LeadingAge NY Advocates for Renewed Stakeholder Engagement and Input on NHTD Waiver Enrollment Cap

(Aug. 4, 2026) LeadingAge NY continues to engage with the Department of Health (DOH) and Executive staff on management of the Nursing Home Transition and Diversion (NHTD) waiver program regarding impacts of the recent placement of an enrollment cap on waiver participants and providers.

The Centers for Medicare and Medicaid Services (CMS) recently authorized a participant enrollment cap for NY's NHTD waiver program to bring it back to a budget-neutral position. Stakeholders had been engaging with DOH and Executive staff to exchange concerns and suggestions to help make the program more efficient and financially stable.

LeadingAge NY recently shared concerns with the Department and Executive regarding the cap's impact on workforce and provider stability, especially in rural and workforce-challenged regions. We advocated for a regional aggregate budgeting process and requested utilization and enrollment data from the Department to better understand how the waiver program serves different regions of the state. Our letter is available here.

LeadingAge NY also joined the Alliance of Traumatic Brain Injury (TBI) and NHTD Waiver Providers and several other organizations calling for renewed stakeholder engagement in the waiver to provide more options for bringing the program to a budget-neutral state. That letter is here.

The NYS Legislature recently passed a bill in both houses which would set forth a regional waitlist process for the waiver. LeadingAge NY supports this measure, but hopes that the State can also create financial efficiencies and oversight measures so the cap can eventually be lifted. The legislation is available here.

Members should reach out to us to share impacts the cap is having on both participants and providers. This information is helpful as we continue to advocate for the program.

Contact: Meg Everett, meverett@leadingageny.org