Home and Community-Based Services

 
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Medicaid Related Assistance
Medicaid & Long-Term Care
 
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What you need to know

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​Home and community-based services allow people to receive services at home or in their community rather than in isolated settings. Many services are provided via waivers, which provide additional services to those regularly covered by Medicaid





Available Services


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

FAQs

How do I find out if I can receive Personal Assistance Services?
Visit iServe​

How do I know how many Personal Assistance Services I need?
Together, you, and your iServe 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 designate trained them, the needed form is completed correctly and returned to DHHS, and 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:​


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 that 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.​

 

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Katie Beckett - Eligibility Category

What is the Katie Beckett category?

This program is for children who live in their parent's home. It provides Medicaid eligibility to children who otherwise require hospitalization because of their high level of healthcare needs.


Who may need this Medicaid coverage?

Families who are not eligible for Medicaid and have a child or children under age 19 years, 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
  • A 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 category?

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 category 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​ 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.


For more information, see the Katie B​eckett program flyer. 
 


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:
http://edn.ne.gov/ 

To refer a child to the Early Development Network, call Nebraska Child Find at (888) 806-6287 or make a referral online at https://edn.ne.gov/cms/make-a-referral-0​.

System of Payments Policy and Procedures for Part C Services 

Transition Agreement 

Comprehensive ChildFind System Policy 



Medicaid Waivers

​Medicaid waivers are administered by the Division of Developmental Disabilities.


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.



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​.