Introduction to the Home and Community-Based Services (HCBS)/Traumatic Brain Injury (TBI) Medicaid Waiver

The HCBS/TBI waiver is administered centrally by the New York State Department of Health (DOH) and implemented through Regional Resource Development Centers (RRDC) and Specialists (RRDS) who serve to assure access to services in communities throughout the State.
The waiver uses Medicaid funding to provide supports and services to assist individuals with a Traumatic Brain Injury (TBI) toward successful inclusion in the community. Waiver participants may choose to move into the community from a nursing facility. Others may choose to participate in the waiver to prevent unnecessary institutionalization.
HCBS/TBI waiver services are available to supplement informal supports; the broad array of local, State and federally funded services, as well as Medicaid State Plan services to assure the health and welfare of the individual in the community.

Philosophy of the HCBS/TBI Waiver

The dignity of risk and right to fail are integral parts of the waiver’s philosophy. The philosophy of the waiver supports the participant’s right to choose where to live, who to live and socialize with, and what goals and activities to pursue.
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 plan for services.
This process leads to personal empowerment, increased independence, greater community inclusion, self-reliance and meaningful and productive activities.


The New York State Department of Health oversees the TBI 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 TBI 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