I/DD Waivers in New York

All states: Medicaid disability services map

New York I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in New York?

The New York State Office for People With Developmental Disabilities (OPWDD) runs I/DD home and community services. It operates the state's I/DD waiver under the New York State Department of Health, which is the state Medicaid agency. Care management, the person's main point of contact for planning services, comes from seven regional Care Coordination Organizations.

• OPWDD: decides who is eligible through its regional offices, runs the Front Door, certifies residential and day programs, sets most rates and oversees providers. In 2024 OPWDD reported about $9.97 billion in Medicaid fee-for-service payments for 132,998 people, according to its annual figures.
• NYS Department of Health: the single state Medicaid agency. Medicaid claims are paid through eMedNY, the state's Medicaid billing system, and the Department of Health runs the electronic visit verification (EVV) program.
• Front door: a person or family contacts the regional OPWDD Front Door office. A Care Coordination Organization or Service Access Agency can help. Front Door contact is required before a waiver application is accepted.
• Care management: seven regional Care Coordination Organizations (CCOs): Advance Care Alliance, Care Design New York, LifePlan CCO NY, Person Centered Services, Prime Care Coordination, Southern Tier Connect and Tri-County Care. Each offers Health Home Care Management or Basic HCBS Plan Support.

What Medicaid waivers and programs serve people with I/DD in New York?

New York has one I/DD waiver, the OPWDD Comprehensive Home and Community-Based Services (HCBS) Waiver. It is a 1915(c) waiver, a federal Medicaid option that lets a state pay for home and community services instead of institutional care. It serves people of any age, and its current five-year term runs from October 1, 2024 to September 30, 2029.

• OPWDD Comprehensive HCBS Waiver (1915(c), control number NY.0238): serves people with an intellectual or developmental disability that began before age 22, found eligible by OPWDD, who meet the level of care for an intermediate care facility (ICF/IID), live in New York in an appropriate living arrangement and are not in another HCBS waiver or a managed long term care plan. OPWDD announced CMS approval of the renewal on October 3, 2024, covering nearly 100,000 people, and its renewal notice projected 114,000 by September 30, 2029.
• Main services: Residential Habilitation (Supervised and Supportive IRAs and Family Care), Community Habilitation, Day Habilitation, Pathway to Employment, Prevocational Services, Supported Employment (SEMP), Respite, Assistive Technology (including Home-Enabling Supports), Intensive Behavioral Services, environmental and vehicle modifications, Community Transition Services, Live-in Caregiver, Family Education and Training, and self-direction services (Fiscal Intermediary, Support Brokerage and Individual Directed Goods and Services).
• Amendment 01: OPWDD's waiver page lists 2025 Waiver Amendment 01 as the current waiver, effective April 1, 2025. CMS approved it together with a 1915(b)(4) waiver, a separate federal approval that lets OPWDD contract with selected agencies for Home-Enabling Supports.
• Home-Enabling Supports: part of the waiver's Assistive Technology service for people living in their own or family home. It covers assistive devices and technology, remote supports and Health Assessment and Coordination Services, and is delivered only by approved not-for-profit agencies listed by region. It is not a separate waiver.

A related program, the Department of Health's Children's Waiver, serves children under 21 with several kinds of needs, including some children with I/DD who are medically fragile or in foster care. A person can be in only one waiver at a time. New York also has Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), the institutional option certified by OPWDD; in 2024, 3,458 people lived in community-model ICF homes and 185 in the institutional model.

Does New York pay for I/DD services through managed care?

No. OPWDD waiver services are paid fee-for-service by New York Medicaid through eMedNY. OPWDD commissioned a managed care assessment, and the consultant Guidehouse delivered a final report in August 2024, but OPWDD has not decided whether to use managed care and has not published a timeline.

• Who pays claims: providers bill New York Medicaid fee-for-service through eMedNY.
• Who coordinates services: the person's Care Coordination Organization, not a health plan. CCOs are Health Homes, a Medicaid care management model, or offer Basic HCBS Plan Support.
• Managed care study: OPWDD's managed care assessment page says no decision has been made and that more engagement with stakeholders would come before any change.

