New York

Check the referral pause first

The New York Department of Health's NHTD page says the waiver has reached its approved participant maximum. New referrals will be closed by letter and will not move forward to intake. Regional Resource Development Centers (RRDCs) receive updates about available spaces.

That notice matters before you plan a project around this program. Contact your RRDC for the current position. If you already participate, ask your service coordinator how to request a change to your service plan. The new-referral notice does not say that current participants lose their services.

What the modification service lists

Nursing Home Transition and Diversion (NHTD) is a Medicaid waiver. Its environmental-modification service covers approved adaptations through the participant's service plan. The NHTD manual's environmental-modification section names the items below.

What the NHTD team clarified about door-entry tubs

In a written response dated September 28, 2026, the NHTD team said a plain door-entry soaking tub can be considered case by case when medically necessary for the waiver participant. The response calls for a letter of medical necessity signed and dated by an MD, DO or NP. Modifications cannot primarily benefit other household members.

The team said whirlpool jets, heaters and other features need a medical-necessity justification for each component. The initial modification evaluation must confirm the need and that the home can accommodate the work. The homeowner must provide written consent.

This response addresses conditional consideration. It does not approve your proposed tub, installation or reimbursement. Ask your service coordinator or RRDC to confirm the exact fixture, features and work in writing before signing or paying. The team also clarified that the enrollment cap does not affect people already enrolled.

The public manual separately lists hot tubs and whirlpools among exclusions. In its October 14 follow-up, the team pointed to the manual’s allowable adaptations, participant-benefit exclusion and home-evaluation process. These general requirements support the review process; they do not state the specific door-entry tub interpretation or its effective date.

Who the program serves

The state program page lists community-based Medicaid eligibility and nursing-home level of care among its criteria. Applicants must be age 65 or older, or age 18 to 64 with a verified physical disability. They must be able to live safely in the community with the available services and supports.

These criteria do not override the referral pause or establish your eligibility. The RRDC and program review the individual application and services.

Spending limits and required assessments

The manual sets a combined limit for home and vehicle modifications over a stated period. It also sets thresholds for prior state approval and a Home Evaluation. The table keeps those amounts with the source wording.

Keep the time period, combined services and approval conditions with those figures. They are program limits, not a guaranteed payment or the amount remaining for your project. The service plan must include the modifications, and the Department of Health must approve the agencies providing them.

Include the evaluation and project-management paperwork

The manual’s allowable E-mods section includes wiring and plumbing integral to an approved adaptation, along with necessary assessments and project management. Attach an itemized explanation of the project-management fee to the signed Environmental Modification Description and Initial Cost Projection form, DOH-5753.

Under Step 4, the E-mod provider arranges a comprehensive property evaluation before work starts. A rehabilitative evaluation agency, Home Evaluation Specialist or independent building contractor versed in ADA compliance standards may perform it. The report covers the work and specifications, possible assessment and project-management costs, need, safety, participant benefit, the most cost-effective approach and whether the home can accommodate the modification. The process also requires mid-project and post-work evaluations.

The manual also specifies a three-phase Home Evaluation for modifications estimated at $5,000 or more. Your service coordinator can confirm which evaluations, current forms and supporting documents apply to the proposed work.

Questions for your service coordinator or RRDC

• Does the referral pause affect the route I am asking about?
• If I already participate, how do I request the proposed modification in my service plan?
• Who can provide the signed and dated medical-necessity letter for each proposed tub component?
• Which assessment, Home Evaluation, written homeowner consent and state approvals apply?
• Does the signed initial cost projection include the itemized project-management fee?
• How much of the combined modification limit has already been used?
• Which providers and work can the program authorize before I sign or pay?

Keep a written description of the equipment, installation and building work. Our stair-lift quote guide, walk-in tub quote guide and tub-to-shower scope guide help organize that scope. Their regional seller examples do not establish New York prices or an NHTD award.

Scope and source date

This guide covers NHTD, and leaves other New York Medicaid programs and local grants outside its scope. Readers in Texas have a separate state program: the Texas STAR+PLUS home modification guide covers that state's entry, service categories and unanswered walk-in tub question. We checked the public manual and forms references on October 14, 2026, alongside the NHTD team’s September 28 response and October 14 follow-up. The referral notice was last checked here on October 12, 2026. The correspondence is separate from the public manual and does not replace its approval process. Intake can change. Check the program's current notice and ask your RRDC before including funding in your project budget.