Most older adults or adults with disabilities prefer the comfort, familiarity, and independence of aging in place rather than moving into a nursing home. If you or a loved one is an NYC resident exploring home care support, it’s worth checking your eligibility for the NHTD Waiver Program. This New York Medicaid program provides in-home care for seniors who qualify for community-based Medicaid, require a nursing home level of care, and meet the program’s age or disability requirements.
What is the NHTD Waiver Program
The thought of leaving home for a nursing facility can often be painful for older New Yorkers who realize they need more care. Home is where they’ve built their routines, relationships, and independence — it’s where they can stop by their favorite corner bodega, walk to the park to meet friends, or catch up with neighbors on their stoop.
The Nursing Home Transition and Diversion Waiver was created in response to this need — so that seniors can remain in familiar surroundings for as long as safely possible. Funded by New York Medicaid, the NHTD program is one of many Home and Community-Based Services (HCBS) waivers that are designed to help eligible individuals live safely in their own homes instead of a nursing facility.
Who the program is designed for
The NHTD is for older New Yorkers who live at home but are at risk of placement in a nursing home, as well as those preparing to transition out of a nursing facility and back into the community.
Understanding the differences between NHTD vs. nursing home care can help families determine which option best fits their loved one’s needs. While a nursing home delivers around-the-clock care in a regulated residential facility, the NHTD delivers approved long-term care services in the comfort of one’s home.
The NHTD grants older adults greater control over their care plan, allows them to stay within their community, and is often more cost-effective for Medicaid recipients.
NHTD Eligibility Requirements
To qualify for the NHTD waiver, older adults must meet several requirements and complete a level of care assessment.
Medicaid, Age, and Disability Requirements
To qualify for the NHTD Waiver Program, applicants must generally be
- Eligible for community-based Medicaid
- 65 or older or 18–64 with a verified physical disability
- A resident of New York State
Nursing home level of care assessment
The NHTD’s nursing home level of care assessment is an in-home evaluation to verify that the individual has medical or care needs that would otherwise require care in a nursing facility. The assessment is conducted by healthcare professionals and looks at factors like:
- Medical conditions, medications, and treatments
- Mobility and daily activities like eating, bathing, and dressing
- Cognitive or behavioral concerns
- Home environment or safety concerns
If you don’t meet the eligibility requirements for the NHTD Waiver Program, other Medicaid-funded home care options may still be available. For example, Personal Care Aide programs — like Americare’s PCA program — train family members who are interested in providing caregiving as a paid career.
Services Covered Under NHTD
The NHTD covers a wide range of services that are necessary for older adults to live safely at home in New York City. This includes:
Service coordination and in-home help
Navigating available home care interventions can be overwhelming, especially for older adults living with physical or cognitive challenges. That’s why the NHTD matches each participant with a service coordinator who acts as a central point of contact for participants and their families, coordinating individualized care services.
Depending on the individual’s approved plan, NHTD services may include:
- personal care
- independent living support
- transportation assistance
- structured day programs
- community integration counseling
Home modifications and assistive technology
Many older adults and adults with physical disabilities need changes to their homes to continue living there safely. The NHTD Waiver Program may cover home modifications and assistive technology as part of an approved care plan. This may include wheelchair ramps, grab bars, widened doorways, stair lifts, bathroom modifications, and adaptive equipment that makes everyday activities safer and more manageable.
How to Apply for the NHTD Waiver Program
If you’re wondering how to apply for the NHTD program, the process depends on whether you’re already living in the community or in a nursing facility.
The good news is that you won’t have to handle the application process alone. You can reach out to a trusted home care agency like Americare, your local Regional Resource Development Center, or your facility discharge planner to guide you through the process.
If living in the community: contacting the RRDC
If you or a loved one lives at home and is interested in the NHTD program, the first step is to reach out to your local RRDC or submit a referral form. The RRDC will set up an intake meeting to gather your information, share more details about NHTD, and guide you through the next steps.
If in a nursing facility: discharge planner referral
Seniors or older adults in nursing facilities can start the application process by speaking with their facility’s discharge planner or social worker. They can coordinate with either the appropriate RRDC office or Open Doors, a New York program that helps people in nursing homes move back into the community.
As part of the transition, your care team will help determine whether community living is a safe option, what home care services you’ll need, and which providers will be involved in your care after discharge.
| Your Situation | First Step | Who to Contact |
| Living in the community | Schedule an intake meeting | Local Regional Resource Development Center (RRDC) |
| Currently in a nursing facility | Request a referral from your discharge planner | Open Doors or the regional office |
| Already assessed and approved | Select a service coordination agency | Americare or another approved coordinator |
To learn more about the NHTD application process, read our NHTD enrollment guide.
Getting Started With NHTD-Supported Care
New York isn’t always the easiest place to grow older. Walk-up apartments, crowded subway stations, busy sidewalks, and the pace of city life can make everyday tasks more challenging as care needs change. With the right support, however, many older adults can continue living safely in the homes and neighborhoods they know best.
If you’re exploring the NHTD Waiver Program, Americare is here to help. Our goal is to help individuals make the best healthcare choices and connect them with care that meets their needs.
Whether you’re looking for assistance for yourself, a family member, or a patient, reach out to Americare to get started with home care, or contact our team to learn more about the NHTD program.
FAQs
Q: What is the NHTD Waiver Program?
A: A New York Medicaid program that helps seniors and adults with physical disabilities live in their own homes or communities instead of a nursing home.
Q: Who is eligible for the NHTD Waiver Program?
A: Applicants must have active community Medicaid, need a nursing home level of care, and be age 65+ or 18–64 with a verified physical disability.
Q: What services does the NHTD program cover?
A: Service coordination, in-home personal care, home modifications like ramps, assistive technology, and daily living support such as transportation and community counseling.
Q: How do I apply for the NHTD Waiver Program in NYC?
A: If you’re living in the community, contact your local Regional Resource Development Center (RRDC) to schedule an intake meeting. If you’re in a nursing facility, ask your discharge planner to submit a referral.
Q: Does the NHTD Waiver Program require a nursing home level of care assessment?
A: Yes — applicants must be assessed as needing a nursing home level of care, while also being able to live safely in the community with support.