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Department of Health and Human Services
Administration on Aging


Nursing Home Diversion Initiative

The Administration on Aging’s (AoA) Nursing Home Diversion (NHD) grant initiative is a competitive grants opportunity designed to assist individuals who are at risk of nursing home placement and spend down to Medicaid to enable them to live in the community. The NHD grants are administered through State Units on Aging (SUAs), in partnership with Area Agencies on Aging (AAAs) and in collaboration with community service providers and other key long-term care stakeholders.

This initiative encourages the Aging Services Network to modernize and transform the funding they receive under the Older Americans Act, or other non-Medicaid sources, into flexible, consumer-directed service dollars. This grant opportunity is designed to complement the Centers for Medicare & Medicaid Services (CMS) “Money Follows the Person Initiative” by strengthening the capacity of states to reach older adults before they enter a nursing home and spend down to Medicaid. It also supports states’ long-term care rebalancing efforts.

AoA Vision for NHD Initiative

AoA’s long-range vision is to have a long-term care service system which is person-centered, consumer-directed and helps people at risk of institutionalization continue to live at home for as long as possible. The system can be built through the use of consistent NHD standards.

The standards include service elements and system elements. The service elements are designed to ensure that the program reaches its intended target population, and that the needs and preferences of consumers and their family caregivers are fully considered in the design and implementation of the program. The systems elements are designed to ensure the effective and efficient administration of a nursing home diversion program.

NHD Grantees

AoA launched the NHD initiative in the fall of 2007. In its initial year, AoA issued awards to 12 states for a combined federal and non-federal funded grant program of $8.8 million. In 2008, AoA issued awards to a total of 14 states at a combined federal and non-federal amount of approximately $16.2

Partnership with U.S. Department of Veterans Affairs

New to 2008, is the Department of Health and Human Services collaboration with the U.S. Department of Veterans Affairs (VA). The AoA is working closely with the Veterans Health Administration to provide an additional opportunity to SUAs and AAAs to serve veterans of all ages at risk of nursing home placement.

The VA will deliver the Veteran’s Directed Home and Community Based Service Program (VDHCBS) in 10 states and will invest approximately $3 million to serve veterans at risk of institutionalization. The VA will directly purchase services through SUAs and/or AAAs for the VDHCBS program.

FY2007 State Grantees
(click state for project summary)

FY2008 State Grantees
(VA will be awarding $3 million to the states marked with an asterisk (*)).

  • Arkansas*
  • Connecticut*
  • Florida*
  • Georgia
  • Louisiana
  • Massachusetts*
  • Michigan*
  • New Hampshire
  • New Jersey*
  • New York*
  • Ohio
  • Texas*
  • Virginia*
  • Washington*
AoA.gov
Additional Topics
* Fact Sheet
* 2008 Program Announcement
* 2008 Program Announcement Resource Page
* 2008 Program Announcement Frequently Asked Questions
* 2007 Press Release
* 2007 Program Announcement
* NHDM Senior Citizens Law Center Newsletter Article (PDF)
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  Last Updated Last Modified: 1/8/2009 7:25:15 AM  
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