NHTD stands for Nursing Home Transition and Diversion. It is a New York State Medicaid waiver program designed to help people with disabilities and seniors who are at risk of nursing home placement continue living in their own homes and communities. The program funds a range of supportive services that make independent living possible for individuals who would otherwise require institutional care.

The NHTD waiver covers services that support safe, independent living at home. Depending on the participant’s assessed needs, covered services can include home and community support, skill-building assistance, assistive technology, environmental modifications, respite care, and service coordination. Medical services that fall under standard Medicaid coverage are handled separately. For individuals whose needs go beyond what the waiver covers, private pay home care options can fill those gaps without insurance restrictions. The specific services approved for each participant are determined through an individualized service plan developed with a care coordinator.

The NHTD waiver is open to adults 18 and older with a physical disability, and to seniors 65 and older, who require a nursing-facility level of care but choose to live in the community. Applicants must be enrolled in New York State Medicaid and demonstrate that they can be safely supported at home with the services the waiver provides. Individuals with traumatic brain injury may be directed to the separate TBI waiver program, which runs alongside NHTD under the same state framework.

In Brooklyn, the NHTD program functions the same way as it does statewide, but participants work with locally based service coordinators and approved providers who are familiar with the borough’s resources and community networks. All Heart Homecare Agency is an approved NHTD provider serving Brooklyn, helping eligible residents access the program, navigate the enrollment process, and receive the home and community-based services they qualify for.

New York City has one of the largest concentrations of NHTD participants in the state, served across all five boroughs. NYC residents who qualify work with a Regional Resource Development Center (RRDC) to begin the enrollment process, after which an approved provider takes over service coordination and delivery. Given the density and diversity of NYC’s population, local providers with multilingual staff and borough-specific knowledge play a significant role in making the program accessible to the communities that need it most.