Waiver Program


The Medicaid Waiver Program is state-specific, and covers the cost of the program participant’s treatments in the home or other community-based settings. Prior to 1991, the federal Medicaid program would only pay for services if a person lived in an institution, but that changed when the Home and Community Based Services (HCBS) Waiver (also known as1915 (c) Waiver) became part of the Social Security Act. The HCBS Waiver provides financial coverage for services to qualifying participants who reside in a community setting, for example, a home or apartment.

Nursing Home Transition and Diversion (NHTD) Waiver Program


Sunshine’s team offers services to Medicaid clients who are seniors and/or are disabled through the Nursing Home Transition and Diversion (NHTD) Waiver Program. Under NHTD participants are coming from a nursing facility or other institution and transitioning to another living situation, or want an alternative to living in an institution. The participant is the primary decision-maker who works with Sunshine’s team to develop a service plan that will help them re-enter their community, become self-reliant and live independently with the help needed so they can lead productive lives.

Sunshine’s team offers counseling services to NHTD Waiver Program participants in New York State. For more information please call: 845-613-7838

Sunshine’s NHTD Waiver Program Services


Service Coordination (SC)

A Sunshine Home Care’s Service Coordinator assists the NHTD participant to ensure that all of the appropriate paperwork is completed and filed to gain access to the New York Medicaid plan’s services as well as any local, state and federally funded educational, vocational, social, medical and other services for which the participant may qualify.

Independent Living Skills Training (ILST)

ILST is geared for participants with progressive illnesses to help them maintain essential skills that allow them to live as independently as possible in their community. Independent Living Skills include: personal care, medication management, communication and interpersonal skills, money management, problem solving and vocational skills and household maintenance.

Community Integration Counseling (CIC)

CIC is a counseling service for waiver participants who are experiencing problems managing emotions as the result of adjusting to a physical or cognitive disability. The CIC can be provided either in the patient’s home or in the provider’s office.

Positive Behavioral Intervention and Support Services (PBIS)

PBIS is for the waiver participant who is experiencing significant behavioral difficulties that jeopardize their ability to remain in their community. The PBIS team works with the Waiver participant to identify the counter-productive behaviors, and develop a plan of “interventions” that will help to recognize the triggers and actions to take to decrease frequency and severity. The end result is learning tactics to employ to manage the counter-productive behaviors, and improve the communication with people in the community and family caregivers.

Sunshine Home Care staff assesses behaviors, develops a plan of action, and works with the participant and family to ensure the Behavioral Intervention and Support Plan focuses on exchanging inappropriate for more socially accepted behavior.

Structured Day Program Services (SDP)

SDP services are designed on a case-by-case basis. The services work with waiver plan participants to strengthen every day skills essential to lead productive lives such as personal care, task completion, communication, problem-solving, socialization, mobility, money management, running a household, and controlling maladaptive behavior.

Nutritional Counseling and Educational Services

Nutritional Counseling and Education Services are designed to guide and inform the waiver participant about their nutritional needs based on individual’s particular health and physical conditions.

Community Transitional Services (CTS)

CTS is a one-time service offered to waiver participants who are moving from an institutional setting to a home or an apartment. CTS will cover reasonable costs for moving-in and set-up in the participant’s new place of residence.