Medicaid Home and Community-Based Programs

 
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Medicaid Related Assistance
Medicaid & Long-Term Care
 
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No

What would you like to do?

What you need to know

What's a program?

A program is a group of services intended to meet an individual's or family's needs. Home and community-based services provide opportunities for Medicaid beneficiaries to receive services in their own home or community rather than isolated settings. Many of these services are provided via waivers, which provide additional services to those regularly covered by Medicaid

First, a person must qualify for the program. Each program has its own requirements. People who are eligible for a program are called participants.

Once eligible, participants will partner with a services coordinator or a social services worker to get the services they need.


 

Aged and Disabled Waiver

What is the Aged and Disabled Waiver?

This is a program that offers an array of services to support people in their homes.

Who may need this program?

Individuals of all ages who:

  • Are eligible for Medicaid and have needs at nursing facility level of care
  • Want to live at home rather than a nursing facility
  • Can be served safely at home

More information is available on the AD Waiver page.

Developmental Disabilities Waivers

What are developmental disabilities waivers?

There are two developmental disabilities waivers: the Comprehensive Developmental Disabilities Waiver and the Developmental Disabilities Adult Day Waiver. ​These programs fund services for people with developmental disabilities.

Who may need this program?

People who are diagnosed with a developmental disability and have limitations outlined in state statute.

What services may be available through developmental disabilities waivers?​​

More information is available on the DD Waiver page.


Katie Beckett Program

What is the Katie Beckett program?

This program provides Medicaid eligibility to children who otherwise would be hospitalized because of their high level of health care needs.


Who may need this program?

Families with a child or children under 19 years of age who have one or more of the following:

  • A ventilator to breathe
  • A tracheostomy
  • A Need for intravenous therapy involving central lines for daily fluids or nutrition
  • Need for frequent and complex medical care that requires use of equipment to prevent life-threatening situations

What services may be available through the Katie Beckett program?

All Medicaid services based on medical need, including (but not limited to):

  • Nursing care in the home
  • Hospital stays
  • Medicine, medical supplies and equipment
  • Physician fees

We earn too much money for Medicaid, but our child has many health problems and has been in the hospital since birth. Can the Katie Beckett program help?

Only the child's income is considered for the Medicaid eligibility process for children served by the Katie Beckett program. Contact your local DHHS office to begin the Medicaid application process, and be sure to say you want your child assessed to determine if he or she qualifies for Katie Beckett. 

Does a private health insurance policy affect eligibility?

No, your child can still be eligible for the program if your family has private health insurance through a job or another group. The private insurance must be used first and Medicaid pays after your other health insurance has paid.
 

Program of All-Inclusive Care for the Elderly (PACE)

What is the PACE?

PACE provides comprehensive, coordinated health care and long-term services and supports for voluntarily-enrolled individuals. PACE provides another alternative along the continuum of available long-term care services and supports. It enables participants to continue to live in their homes and communities.

Who may need this program?

Individuals aged 55 years and older who:

  • Meet nursing facility level of care criteria
  • Live within the service area of an approved PACE provider
  • Are able to safely live in a community setting with PACE services at the time of enrollment

What services may be available through PACE?

The benefits package for PACE includes all Medicare and Medicaid-covered items and services. It covers other services as determined necessary by the PACE provider's interdisciplinary team. All services must be received solely through the PACE provider and its subcontractors.

Who is an approved PACE provider, and what is their service area?

Immanuel Pathways is currently the only approved PACE provider in Nebraska. Their service area is all of Douglas and Sarpy counties and portions of Cass, Dodge, Saunders, and Washington counties. 

Who can enroll in PACE?

Medicaid and Medicare-eligible individuals may pursue enrollment in PACE, as well as private pay individuals.

What does it mean to meet nursing facility level of care criteria?

Nursing facility level of care means you have needs which require you to receive services similar to those provided to individuals who live in a nursing home.  For example, you may need assistance from another person with daily tasks such as getting dressed, taking a bath or shower, eating or walking safely. Other areas considered are how much help you need to take medications, any memory problems or health conditions you may have, and how they are managed. Nursing facility level of care criteria are located in DHHS regulations at 471 NAC 12.

Where can I read the DHHS regulations about PACE?

The DHHS regulations for PACE services are available at Title 471 NAC Chapter 37.

For more information, email DHHS.Pace@nebraska.gov.

Traumatic Brain Injury (TBI) Waiver

What is the Traumatic Brain Injury (TBI) Waiver?

This program funds specialized assisted living services for persons with traumatic brain injury.

Who may need this program?

Individuals with traumatic brain injury who:

  • Qualify for nursing-facility level of care
  • Are ages 18 through 64
  • Want to live in assisted living 

What services may be available through the TBI  Waiver? 

More information is available on the TBI Waiver page​. 

Nebraska's Person-Centered Planning Initiative

The Department of Health and Human Services (DHHS) and the Nebraska Council on Developmental Disabilities are launching a new Person-Centered Planning initiative to reinvigorate person-centered supports for all Nebraska's Home and Community-Based Services (HCBS) Waivers.

Person-centered planning is used to create service plans for the DHHS HCBS Waivers: the Aged and Disabled Waiver, Developmental Disabilities Waivers, and the Traumatic Brain Injury Waiver.

For more information on Person-Centered Planning, visit the DHHS Developmental Disabilities Person-Centered Planning webpage.