NHTD Waiver in Rochester: Your Guide to Home Care in Monroe County

When a serious illness, injury, or disability makes it difficult to live independently, the instinct for most people is the same: stay home. Not in a nursing facility. Not in an institution. Home. In Monroe County and the surrounding Western New York region, the NHTD Waiver makes that possible for thousands of adults who might otherwise have no choice but nursing home placement.

The NHTD Waiver in Rochester is a Medicaid-funded program that delivers home and community-based services to adults with physical disabilities and traumatic brain injuries, giving them the supports they need to live safely and independently outside of institutional care. This guide explains how the program works in Monroe County, who qualifies, how to apply through the local DDSOO office, and what Priority Groups can do to help you navigate every step.

What Is the NHTD Waiver?

The Nursing Home Transition and Diversion (NHTD) Waiver is a New York State Medicaid Home and Community-Based Services (HCBS) program administered by the Department of Health. Its dual mission is reflected in its name:

• Transition: Helping individuals who are currently living in nursing homes or other institutional settings move back into the community with a structured, funded support plan.
• Diversion: Preventing nursing home admission in the first place by providing the services and supports needed for someone at risk of institutional placement to remain safely at home.

Unlike standard Medicaid personal care, the NHTD Waiver goes far beyond help with bathing and dressing. It funds community integration, assistive technology, environmental modifications, and independent living skills training — the full range of supports that make the difference between living in a facility and living in your own home.

Who Qualifies in Monroe County?

Eligibility for the NHTD Waiver is determined by the same statewide criteria regardless of which county you live in. To qualify, an individual must meet all of the following:

1. New York Medicaid Enrollment: The applicant must be enrolled in New York Medicaid or be able to qualify. Most applicants with significant disabilities will qualify through standard Medicaid pathways.
2. Nursing Home Level of Care: A clinical assessment must determine that the applicant's care needs are at the threshold typically met in a nursing facility. This does not mean they must be in a nursing home — only that their medical needs are at that level of complexity and intensity.
3. Age 18 or Older: The NHTD Waiver serves adults. Children and adolescents may qualify for other state programs.
4. New York Resident: The applicant must reside in New York State and wish to live in a community (non-institutional) setting.
5. Preference for Community Living: The applicant must want to live in the community and be able to do so safely with the right supports in place.

Conditions That Commonly Qualify in Rochester

The NHTD Waiver does not restrict eligibility to specific diagnoses, but common qualifying conditions in the Rochester/Monroe County area include:

• Traumatic brain injury (TBI) from accidents, falls, or assault
• Stroke-related disabilities and hemiplegia
• Spinal cord injuries and paralysis
• Multiple sclerosis (MS)
• Parkinson's disease and other neurological conditions
• Advanced musculoskeletal disorders (severe arthritis, joint disease)
• Chronic conditions requiring daily skilled or personal care
• Post-surgical rehabilitation needs requiring long-term support

Services Covered in the Rochester Region

The NHTD Waiver provides a comprehensive range of services throughout Monroe County and the broader Rochester area. All services are included in the participant's Individualized Service Plan (ISP) and are delivered by approved providers.

Personal Care and Home Support

• Home and Community Support Services (HCSS): Assistance with bathing, dressing, grooming, meal preparation, medication reminders, and household maintenance. Aides work within the home and accompany participants in the community.
• Respite Care: Temporary relief for family caregivers, available in-home or in approved community settings.
• Home-Delivered Meals: Nutritionally balanced meals for participants who are unable to safely prepare food independently.

Community Integration

• Community Integration Counseling: Professional guidance to help participants rebuild social connections, access community resources, and develop coping strategies for community living.
• Structured Day Programs: Supervised daytime programming providing social engagement, skill-building activities, and therapeutic support.
• Peer Mentoring: Connection with others who have successfully navigated disability and community reintegration — a particularly valuable resource in Rochester's active disability community.

Environmental and Assistive Technology

• Environmental Modifications (E-Mods): Physical changes to the home to improve safety and accessibility — including wheelchair ramps, grab bars, roll-in showers, widened doorways, and stair lifts. For participants transitioning from Strong Memorial or Rochester Regional hospitals, E-Mods can be initiated as part of discharge planning.
• Assistive Technology: Devices and systems that promote independence, including personal emergency response systems, adaptive communication devices, and mobility equipment.
• Moving Assistance: For individuals transitioning out of a nursing home, the waiver can cover relocation costs to establish a community residence in Monroe County.

