Program is about giving power and options to senior citizens and individuals with physical disabilities in New York State. By focusing on independent living and community support, the program enhances the quality of life for its participants. 

    If you want to learn more or start your application process, feel free to contact our home care agency in NY at 212-540-2984. We are here to help you navigate the NHTD Medicaid Waiver Program and achieve greater independence and self-reliance in your community.

    For more information on home care insights and guidance, continue exploring our website or reach out to our dedicated team. Your journey toward a more independent and fulfilling life begins here with Homecare Advisory Group.