Home Care for Adults With Disabilities in NYC: Programs, Waivers, and Support

When people hear “home care,” they usually picture an elderly parent. But a large share of the people who benefit most are younger adults living with disabilities — from spinal cord and mobility conditions to brain injuries and developmental disabilities. New York has built specific programs to help these adults live at home and in their communities rather than in institutions, and knowing which one fits is the key to unlocking support.

Types of Home Care Programs for Adults With Disabilities

The best-fit program depends on the nature of the disability:

Matching the Program to the Person

These programs aren’t interchangeable — each is designed around a different kind of need. An adult with a physical disability who needs help bathing, dressing, and moving safely is usually best served by Medicaid personal care or the NHTD waiver. Someone rebuilding independence after a brain injury benefits from the supervision, cueing, and skills training the TBI waiver provides. And a person with a developmental disability that began early in life accesses a whole system of support through OPWDD. Part of getting started is simply identifying which door to walk through — something an experienced team can help with quickly.

What Support Actually Looks Like

Home care for adults with disabilities goes beyond basic personal care. Depending on the program, it can include help with daily activities, safe transfers and mobility, medication supervision, independent-living skills training, community integration, and respite for family members who provide much of the care themselves. The goal is consistent: maximum independence, with support filling the gaps.

How to Get Started

Frequently Asked Questions

Can adults under 65 get home care in NYC?

Yes. Home care is available to adults of any age who have a qualifying need. Younger adults with disabilities often access it through Medicaid personal care or a specialized waiver like NHTD, TBI, or OPWDD.

What’s the difference between the NHTD and TBI waivers?

The NHTD waiver serves adults with physical disabilities who could otherwise need a nursing home, while the TBI waiver is designed specifically for people with traumatic brain injuries, adding supervision, cueing, and skills training suited to cognitive and behavioral needs.

How do adults with developmental disabilities get home care?

Through OPWDD, New York’s system for people with developmental disabilities such as autism, intellectual disability, and cerebral palsy. It funds in-home support, community habilitation, day programs, and respite.