Home and Community-Based Services

Medicaid Related Assistance
Medicaid & Long-Term Care

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What you need to know

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.

Our services help people who are aged or have disabilities meet their needs while living where they choose.

First, a person must qualify for a program that offers the service. Each program has its own requirements. People who qualify for a program are also called participants. Not all services are available through all programs.

Participants work with a services coordinator or a Social Services worker to get the services they need. These workers assess the participant's needs and determine if they are eligible for a service or program.

Included below are services we offer:

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)
  • Need structured activities, support and supervision

You must first qualify for a DHHS program, such as the Aged and Disabled Waiver, that has the Adult Day Services, and a worker must determine that you need this service.


How do I find out if I can receive Adult Day Services? 
Contact a local DHHS office.

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 services 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

How do I qualify for Assisted Living Service?


How do I find out if I can receive Assisted Living Service?
If you are an adult with disabilities, ages 18 to 64, contact your local League of Human Dignity or local Area Agency on Aging. If you are age 65 or older, contact your local Area Agency on Aging.

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:


How do I find out if I can receive Assistive Technology Supports and Home/Vehicle Modifications?

  • If you need services for a child with disabilities, contact your local DHHS office or Early Development Network.
  • If you need services for an adult ages 18 to 64, contact your local League of Human Dignity or local Area Agency on Aging.
  • If you need services for an adult age 65 or older, contact your local Area Agency on Aging.

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.

Child Care for Children with Disabilities

What is the Child Care for Children with Disabilities (CCCD) service?
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 Child 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 CCCD?
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


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 CCCD 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 CCCD?
The family, in partnership with the services 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 CCCD take the place of school system responsibilities and services?
No. CCCD 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 CCCD provider?
CCCD providers must be approved by DHHS. If you have someone in mind, give their information to your Early Development Network or DHHS services coordinator.

Early Development Network Services

What are Early Development Network Services?
Services for children birth to age 3 who are not developing typically or who have been diagnosed with a health condition that will affect their development. These services are provided by the Nebraska Early Development Network.

Who needs Early Development Network Services?
Families with an infant or toddler who may need:

  • Services coordination
  • Special instruction
  • Speech/language therapy
  • Physical therapy
  • Occupational therapy
  • Psychological services
  • Assistive technology devices and services
  • Transportation
  • Audiology
  • Vision services

Does my child qualify for Early Development Network Services?
Your child may qualify for services if he or she is under the age of 3 and is not developing typically or has a health condition that may affect development. Your child must be evaluated by a multi-disciplinary team (MDT) in your school district in order to qualify.

To find out more about Early Development Network Services, please visit:

To refer a child to the Early Development Network, call Nebraska Child Find at (888) 806-6287.

System of Payments Policy and Procedures for Part C Services

Transition Agreement

Comprehensive ChildFind System Policy

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

Do I qualify for home-delivered meals service?
You must first qualify for a DHHS program that has home-delivered meals and an authorized worker must assess that you need this service.

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.


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. Rather, a DHHS worker 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.

Do I qualify for Independence Skills Building Service?
You may qualify if you are:


How do I find out if I can receive Independence Skills Building Service?
If you need services for an adult ages 18 to 64 who has disabilities, contact your local League of Human Dignity or local Area Agency on Aging. If you need services for an adult age 65 or older, contact your local Area Agency on Aging.

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 Assistance Services

What are Personal Assistance Services?
Assistance with activities of daily living, such as bathing or dressing, for an individual who has a chronic medical condition or a disability.

Who needs Personal Assistance Services?   
Individuals with a chronic medical condition or a disability who need help with daily activities. These are activities they would do for themselves if they did not have the condition or disability.

Do I qualify for Personal Assistance Services?
You may qualify if you are an individual of any age:

  • Receiving Medicaid
  • Living in your home, not an institution
  • Have an assessed need for the service in order to live in the community


How do I find out if I can receive Personal Assistance Services?
Contact your local DHHS office or visit AccessNebraska

How do I know how many Personal Assistance Services I need?
Together, you and your local DHHS worker will complete an assessment to determine the amount of time you require for your specific needs.

Can I choose my Personal Assistance Services provider?
Yes, you have the right to choose your provider and direct your own care.

Can a family member be my paid provider?
Yes, as long as the family member is not legally responsible for you. A spouse or the parent/guardian of a minor child cannot be paid providers. The individual must be able to meet qualifications to become a provider.

I have a medical procedure that needs to be done. Can the Personal Assistance Provider complete this task?
Yes, if the provider can show you that they can do the task after you or your designee trained them, and if you provide ongoing monitoring and direction for the task.

Can I be employed and receive personal assistance services?
Yes, if you work at least 40 hours per month and you are paid at least minimum wage.

More information:

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
  • Able to use the device properly and have identified a person who can respond immediately
  • Eligible for a DHHS program that has the PERS, such as the Aged and Disabled Medicaid Waiver


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.

How do I find out if I can receive this service?
Contact your local DHHS office, League of Human Dignity, or Area Agency on Aging.

Respite Service

What is respite service?
Sometimes caregivers need a temporary break from caregiving so they can come back refreshed and ready to provide good care again.

Respite service pays someone to come into the home, take care of an individual with special needs and give the primary caregiver a temporary break.


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

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

How do I find out if I can receive respite?
If you are an adult ages 18 to 64, contact your local League of Human Dignity or local Area Agency on Aging. If you're age 65 or older, contact your local Area Agency on Aging. If you're the parent of a child with disabilities, contact your local DHHS office or local Early Development Network.

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 services coordinator at one of the following offices:

  • For children, call your local DHHS office or local Early Development Network.
  • For adults age 18-64 with physical disabilities, call your League of Human Dignity.
  • For adults 65 and older, call your Area Agency on Aging.

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 of the Aged and Disabled Waiver 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
  • Are unable to secure free transportation


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
  • 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.

What if I need transportation but I'm not on Medicaid?
You may qualify for a Social Services block grant.