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Not sure the TBI waiver is the right program? Call us. We can help you compare it with Medicaid MLTC and explain the next step. Online, share only basic contact details; a coordinator will call you back.
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TBI Medicaid waiver, Nassau and Suffolk
TBI waiver home care on Long Island
New York's Traumatic Brain Injury (TBI) Medicaid waiver pays for supports that help adults with a brain injury live at home instead of in a nursing facility. You apply through SILO in Medford. Bryan Skilled Home Care Inc., a licensed home care agency in Amityville, can then provide authorized home care in Nassau and Suffolk.
Call (631) 608-8523 Mon to Fri, 9 to 5
- Licensed Home Care Services Agency (LHCSA)
- Serving Long Island since 2011
- 24-hour on-call for clients
Start here
For discharge planners and Service Coordinators
Refer the patient to SILO for the waiver application. When the service plan names home care, send the referral to us, or fax documents to (631) 608-8527.
What the TBI waiver is
The TBI waiver is a home and community-based Medicaid program run by DOH through regional centers. A waiver lets Medicaid pay for services it does not usually cover, as long as they help a person live in the community. It can serve people coming home from a nursing facility or hospital setting (transition), and people at home who are at risk of needing one (diversion).
The participant is the main decision maker: they pick where they live, which services they use, and which agencies provide them. Participants may also qualify for help with housing costs. Official details are on DOH's TBI waiver page and in its TBI waiver brochure.
Things that can get in the way: being enrolled in a Managed Long Term Care (MLTC) plan, PACE, a Health Home, or a HARP (you would need to disenroll first), or living in an Assisted Living Program or other licensed group setting. If the person is 65 or older, or the main need is not a brain injury, read Medicaid home care on Long Island, or, for seniors and adults with physical disabilities, our NHTD waiver guide.
How to apply on Long Island
- Get Medicaid in placeCommunity Medicaid with long-term care coverage comes first. If an application is pending, start now; it is often the slowest step.
- Contact SILOThe person, a family member, a discharge planner, or a social worker can make the referral.
- Meet with SILOA SILO specialist explains the waiver, your rights, and your choices.
- Choose a Service CoordinatorPick one from SILO's list of approved agencies. They gather records and forms to show eligibility.
- Build the service planThe plan names each service, how often, and the provider. This is where you can name Bryan Skilled Home Care.
- Approval and startSILO issues a written decision and services begin on the authorized date. DOH says SILO reviews each plan every six months. You can ask for a Fair Hearing if you disagree.
Contact SILO to apply
Suffolk Independent Living Organization (SILO)
Regional Resource Development Center for Nassau and Suffolk
TBI applications: (631) 320-1662
3253 Route 112, Building 10, Medford, NY 11763
RRDC fax: (631) 320-1664
Main line: (631) 880-7929 · info@siloinc.org
SILO hours: Mon–Thu 8 am–4 pm, Fri 8 am–1 pm
SILO's NHTD/TBI waiver page · SILO contact page
SILO is a separate organization. Bryan Skilled Home Care does not take TBI waiver applications.
What Bryan Skilled Home Care provides under the TBI waiver
We are a Licensed Home Care Services Agency (LHCSA). When the service plan authorizes it, we provide:
Home and community support
Aide hours for supervision and hands-on help with bathing, dressing, grooming, meals, light housekeeping, and moving safely at home.
Supervision and cueing
After a brain injury, memory, planning, and judgment can change. Aides keep a steady routine, give reminders, and watch for safety risks.
Nursing oversight
A registered nurse helps shape the plan of care and oversees the aide's work. Our nurses make skilled visits when authorized.
Medication reminders
Aides give timely reminders, with nurse oversight, when medication management is part of the plan.
Teamwork with the Service Coordinator
Aides report changes to our nurse, and we keep the Service Coordinator informed so the plan can be updated.
Where we serve
Nassau and towns across Suffolk; the East End based on availability. Not Queens. See home care in Nassau County and home care in Suffolk County.
We staff what the waiver authorizes. We do not set hours or decide eligibility. Other TBI waiver services, such as ILST, CIC, PBIS, day programs, respite, and environmental modifications, come from other approved providers your Service Coordinator lines up.
