Health Insurance & Medical Costs · Surprise rank #365
Stay Out of a Nursing Home With a Medicaid-Funded Package of Home Services
NHTD and TBI waivers can provide home care, respite, assistive technology, service coordination and accessibility modifications.
Who
Medicaid-eligible people meeting nursing-home level of care; TBI has additional brain-injury criteria.
Where: Statewide through Regional Resource Development Centers.
What to do
Start here: Check the current NHTD status first. While new NHTD referrals are paused, ask the Regional Resource Development Center or NY Connects about the TBI waiver, Open Doors, or other community-based alternatives.
Eligibility: Medicaid, level-of-care and waiver-specific age/diagnosis/residence criteria; an approved service plan is required.
What you get
Eligible people who would otherwise need institutional care may receive coordinated home- and community-based services to live outside a nursing home.
Benefit: Service coordination, independent-living skills, home supports, respite, assistive technology and approved environmental modifications.
Possible value: Potentially tens of thousands of dollars annually, depending on the service plan.
Good to know
Important: NHTD is not accepting new referrals after reaching its approved participant cap. TBI eligibility and provider capacity are separate and must be screened.
Availability: NHTD is closed to new referrals as of August 2, 2026; TBI and other alternatives vary by eligibility and local capacity.
Why people miss it: Waivers are complex and rarely presented as an alternative before institutional placement.
Sources reviewed: Aug 2, 2026