Regulations and Waivers for DDD

Statutes & Regs
Developmental Disabilities

What would you like to do?

What would you like to do?

What you need to know

What you need to know


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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Public Hearing - Title 404 NAC 4

DHHS will host a public hearing on Title 404 NAC 4 on November 1, 2023 at 1:00 PM, CT.​

The purpose of this hearing is to receive comments on proposed changes to Title 404, Chapter 4 of the Nebraska Administrative Code (NAC) – Certification Requirements For Certified Providers of Services. These regulations govern community-based services for persons with developmental disabilities. The proposed changes update requirements and add clarification language for background checks, crimes, and administrative sanctions; update section headings, formatting, re-numbering sections, and correct punctuation.

Authority for these regulations is found in Neb. Rev. Stat. §§ 81-3117(7) and 83-1226.

Interested persons may attend the hearing and provide verbal or written comments, or mail, fax, or email written comments, no later than the day of the hearing to:  DHHS Legal Services, PO Box 95026, Lincoln, NE 68509-5026, (402) 742-2382 (fax) or, respectively.

A copy of the proposed changes is available online at, or by contacting DHHS at the mailing address or email above, or by phone at (402) 471-8417. The fiscal impact statement for these proposed changes may be obtained at the office of the Secretary of State, Regulations Division, 1201 N Street, Suite 120, Lincoln, NE 68508, or by calling (402) 471-2385.

Auxiliary aids or reasonable accommodations needed to participate in a hearing can be requested by calling (402) 471-8417. Individuals who are deaf or hard of hearing may call DHHS via the Nebraska Relay System at 711 or (800) 833-7352 TDD at least 2 weeks prior to the hearing.​

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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.

Approval for the TBI Waiver

Nebraska DHHS has received approval from the Centers for Medicare and Medicaid Services (CMS) for the Traumatic Brain Injury (TBI) Waiver Renewal. This waiver is effective October 1, 2023.

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The Public Comment page has information about waiver changes.

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

Available HCBS Waivers 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 and older who have had a traumatic brain injury. Helps people live safely​ in their home and community. A participant must meet level of care for a nursing facility (NF).

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. ​​