Regulations and Waivers for DDD

 
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Statutes & Regs
Developmental Disabilities
 
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What you need to know

What you need to know

​​​​​​​​​Regulations

Medicaid Home and Community-Based Services (HCBS) Waiver services must comply with state regulations, known as the Nebraska Administrative Code (NAC).​

The following regulations apply to Medicaid HCBS waiver services:

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Medicaid HCBS Waivers

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.

The Public Comment page has information about CMS-approved DD waivers, which go into effect October 1, 2021.

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

HCBS Waivers Available for Eligible People​ - 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.
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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 developmental disabilities. 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). 
  • Developmental Disabilities Adult Day (DDAD) Waiver  – Offers services for people ages 21 and over with developmental disabilities. 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). 
  • 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 Appendix K Amendments - March 6, 2020 to June 30, 2021

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 Approved Amendments for Nebraska's Medicaid HCBS Waivers - April 15, 2021

Appendix K Approved Amendments for Nebraska's Medicaid HCBS Waivers - March 24, 2021

Appendix K Approved Amendments for Nebraska's Medicaid HCBS Waivers - December 17, 2020

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. ​​