New York Application for a 1915 (c) HCBS Waiver

The Nursing Home Transition and Diversion (NHTD) Medicaid Waiver will provide community-based alternatives to individuals with disabilities, who are at least eighteen (18) years old, and eligible for nursing facility placement. The NHTD will allow waiver participants to avoid or transition from unwanted nursing home placement. Designed to promote waiver participant choice, NHTD waiver participants will choose:
(1) to receive NHTD services instead of nursing home services
(2) to receive NHTD services instead of other Home and Community
Based Services (HCBS) Medicaid Waiver services for which they may be eligible
(3) their service providers
(4) what services to receive

The NHTD structure is modeled after New York's successful 1915(c) Traumatic Brain Injury Medicaid Waiver. Within the first three years, this application is requesting to serve at least five thousand (5000) individuals, who are eligible for nursing home care, to remain in or return to the community. Such individuals will be eligible to receive a variety of comprehensive community-based services and supports.

The New York State Department of Health (DOH), Office of Medicaid Management (OMM), Division of Consumer and Local District Relations (DCLDR), Bureau of Long Term Care (BLTC) is responsible for the operation and oversight of the NHTD. In order to promote efficiency and allow for regional flexibility, DOH will contract with not-for-profit agencies in nine (9) regions across the state with demonstrated experience providing community-based services to individuals with disabilities and seniors. These agencies will serve as Regional Resource Development Centers (RRDCs) and employ Regional Resource
Development Specialists (RRDSs). 

The RRDCs will be responsible for determining waiver participant eligibility, reviewing Service Plans, meeting regional aggregate budgeting targets, organizing local outreach efforts, developing regional resources, making recommendations to DOH about enrolling waiver services providers, and training service providers. In order to further assure the health and welfare of waiver participants, each RRDC will employ a Nurse Evaluator who will evaluate, as necessary, new waiver participants and waiver participants returning to the community for the potential need for medically
related waiver services.