New York Medicaid Home and Community-Based Waivers

Home and Community-Based 1915(c) Waivers for Respite Support and 1115 Managed Long-Term Services and Supports

Medicaid is a program in every state that pays for medical assistance for certain individuals and families with low incomes and resources. It is the largest source of funding for medical and health-related services for America’s poorest people. Because Medicaid is funded jointly by the federal and state governments, the services paid for vary from state to state. In addition to medical services, Medicaid will pay for home and community-based services (HCBS) through the state plan as well as through Medicaid waivers that offer services as a lower-cost alternative to treatment in a medical or long-term care facility, such as a nursing home. Respite is usually paid for through one or more of the following types of waivers: research and demonstration (1115), managed care (1915b) and HCBS (1915c) waiver programs. Many states are transforming their Medicaid programs and moving traditional HCBS waiver services to some form of Managed Long-term Services and supports.  

 Many of New York’s Home and Community-Based Services (HCBS) 1915(c) waivers have been, or are being, incorporated into the 1115 Demonstration: “Medicaid Redesign Team” and will be operated as Managed Long-term Services and Supports (MLTSS). The transition to MLTSS is occurring in phases with specific populations transitioning through 2020. Thus far only NY Long-term Home Health Care Program, NY Nursing Home Transition and Diversion, and Traumatic Brain Injury waivers are part of the demonstration, however the others will move over in the future. All of the waiver services offered by the HCBS 1915(c) waivers including respite care are to continue to be provided in the MLTSS delivery system.