MEDIA CONTACT
Erin Maier (531) 893-1359,
erin.maier@nebraska.gov
Lincoln, NE – Following a thorough review and extensive public input, the Nebraska Department of Health and Human Services (DHHS) has announced important updates to the Aged and Disabled (AD) and Traumatic Brain Injury (TBI) Waivers aimed at improving access to services and better supporting Nebraska families caring for older adults and individuals with disabilities.
A key change in the updated waiver draft submitted to the Centers for Medicare & Medicaid Services (CMS) ensures participants using in-home and out-of-home providers can now request exceptions to the cost limit, supporting opportunities for individuals to receive care in the setting that best meets their needs.
“These changes reflect the state's commitment to balancing access to supports and the ability to offer a sustainable waiver program," said Tony Green, Director of DDD. “We closely reviewed the input received from individuals, families, and providers and adjusted the waiver to fit the needs of those we serve. We are also continuing to ensure that the cost of services are driven by needs assessments and clinical reviews."
Previously, the proposed waiver included a cost limit set at 150% of the average nursing facility rate. While exceptions to this limit were allowed through a Developmental Disabilities (DD) Clinical Team review, the waiver did not specify how the exception would be implemented when using in-home providers exclusively or in combination with out-of-home providers. Under the updated waiver, participants using both in-home and out-of-home are eligible to request a threshold exemption. These exception requests would still be based on assessed needs and clinical reviews.
All requests for exceptions to the 150% cost threshold will be carefully reviewed by a DD Clinical Team composed of experienced professionals, including medical experts, behavioral clinicians, and caseworkers.
The clinical team will evaluate complex medical and support needs, assess risks to health and safety, and determine appropriate levels of care based on the individual circumstances of the waiver recipient. This comprehensive review process will help ensure each decision is clinically sound, consistent, and centered on the participant's well-being and safety.
The AD Waiver is a Home and Community-Based Services (HCBS) waiver that allows older adults and individuals with disabilities to receive long-term care in their homes or communities rather than in institutional settings. DHHS initially and continues to propose updates aimed at addressing significant cost growth, which has increased by more than 300% since 2016.
These revisions will not initiate another public review period. A draft of the submitted waivers, public comment, and response documents has been posted to the DDD Public Comment page: dhhs.ne.gov/Pages/DD-Public-Comment.aspx.