Services On The Traumatic Brain Injury Waiver

Medicaid Related Assistance
Developmental Disabilities

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) Traumatic Brain Injury (TBI) Waiver offers specialized services for people who have had a traumatic brain injury. 


To be eligible for TBI Waiver services, you must receive Nebraska Medicaid, be age 18 years or older, have a diagnosis of traumatic brain injury, meet Nursing Facility Level of Care, and have a need for services.

Service Coordination

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

Your Service Coordinator:​

Contact Service Coordination Offices
  • Works with you to develop your service plan based on your needs
  • Helps you work with the TBI provider
  • 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 the TBI provider, your family, and your community
  • Makes sure services promote independence, productivity, and inclusion

When you have the TBI Waiver, you choose your Service Coordination provider. You can choose the Area Agencies on Aging or League of Human Dignity.

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Traumatic Brain Injury Waiver Services

The TBI Waiver services help people who are have a traumatic brain injury diagnosis. Services meet needs while the participant lives where they choose. The following services are available to TBI Waiver participants. ​

  • Quick G​uide - Brief descriptions of TBI Waiver services.
  • Service Handbooks are available under each service drop down and on the Resources page. These handbooks give full service definitions.​

Work with your TBI Waiver Service Coordinator to see which services you qualify to receive.​

Adult Day Health

TBI Adult Day Health includes social and health activities provided outside the participant's home. Includes personal care, health assessment and nursing services, meal services, recreational therapy supportive services, and other activities.

Assistive Technology

Assistive Technology includes the purchase or rent of items, devices, or product systems to increase or maintain your ability to perform normal daily activities.

This service includes designing, fitting, adapting, and maintaining equipment, as well as training or technical assistance to use equipment. This service also includes an assessment to identify the type of assistive technology you need.​

Caregiver Training

Caregiver Training provides training and education to your unpaid caregiver who provides informal supports.


Chore assists you in maintaining your health and safety in your own home. Chore occurs less frequently than TBI Companion.

Chore may include housekeeping activities such as in-home cleaning and care of household equipment, appliances, or furnishings; minor repairs of windows, screens, steps or ramps, furnishings, and household equipment; and landscaping. Landscaping includes snow and ice removal, mowing, raking, removing trash (to garbage pick-up point), pest remediation, and clearing water drains.

Community Connections

Community Connections supports and assists you in participating in community or social activities.


TBI Companion includes supervision and social supports provided in your home and possibly community settings. This service may include light housekeeping tasks, paying bills, errand service, essential shopping, food preparation, and laundry service.

Home Modifications

Home Modifications are changes to your home to increase or maintain your ability to perform normal daily activities, making it easier and safer to get around and do things for yourself. Modifications should help you better access your home and need less help from other people.

Home-Delivered Meals

Home-delivered meals are delivered to your home, using sanitary utensils and equipment, maintaining proper food temperatures, and containing 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 when you are unable to prepare your own meals.

Non-Medical Transportation

Non-Medical Transportation provides transportation to and from community resources to help you continue living at your home.

Personal Care

​TBI Personal Care includes assistance with activities of daily living (ADL) and health-related tasks and may include instrumental activities of daily living (IADL). It is provided in your home and community.

This service helps you accomplish tasks you would normally do for yourself if you did not have a TBI.

Personal Emergency Response System (PERS)

PERS is an electronic device used to help you contact someone in an emergency. The system is connected to your telephone and notifies a designated person or call center when you push a button.​


TBI Respite is a short-term service you can use when you cannot care for yourself. Respite is temporary relief to the usual caregiver who lives with you. Your provider helps with activities of daily living, health maintenance, and supervision.

Supported Employment - Follow-Along

Supported Employment – Follow-Along helps you keep your competitive job. This service may be provided to you or by communicating with your employer for you. 

Supported Employment - Individual

Supported Employment – Individual provides a job coach for one-on-one teaching to help you keep your competitive job. This service is provided at your job. Your provider helps you with job skills and referrals for other resources.

Supported Residential Living

Supported Residential Living was previously called Assisted Living. It 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. Supported Residential Living occurs in an assisted living facility licensed through Public Health and regulated by Medicaid and Long Term Care (MLTC). 

​The participant pays the room and board cost and any applicable Medicaid share of cost. 

Vehicle Modifications

Vehicle Modifications are changes to an automobile/van to accommodate your need to integrate more fully into the community.  Modifications should help you better access your vehicle and need less help from other people.​

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. Providers for the TBI Waiver have TBI-specific training and knowledge.

  • TBI Agency Provider - A company enrolled as a Medicaid provider to provide the TBI Waiver service you choose. The agency provider is responsible for hiring and supervising employees who work with you, and other administrative functions.
  • TBI Independent Provider - A person enrolled as a Medicaid provider and employed by you. You are responsible for hiring and supervising your TBI 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.
  • TBI Assisted Living Facility - A facility, where you live in your own apartment while receiving a range of support services in a home-like environment. The assisted living facility has a resident service agreement with you to ensure your services are what you need, according to your person-centered plan.

Presentation: Updated TBI Waiver and Provider Enrollment

DDD held a meeting is to introduce changes to the TBI Waiver for providers, including updates to provider requirements and expectations.