Nursing Home Transition and Diversion Waiver Program

The Nursing Home Transition and Diversion (NHTD) waiver uses Medicaid funding to provide supports and services to assist individuals with disabilities and seniors toward successful inclusion in the community. Waiver participants may come from a nursing facility or other institution (transition), or choose to participate in the waiver to prevent institutionalization (diversion). NHTD 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.

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 interventionsare 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 ommunity.

Independent Living Skills Training (ILST)

Independent Living Skills Training (ILST) services are individually designed to improve/maintain the ability to live as independently as possible in the community. ILST assists with recovering skills that have been decreased by onset of disability. ILST is targeted to those with progressive illnesses to maintain essential skills. Such skills include: self-care, medication management, task completion, communication skills, interpersonal skills, socialization, sensory/ motor skills, transportation skills, reduction of maladaptive behaviors, money management, problem-solving skills, vocational skills, and household maintenance.

Community Integration Counseling (CIC)

Community Integration Counseling (CIC) is an individually designed service intended to assist waiver participants who are experiencing significant problems managing the emotional responses inherent in adjusting to a significant physical or cognitive disability while living in the community. CIC is a counseling service provided to the waiver participant who is coping with altered abilities and skills, a revision of long term expectations, or changes in roles in relation to significant others. This service is primarily provided in the provider’s office or the waiver participant’s home.

Positive Behavioral Intervention and Support Services (PBIS)

Positive Behavioral Interventions and Supports (PBIS) services are individually designed and are provided to waiver participants who have significant behavioral difficulties that may jeopardize their ability to remain in the community of choice due to inappropriate responses to events in their environment. The PBIS should be provided in the situation where the significant maladaptive behavior occurs.

Structured Day Program Services

Structured Day Program (SDP) services are individually designed services, provided in an outpatient congregate setting or in the community, to improve or maintain the waiver participant’s skills and ability to live as independently as possible in the community. Services may include assessment, training and supervision to an individual with self-care, task completion, communication skills, interpersonal skills, problem- solving skills, socialization, sensory/motor skills, mobility, community transportation skills, reduction/elimination of maladaptive behaviors, money management skills, and skills to maintain a household.

Environmental Modifications (E-Mods)

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. Environmental modifications may be made to a residence owned by the participant or rented, with permission received from the landlord.

Assistive Technology

Assistive Technology (AT) service is a service that directly assists a waiver participant in the selection, acquisition, or use of an assistive technology device. This service is approved when the requested equipment and supplies improve or maintain the waiver participant’s level of independence, ability to access needed supports and services in the community or, maintain or improve the waiver participant’s safety.

Community Transitional Services

Community Transitional Services (CTS) are defined as individually designed services intended to assist a waiver participant to transition from a nursing home to living in the community. 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.

Nutritional Counseling and Educational Services

Nutritional Counseling and Educational Services are individually designed services which provide an assessment of the waiver participant’s nutritional needs and food patterns, and the planning for the provision of food and drink appropriate for the waiver participant’s conditions, or the provision of nutrition education, and counseling to meet normal and therapeutic needs.