Independent Living Skills and Care Coordination

• Independent Living Skills (ILS) Training: Hands-on coaching in daily tasks such as budgeting, grocery shopping, using Rochester's public transit (RTS), managing medications, and household management.
• Service Coordination: An assigned Service Coordinator manages your overall care plan, coordinates among all providers, and updates your ISP as your needs change.
• Positive Behavioral Interventions: Specialized behavioral support for participants whose conditions create challenges that affect their ability to live and participate in the community.

Applying Through the Rochester DDSOO

In Monroe County, NHTD Waiver applications are processed through the Western New York DDSOO, which serves the Rochester region. Here is how to get started:

Hospital Discharge Planning in Rochester

Two of Rochester's largest health systems — Strong Memorial Hospital (University of Rochester Medical Center) and Rochester Regional Health — regularly discharge patients who need ongoing home care support. The NHTD Waiver is one of the most important programs available to these patients, and both systems have discharge planners familiar with the waiver application process.

If you or a family member is being discharged from Strong Memorial, Rochester Regional, or another Monroe County facility and requires long-term home care, ask the discharge planner specifically about the NHTD Waiver. Key points to communicate:

• Request that the discharge team initiate or assist with the DDSOO referral before discharge.
• Ask for all relevant medical records, imaging reports, and physician statements to be compiled for the waiver application.
• If home modifications (E-Mods) will be needed before a safe return home, flag this early — Environmental Modifications can be initiated through the waiver application process, but they take time.
• Contact Priority Groups at (585) 201-7179 as early as possible during the hospitalization so we can begin coordinating your care before discharge.

Why Choose Priority Groups in Rochester

Priority Groups has been serving individuals with disabilities in the Rochester area and providing home care supports that help people live with dignity, independence, and connection in their communities.

• Local Knowledge: We understand Monroe County's healthcare landscape — from Strong Memorial discharge workflows to Rochester Regional rehab programs — and we know how to navigate local systems efficiently on your behalf.
• Free Eligibility Review: Not sure if you qualify? Call us for a no-obligation assessment. We will review your situation and tell you clearly whether the NHTD Waiver is the right fit and what your next steps should be.
• Application Support: We help families compile documentation, complete referral packets, and stay on track throughout the DDSOO process. Our coordinators have guided many Rochester-area applicants from first call to service start.
• Trained Home Care Aides: Our aides deliver personal care and home support services with the professionalism and compassion that Monroe County families deserve. All aides are background-checked and trained for the specific needs of their participants.
• Ongoing Advocacy: We track your Medicaid renewals, recertification deadlines, and ISP update windows so you can focus on your life — not paperwork.

Service Area: Monroe County and Beyond

Priority Groups serves NHTD Waiver participants throughout the greater Rochester region, including:

• Monroe County — Rochester, Brighton, Greece, Irondequoit, Gates, Henrietta, Webster, Penfield, Pittsford, Victor
• Ontario County — Canandaigua, Geneva, Phelps
• Livingston County — Geneseo, Avon, Mount Morris
• Genesee County — Batavia, Le Roy, Bergen
• Wayne County — Newark, Lyons, Sodus
• Orleans County — Albion, Medina, Holley

If you are not sure whether your address falls within our service area, call us at (585) 201-7179 and we will confirm immediately.

Frequently Asked Questions

How long does the NHTD Waiver application take in Monroe County?

Most applicants in the Rochester area can expect 4 to 8 weeks from initial DDSOO contact to service start. Having complete documentation ready from the beginning significantly reduces delays. If you are transitioning from a hospital, starting the process before discharge can accelerate the timeline.

Can I stay in my Rochester-area home if I qualify for the NHTD Waiver?

Yes — that is the entire point of the program. The NHTD Waiver is specifically designed to allow individuals to remain in or return to their own homes and communities rather than entering institutional care.

Do I have to use a specific agency for home care?

No. You have the right to choose your own NHTD Waiver service providers. Priority Groups is one option available to Monroe County residents, and we encourage you to make the choice that feels right for you and your family.

Is there a waiting list for the NHTD Waiver in Rochester?

New York State does not currently maintain a formal waiting list for the NHTD Waiver, though capacity can vary. Applying as early as possible is always recommended.

Can the NHTD Waiver help me move out of a Rochester-area nursing home?

Yes. The "Transition" component of the NHTD Waiver is specifically designed for individuals living in nursing homes who want to return to the community. The waiver can fund Environmental Modifications, moving expenses, and the full range of home care services needed to make the transition safely.