Regulations and Waivers for DHHS-DD

 
4
Disabilities Assistance
Developmental Disabilities
 
No
No

What would you like to do?

What would you like to do?

What you need to know

What you need to know

Regulations

Developmental disabilities services must comply with state regulations, known as the Nebraska Administrative Code (NAC).

The following regulations apply to developmental disabilities services:

Read MoreShow Less

Medicaid HCBS Waivers

Public Comment Period for Aged and Disabled (AD) Waiver

Pursuant to 42 C.F.R. §441.304(f), the Nebraska Department of Health and Human Services (DHHS) is required to give public notice related to the state's plan to amend a Medicaid Home and Community-Based Services (HCBS) waiver for individuals with who are disabled or aged. 

The Nebraska Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care (MLTC) is developing an amendment to implement changes to the 1915(c) Home and Community Based (HCBS) Aged and Disabled (AD) Waiver.

The 30-day public comment period is from November 5, 2020 – December 5, 2020. 

PowerPoint from November 10 and 17 Presentations - Statewide Webinars offered for comment.

The following lists a summary of the proposed changes:

  • Update language to identify the Division of Developmental Disabilities will administer this waiver and provide oversight.
  • Update language in the waiver application to reflect regulation changes for nursing facility level of care criteria for children determinations.
  • The standardized assessment that will be used to gather information to determine nursing facility level of care for children will be the InterRAI Pediatric Home Care tool.
  • Information gathered with the InterRAI Pediatric Home Care assessment will be used to develop the plan of services and supports for youth ages 4-17.

View the draft HCBS AD Waiver application.

A hard copy of the waiver application can be requested via mail, email, or by phone at (402) 471-9156.

Interested persons are invited to submit their written comments to the Department. Written comments must be received by December 5, 2020.

Public comments may be:

  • Emailed to: DHHS.HCBSPublicComments@nebraska.gov  
  • Faxed to: (402) 471-9449
  • Or mailed to:
    Department of Health and Human Services
    Division of Developmental Disabilities
    ATTN: Donna Brakenhoff
    301 Centennial Mall South
    P.O. Box 95026
    Lincoln, NE 68509-5026

After the public comment period, when submitted to the Centers for Medicare and Medicaid, the HCBS waiver will include a summary of the public comments received during the public input process, and if any comments were not adopted, the reasons why.  The summary will also specify any modifications made to the waiver as a result of the public input process. 

Read MoreShow Less


Medicaid Home and Community-Based Services (HCBS) waivers allow Nebraska to use federal Medicaid funds for services in the community. When a person receives waiver services, the state receives federal money. This allows more people to receive services.

To be eligible for the program, a person must have Medicaid. To apply for Medicaid, contact your local DHHS office or apply online at ACCES

SNebraska.

Medicaid HCBS Waivers for Eligible Nebraskans - A quick look at Nebraska's four Medicaid HCBS waivers.

  • A participant can only be on one waiver at a time.
  • A participant can be on one waiver while waiting for a different waiver.
Read MoreShow Less

  

Current Medicaid HCBS Waivers

To be on a Medicaid HCBS waiver, a person must meet level of care requirements outlined in the waiver.

  • Aged and Disabled (AD) Waiver - Offers services for people over the age of 65 and people of all ages who have disabilities. Helps people live safely in their own home. A participant must meet level of care for a nursing facility (NF).
  • Comprehensive Developmental Disabilities (CDD) Waiver  – Offers services for people of all ages with DD. Maximizes independence as participants live, work and socialize in their communities. A participant must have a developmental disability and meet level of care for an intermediate care facility for people with developmental disabilities (ICF/DD). This waiver includes the October 1, 2020 amendment for Medicaid Expansion.
  • Developmental Disabilities Adult Day (DDAD) Waiver  – Offers services for people ages 21 and over with DD. Maximizes participants' independence to work in their communities. There is a focus on competitive, integrated employment. A participant must have a developmental disability and meet level of care for an intermediate care facility for people with developmental disabilities (ICF/DD). This waiver includes the October 1, 2020 amendment for Medicaid Expansion.
  • Traumatic Brain Injury (TBI) Waiver - Offers services for people ages 18 through 64 who want to live in assisted living. A participant must have a traumatic brain injury and meet level of care for a nursing facility (NF).

DD Waiver Amendment for Medicaid Expansion

July 9, 2020 CMS approved amendments to the DD waivers to expand Medicaid coverage. With this amendment DHHS:

  • Added, in Appendix B, an additional Medicaid Eligibility Groups Served in the Waiver, to comport with Nebraska's expansion of Medicaid;
  • Revised sampling approach for data collection in Appendix G performance measure A.3; and
  • Revised incorrect language in the denominator of Appendix G performance measure C.3.

The effective date of the amendment is October 1, 2020.

COVID-19 Preparedness and Response Appendix K Amendments

CMS approved on April 20, 2020. Appendix K is in response to the COVID-19 pandemic and outline temporary changes to the service delivery system. Appendix K did not require public comment as it was in response to a state of emergency.

Appendix K Extensions for Nebraska's Medicaid HCBS Waivers - September 14, 2020

Appendix K for Nebraska's Medicaid HCBS Waivers - April 20, 2020

    Additional Information:

      Technical Amendments to Increase Numbers on CDD Waiver

      When CMS approved a technical amendment, changes to increase numbers do not require public or tribal comment, as they are technical and in response to questions by CMS.

      February 25, 2020

      The following change was made to the CDD Waiver (Intro-Main and Appendix B):

      • An increase in the category reserved for transition of participants from other waivers. Increased years three through five from 100 to 300.

      September 9, 2019

      The following changes were made to the CDD Waiver (Intro-Main and Appendix B):

      • An increase in the category reserved for transition from the child welfare system. Increased years three through five from 35 to 80.
      • An increase in the category reserved for transition of participants from other waivers. Increased years three through five from 10 to 100.

      May 7, 2019

      The following changes were made to the CDD Waiver (Intro-Main and Appendix B):

      • An increase in the unduplicated number of participants served. Increased year two from 4,200 to 4,350 and increased years three through five from 4,200 to 4,500.
      • An increase in the maximum number of participants served at any point in time. Increased year two from 4,150 to 4,263 and increased years three through five from 4,150 to 4,410.
      • An increase in the category reserved for transition from the foster care system. Increased year two from 5 to 45, and increased years three through five from 5 to 35.
      • An increase in the category reserved for emergency. Increased years 2 through 5 from 40 to 75.

      Nebraska Legislature

      The Developmental Disabilities Services Act can be found in Nebraska Revised Statute §§83-1202 to 83-1227. On the legislative page, the Act may be viewed by using the right arrow to move through statutes.