Is there a waiting list for I/DD services in New York?

New York limits certified residential openings and does not publish a count of people waiting. We did not find a waiting list for enrollment in the waiver itself. People seeking a certified home are placed in a need category by OPWDD, and openings are matched by that category.

• Need categories: OPWDD's Residential Support team assigns people who are ready to seek a residential opportunity to an Emergency Need, Substantial Need or Current Need category. The Certified Residential Opportunities protocol matches people to certified homes, and providers are asked to consider Emergency Need cases first, according to OPWDD's housing page for providers.
• Scale: a November 3, 2025 Assembly hearing notice said nearly 35,000 of the 130,000 people OPWDD serves live in a Certified Residential Opportunity and that placement can take weeks, months or years.
• Recent moves: the Commissioner's February 4, 2026 budget testimony reported nearly 900 people moved into certified residential opportunities and a Housing Capacity Management platform under development.

For a person's status, families can ask their care manager or their OPWDD regional office.

How do people apply for I/DD services in New York, and how are budgets set?

A person starts by contacting the regional OPWDD Front Door office. OPWDD regional staff decide whether the person has a qualifying developmental disability, and a care manager from a Care Coordination Organization then helps with planning and waiver enrollment. An assessment, the Coordinated Assessment System (CAS) for adults or CANS for children, informs the plan and the range of services.

• Eligibility: OPWDD regional offices decide in up to three steps (a staff completeness review, a clinician committee and an independent Eligibility Review Committee). They use a psychological report with IQ testing, a standardized adaptive behavior assessment, medical and social reports, and proof the disability began before age 22. See OPWDD's eligibility page.
• Waiver enrollment: also requires Medicaid and ICF/IID level of care.
• Coordinated Assessment System (CAS): an assessment adapted from interRAI, an international set of assessment tools. It is required for everyone 18 and older receiving or applying for OPWDD services, at the start, every two years and on a significant change. Some assessments are done by Maximus, a state contractor. See OPWDD's CAS page.
• Children: people 17 and younger are assessed with the Child and Adolescent Needs and Strengths (CANS). OPWDD's assessments page also lists the DDP-2.
• How services are sized: CAS results feed OPWDD Service Ranges, which care managers use in planning and OPWDD uses in authorizing services. We did not find a published dollar budget or cap tied to each range. Ask the care manager or the OPWDD regional office.

What day and residential services can I/DD providers offer in New York?

Under the Comprehensive Waiver, providers can offer Day Habilitation, Community Habilitation, prevocational and employment services, and three kinds of certified residential homes: Supervised IRAs, Supportive IRAs and Family Care. OPWDD certifies the residential homes and site-based day programs. The research did not find a published staff ratio or billing unit for New York day services.

Day and employment services

• Day Habilitation (site-based and Day Hab Without Walls): builds self-help, socialization, communication, travel, adult education and self-advocacy skills, often through volunteer work. It is usually delivered at an OPWDD-certified site, or in the community as Day Hab Without Walls. Group and Supplemental Group Day Habilitation are paid a provider-wide rate set from cost reports. See OPWDD's day services page.
• Community Habilitation: skill building and hands-on help with daily living, community inclusion, travel training and social and leisure skills, at home or in the community, for people who do not live in an OPWDD certified or operated home. In-home Community Habilitation is subject to EVV.
• Employment services: Pathway to Employment is a year-long, usually part-time career exploration service. Community-based prevocational services build work skills. The Employment Training Program (ETP) arranges a paid internship with wages paid through ETP. Supported Employment (SEMP) gives ongoing supports to keep a competitive job or self-employment. All require OPWDD eligibility, a care manager and waiver enrollment. See OPWDD's employment page.

