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Nebraska Families' Input Drives Key Changes Ahead of Waiver Renewal
Lincoln, NE – At the direction of Governor Jim Pillen, and following a thorough review and extensive public input process, the Nebraska Department of Health and Human Services (DHHS) is revising proposed changes to the Aged and Disabled (AD) Waiver.
“I am truly appreciative of the Nebraskans who reached out to my office and participated in the public feedback process," said Governor Pillen. “Based on my conversations with dedicated family members and AD Waiver recipients, I directed DHHS to take a second look at the proposal and make necessary changes to ensure Nebraska families continue receiving the support they need."
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. As part of the federally required five-year renewal process, DHHS initially proposed updates aimed at addressing significant cost growth which has increased by more than 300 percent since 2016.
The revised proposal balances fiscal responsibility with the continued delivery of critical services, ensuring participants can remain safe, independent, and supported in their communities while addressing unsustainable cost trends.
Key revisions include:
- Removal of Previously Proposed Personal Care and Companion Hour Limits
- The 40-hour weekly cap on personal care services for live-in caregivers has been eliminated.
- The 70-hour combined limit on Legally Responsible Individual (LRI) personal care and companion services has also been removed.
- Revised Provider Qualifications
- DHHS has altered the previously proposed Institutional Cost Limit.
- A 150% modified cap will remain in place with an exception process available when services provided by out-of-home caregivers are necessary to protect the participant's immediate health and safety.
These revisions will initiate a second public review period. The public comment period will be open from February 2, 2026, through March 4, 2026. Written comments must be postmarked or received by DHHS no later than March 4, 2026.
Public input remains a critical component of the waiver renewal process, offering individuals, families, caregivers, and stakeholders the opportunity to share insights on services that best meet the needs of Nebraskans.
“DHHS is grateful for the time and thoughtful feedback Nebraskans have shared throughout this process," said Tony Green, Director of the DHHS Division of Developmental Disabilities. “We believe these revisions will allow us to continue providing high-quality care while responsibly managing costs."
As part of the initial waiver amendment process, DHHS opened a public comment period from December 5, 2025, through January 5, 2026, and hosted four virtual public comment sessions. Nearly 600 individuals participated via Zoom with hundreds of additional comments submitted through email and mail.
Following the close of the second public comment period DHHS will review and post public comments on its website and submit a summarized response to Centers for Medicare & Medicaid Services as part of the waiver application.
Additional information about the public comment period is available at:
https://dhhs.ne.gov/Pages/DD-Public-Comment.aspx