The Nursing Home Transition and Diversion (NHTD) Medicaid Waiver is a Home and Community Based Services (HCBS) program, administered by the New York State Department of Health (DOH) through contractual agreements with Regional Resource Development Centers (RRDC) and Quality Management Specialists (QMS). The RRDC employs the Regional Resource Development Specialist (RRDS) and Nurse Evaluator (NE), who serve specific counties throughout the State.
The NHTD waiver uses Medicaid funding to provide supports and services to assist individuals with disabilities and seniors toward successful inclusion in the community. Waiver participants may come from a nursing facility or other institution (transition), or choose to participate in the waiver to prevent institutionalization (diversion).
Waiver services may be considered when informal supports, local, State and federally funded services and Medicaid State Plan services are not sufficient to assure the health and welfare of the individual in the community, or when waiver services are a more efficient use of Medicaid funds.

Philosophy of the NHTD Waiver

The NHTD Medicaid waiver was developed based on the philosophy that individuals with disabilities and/or seniors have the same rights as others. This includes the right to be in control of their lives, encounter and manage risks and learn from their experiences. This is balanced with the waiver program’s responsibility to assure the waiver participants’ health and welfare.
Waiver services are provided based on the participant’s unique strengths, needs, choices and goals. The individual is the primary decision-maker and works in cooperation with providers to develop a Service Plan. This process leads to personal empowerment, increased independence, greater community inclusion, self-reliance and meaningful productive activities. Waiver participant satisfaction is a significant measure of success of the NHTD waiver.


The New York State Department of Health oversees the NHTD Waiver program. The Department of Health contracts with the Regional Resource Development Center (RRDC) to manage the waiver throughout the state. Referrals must first be made to the RRDC. Once the application process is initiated, the participant may choose Access To Home Care Services as their Service Coordination provider.
Access To Home Care Services is approved to provide NHTD Waiver services in the Binghamton Southern Tier Region (counties of Cayuga, Cortland, Tompkins, Schuyler, Chenango, Otsego, Delaware, Broome, Tioga, Chemung, Steuben, Allegany and Cattaraugus) and the Syracuse/Utica North Region (counties of Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego and St. Lawrence).
To receive services in the Binghamton Southern Tier Region, please contact the Southern Tier Independence Center at 607-724-2111.
To receive services in the Syracuse/Utica North Region, please contact ARISE Child and Family Services at 315-671-2980.

Additional Information