TBI waiver questions
Is the TBI waiver the same as NHTD?
No. Both are New York Medicaid waivers, and on Long Island both are handled by SILO, the Regional Resource Development Center for Nassau and Suffolk. The TBI waiver is for adults 18 to 64 whose main need comes from a traumatic brain injury or a related condition. NHTD serves seniors and adults with physical disabilities; see our NHTD waiver page.
Who decides how many home care hours a TBI waiver participant gets?
The service plan, built with the Service Coordinator and authorized by SILO. We staff the authorized hours. For extra hours beyond the plan, private pay is an option. Call (631) 608-8523 for rates.
Who decides TBI waiver eligibility?
SILO does, following New York State Department of Health rules. A home care agency does not decide eligibility or set hours. DOH lists related conditions with deficits similar to a traumatic brain injury, such as stroke or anoxia, as possibly qualifying; progressive degenerative diseases do not.
What if the person is in an MLTC plan?
A person enrolled in a Managed Long Term Care plan needs to disenroll before waiver services start. SILO and the Service Coordinator can explain the timing so care does not lapse.
What should I have ready before contacting SILO?
The Medicaid number or the status of a pending application, records that document the brain injury or related condition, the address where the person will live and who else lives there, a short list of daily tasks the person needs help with, and the names of current doctors and any discharge paperwork.
How long does the TBI waiver process take?
It depends on Medicaid, housing, and paperwork, so ask SILO about your situation. Services begin on the date SILO's approval authorizes. Once hours are authorized, we match an aide to the schedule.
Can I choose Bryan Skilled Home Care as my TBI waiver home care provider?
Yes, if you live in Nassau or Suffolk. Waiver participants choose their providers in the service plan. Tell your Service Coordinator you want us, or call (631) 608-8523. We do not provide waiver services in Queens.
How do you care for someone with a traumatic brain injury at home?
Start with a steady routine and a safe home. Many people with a brain injury do best when meals, medications, rest, and appointments happen at about the same time each day, with simple written reminders and fewer distractions. Clear walkways, add lighting and grab bars where needed, and keep sharp or risky items out of easy reach if judgment has changed. Watch for fatigue, frustration, and changes in sleep, mood, or behavior, and tell the doctor about them. Families do not have to do it alone: a home care aide can help with daily tasks and supervision, and a nurse oversees the plan of care.
What does a home care aide do day to day for someone with a brain injury?
An aide follows the plan of care. Depending on what is authorized, that can include help with bathing, dressing, grooming, toileting, meals, light housekeeping, and moving safely around the home. Aides also give cues and medication reminders, help keep the daily routine on track, and watch for safety risks. Aides give medication reminders only; they do not give medications. Our registered nurse oversees the aide, and aides report any change in condition to the nurse so the plan can be adjusted.
Is home care a good alternative to a nursing home, assisted living, or a group home after a brain injury?
For many adults it can be. The TBI waiver exists to help eligible people live at home or in the community instead of a nursing facility. Home care brings help into a familiar setting, on a schedule built around the person, with family close by. It is not right for everyone: some people need more supervision than home care can safely provide. SILO and the Service Coordinator can help you weigh the options, and we will tell you plainly what hours we can staff.
Can someone with a brain injury get long-term care at home?
Yes. Long-term care at home can be paid for through the TBI waiver when SILO authorizes it, through Medicaid Managed Long Term Care for people who are not on the waiver, through private pay, or a mix. We also work with long-term care insurance. The number of hours depends on the person's needs and what the plan or program authorizes, and the plan is reviewed as needs change. Call (631) 608-8523 to talk through which path fits.
How do I start TBI waiver home care on Long Island?
Contact SILO, the Suffolk Independent Living Organization in Medford, which handles TBI waiver applications for both Nassau and Suffolk (see SILO contact details above). SILO explains the waiver and helps you choose a Service Coordinator, who builds the service plan. When you pick your home care provider, tell the Service Coordinator you want Bryan Skilled Home Care, or call us at (631) 608-8523. Our office is open Monday to Friday, 9 to 5, with 24-hour on-call for people already on service. Once hours are authorized, we match an aide to the schedule.