Nursing Home Transition and Diversion Waiver:
The Home and Community Based Services Nursing Home Transition and Diversion Waiver (HCBS/NHTD) provides support and services to assist individuals with disabilities and seniors toward successful inclusion in the community. Participants may come from a nursing facility or other institution, or choose to participant in the program to prevent institutionalization.
HCBS/NHTD waiver services may be considered when informal supports, local, state and federally funded services and Medicaid State Plan services are not sufficient to assure the health and welfare of the individual in the community, or when waiver services are a more efficient use of Medicaid funds. Using Medicaid funding, the HCBS/NHTD waiver is administered by the New York State Department of Health (DOH) through contractual agreements with Regional Resource Development Centers (RRDC) and Quality Management Specialists (QMS).
To be eligible for the NHTD Medicaid Waiver an individual must:
Be capable of living in the community with needed assistance from available informal supports, non-Medicaid supports and/or Medicaid State Plan services and be in need of one or more waiver service
- Be eligible for nursing home level of care
- Be authorized to receive Medicaid Community Based Long Term Care
- Be at least 18 years of age or older
- Be considered part of an aggregate group that can be cared for at less cost in the community than a similar group in a nursing home
- Choose to live in the community as a participant in this waiver rather than in a nursing home
- Not participate in another HCBS waiver
The following services are available under the HCBS/TBI waiver program.
Service Coordination (SC)
The Service Coordinator is the participant’s planner, organizer, and service plan writer. Service Coordinators obtain and coordinate the services that are necessary for the participant to return to or remain in the community. These services may include: waiver services, Medicaid State Plan services, educational, vocational, social, and medical services available within the community.
Positive Behavioral Interventions and Supports (PBIS)
PBIS Services are provided to participants who have significant behavioral difficulties that jeopardize their ability to remain in the community of choice due to inappropriate responses to events in their environment. PBIS services include but are not limited to:
A comprehensive assessment of the individual’s behavior, skills and abilities
- The development and implementation of a holistic structured behavioral treatment plan
- The training of family, natural supports and other providers so they can effectively use the basic principles of the behavioral plan
- Regular reassessments of the effectiveness of the behavioral treatment plan, making adjustments to the plan as needed.
Community Integration Counselor (CIC)
CIC services are designed to help participants more effectively manage the emotional difficulties associated with adjusting to and living in the community. It is a counseling service provided to those coping with altered abilities and skills, the need to revise long term expectations, and changed roles in relation to significant others. This service is generally provided in the provider’s office or the participant’s home. It is available to participants and/or anyone involved in an ongoing significant relationship with the participant when the issues to be discussed relate directly to the participant.
Independent Living Skills Trainer (ILST)
ILST services are designed to improve or maintain the ability of the participant to live as independently as possible in the community. ILST assists in recovering skills that have decreased as a result of onset of disability. Also, ILST will primarily be targeted to those individuals with progressive illnesses to maintain essential skills.
Community Transitional Services (CTS)
CTS services are intended to assist participants with the physical transition from a nursing home to living in the community. CTS is a one-time service per enrollment and is ONLY provided when transitioning from a nursing home.
Structured Day Program (SDP)
Structured Day Program services are designed to improve or maintain the participant’s skills and ability to live as independently as possible in the community. These are typically provided as outpatient services due to the difficulty that many individuals with physical or cognitive disabilities have transferring or generalizing skills learned in one setting to another. This service provides the skills training that is needed as well as the consistent reinforcement of those skills in real life settings.