Residential services

• Supervised Individualized Residential Alternative (IRA): small community group homes with 24/7 support for daily living, meals, medication management and community life, typically 3 to 8 people and up to 14. Certified by OPWDD and paid a provider-wide rate set from cost reports.
• Supportive IRA: certified homes for people who need less than 24-hour supervision, with staffing set by need and periodic help with budgeting, appointments and independent living skills. Certified by OPWDD.
• Family Care: the person lives with a certified family provider who gives support, guidance and companionship. Sponsoring agencies certify the homes for OPWDD, adults in the home have background checks and each home is safety inspected. Providers are paid for room and board, residential habilitation, mileage and other costs. See OPWDD's Family Care page.
• Supports in non-certified settings: people in their own or family homes can use Community Habilitation, environmental modifications, live-in caregivers and paid neighbors. Integrated Supportive Housing pairs affordable housing with services from OPWDD providers.

OPWDD describes its certified home types on its Certified Residential Opportunities page.

How are I/DD provider rates set and how do agencies enroll in New York?

New York sets I/DD rates. Supervised IRAs, Supportive IRAs and Group and Supplemental Group Day Habilitation have one provider-wide rate per provider, computed from a 12-month base year cost report. Other services such as Community Habilitation use fee structures. Rates are raised each year through legislated increases.

• Rate method: the rate regulation builds provider-wide rates from a full 12-month base year Consolidated Fiscal Report (CFR), the annual cost report, with operating, facility and capital parts. The method applies from July 1, 2019.
• Latest increase: OPWDD's June 9, 2026 letter on the FY 2027 enacted budget lists a 2.7 percent targeted inflationary increase for voluntary-operated providers (up from 1.7 percent proposed), a 5 percent Family Care rate increase and $30 million in FY 2027 ($60 million a year when fully in place) for new service opportunities. The letter does not give an effective date.
• Earlier increases: OPWDD's increase page lists 2.6 percent (2025-26), 2.84 percent (2024-25), 4 percent (2023-24) and 5.4 percent (2022-23). Providers must certify how the funds are used and keep records for ten years.
• Becoming a provider: OPWDD's Service Providers page is the starting point. We did not find an OPWDD page that explains step by step how a new agency is approved to provide waiver services. Ask the OPWDD regional office for the area you want to serve.
• EVV: EVV applies to OPWDD in-home Community Habilitation and in-home respite codes, including the codes billed through a Fiscal Intermediary. Community Habilitation delivered entirely in the community, SEMP and ETP are exempt, according to the Department of Health's EVV billing code list. New York uses an open model: providers choose any compliant EVV system and send data to the eMedNY aggregator. The Department of Health's EVV FAQ (September 15, 2026) says claims without a matching EVV record are not automatically denied or held.

What is changing next for I/DD services in New York?

As of October 23, 2026, we did not find a confirmed upcoming change with a set date for New York's I/DD services. The current waiver term runs to September 30, 2029. Two items are worth watching, and neither has a date.

• Managed care: OPWDD has studied moving waiver services into managed care but says no decision has been made and that it would engage stakeholders before any change.
• Home-Enabling Supports: the Commissioner's February 4, 2026 budget testimony said Home-Enabling Supports was about to launch statewide. We did not find a launch date.

Recent changes already in place include the 2025 Waiver Amendment 01 (effective April 1, 2025) and the FY 2027 budget's 2.7 percent targeted inflationary increase and 5 percent Family Care increase. For news on waiver amendments, check OPWDD's HCBS Waiver page.

New York I/DD sources

• OPWDD: Get Started (Front Door)
• OPWDD: Home and Community-Based Services Waiver
• OPWDD: CMS approval of the Comprehensive HCBS Waiver renewal (October 3, 2024)
• OPWDD: Managed care assessment
• OPWDD: Housing and residential support for providers
• OPWDD: Coordinated Assessment System (CAS)
• OPWDD: FY 2027 enacted budget letter (June 9, 2026)
• NYS Department of Health regulation on OPWDD provider-wide rates
• NYS Department of Health: EVV applicable billing codes
• NYS Department of Health: EVV FAQs

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• What is Active Support in Disability Services?
• I/DD services in every state (map)
• New York EVV requirements

Page history

• October 23, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.