Services on the Aged and Disabled Waiver

 
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Medicaid Related Assistance
Developmental Disabilities
 
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What would you like to do?

What you need to know

​​​As a participant in Medicaid Home and Community-Based Services (HCBS) Waiver services, there are many community-based services you may choose. The services available to you are based on which waiver you have. HCBS Waivers Available for Eligible People looks at the four waivers and includes a chart of services by waiver.

The Medicaid Home and Community-Based Services (HCBS) Aged and Disabled (AD) Waiver offers an array of services to support people in their homes. 

For information on AD Waiver eligibility, visit the Eligibility page.

For the waiver document and regulations pertaining to the AD Waiver, visit the Regulations and Waivers page.

Service Coordination

When you are on a waiver, a Service Coordinator provides case management to coordinate and oversee your services. 

Your Service Coordinator:

  • Works with you to develop your service plan based on your needs
  • Helps you find and work with providers
  • Helps you access resources such as Medicaid, SSI, and SNAP
  • Helps you identify and access community resources
  • Holds meetings at least every six months to help you work toward life goals
  • Monitors your plan to ensure it is being implemented and adequately addresses your needs
  • Follows up with you to ensure your needs are being met
  • Follows up with your guardian and, as requested, your family
  • Adjusts your service plan when changes are needed for success
  • Helps advocate for what you need from your service provider(s), family, and community
  • Makes sure services promote independence, productivity, and inclusion

When you have the AD Waiver, your Service Coordination provider is determined by your age:

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Aged and Disabled Waiver Services

AD Waiver services help people who are aged or have disabilities. Services meet needs while the participant lives where they choose. The following services are available to AD Waiver participants. Work with your AD Waiver Service Coordinator to see which services you qualify to receive.

Adult Day Services

What are Adult Day Services?
Social activities, supervision, supportive services, meals, and health services that are provided in a licensed setting.

Who needs Adult Day Services?  
Someone who has physical, emotional or cognitive impairments.

Do I qualify for Adult Day Services?
You may qualify if you are 18 years or older (19 in some situations) and need structured activities, support, and supervision. Your Service Coordinator must determine that you need this service.

FAQs

Adult Day Services includes a meal, but what if I am on a diabetic diet?
Special diets will be accommodated as needed.

What types of activities are provided?
Social and recreational, both individual and group.

What if I have a specific need such as help with walking?
You will be helped with your individual needs.

How can I find an adult day center in my area?
Contact a DHHS office, your Service Coordinator, view a listing of licensed Adult Day services, or locate a listing of Adult Day services in your area.

Assisted Living Service

Assisted Living provides shelter, food and other services such as assistance with personal care activities, activities of daily living (ADL), instrumental activities of daily living (IADL) and health maintenance.

What is offered with Assisted Living Service?

  • Socialization activities
  • Essential shopping
  • Health maintenance activities
  • Housekeeping activities
  • Laundry services
  • Medication assistance
  • Personal care services
  • Transportation services

FAQs

Are Assisted Living Facilities regulated and licensed? 
Yes, they are licensed through Public Health. Assisted living facilities that accept Aged and Disabled Waiver participants are also regulated by Medicaid.

What does the Assisted Living Service cost through the Aged and Disabled Waiver? 
The participant pays the room and board costs and any share of cost when applicable.

How can I find a licensed Assisted Living provider?
You can search based on your location:
Access Assisted Living Choices
View a listing of licensed Assisted Living Facilities

What if I do not qualify for the Aged and Disabled Waiver?
If you don't qualify, you can apply for financial assistance with the Assistance to the Aged, Blind or Disabled (AABD) program. 

Assistive Technology Supports and Home/Vehicle Modifications

Assistive Technology Supports are specialized equipment and supplies that help participants increase, maintain, or improve their functional capacities. 

Home/vehicle modifications are the physical adaptations to the primary residence, automobile or van of the participant or participant's family to accommodate or improve their function.

Do I qualify for Assistive Technology Supports and home/vehicle modifications?
You may qualify if you are assessed as needing devices, equipment, or modifications by Assistive Technology Partnership. 

FAQs

What services are covered?
Aids to daily living vital for health and well-being. For example, you may get help with:

  • Personal care
  • Eating
  • Bathing
  • Dressing
  • Hygiene
  • Housekeeping
  • Changes to your vehicle, such as a wheelchair lift or a raised roof for a van

What services are not covered?

