The Traumatic Brain Injury (TBI) Medicaid Waiver Program

The Traumatic Brain Injury Waiver (TBI) program is a special Medicaid funded program for income eligible adults between the ages of 18-64 who have been diagnosed with a Traumatic Brain Injury, and who without waiver services would have to live in a residential long term care facility. 

The TBI program provides services to individuals with traumatic brain injuries and their families. Assistance with relocating people with a TBI who are currently residing in nursing homes, living with family members or residing in a psychiatric facility into a more appropriate community setting where they can live independently.

The New York State Department of Health determines participant eligibility based on the following criteria:

• Individuals must be Medicaid eligible 
• Individuals must be diagnosed with a Traumatic or Acquired brain injury 
• Individuals must be between the ages of 18 to 64 years old 
• Individuals must be eligible for nursing facility level of care as determined by the initial assessment 
• Individuals must choose to live in the community rather than a nursing facility 
• Individuals can identify a safe living arrangement to meet their needs 
•  Individuals can be supported safely within the community with the funds and services available under the HCBS/TBI Waiver Program

Based on an Individualized Service Plan, the following services can be provided such as Service Coordination, Home and Community Support assistance, Independent Living Skills Training, respite care, vocational support, housing support, and other services that are necessary to keep the individual living in the community.

The Nursing Home Transition and Diversion (NHTD) Medicaid Waiver Program

The NHTD Waiver Program identifies and assesses, plans, and supports the transition of nursing home residents, who are eager to and capable of returning to community living, back to integrated community living situations of their own choosing. In addition, the program assists in the diversion of individuals at risk of being placed in a skilled nursing facility.

TBI and NHTD Waiver Program Services Provided by Unlimited Care, Inc.

Service Coordination- A Service Coordinator is chosen by the Waiver participant and/or guardian to work with identifying and coordinating support and services. 

Independent Living Skills Training- provides one-to-one support to focus on increasing independence in practical skills, such as cooking, shopping, banking etc. 

Home and Community Support Services- provides oversight and supervision and assistance to enable the Waiver participant to reside safely within the home and community environments. 

Unlimited Care Inc. has been a leader in providing services for the NYS Medicaid Waiver TBI program since 1996 and the NHTD program since 2010. Unlimited Care is approved by the Department of Health to provide services in the RRDC New York City Region, Lower Hudson Valley Region, 

Long Island Region, Capital Region, Adirondack Region and Rochester Region. Our specially trained professionals and paraprofessionals offer compassionate service and peace of mind to our TBI and NHTD participants and their families by providing a comprehensive network of services and support.

NYS NHTD and TBI Waiver Program Process

• Contact your local Regional Resource Development Center (RRDC) (Add link to the RRDC addresses and contact information)
• RRDC screens and determines eligibility of the participant 
• Once approved, the RRDC provides the participant with a list of service providers 
• Participant interviews providers and notifies RRDC of provider choice 
• Provider meets with participant and initiates writing an initial service plan 
• Once the RRDS approves the Service Plan the waiver services may provided.