Hey guys, I am trying to help a family member receive 24-hour care, as she has severe dementia and extreme difficulty with mobility. She currently receives Medicaid service MTLC for a total of 40 hours a week. She lives in NYC (Queens). We have requested an increase in her hours through MTLC, but the request was denied based on a previous assessment claiming that these hours were sufficient. We recently reached out to the NYS Health Department, and a representative provided us with information about an alternative program called NHTD. We are trying to get someone on the phone, but it seems extremely difficult to reach them. My question is the following: Do we have to submit an appeal before we can pursue the NHTD waiver program, or can they start their initial assessment based on our current condition? An appeal will significantly delay the process, but I want to make sure we are on the right path. Every response is highly appreciated. Thank you.