DDD Regulations and HCBS Medicaid Waivers
Developmental disabilities community-based services are governed by Title 404 NAC.
Regulation Drafts for Public Comment
The Division of Developmental Disabilities (DDD) is in the process of writing new regulations. We are not yet in an “official” public comment period, but are providing working drafts for stakeholder review on a public comment page. The working draft will continue to change as input is received. We want to ensure that you, our stakeholders, have maximum opportunity to review and make suggestions.
The Division administers Medicaid Home and Community-Based Services (HCBS) Waivers. Waivers allow the State of Nebraska to utilize federal Medicaid funding for services in the community that were originally only offered in institutions.
When a services participant is on a waiver, the state receives federal dollars to help pay for those services. This helps state funds stretch so the Division can fund services for more people.
Waiver eligibility is separate from eligibility for services. To be eligible for a waiver, a participant must:
Apply for Medicaid, be eligible, and accept if qualified. To apply for Medicaid:
Have needs requiring services offered by Intermediate Care Facilities for persons with intellectual or developmental disabilities (ICF/IDD)
Have yearly Level of Care assessment to determine needs
Have a physical exam yearly, with a report sent to the Division
Submit an evaluation by a licensed psychologist within the last 3 years that includes IQ testing and adaptive testing
Waiver Application for Public Comment
DDD is working with the Centers for Medicare and Medicaid Services (CMS) to determine Nebraska's HCBS waivers for DD services. The public comment period has ended for the renewal of the 4154 Comprehensive DD Services waiver, the renewal of 0394 DD Day Services waiver, AND the amendment to the 4154 Comprehensive DD Services waiver. Details can be found on the Public Comment webpage.
Current DD Medicaid Waivers are:
Developmental Disabilities Adult Comprehensive Waiver (DDAC) - This waiver is available to participants ages 21 and older. These services may include day support, residential support, respite, home modifications, vehicle modifications, and personal emergency response system (PERS).
Developmental Disabilities Adult Day Waiver (DDAD) - This waiver is available to participants ages 21 and over. These services may include day support, respite, home modifications, vehicle modifications, and personal emergency response system (PERS). Children's Developmental Disabilities Waiver (CDD) - This waiver is available to participants under age 21. These services may include residential support, respite support, homemaker, habilitative childcare, home modifications, vehicle modifications, and personal emergency response system (PERS). Day services are not available when a school system is responsible.