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Nursing Home Transition and Diversion (NHTD) Medicaid Waiver Program.  A Department of Health/Regional Resource Development Center Initiative.

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 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.

As a Waiver Service Provider agency, we provide Waiver Services under the Nursing Home Transition and Diversion (NHTD) Waiver Program. SYSTEMS AND ABILITIES, INC. works to help people currently living in nursing homes transition back into the community of their choice (Transition), and also work with individuals currently living in the community, who are at risk for nursing home placement to divert them from ending up in nursing homes (Diversion).
This is achieved through working with Local and State agencies to put in place services and supports that makes it possible for their continued residence in the community. In the event that such services or supports are not available through Local and State agencies, we will apply for funding for such services and/or supports through the NHTD Waiver, such as 24 hours care for oversight and supervision, Housing opportunities in the locality of their choice and Environmental Modification Services to help make community residences accessible to our Program participants. Our program participants are assigned trained Service Coordinators, who continually work with our program participants to assess their needs and source the necessary supports and services that ensures that their health and welbeing are maintained while living in the community.


The Office for People With Developmental Disability (OPWDD) Home and Community Based Services (HCBS) Medicaid Waiver Program.
SYSTEMS AND ABILITIES, INC. will seek, develop, implement or provide services for people with Developmental Disabilities under the patronage and guidance of the Office for People With Developmental Disabilities [OPWDD]. Systems and Abilities, Inc. exists for the main purpose of providing services that are Person’s Centered and individualized to the individuals being served. With the main emphasis on utilizing already acquired skills and abilities, or help develop skills and abilities to increase level of independence in all areas of lifestyle enhancements, and thus help integrate individuals into a normalized community environment.

 Putting People First

“Putting People First” is OPWDD’s simple, guiding principle. And simply put, it means giving people with developmental disabilities as much individual choice and control over their own lives as possible, as well as the chance to achieve four basic outcomes:

  • Live in a home of their choosing within their community;

  • Work and/or engage in activities that allow them to contribute to their communities;

  • Have meaningful relationships with those important to them; and

  • Have good health. 






- Service Coordination (SC).
Service Coordination is an individually designed intervention which provides primary assistance to the waiver applicant/participant in gaining access to needed waiver and Medicaid State Plan services, as well as other local, state and federally funded educational, vocational, social, medical and any other services. These interventions are expected to result in assuring the waiver participant’s health and welfare and increasing independence, integration and productivity. The Service Coordinator (SC) will assist the applicants/participants in obtaining and coordinating the services that are necessary to return to or remain in the community.

- Moving Assistance.
Moving Assistance Services are individually designed services intended to transport a waiver participant’s possessions and furnishings. This service can be used when the waiver participant must be moved from an inadequate or unsafe housing situation to a viable environment which more adequately meets the waiver participant’s health and welfare needs and alleviates the risk of unwanted nursing home placement.

- Community Transition Services.
CTS provide funding for the reasonable costs of one-time set-up expenses for individuals transitioning from a nursing home to their own home or apartment in the community. Reasonable costs are defined as necessary expenses for an individual to establish his/her living space.

- Environmental Modification
Environmental Modifications (E-mods) are internal and external physical adaptations to the home, which are necessary to ensure the health, welfare and safety of the waiver participant. These modifications enable the waiver participant to function with greater independence and prevent institutionalization.

- Assistive Technology. 
The purpose of this service is to supplements the Medicaid State Plan Service for Durable Medical Equipment and supplies, which provides a broad range of special medical equipment and supplies.




WILC (LOGO) Westchester Independent Living Center, Inc.



- Community Habilitation Services
Habilitation Services are those supports and services that assist people to live successfully in their home, work at their jobs and participate in the community. Habilitation Plans describe what staff (the word "staff" in this memo includes family care providers) will do to help the person reach his or her valued outcome(s) that have been identified in the Individualized Service Plan (ISP). The ISP provides the authorization for delivering a particular Habilitation Service such as Community Habilitation Services involve staff teaching a skill and/or helping the person, i.e., providing a support, and new experiences

- Hourly Respite Care.

Respite services provide temporary relief from the demands of care giving, which helps reduce overall family stress. This often enables families to better meet the needs of their loved one with a developmental disability. Respite can be provided in the home or out of the home, during the day, evenings or overnight. Respite is an “indirect” service that provides relief to individuals who are responsible for the primary care and support of an individual with a developmental disability. When a family member, Family Care provider, or live-in/house-parent staff person has to deal with such things as illness, emergency, and care giver or staff vacation, respite services can ensure that the individual’s needs are met.

- Medicaid Service Coordination.
Service coordination assists persons with developmental disabilities and their families in gaining access to services and supports appropriate to their needs. OPWDD delivers almost all service coordination through its Medicaid Service Coordination program. MSC is provided by qualified service coordinators and uses a person-centered planning process in developing, implementing, and maintaining an Individualized Service Plan.









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