Date of Award




Document Type


Degree Name

Doctor of Public Health (DrPH)


School of Public Health

Content Description

1 online resource (pages xii, 80) : illustrations, 1 color map.

Dissertation/Thesis Chair

Wendy Weller

Committee Members

Barry Sherman


Home and Community Based Services, Long Term Care, Medicaid, Medicaid Waiver Program, Nursing Homes, Public Health Policy, Nursing homes, Federal aid to nursing homes

Subject Categories

Medicine and Health Sciences | Public Health | Public Policy


The New York State Nursing Home Transition and Diversion Medicaid waiver program (NHTD) assists individuals with long-term care needs with the goal of living safely in their communities. This program is founded on two assumptions: it is less expensive to provide long-term care services to Medicaid recipients in the community as opposed to a nursing home and those who are willing and capable of living in a community setting should do so. However, the healthcare environment in the United States is facing the rising cost of long-term care. The first assumption, if true, could be used as a means to control and contain these costs. This study set out to review cost data associated with the NHTD program and to test the hypothesis that this program costs less by providing long-term care services in community settings versus nursing homes.