Home-Enabling Supports NY

Eligibility

Who qualifies for HES

HES is for people enrolled in OPWDD's HCBS waiver who live in a non-certified home, or who are moving to one. This page covers the rules — and the edge cases where most questions come up.

The eligibility test

Three conditions:

  1. The person is enrolled in OPWDD's HCBS waiver.
  2. They live in a non-certified home. (Leaving a certified setting? HES becomes available once you're officially out — so the care manager, provider, and an HES vendor can plan the referral ahead of the move.)
  3. For Remote Supports only: they are age 15 or older. (Children under 15 can still receive Assistive Devices and HACS .)

If those conditions are met, HES is on the table.

Setting matters more than diagnosis

Most HES eligibility decisions come down to where someone lives. Certified settings — IRA s, ICFs, family care homes, developmental centers — are not HES-eligible because they have paid supervisory staff built in. Non-certified settings — your own home, a family home, a supportive apartment that is not an OPWDD-certified IRA — are.

Non-certified — HES-eligible

  • Own home or apartment

    The default HES case — a home that is owned, rented, or co-leased with natural supports.

  • Lives with family in a non-certified home

    Family carries much of the daily support; HES can extend independence within the family home.

  • Supportive apartment or supportive housing (non-certified)

    Eligible as long as the apartment is not an OPWDD-certified IRA. If unsure, ask the Care Manager.

Certified — only with a transition plan

  • Supervised IRA (Individualized Residential Alternative)

    A 24-hour-staffed group home, certified by OPWDD.

  • Supportive IRA

    Certified despite the name — not the same as non-certified supportive housing. Same rule as a Supervised IRA.

  • ICF (Intermediate Care Facility)

    An OPWDD-certified Intermediate Care Facility.

  • Family Care / certified host home

    An OPWDD-certified host home.

  • Developmental Center or state-operated residence

    A state-operated, certified facility.

  • Community Residence (CR)

    An OPWDD-certified residential setting.

Two settings share the name "supportive"

A Supportive IRA is a certified residence. It follows the same transition-intent rule as a Supervised IRA. Supportive Housing (also called a Supportive Apartment) is a separate, non-certified program listed under OPWDD's Independent Living in the Community page. Same word, opposite eligibility for HES.

Ask the Care Manager to confirm which one applies before starting a referral — the eligibility outcome turns on it.

HES alone doesn't satisfy "reasonable indication of need"

A small but important rule from ADM 2023-06 and 42 CFR §441.302(c): HES alone is not sufficient to demonstrate the ongoing need that keeps someone enrolled in the HCBS waiver. The person must also receive at least one monthly waiver service — or monthly health and safety monitoring like care management — to maintain enrollment.

For most people, monthly care management contact satisfies this. If HES would be the person's only service — for example, when someone is graduating off other supports — confirm with the Care Manager that the enrollment requirement is still met.

Excluded waivers

Two HCBS waivers operated by the Department of Health are not eligible for HES:

  • Children's HCBS Waiver
  • Traumatic Brain Injury (TBI) Waiver

If the person qualifies, read how the process works next. Still deciding? Run the 2-minute referral screener.

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