Nursing Home Transition and Diversion (NHTD) Waiver Services Approved Rates

Below is a list of the approved rates for the Nursing Home Transition and Diversion (NHTD) waiver services. The definitions of services are more fully presented in the NHTD Program Manual. For a complete understanding of the policies and procedures for payment of these rates, please consult with the NHTD Program Manual.

Service Definition Unit Rate (*, **)
1 - Service Coordination Assistance with the development and implementation of a person-centered individualized Service Plan that will lead to the waiver participant's independence, integration into the community, health and welfare.    
A - Initial
i. Initial Diversion
This one time payment is provided only for the successful completion of an Application Packet which results in the eligible individual living in the community being accepted into the waiver and diverted from going into a nursing home. 1 TIME $679.00*
$522.32**
A - Initial
ii-Initial Transition
This one time payment is provided only for the successful completion of an Application Packet which results in the eligible individual being accepted into the waiver and being transitioned from the nursing home and moving to the community This payment is made when the individual has been in the nursing home for less than 6 months. 1 TIME $1,176.00*
$904.77**
A - Initial
iii Initial - Long
Term Transition
This one time payment is provided only for the successful completion of an Application Packet which results in the eligible individual being accepted into the waiver and being transitioned from the nursing home and moving to the community This payment is made when the individual has been in the nursing home for more than 6 months. 1 TIME $1,673.00*
$1,287.22**
B - Ongoing
Intensive
This is a monthly payment for this service. MONTHLY $497.00*
$382.45**
 
2 - Assistive
Technology
Equipment that will improve the participant's independence, decrease reliance on staff, or will be a cost effective aid for community integration. This waiver service complements State Plan funded Durable Medical Equipment. PER ITEM PER ITEM
 
3 - Community
Integration
Counseling
Assistance to help the waiver participant cope with altered abilities and skills, revision of long term expectations, and/or changes in their roles in relation to significant others. HOUR $91.00*
$69.93**
 
4 - Community
Transitional
Services
Assistance in transitioning from a nursing home back to the community; including the cost of moving, essential furnishings, deposits for utilities, rental deposits or one time cleaning services prior to occupancy. PER ITEM PER ITEM
 
5 -Congregate and
Home Delivered
Meals
Meals for waiver participants who cannot prepare or obtain nutritionally adequate meals for themselves, or when the provision of such meals will decrease the need for more costly supports to provide in-home meal preparation. PER MEAL PER MEAL
 
6-Environmental
Modifications
Internal and external physical adaptations to the home necessary to enable the person to function with greater independence, or to assure health and welfare. PER E-MOD PER E-MOD
 
7 - Home &
Community
Support Services
This service provides discrete oversight and/or supervision of the waiver participant when the individual is involved with non-task related activities. If the participant is also in need of assistance or supervision with Activities of Daily Living (ADL) or Instrumental Activities of Daily Living (IADL), this service will be used to meet those needs. HOUR A Licensed Home Care Service Agency will receive their existing hourly rate paid for Personal Care Services (PCS) for this service. If a rate has not been established, the agency will receive the average PC rate for the region.
7 - Home and
Community
Support Services -
Nursing Visit
This rate is for the initial and needed follow-up assessments of the participant receiving this service. VISIT $60.00
 
8 - Home Visits by
Medical Personnel
Needed medical care provided by a physician, nurse practitioner or physician's assistant to waiver participants who are unable to leave their home. 20 Minutes $40.00
 
9 - Independent
Living Skills
Training
Training to improve or maintain the waiver participant's ability to live as independently as possible by focusing on essential community living skills such as task completion, money management, and the ability to maintain a household. HOUR $46.35*
$34.97**
 
10 - Moving
Assistance
Transport of the participant's possessions and furnishings when moving within the community. HOUR $60.00
 
11 - Nutritional
Counseling
Assessment, planning, education and counseling for the waiver participant's nutritional needs and eating habits. HOUR $93.00*
$80.00**
 
12 - Peer
Mentoring
This service is intended to improve the waiver participant's self-sufficiency, self-reliance, and ability to access needed services, goods, and opportunities in the community. This will be accomplished through education, teaching, instruction, information sharing, and self-advocacy training, provided by a "peer". HOUR $25.00
 
13 - Positive
Behavioral
Interventions
and Supports
Interventions provided to waiver participants whose significant maladaptive behaviors, if continued, would result in the individual being removed from the community. HOUR $68.00*
$52.45**
 
14 - Respiratory
Therapy
Services providing preventative, maintenance and rehabilitative airway-related techniques and procedures. HOUR $81.00*
$86.00**
 
15 - Respite Care Relief for non-paid primary caregivers of a waiver participant. 24 HOURS $334.37
 
16 - Structured Day
Program
Outpatient congregate services including a wide array of interventions and supports ranging from pre-vocational to socially-oriented activities. HOUR $22.00*
$17.05**
 
17 - Wellness
Counseling
Proactive care education for successfully managing a chronic illness. VISIT $30.00
 

Note:
* Denotes Downstate Rate (New York City and the counties of Nassau, Suffolk, Rockland, and Westchester)
**Denotes Update Rate