  • General home repairs
  • Standard housing obligations
  • New constructions or additions to a home purchased after enrollment in the waiver
  • Adaptations that add to the total square footage of the home except when necessary to complete an adaptation.
  • Improvements exclusively required to meet local building codes
  • Adaptations to assisted living apartments
  • Supports not directly benefiting the participant
  • Durable medical equipment

Do I have to be a homeowner?
No, you do not have to own your home, but:

  • You must be living in a dwelling that fits your needs;
  • The dwelling must have no health or safety risks (such as code issues); and 
  • The landlord must agree to the changes in your home.

Extra Care for Children with Disabilities

What is the Extra Care for Children with Disabilities?
This service provides specialized care for the child or youth with disabilities up to age 18. Childcare is provided so that the usual caregiver can be employed or take training that will help the family's earning power (such as earning a degree).

Who needs Extra Care for Children with Disabilities?
You may need this service if you are the usual caregiver for a child or youth with disabilities and you need to:

  • Find employment or stay employed
  • Enroll in and regularly attend vocational or educational training
  • Earn a high school diploma or equivalent diploma, or first undergraduate degree

Do I qualify for Extra Care for Children with Disabilities?
The child must be eligible for Medicaid and have care needs similar to people who live in a nursing home. There must be a need for this special service that cannot be met another way

FAQs

Where is this care provided for the child?
Care is provided in the child's home by a DHHS-approved provider, or in a setting approved by DHHS.

How many hours of Extra Care for Children with Disabilities can my family receive?
Care provided by this service must be more than 2 hours per week every week and average less than 12 hours per day.

What is the role of the family receiving Extra Care for Children with Disabilities?
The family, in partnership with the Service Coordinator:

  • Is an active participant in developing the child's plan of services and supports
  • Sets priorities
  • Develops desired outcomes for the care
  • Identifies potential service providers
  • Makes choices in selecting, directing, and dismissing providers

Can Extra Care for Children with Disabilities take the place of school system responsibilities and services? 
No. Extra Care for Children with Disabilities must not be used for a service which is the responsibility of a school system or for a time when the child should be in school.

Can I select anyone to be my child's Extra Care for Children with Disabilities provider?
Providers must be approved by DHHS. If you have someone in mind, give their information to your AD Waiver Service Coordinator.

Home-Delivered Meals

What are home-delivered meals?

  • A meal delivered to your home
  • Transported and delivered using utensils and equipment which are sanitary and maintain proper food temperatures
  • Contain one-third of the minimum daily nutrition requirement for adults using a variety of foods from day to day

You may qualify for home-delivered meals service if you are:
An adult with disabilities who is unable to prepare your own meals, or age 60 or older who is unable to prepare your own meals.

FAQs

I can fix my own meals, but I feel I need more money to buy food. Do I qualify?
Probably not. Home-delivered meals service is not intended to add to a person's food budget. Your AD Waiver Service Coordinator must assess that:

  • You are unable to prepare your own meals due to physical, cognitive, and/or safety limitations or your nutrition risk assessment indicates “high risk;"
  • There is no other source that will provide meal services at no charge (such as a relative, neighbor, responsible adult, friend, or other program or agency); and 
  • You do not reside in a facility that is required to provide meals for you.

Independence Skills Building Service

Independence Skills Building (ISB) is training for aged persons and adults with disabilities in activities of daily living, instrumental activities of daily living and home management to increase independence. Training may occur in the participant home or in the community and could involve the participant and/or the caregiver.

FAQs

What type of training can I receive?
Training with skills like:

  • Bathing
  • Dressing
  • Grooming
  • Eating
  • Mobility
  • Toileting and transferring

Training with home management skills like:

  • Housekeeping
  • Cleaning
  • Using transportation
  • Managing money
  • Shopping
  • Preventing accidents

How long can I use the Independence Skills Building Service?
This service will continue as long as progress is being made on the outcomes identified in the plan.

Personal Emergency Response System (PERS)

What is a Personal Emergency Response System (PERS)?
A communication device, sometimes called lifeline, which you can use to call for help in an emergency. There are a range of devices offered to meet this need.

Who may be eligible for PERS?
Someone who:

  • Lives alone or with a caregiver who also has health problems or who works outside the home
  • Has a history of falls
  • Has a health problem that might result in an emergency

Do I qualify for a PERS?
You may qualify if you are an adult with a health need for the device, who is able to use the device properly, and have identified a person who can respond immediately.

