New York State–Approved HCBS Provider

Independence, supported.

Not supervised.

A Guardians Hand LLC helps individuals enrolled in New York's TBI and NHTD Medicaid Waiver programs live safely and independently at home — with person-centered care built around their own goals.

TBI Waiver NHTD Waiver

Call 813–591–8381 takoya@aguardianshandllc.com

Takoya Pierremont, RN BSN — Founder Serving Lower & Upper Hudson Valley and NYC

Takoya Pierremont, RN BSN, founder of A Guardians Hand LLC

A Guardians Hand LLC — Since 2024

About A Guardians Hand

Independence is the goal — we're the support that gets you there.

A Guardians Hand LLC is a New York State–approved Home and Community-Based Services (HCBS) provider serving individuals enrolled in the TBI and NHTD Waiver programs.

Our mission is to empower individuals with disabilities and chronic health conditions to live safely and independently in their own homes and communities — rather than in nursing facilities. Every service we provide is person-centered, individualized around each participant's own goals, strengths, and needs.

TBI Waiver Supports individuals who have experienced a traumatic brain injury and need assistance to remain independent in the community.

NHTD Waiver Supports seniors and individuals with physical disabilities transitioning from nursing homes or at risk of nursing home placement.

Empowering Independence. Changing Lives.

Our Services

Person-centered support, built around you.

Every service is individualized based on each participant's own goals, strengths, and needs — never one-size-fits-all.

A Guardians Hand LLC providing in-home support services

Support that meets you at home

ILST

Independent Living Skills Training

Practical, hands-on training that builds the everyday skills needed to live independently and confidently.

Budgeting and money management
Meal planning and cooking
Household organization and cleaning
Appointment scheduling and management
Medication reminders (non-medical)
Community integration
Transportation training
Technology and computer skills
Shopping and daily living skills

PBIS

Positive Behavioral Interventions & Supports

Compassionate support that helps build coping strategies, communication, and emotional regulation.

Developing positive coping strategies
Improving communication skills
Behavioral support
Emotional regulation
Problem-solving skills
Increasing independence while reducing challenging behaviors

Who We Serve

Eligible participants across two waiver programs.

We proudly support individuals working toward greater independence, confidence, and quality of life in their own communities.

01 — TBI WAIVER PARTICIPANTS

Living with traumatic brain injury

Individuals who have experienced a traumatic brain injury and need structured support to remain independent and engaged in their community.

02 — NHTD WAIVER PARTICIPANTS

Transitioning from nursing care

Seniors and individuals with physical disabilities who are transitioning out of nursing homes, or at risk of nursing home placement.

Service Area

Lower Hudson Valley Upper Hudson Valley New York City

How It Works

Getting started is simpler than you think.

From your first call to your first visit — here's what to expect.

Reach Out

Call or email us to share your situation and current waiver status.

We Listen

We talk through your goals, needs, and what kind of support fits your life.

Build a Plan

Your services are individualized around your own strengths and goals.

Begin Support

We start working alongside you — in your home and community.

Call 813–591–8381 takoya@aguardianshandllc.com

Frequently Asked Questions

Questions about getting started.

Answers to what families and participants ask most about the TBI and NHTD Waiver programs.

They're New York State Medicaid–funded Home and Community-Based Services (HCBS) programs. The TBI Waiver supports individuals who have experienced a traumatic brain injury, while the NHTD Waiver supports seniors and individuals with physical disabilities who are transitioning from, or at risk of, nursing home placement. Both are designed to help people receive care at home instead of in an institutional setting.

Eligibility is determined by New York State and is based on factors like your diagnosis, level of need, and current Medicaid status. If you're not yet enrolled in the TBI or NHTD Waiver, we can help point you toward the right resources to start that process.

Independent Living Skills Training (ILST) focuses on practical day-to-day skills — budgeting, cooking, transportation, and similar tasks that support independent living. Positive Behavioral Interventions and Supports (PBIS) focuses on coping strategies, communication, and emotional regulation. Many participants receive a combination of both, based on their individual service plan.

Services under the TBI and NHTD Waiver programs are funded through Medicaid for eligible participants. There's no separate out-of-pocket fee for covered services once you're enrolled in the applicable waiver program.

We serve eligible participants throughout the Lower and Upper Hudson Valley and New York City.

Call or email us and we'll walk through your situation together — your current waiver status, your goals, and what kind of support would help most. From there, we'll outline next steps based on your individual needs.

Still have questions? Email us or give us a call.