Skip to main content

NYS DOH Deepens Focus Group Meetings on Future of NHTD

The Situation Report | July 21, 2025

Last Friday, July 18, the State Department of Health (DOH) convened its second focus group meeting on the Nursing Home Transition and Diversion (NHTD) program, with participation by HCANYS and other stakeholders. The discussions built on the initial stakeholder meeting several weeks ago, further probing the issues and imperatives at stake in shaping NHTD’s future.

The 2025-26 state budget included an Executive proposal to cap NHTD. In the aftermath, DOH and the Governor’s office are holding these meetings to invite ideas on how to best meet the budget’s goals for NHTD, while simultaneously optimizing NHTD’s role and services as part of the state’s long term care continuum.

At Friday’s meeting, the Executive shared the latest NHTD enrollment and expenditure data, including the percent enrolled per geographic region of the state, as well as the varying trends related to NHTD cost per patient depending on whether referrals emanate from the community or from patients initially enrolled in Medicaid managed care plans.

The Executive views NHTD as at or nearing capacity, and posited at least one approach that would make “slots” available for new enrollees regionally proportional with the slots that open up from patient discharge. The Executive stated that, currently, about 480 people per year leave the waiver. Current enrollment by region shared by DOH is as follows:

  • 58% NYC
  • 14% Long Island
  • 12% Hudson Valley
  • 16% Upstate/Rest of State

Data for the Upstate region was further delineated according to the Adirondack, Southern Tier, Capital, Rochester, and Syracuse areas, with enrollment in these areas ranging from 2.2% to 3.8%.

Next Steps

The Executive indicated that it will explore both short- and long-term goals with the program, and continue to engage provider stakeholders in these meetings. The Executive further indicated that, in August, it will similarly meet with health plans and associations representing the plans, to also gauge their perspectives and input. HCANYS will also be present in these meetings as an association with health plan members.

HCANYS views these discussions on NHTD as critical to both the further shape, accessibility and sustainability of the NHTD, as well as carrying crucial implications for the entire long term care continuum in New York State. HCANYS will conduct in-depth work with our provider and health plan members participating in NHTD, as well as with the HCANYS Board; we will further proactively prepare and submit our ideas and recommendations for NHTD to the Executive.