FAQs

What does the device look like?
The PERS is a button that can be worn around your neck, but it can also be available to you in other ways depending on your needs. For example, it can be worn as a wristband, on a belt or carried in a pocket. Sometimes it can be adapted to a wheelchair.

Will someone show me how to use the PERS?
Yes, someone will meet with you to explain how to use the device.

When I push the button or use the device, is someone notified?
After you push the button, a signal goes to an agency who then contacts a person or responder on a list of people you choose. The responder quickly contacts you to see what you need. 

Respite Service

What is Respite?
Sometimes caregivers need a temporary break from caregiving so they can come back refreshed and ready to provide good care again. Respite pays someone to come into the home, take care of a participant and give the primary caregiver a temporary break.

FAQs

Do I qualify for Respite?
You may qualify for Respite if you reside with and care for someone and you are not able to pay for respite. 
A need for this service must exist. You can only receive Respite from one funding source.
  
Who may be eligible for Respite?

  • Ongoing, continuous caregivers
  • Spouses who care for partners with disabilities
  • Parents of adults with disabilities
  • Adult children caring for siblings with disabilities

What does Respite mean for a caregiver?
Respite could mean:

  • A break
  • A chance to get away
  • A chance to shop
  • A chance to spend time with other family members
  • Time to take care of personal business
  • Time to get medical care

How do I locate a Respite provider in my area?
Contact your AD Waiver Service Coordinator.

Non-Medical Transportation Service

Non-Medical Transportation Service provides transportation to participants age 19 or older to and from community resources that help them remain living at home.

Who needs Transportation Service?
Participants who:

  • Do not own or have access to a working licensed vehicle;
  • Do not have a current valid driver's license;
  • Are unable to drive due to a documented physical, cognitive or developmental limitation;
  • Are unable to travel or wait by themselves; and
  • Are unable to secure free transportation.

FAQs

Where can I get transportation to?
Non-Medical Transportation provides the following services:

  • Transportation to and from other waiver services;
  • Transportation to community activities where waiver services are not provided;
  • Public transit tokens or passes; and
  • Escorting a participant to non-medical activities or appointments.

What if I need medical transportation?
You may be able to obtain transportation to most services covered by Medicaid.

Provider Options

You can choose the provider(s) you want to work with. There are different types of providers available for Medicaid HCBS waiver services.

  • AD provider - a person enrolled as a Medicaid provider and employed by you. You are responsible for hiring and supervising your AD provider. Once you choose a person, the state has an approval process to ensure requirements are met. Your Service Coordinator will help with the process.

Frequently Asked Questions (FAQs)

How is the safety and well-being of participants ensured?

The Nebraska Medicaid and Long-Term Care Home and Community-Based Services (HCBS) Waivers Unit utilizes a quality improvement system to ensure the health and well-being of participants through continuous, participant-focused monitoring and improvement.

  • The quality improvement system is guided by key principles and defined roles and functions.
  • A quality council advises the HCBS Waivers Unit on strategies to improve all aspects of the quality improvement system and reviews progress on strategies.
  • Processes are used to measure compliance, CMS assurances, participant outcomes and utilization.
  • Survey results and reports are compiled from data obtained through the quality improvement system processes.​

I earn too much money to qualify for Medicaid, but my child has a physical disability and we could use waiver services. Can you help?

There is a process to follow so that a parent's income is not counted for disabled children who meet waiver eligibility. Contact your local DHHS office to begin the Medicaid application process, and be sure to say you want your child assessed to determine if they qualify for the waiver.

How many hours in the day can I have help?

Each person's needs are different, so there is not a set number of hours of assistance per day. You and your Service Coordinator will work together on a plan of services to meet your needs and keep you safe at home.

I am an adult living in my own apartment. If I qualify for the AD Waiver, who will I get to help me in my home? Who can come in to clean and do laundry? Who can help when I take a bath?

First, an assessment is completed to determine what kind of help you need to stay safely in your home. Next, staff from the waiver program will connect you with a choice of providers to help you in your home. You choose who provides services for you and when they work for you. Some providers are agencies. Other providers are self-employed and do not work for an agency. When you know someone that you want to work for you as your provider, refer the person to the waiver staff.

Additional Information for AD Waiver

Quality Improvement Roles and Functions

Processes