Page 296

MRG

UPDATED: JANUARY 2011

722

OTHER ELIGIBILITY REQUIREMENTS WAIVERS

NURSING HOME TRANSITION AND DIVERSION WAIVER (NHTD)

Description: Section 366 (6-a) of the Social Services Law authorizes the Nursing Home Transition and Diversion Waiver (NHTD). The NHTD waiver is overseen on a daily basis by 9 Regional Resource Development Centers (RRDCs) under contract with the New York State Department of Health.

The NHTD is a 1915 (c) Medicaid Home and Community Based Services Waiver (HCBS) authorized by the federal government. This waiver provides a community based alternative for providing care to seniors and persons with physical disabilities who are at least 18 years of age and require nursing home level of care. The waiver allows individuals to access Medicaid for medically necessary State Plan services as well as NHTD waiver services.

Policy: An individual participating in the NHTD waiver must be:

• Assessed to be eligible for nursing home level of care, using the Patient Review Instrument (PRI) (DOH-694) and SCREEN (DOH-695), which must be performed by a certified assessor who can conduct a PRI/SCREEN;

• In receipt of Medicaid coverage for Community Based Long Term Care services OR Outpatient Coverage for Community-Based Long Term Care;

• Capable of living in the community with the assistance of available informal supports, Medicaid State Plan services and one or more waiver service;

• At least eighteen years of age with a physical disability or aged 65 and older; and

• Part of an aggregate group that can be cared for at less cost in the community than in a nursing home.

An individual cannot be enrolled in the NHTD waiver and any of the other HCBS waivers at the same time (i.e. the Long Term Home Health Care Program waiver, the Traumatic Brain Injury waiver, and the Office for People with Developmental Disabilities HCBS waiver). Nor can an individual be enrolled in NHTD and Program of All Inclusive Care of the Elderly (PACE). If an individual is determined to be eligible for more than one waiver, a choice between the NHTD waiver and other HCBS waivers must be made by the applicant and/or legal guardian.