Long Term Care Community Diversion Programs are vital initiatives designed to support individuals, particularly seniors and those with disabilities, to live fulfilling lives within their communities rather than in institutional settings. These programs champion self-determination and provide crucial services tailored to individual needs. One prominent example of such a program is the NHTD waiver program in New York State.
What is the NHTD Waiver Program?
The NHTD (Nursing Home Transition and Diversion) waiver program is a New York State Medicaid program that exemplifies a long term care community diversion program. It offers comprehensive support services to Medicaid-eligible individuals, including seniors and people with physical disabilities, enabling them to reside in community-based settings as an alternative to nursing homes or other institutions. The core principle of the NHTD waiver is to empower participants to live as independently as possible, making their own choices about their care and lives.
The program is built upon the understanding that individuals requiring long term care have the right to self-direction and community integration. Participants are central to the decision-making process, actively involved in choosing the services they receive, selecting their service providers, and defining their desired outcomes. This person-centered approach ensures that care plans are tailored to each individual’s unique strengths, needs, preferences, and goals.
Beyond standard waiver services, eligible participants may also access a state-funded housing subsidy, contingent on available funds, to further support community living. This subsidy, while administered by the NHTD program, is not classified as a waiver service but rather an additional support mechanism to facilitate successful community transitions.
The philosophy underpinning the NHTD waiver program rests on the fundamental rights of individuals with physical disabilities and seniors. It recognizes their entitlement to control their lives, experience and manage risks, and learn from their experiences – principles that are balanced with the program’s commitment to safeguarding participant health and well-being within the community.
The collaborative approach is key to the NHTD waiver’s success. Participants work closely with providers and other chosen individuals to develop a personalized Service Plan. This process fosters personal empowerment, promotes greater independence, encourages community inclusion, and supports self-reliance and engagement in meaningful activities. Participant satisfaction is a crucial indicator of the NHTD program’s effectiveness and success in delivering person-centered care and achieving community diversion.
Who is Eligible for the NHTD Program?
To be eligible for the NHTD program in New York State, individuals must meet specific criteria:
- Medicaid Eligibility: Applicants must be eligible for community-based Medicaid in New York State.
- Nursing Home Level of Care Need: Individuals must be assessed as requiring a nursing home level of care, indicating a significant need for long term support services.
- Age and Disability Requirements: Applicants must be either between 18 and 64 years of age with a verified physical disability, or aged 65 or older at the time of application.
Furthermore, applicants must demonstrate the ability to live safely in a community setting with the services and supports provided through Medicaid, the NHTD waiver program, and other available community resources. This ensures that community-based living is a safe and sustainable option for each participant.
How to Apply for the NHTD Program
The application process for the NHTD program varies depending on the applicant’s current living situation.
For Individuals Currently in a Nursing Home:
The initial step is to discuss your interest in the NHTD program with the nursing home’s discharge planner. The discharge planner can provide a referral to Open Doors, a program dedicated to assisting individuals transition from institutional care to community living, and/or the Regional Resource Development Center (RRDC). Direct contact with the RRDC is also an option. These resources provide guidance and support throughout the application process.
For Individuals Currently Living in the Community:
Individuals residing in the community who are interested in participating in the NHTD waiver program, or their representatives, should directly contact the RRDC in their local area to initiate the application process.
Detailed information regarding the application process is available on the Applicants & Participants page of the New York State Department of Health website. As part of the application, individuals will attend an intake meeting with the RRDC. Following this meeting, applicants collaborate with a Service Coordinator (case manager) to develop an Initial Service Plan (ISP). This ISP outlines the necessary services and supports to ensure the participant’s health and safety while living in the community, and forms the basis of their personalized care within the NHTD program.
Why is it a 1915(c) Medicaid Waiver?
The designation “1915(c) Medicaid waiver” refers to the legislative basis of the NHTD program and its function within the broader Medicaid system. In 1981, the US Congress authorized the use of Medicaid waivers under Section 1915(c) of the Social Security Act. These waivers allow states flexibility in how they deliver Medicaid services, specifically to provide home and community-based services (HCBS) that are not typically covered under traditional Medicaid. These HCBS are designed to serve individuals who, without these services, would likely require institutional care, such as nursing home placement.
This waiver authority enables states to offer a wider range of services tailored to prevent institutionalization. The NHTD waiver, approved by the Centers for Medicare and Medicaid Services (CMS) in 2007, leverages this 1915(c) waiver to provide New Yorkers with access to essential community-based services. By utilizing this waiver mechanism, New York State can offer services beyond the standard Medicaid offerings, directly supporting the goal of long term care community diversion and empowering individuals to live in their homes and communities.
Conclusion
Long term care community diversion programs like the NHTD waiver are crucial for promoting independence, choice, and community integration for seniors and individuals with disabilities. By offering tailored services and supports within a framework of self-determination, these programs not only enhance the quality of life for participants but also represent a cost-effective and person-centered approach to long term care. The NHTD waiver program stands as a testament to the effectiveness of community-based care in enabling individuals to thrive outside of institutional settings, reinforcing the importance of such programs in the landscape of long term care.
