The state of New York has two programs to help pay for in-home care for seniors who choose to age in place: the HCBS/LTHHCP waiver and the NHTD waiver. The first of these is open to all adults who are disabled or frail, qualify for Medicaid, and require a nursing home level of care. The second waiver helps transition seniors out of facility-based care and into their own homes, where they receive in-home caregiver support and home health care services.

The Home and Community-Based Services Waiver/Long-Term Home Health Care (HCBS/LTHHCP) Program

The HCBS/LTHHCP program provides case manager and care coordination services to older adults and people with disabilities who would usually require skilled nursing care in a residential setting. The application process includes getting a doctor’s assessment of the applicant’s need for in-home support and a home visit by the intake worker to make sure applicants can remain safely at home. 

This program is coordinated by the state through the Department of Social Services, but caregiver and case manager assistance comes directly from a private nonprofit agency on aging. To remain eligible, seniors must access at least one covered service every 30 days, but costs must not exceed the estimated cost of nursing home care.

The Nursing Home Transition and Diversion (NHTD) Medicaid Waiver

Seniors who participate in the NHTD waiver program have access to self-directed community care services that can help them avoid institutional care. Applicants must either be currently enrolled in Medicaid or meet the Medicaid enrollment criteria for income and assets. The application and enrollment process includes a home visit and medical assessment, and eligible enrollees must be seniors aged 65 and over or aged 18-64 and have a disability. The program accepts applications from current nursing home residents prior to discharge and can help seniors with the transition back home. 

Other covered services include in-home caregiver support, home-delivered meals, transportation assistance, respite care and limited home modifications. Applications may be submitted through the discharge planner at a participating nursing home, via the Regional Resource and Development Center, or through Open Doors, the New York Association on Independent Living.